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13110103CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 23500 CRISTO REY DR UNIT 201E CONTRACTOR: BAY AREA ENTERPRISE PERMIT NO: 13110103 OWNER'S NAME: DEVINE EMILY E TRUSTEE 2110 MANGIN WAY DATE ISSUED: 11/15/2013 OWNER'S PHONE: 6505371523 SAN JOSE, CA 95148 PHONE NO: (408)238-5043 ICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL License. Class D Lic. # 319 UNIT 201E- REPLACE BATHROOM FAN & SENSOR, I REPLACE Contractor Z— Date 18 OUTLETS AND SWITHCES, 7 RECESSED LIGHTS, I hereby affirm that iam licensed under the provisions of C apter 9 (commencing with Section 7000) of Division 3 of the JR.& 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: $2900 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 APN Number: 34253071.00 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 WITHINX80 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 DA M LAST CALLED INSPECTION. indemnify and keep h ess the City of Cupertino against liabilities, judgments, costs, and expe ses wh'c may accrue against said City in consequence of the P7 granting granting of i ennit. dditionally, the applicant understands and will comply Issued by: Date: -61 with all noq4nt sour a regulations per the Cupertino Municipal Code, Section 9.18. j( t RE -ROOFS: Signture Date U 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 -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 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 HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requiremenoder Chapter 6.95 of the California Health & Safety Code, Sections 2550 , 2 533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Muni ipCode, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) shout I sare or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's devices which emit hazardous material. Additionally, should I use equipmeYunicipal Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Areauality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cup rtin Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 5 5, 2 533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: n Date: I/ 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 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION 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 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION I\�� 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 `` v (408) 777-3228 • FAX (408) 777-3333 • building(d-)cuoertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI M REVISION/ DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS O F 9 � (41 ' # �� f �392.-5-3 lir PHO �Z OWNER NAME �/ i1 Q��„e �I r' �IJZ�C E-MAIL STREETADD� WLv Ci-( CITY, STATF�, ZIP — I FAX 3Rrv'-40 '. C CONTACT NAME ; veC PHONE ; Tom[) �_ �7 E-MAIL /� —(y ` , CB r J 39 � L ?i STREET ADDRESS CITY, STATE, ZIP i !/O JYG f'r>7 ❑ OFR.'ER ❑ OwNER-BuiLDER ❑OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT 13 ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ` Fe(y �� LICENSE c� j, TYPE BUS. LIC # COMPANY NAME a yLICENSE EL` ~ FAX STREET ADDRESS f, G CITY, STATE, ZIP C �� > PHONE ARCHITECT/ENGINEER NAME V LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK C- 9t- EXISTING USE PROPOSED USE COAISTR TYPE # STORIES 1 USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH DV✓ELLING UNITS: IS A SECOND UNIT []YES SECOND STORY ❑ YES BEING ADDED? ❑ NO ADDITION? ILIO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLAI.II.'I1.G APPL # ❑ NO PLANNING APPROVAL ER JA IS THE BLDG AN ❑ YES EICHLER Rom E? E]NO�. REC£I '. D Y r ' ; � . '� per' . ', r' -_ TOT AT!)!