13100194I"
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10320 LOCKWOOD DR
CONTRACTOR: SEARS HOME
PERMIT NO: 13100194
IMPROVEMENT
OWNER'S NAME: RAJESH SHENOY
1024 FLORIDA CENTRAL PKWY
DATE ISSUED: 10/29/2013
OWNER'S PHONE: 6507014407
LONGWOOD, FL 32750
PHONE NO: (925)245-2000
LX LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL II
License Class Lic. # % r 3 7
KITCHEN REMODEL 168 SQ FT, M,E,P'S
Contractor 4 i- r Nf p Date
I hereby affirm that I am licensed un er 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
Sq. Ft Floor Area:
Valuation: $27076
perf ance of the work for which this permit is issued.
e and will maintain Worker's Compensation Insurance, as provided for by
e tion 3700 of the Labor Code, for the performance of the work for which this
APN Number: 34215053.00
Occupancy Type:
p rmit 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
WITHIN IM DAYS OF 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
180 DAY ROM LAST CALLED 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/
'�
Issued by: Date
granting of this permit. Additionally, the applicant under s and will comply
with all non -point Municipal Code, Section
1161
9.18.
7:;;;�7Da4e!2/2_9L13
RE -ROOFS:
Signature
All roofs shall be inspected priorto any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
❑ -BUILDER 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 Code, Chapter
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sections 25505, 25533, and 25534
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: Date: Jp
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
CONSTRUCT N LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I must
I hereby affirm that there is a construction lending agency 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
GENERAL PERMIT APPLICATION G`�
e� MEP
IM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERT[NO (408) 777-3228 • FAX (408) 777-3333 • build incla)cupertino.or4 MISC
PLUMBING MECHANICAL tELECTRICAL I—IMISCF.I.I.ANE01JS
PROJECT ADDRESS �O / - L
APN # .�Lu 5 ^
v
✓�-''—c)
OWNER NAME !7 _
PHONE.
� /�✓
E-MAIL
STREET ADDRESS
(M1,rJ"V
CG ,ST;C � PI (� C� r^y� /-�/ 4
7E-MAVIL.
FAX
CONTACT NAME BERNIE MATHESON
PHONE 925-245-2013
STREET ADDRESS
263 E. AIRWAY BLVD.
CITY, STATE, ZIP
LIVERMORE,CA 94551
FAX
925-245-2017
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT LJ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
BERNIE MATHESON
LICENSENUMBER 721379
LICENSE TYPEB, C10
C17 C6
BUS. LIC#
COMPANYNAME SEARS HOME IMPROVEMENT
E-MAIL
FAX 925-245-2017
STREETADDRESS 283 E. AIRWAY BLVD.
CITY, STATE, ZIP LIVERMORE, CA 94551
PHONE 925-245-2013
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
GSE OF D or DUPLEX ❑ MULTI -FAMILY
BLd LDING. E] COMMERCIAL
PROJECT IN WILDLAND ❑ YES
URBAN INTERFACE AREA ❑ NO
PROJECT IN ❑ YES
FLOODZONE ❑ NO
IS THE BLDG AN ❑ YFS
EICHLER HOME' ❑ \O
' 0 I 1 ' r
DESCRIPTION OF WORK GH c
t� /J C� S. F
A-7 i"' ( Il� l'^ 31 AkA oA rc. k,1-A),C ' 1 7 / J,`
TOTAL VALUATION: 2 7 O ,
RECEIVEDBY:
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work ,aud-vehiy it is accurate. 1 agree to comply with all applicable local
ordinances and state laws relating to building construction. I authorize representativgs e{ upertmo to enter the above -i ntifiproperty for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFO REQUIRED
OFFICE USE ONLY
E -COUNTER
❑ EXPRESS
❑ STANDARD
U
.d7
❑ LARGE
W
❑ MAJOR
MEPMiscApp_2011.doc revised 06/21111
CITY OF CUPERTINO
F,m-7- FEE ESTIMATOR — BUILDING DIVISION
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc). These fees are based on the nreliminary information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Elf 7/1/13)
ADDRESS: 10320 LOCKWOOD DR
DATE: 10/29/2013
REVIEWED BY: MENDEZ
�1�'t:!). l� `Ptlt/Z I <'i':
APN:
BP#:
"VALUATION: 1$27,076
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
I
PENTAMATION 1R3SFDREM
I PERMIT TYPE:
WORK
KITCHEN REMODEL 168 SQ FT M E P'S
SCOPE
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc). These fees are based on the nreliminary information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Elf 7/1/13)
l�fc'Cft f VL7Yt (. h<('4
h/irill ", } ;rLR r` �.. hCC%
MISC ITEMS
�1�'t:!). l� `Ptlt/Z I <'i':
Pi"a i' P ml" %'i'<';
f,l<C'. 1" rmlt I't't:"
0[h, r �1 fc, h. Nisi>
fl'i,c�r l'b"mb fi,">_
C.}lht�i' L;'<'r. Ixzsfr.EIF
11(e'h hiv), i`c<.
