13100197I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 10139 CASS PL
OWNER'S NAME: KAIEHU KAAHAAIA
OWNER'S PHONE: 3105027443
LICENSED CONTRACTOR'S DECLARATION
License Class Lic. # J S— vJ
Contractor 17 f -7 60 A,.1 t"� Date
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:
I have and will maintain a certificate of consent to self - insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
1�rformance of the work for which this permit is issued.
Mme and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APPLICANT CERTIFICATION
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section/
9.18.
Signature C :j Date r/!�
❑ OWNER- BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
1, 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
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
declarations:
I have and will maintain a Certificate of Consent to self - insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
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
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature Date
CONTRACTOR: GRIDLEY COMPANY I PERMIT NO: 13100197
122 ORCHARD CITY DR DATE ISSUED: 10/29/2013
CAMPBELL, CA 95008 1 PHONE NO: (408)374 -0900
JOB DESCRIPTION: RESIDENTIAL U COMMERCIAL
REPLACE 2 (E) WINDOWS, RECONFIGURE & REMODEL
(E)
MASTER BATH (96 S.F.), REMODEL (E) LAUNDRY RM (64
S.F.), RELOCATE WATER HEATER TO OUTSIDE (N)
Sq. Ft Floor Area: I Valuation: $90000
APN Number: 35701037.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS D JNSPECTION.
Date: d Z
RE- ROOFS:
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.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sectio_ .ns-i 05, 25 3 , and 25534.
� j
Owner or authorized ag4nt: 1/,_. 7 Date. D %ti 1 3
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
L21
CUPERTINO
I-T
I 1 ATRw rnATCTU I TrTInXT
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION O
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 O
(408) 777 -3228 • FAX (408) 777 -3333 • buildino cupertino.org
1 1 A n r I
— -- u
Mr1vIa1U1N i Lnrr1KXt.1J ORIGINAL PERMIT #
OJECTADDRESS C S 5 I L L
07
APN N � � _ 01 — C/
OWNER NAME
AANIAA�N/a tr 6*APJ i W,0 G�M�
[STREET
PHONE
�YY 3
EMAiL3S7_o
V
ADDRESS
Ul3�l . 5.3 L�J f£
CITY, LATE, ZIP
f/2 f I'✓0 CjP U1 `i
FAX
,f
CONTACT NAME PHONE
J�! 1�N �I✓ li Z fv /`I E -MAIL /'
/ vg. y�2. 98gy off E' 4r12*I-£ 1 c0/h�9Ny.
STREET ADDRESS / CITY, ST E ZIP �J
L7-_Z 0&j11711-1) c•� /' i S 6,l L� C/7 �jS�Da FAX
❑ OWNER ❑ OWNER- BUBDER ❑ OWNER AGENT FrICONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
NTRACTO NAME // ! LICENSE
^�11.� E�6 U LICENSE TYPE
BUS. LIC # /
MPANY AME E -MAIL
/21pL£y U N �Gf2WL£r p'9^' %.G,,,,,,
[STREET
FAX �q —i y G2 4v
ADDRESS
CITY, ST TE, ZIP �1
PHONE
U � p1loV
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E -MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
sites I %� fc / ?1�� c�/ �✓�u
p/17 d
%/v >T�'v�. �iv / %/�r(c�£SS !,J/�T�/L /�f�f i °✓( (//vJ G' �3 L l i✓ £
EXISTING USE F
PROPOSID U E
CONSTR..T� PE
#STORIES
EXLSTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NErAREA
BATHROOM
/ /
KITCHEN
OTHER
/[jJ
REMODEL AREA U
REMO AREA
RFMOODEL AREA
PORCH AREA
DECK AREA
TOTAL DECKIPORCH AREA
GARAGE AREA; ❑ DETACH
❑ ATTACH
1 DWELLTNG UNITS:
IS A SECOND UNIT ❑ YES
SECOND STORY ❑ YES
- -
CEDiGADDED? ❑ NO
ADDITION? ❑ NO
-
-
PR&APPWCATION ❑ YES
PLANNING APPLX ❑ NO
ff YES, PROVIDE COPY OF
PLANNING APPROVAL LErrFn
PLANNER'S NAME:
-
TOTALVALU tYOA%
at;7
By my signature below, I certify to each of the following: I am the property owner or t to act property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and verify it' I
accurate. agree to comply with all applicable local
ordinances and state laws relates g c on. I authorize representatives of Cupertino to enter the above - identified property for inspection purposes.
