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13080227 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22330 HOMESTE RD CONTRACTOR:ROCK SOLID BUILDERS PERMIT NO: 13080227 OWNER'S NAME: FRIELDING ZELMA TR STEE PO BOX 20265 DATE ISSUED:08/29/2013 OWNER'S PHONE: 4087358716 SAN JOSE,CA 95160 PHONE NO:(408)997-7625 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIAL License Class Lic.# 1 �7') U **UNIT 202**REMODEL(E)KITCHEN WITH(N) J CABINETS,COUNTER TOPS AND SINK(SAME LOCATION, Contractor f�si7 l`J LIKE FOR LIKE I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: kperformance ve and will maintain a certificate of consent to self-insure for Worker's mpensation,as provided for by Section 3700 of the Labor Code,for the of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$7500 ave and will maintain Worker's Compensation Insurance,as provided for by ection 3700 of the Labor Code,for the performance of the work for which this APN Number:32659027.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITIIIN 180 DAYS DE-PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 44180DA M L 11CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the 'Zg fj granting of this permit. Additionally,the applicant understands and will comply a with all non-point source regulatio s per the Cupe ' o unicipal Code,Se tion 9.18. / RE-ROOFS: Signature k' Date r All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILD DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Co e,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 2 Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent- Date o/d permit is issued. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LEND AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agen for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date V CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 n_0 GUF'ER i 11VC3 (408)777-3228•FAX(408)777-3333•buildingAgugertino.org [:]NEW CONSTTRU/CCTION///111 ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS' / / L O; N# ��C 9 0 2 OWNER NA GL• J� .. a P • E-MAII STREET ADDRESS S6 w I v yC j CITY,STATE,ZIP FAX CONTACT NAME PHONE - E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME m4spl ENSE NUMBEFq p(e��_/` LICENSE�T/YP BUS.LIC# fd COMPANY NAME `„ `J� • C.�a FAX STREET ADD S W \x V 6 C Ty ay P Oil 1, •��� ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DES PTI VP EXISTING USE PROPOSED USE CONSTR.TYPE I #STORIES USE TYPE OCC. SQ.FT. VALUATION($) NEW FLOOR DEMO TOTAL AREA T AREA AREA AREA NET AREA (f BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA. REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT []YES SECOND STORY []YES BEING ADDED? 13NO ADDITION? ❑NO PRE-APPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES $}.: _ �. -I TOTAL V UATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME. ❑NO '000 I By my signature below,I certify to each of the following: I am the property owner aut agen on the erty owner's behalf. I have read this application and the information I have provided is correct. I have read the Descri ofWork and erify irMlaccurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. uthorize re rese Ives of Cupertino to enter the above-idenfied pr pe for inspection purposes. Signature of Applicant/Agent: Date: fL�J I SUPPLEMENTAL INFO TION REQUIRED P,T,` `I,E KT-yn ROUTINGSLTI". New SFD or Multifamily dwellings: Apply for demolition pLofbuildin x ,'I O UER 2fCOUNTER © BUILDING PLAN RE 4IEW existing building(s). Demolition permit is required prior to issuag .; - . permit for new building. EJCPRESS PLANNING PLAN REVIEW _Commercial Bldgs: Provide a:completed Hazardous Materials Disclosure C7 s7cANVAxn ❑"PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. _Copy of Planning Approval Letter or Meeting with Planning prior to �®-"sANrrAiiY 311YI R io7srlilCT CfaIAOR submittal of Building Permit application. ❑ ENVIRONMENTALJWE LTH B1dgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 22330 HOMESTEAD RD#202 DATE: 08/29/2013 REVIEWED BY: MELISSA APN: 326 59 027 BP#: "VALUATION: 1$7,500 %PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY Multi-Family Dwelling Buildino is PENTAMATION 1R2REM USE: 3 Stories ® Yes ® No PERMIT TYPE: WORK **UNIT 202**REMODEL E KITCHEN WITH N CABINETS COUNTER TOPS AND SINK SCOPE 00fWIN r It XtecL flan Check Fhrsrb. Plan Check F...lec:_ Plan Check ;LPi>clr. Permit Fee• Plumb.Permit Fee: Elec. Permit Fee: Other Afech.Insp. Other-Plumb Insp. Other Glee.Insp. I.Alech. Insp.Fee: Plumb. hrs/3.Fee: Elec.Insp. Fee: NOTE: This estimate does not include fees due to other Departments(i.a Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). Thesefees are based on the prelimina information available and are only an estimate Contact the De t or addn'1 info. FEE ITEMS (Fee Resolution 11-053 E . 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. Remodel,Kitchen(<=300 sf) Suppl.PC Fee: (j) Reg. 0 OT 0.0 hrs $0.00 $626.00 1REAMESKIT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee-0 Reg. 0 OT0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction .Tax: Adininistrative Fee: Work Without Permit? ®Yes G) No $0.00 G Advanced Planning Fee: $0.00 Select a Non-Residential 0 Travel Doetementarion Fees: Building or Structure I Strong Motion Fee: 1BSEISMICR $0.75 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 , $1.751 $626.00 $627.75 Revised: 07/01/2013 Building Department City Of Cupertino La 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR.LIST JOB ADDRESS: 2230 k�-2b2 PERMIT# 3 08 OWNER'S NAME: ` PHONE# b(;O$ GENERAL CONTRACTOR: S6 BUSINESS'LICENSE.#_.; , ADDRESS: �5 .ti �' L14- , CITY/ZIPCODE;' *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING'FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL ;BE.-SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE 01 TAINED A;CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the folio. mations>' ; SUBCONTRACTOR BUSINESS NAME .,BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood 44 Glass/Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date