1 'trm` b)"p, F'�e�::
1;IeC_ Itrsjz Pcc'
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc). These fees are based on the nreliminary information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Elf 7/1/13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
168 s.f.
$626.00
Remodel, Kitchen (<=300 sf)
1REMRESKIT
Suppl. PC Fee: Q Reg. 0 0T
FO
Trs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee -0 Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
("onsiruction TOX.
"Idininisfratiti•e Fee:
Work Without Permit? 0 Yes Q No
$0.00
Advanced Planning Fee.
$0.00
Select a Non -Residential
Building or Structure
�
i
Travel 1 Oocttnlcnlalioli l -(res°
Strong Motion Fee: IBSEISMICR
$2.71
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$2.00
SUBTOTALS:
1 $4.71
$626.00
TOTAL FEE:
1 $630.71
Revised: 10/01/2013
•
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: 1 D Z O L- v jjCX-.i'> /Z
PERMIT #
OWNER'S NAME: PAJ-6-
5 f -j 5 PCAO
PHONE # SD % O l L/ 0 %
GENERAL CONTRACTOR: Hom k 114 P,
BUSINESS LICENSE #
ADDRESS: Z <? 3 E-
CITY/ZIPCODE:
*Our municipal code requires all bdsinesses 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 OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
ure Date
Please check applicable subcontractors a omplete the following information:
Owner / Contractor Signature
Date
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner / Contractor Signature
Date
15'-0"±
cv
z
(N) HIGH EFFICACY
oc
C)
I
15'-0"±
cv
z
(N) HIGH EFFICACY
oc
C)
INCANDESCENT 65 0 o
D o -4:3-
WATT LIGHT
Lo
cn
(E) '� (E) (E)
(E) v (E) (E)
¢o
Z'OD
Lu
:E 0 0
-.
-`�"_ (E) LIGHT
{ I
'7 7-
i i
-. (N) GAS
Q O RANGE/HOOD
LIJ
C w
a w Q
(E) GD
(E) DW
Qn
r-� .,
I .. �. I
----_
(E) GAS
(E) GD ®
(E) DW 7 9
(N) SINK
(N)
� o
w o v
o oN N
r�
RANGE/HOOD
30"
x 18" i
_
17
TO BE REPLACED
+1
i �;
�
(E)
(E)�
Lo
co(E)�i
14
() ❑
E
N
E
() 4 N HIGH EFFICACY
$�
$
FLORESCENTS
ci '; S
(E) D/WTO
(E) D/WTO TOTAL = 320 WATTS
REMAIN
i
REMAIN
(E) FRIDGE
(E) FRIDGE
(E)
TO REMAAN
rs
(E) TO REMIANo
QD<}
m
Z �
(N)ICE MAKER
-*-
WATER LINE
Q o
o�
OQ
V
Lu
= �U
EXISTING
PROPOSED
= Y O
UO
KITCHEN DETAIL
T�N�COP
UPE'Ft
KITCHEN DETAIL
w
a J w
P�artment
O U
ELECTRICAL WORK PREFORMED BY OTHERS.
oat.
I E 8
pL1ANCE
SCOPE OF WORK:
& WASTE LINE UP TO 8'.
1015.13
SSE NTS
�r;pE COM
REPLACE CABINETS & COUNTERTOPS. EXTEND SUPPLY
DRAWN B°
oKw
INSTALL (N) ICE MAKER WATER LINE. INSTALL (N) SINK, SINK & FAUCET
,DB 16196457
HOOK-UP. VENT MICRO HOOD. INSTALL (N) GAS RANGE, AND HOOD IN SAME
LOCATION AS (E). INSTALL (N) HIGH EFFICACY INCANDESCENT 65 WATT LIGHT &
(4) (N) HIGH EFFICACY FLORESCENT'S TOTAL = 320 WATTS.