Signature of Appiicant/Ag �� -° - Date: /// j
SUPPLEWRTAL INFORMATION REQUIRED
PLANCHECKTYPs
-
ROUMG..SLIP
_ New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
❑ -TOD
❑ B�� Pew
permit for new building.
❑ WIPRESS
❑ PLANNING PLAN REVIEW
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
❑ STANDARD
❑ PUBUC WOR"
form if any Hazardous Materials are being used as part of this project.
❑ LARGE
❑ FM DEPT
— Copy of Planning Approval Letter or Meeting with Planning prior to
submittal of Building Permit application.
MAJOR
❑ SANITARY SEWER DISTRICT
❑ ENVIRONMENTALHEALTR
BldgApp_MLdoc revised 03116111
��, CITY OF CUPERTINO
li�!�!T/�11 lR1R1R. F.CTIMATnR — RUILDING DIVISION
LaiADDRESS:
10139 CASS PLACE
DATE: 10/29/2013
REVIEWED BY: MELISSA
11,71, P�rr�1i1 i c,'_
APN: 357 01 037
BP #:
'VALUATION:
1$90,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY
SFD or Duplex
hrs
$0.00
PENTAMATION 1 R3SFDREM
PERMIT TYPE:
USE:
$0.00
64 s.f.
$418.00
Remodel, Other
1 IREMRESOTx
WORK
REPLACE 2 E WINDOWS RECONFIGURE & REMODEL E MASTER BATH 96 S.F. REMODEL
SCOPE I
(E) LAUNDRY RIM (64 S.F.), RELOCATE WATER HEATER TO OUTSIDE (N) TANKLESS
NOTE: This estimate does not include fees due to other Departments (t.e. rianning, ruouc morns, metre, 5uattu.y 5crvc• , .•,
_ _ f - -_. are L.......t .... IG.. » n, :.w:..n.n� :..f Y n / :nH nvni /nh /o and O/O nn /U nn B3 /[mate. Contact the Dept for addn'i info.
U,strtct, etc. . I nose CCs are t/aseU on u[c • c[w•u•.u•
FEE ITEMS (Fee Resolution 11 -053 E f 7/1/131
... ... ........... ». ».
FEE
Plumb. Plan Check 0.0 hrs $0.00
r7c;c. 1'1<w Check
11,71, P�rr�1i1 i c,'_
Plumb. Permit Fee: IPPERMIT
11-11, C /''unit 1,1"
Chl('�' Ifcch. hI'v,
Other Plumb Insp. 0.0 hrs $47.00
oilicil1.w, 1n)P. El
Suppl. PC Fee: Q Reg. Q OT
0:0
hrs
$0.00
PME Plan Check:
NOTE: This estimate does not include fees due to other Departments (t.e. rianning, ruouc morns, metre, 5uattu.y 5crvc• , .•,
_ _ f - -_. are L.......t .... IG.. » n, :.w:..n.n� :..f Y n / :nH nvni /nh /o and O/O nn /U nn B3 /[mate. Contact the Dept for addn'i info.
U,strtct, etc. . I nose CCs are t/aseU on u[c • c[w•u•.u•
FEE ITEMS (Fee Resolution 11 -053 E f 7/1/131
... ... ........... ». ».
FEE
- ».- -- - - --- --- -
QTY/FEE
- - -- - - -- - - - --
MISC ITEMS
Plan Check Fee:
$0.00
= s.£
$626.00
Remodel, Bath (< =300 sf)
IREMRESBAT
Suppl. PC Fee: Q Reg. Q OT
0:0
hrs
$0.00
PME Plan Check:
$0.00
64 s.f.
$418.00
Remodel, Other
1 IREMRESOTx
Permit Fee:
$0.00
Suppl. Insp. Fee:Q Reg. Q OT
0,0
hrs
$0.00
2 # Window / Sliding Glass Door
$418.00 IWINREP Replacement
PME Unit Fee:
$0.00
PME Permit Fee:
$47.00
L_! J # Plumbing
$28.00 1PRWHEATR Water Heater
C'onso- ciion Tax:
Administrative Fee: IADMIN
$44.00
0
0
Work Without Permit? 0 Yes (F) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non - Residential
Building or Structure
0
Travel Documentation Fee: ITRAVDOC
$47.00
Strong Motion Fee: 1BSEISMICR
$9.00
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$4.00
SUBTOTALS:
$151.001$1,490.00
TOTAL FEE:
$1,641 00
Revised: 10/01/2013
PL01' PLAINS Existing Walls to Remain
CHECKED BY Non Bearing Walls to be Removed
DACE Z� 3 Relocate Existing Wall
PL&N2 DEPT.
RATE
31028L5 0 4'P' AFF
- — — — — — — — — — — — — — — — — — — — =
MA5TER BATH
X V -8" 2X6 CEILING J015T 16" ON CENTER
CH: T -11 9/16" — — — — - — — — — — — — — — — — —
Carpet
r
p-- _ -- ---------------
REMOVE m L
EXISTING NON I MASTER BDRM
BEARING WALL '' 14'-4" X 14'-9"
\
CH: T Carpet
9/16"
W
\ RELOCATE EXISTING ALL Garyet
2468 I
y
.�i
BEDROOM
10'-4"x10'-2"
CH:T -11 1/16"
Carpet
3668 I U I u
m
4? ry LAUNDRY
in
Vinyl
n
Sun
Tunnel
As- Built/ Demo Plan
WH
fV
N �
o
m
n
Map:
C o
cc
pper Sara ,a Woodbury Ot
0
IL > 0) 0
oT ° Monte Ct
Sal ern Atr Varian Park a fl
e -- - d
� � � o
Q 4
- ;o S,
Monta Vistta _ P
ESuba
(a M
er Yar
LowtsH'tf
t
J2 CO
a n y Cupertino Ad
Byrne Ct M
. 81Ja
ss PA9vd
'd � a o
sc O E 44
^ rLi 1. IChi d' Y Ste Chutc
V N
ongd own rid'
c, Cape1
t 1l L NIOT
N V
- T�
J'u t '.� Lomita Ave
., ; 1-1 AI or
ou Almaden Ave
3
Index:
A -1 Cover Page w/ As- Built/ Der�, .;
A -2 Proposed Floor Plan w ffiA;
A -3 Proposed Lighting /Electric
Ain...
F %•J:
Scope of Work:.
- Remove non load bearing walls in Laundry & Master Suite
- Relocate existing wall between Master Bath & Master Bedroom
%b w o
- New Master Bath windows in new location
w < W
- All new sheetrock in Master Bath & Laundry
V I <
v
- New tankless water heater
w N
O
- New gasline for tankless water heater
z_ p
- New tile flooring in Master Bath & Laundry
�n v
1q,
- New vanity and countertop in Master Bath
LU
= o, m w
- New cabientry and countertops in Laundry
- New sinks in new location in Master Bath & Laundry
- New shower configuration in Master Bath
- New 1.28 gpf toilet in new location in Master Bath
- New exhaust fan through existing roof jack in Mast. th
' `
Scale:
1/411 = 1'
- New exhaust fan through new roof jack in-Laundry
-0"
- All new lighting and electrical in M r 5uite & Laun�A
- New exterior door in Laundry in e ?ng locatiop 0�
Date:
10/28/13
Page:
A -1
'
Tempered "
(N) 2060 clear glass casement with ode- she k wrap
I MASTER BATH ry
o
I CH: T' -11 9/16"
I N
Floating Vanity LL
Cn
I m
.o II m -41
N
BDRM
Ut
`^
CH: T -11 9/16"
3' -5 5/1 b" -�
J
K
(V '
Q
Tempered 5hourer Door
P
3
–
a
�-
�— 1 T" x 15" niche,
v
� 50" from pan
V u
E
u n
I
-
F 8
30" Minimum Clearance
lY1
1'-2 9/16"
0
Z
(N) Interior Insulation on 5hou�er Wall
6-8 9/1 b"
IL
f080- sheetrock wrap
U_
v
F_
-
o
o N
BEDROOM
c�
CH:T-11 1/16"
Existing Walls to Remain
New Walls
Al
15' -b 5/8"
13' -2 1 /8"
o MASTER
BDRM
U
V
CH: T -11 9/16"
J
K
1'-2 9/16"
f080- sheetrock wrap
F_
Attic Access
c�
L_
Hanging Rod
2668
o
�o
H
�
q
r
Z
2368
n
�\
I A
�(N)
I GrA Lain Suss
Sungel
Space I
cn
— T—
Proposed Floor Plan
d
> 00
C cc
C w 0
am
E v v 4
u W
c p E 44
N
C
0
/Its
n �
W `-
d tr
W
ZZ�v
N
Z_ p_ ..`` 0
LU
V
=(mW
0
�v
Scale:
1/4" = 1' -0"
Date:
10128,113
Page:
A"2
Tempered
(N) 2060 clear glass casement with shade- sheetrack Wrap
Fci I MA5TER BATH `� N
o GH: T-11 9/16' o
N
\ 2 y
W
Floating Vanity �°
GFCI I = \
R o
o_ 5" LED 1 00
Existing Walls to Remain
New Walls
'V (N) dire (.D
(E) � (E) CATS
4" Ad).
w-
(N)dimmer `
AW
4 "Ad). a
N
Sun Tunnel
(N) 2566
C,ru
Space
Proposed Lighting /Electrical Plan
Electrical Notes:
At least one wall receptacle outlet shall be
installed in bathrooms within 3 feet of outside
edge of each basin. GEC, 210- 52(3)(d)
Bathroom receptacle outlets shall be supplied
by at least one 20 -amp branch circuit. Such
circuits shall have no other outlets. GEC, 210 -
11(c)(3) _
GFGI protection required for all bathroom
outlet receptacles. GEC, 210- 8(a)(1)
All luminaries in bathrooms shall either b�q- h''i h
efficacy or shall be controlled by a vacancy'y
sensor. T -b and compact fluorescent are high,,,,,
efficacy luminaries. T -24
Smoke detectors shall be located in all
bedrooms & in hallways in the immediate
vicinity outside of bedrooms as per GBG
801.2.12
Smoke detectors in the existing construction
may be battery operated only.
ri.
00
C p O
M I /
� z
0
4
5" LED 1000
ti
00
C O E
Exhau
o
MASTER BORM
0
AML
CH: T -11 9/16"
=
FLED 1000
E
>u
U
c
Tempered Shaver Door
°Z, z
�- 15" niche,
50" from pan
q
R
loon
ED 1000
5° D 1000
\
a
E E
U
(�0
I
~
lam/
30" Minimum Clearance
83
(N)'10150. sheetmck wep
(N) Interior Insulation on Shower Wall
I r
Attic Access
E
�
z
FCl FHanging Rod
y
�
m
�
—
BEDROOM
CH: V -1/8"
N
GH:T'- 111/16"
N R
!V
z 5" LED 1000 (N) Exhaust 5" LED 1000
Q
N
Sun Tunnel
(N) 2566
C,ru
Space
Proposed Lighting /Electrical Plan
Electrical Notes:
At least one wall receptacle outlet shall be
installed in bathrooms within 3 feet of outside
edge of each basin. GEC, 210- 52(3)(d)
Bathroom receptacle outlets shall be supplied
by at least one 20 -amp branch circuit. Such
circuits shall have no other outlets. GEC, 210 -
11(c)(3) _
GFGI protection required for all bathroom
outlet receptacles. GEC, 210- 8(a)(1)
All luminaries in bathrooms shall either b�q- h''i h
efficacy or shall be controlled by a vacancy'y
sensor. T -b and compact fluorescent are high,,,,,
efficacy luminaries. T -24
Smoke detectors shall be located in all
bedrooms & in hallways in the immediate
vicinity outside of bedrooms as per GBG
801.2.12
Smoke detectors in the existing construction
may be battery operated only.
ri.
00
C p O
0
4
U =
d v
ti
00
C O E
� N �
N v
0
AML
0
LU
Q W < IT
ZZ�v
N
zwn<o
LnvZ
X =SLUmW
q Q a-
Scale:
1/4" = 1' -011
Date:
10/28/13
Paae:
A-3
N
M"
CUPERTINO
CONTRACTOR SUBCONTRACTOR LIST
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: J (j 131 Ctr-t
PERMIT# i 310011 -7
OWNER'S NAME: J(4,
PHONE # �5 6'2- 7/'-/ -3
GENERAL CONTRACTOR:6 rz I ple IF 7 0V
BUSINESS LICENSE#
ADDRESS:
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 CONTRACT-OR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature Date
Please check applicable -subcdntractors and complete the following information:
6/
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring Carpeting
\'[Yt_ 44of-r Cklvurz
.4
Linoleum Wood
- 7e,
Glazin g
Heating
SETT y h�"#'T)
Insulation
Landscaping
Lathing
Masonry
Painting/ Wallpaper
kil
Paving
Plastering /$7-,k az-"
'6oz, -o 4FA(
;2
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
5�4,--r16,v1
Owner Coutrai6tor- Signature
0 lk?
Date