/ 7A,yIQN- % �7 UC/ By my signature below, I certify to each of the fol : I am the property -or authorized agent t act on the property o tner's behalf. I have read this application and the information I have provided ' cone t I have read scription of Work and verify it is acc . I agre to comply with all applicable local ordinances and state laws relating to buil ' n. I autho repr entarives of Cupertino to enter the abo ide tiff property for ' pection purposes. Signature ofApplicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED :_ 01 ERT COUi�TER L DINGP YILE\FEV1 - iAil�irivrE�� _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building s). Demolition permit is required prior to issuance of bui]dmg permit for new building.REss Commercial Bldgs: Provide a completed Hazardous Materials Disclosure u _ � fonn if any Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. s ; �oR _ ` SEili.. E il,IV ONAMNTAT:HEALIH A BldgApp 2011.doc revised 06/21/11 f CITY OF CUPERTINO UV1V T'i CTTM A Tn72 — TIT TIT.IANC_' 11IVIQI0N .Wech. Plan Check Plumb. Plum Check Elec. Plan Check 0.0 1 hrs $0.00 ;ti1i>.ch. Permit Fie: Plumb. Permit I yet:: Elec. Permit Fee: IEPERMIT Othe y ,Yaech. Insp. Ocher Plumb Insp.Li Other Elec. Insp. EA hrs $47.00 rlrlech. In.sh. Fee: Plumb. Insp. Fee: Elec. Insp, Fee: 1VnTT. • Thic octimatn dans not inelude fees due to other Departments ae. Planning, Public Works, Fire, Sanitary Sewer District, School Contact the Dent for addn7 into. dboLws, eia.. . eiewe ew w.c ow...»... ..•.. .............. FEE ITEMS (Fee Resolution 11-053 E . 7ff /1/13) ADDRESS: DATE: 11/15/2013 REVIEWED BY: Mendez APN: BP#: "VALUATION: 1$2,900 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex p Suppl. PC Fee: Q Reg. ® OT0.0 PENTAMATION 1 REAP10 USE: $0.00 PERMIT TYPE: i WORK unit 201e- replace bathroom fan & sensor, replace 18 outlets and swithces 7 recessed lights, F—T-1 $70.00 Electrical inEw= Fixtures, Lighting SCOPE Permit Fee: .Wech. Plan Check Plumb. Plum Check Elec. Plan Check 0.0 1 hrs $0.00 ;ti1i>.ch. Permit Fie: Plumb. Permit I yet:: Elec. Permit Fee: IEPERMIT Othe y ,Yaech. Insp. Ocher Plumb Insp.Li Other Elec. Insp. EA hrs $47.00 rlrlech. In.sh. Fee: Plumb. Insp. Fee: Elec. Insp, Fee: 1VnTT. • Thic octimatn dans not inelude fees due to other Departments ae. Planning, Public Works, Fire, Sanitary Sewer District, School Contact the Dent for addn7 into. dboLws, eia.. . eiewe ew w.c ow...»... ..•.. .............. FEE ITEMS (Fee Resolution 11-053 E . 7ff /1/13) ... ____________ __. _______ FEE _ _ QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F 26-1 # $47.00 Electrical IBREMRECEP Recep/Switch/Outlets Suppl. PC Fee: Q Reg. ® OT0.0 hrs $0.00 PME Plan Check: $0.00 F—T-1 $70.00 Electrical inEw= Fixtures, Lighting Permit Fee: $0.00 Suppl. Insp. FeeQ Reg. ® OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $47.00 Construction Tax: Administrative Fee: IADMIN $44.00 E) Work Without Permit? ® Yes (E) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure (F) 0� Travel Documentation Fee: ITRAVDOC $47.00 Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg, Stds Commission Fee: 1BCBSC $1.00 - .. $139.50 $117.00 TOTAL FEE 4 ZZ $256.50 Revised: 10/01/2013 I- KAP 1/>c.e p'''�I`CN �L(% �a' A ro0M Fa ?5, Q. Ole( 5cjl�ck5 L"," 3• "?n0the j LTi CF -L /tyh¢ihf `4r'�h I' �e wr & �h 'a 'c tq'a ,,, c1 r s -, J 7 - Not Available on Comer Units } Si rage CUP- -- ;, -Balcony,--- en Ba cony.--ent __— 13!3! X_TVt -- Bath • e M !� c F E �. r ��E I� 1. 'tom" Emergency Response System p Electrical Outlet —TI?is set of plans and specifications MUST be kept at the job site during construction. It is unlawful to make any changes or alterations on same, -or to deviate therefrom, without approval from the Building Official. The Stamping of this plan and specifications SHALL NOT be held to permit or to be an approval of the violation. Cf any provisioIs of any City Ordinance or State Law. By SyV� � 1 I �n�..a�• /Ir Tplpnhnne Outlet �- = 1 foot INTERIOR LIVING SPACE Model C 1020 Square Feet BALCONY SPACE Two Bedrooms o Two Baths 95 Square Feet STORAGE SPACE 7 Square Feet Al I Floor plaits are represenradve. Actual meanaemew and layout may uay. . j� 1 13 a t)o C tr-0&+o � R� tL&t � ,2L � � � ref' ��. < F'�'-u�1 W if -e r11. a YI L(e g5c-ly ...:; NOS -1--5...2413 REVI D-FO-R-1.-EOMF'-t-t: - - _- ^place Top Floor . R _.. ..-Sedro��[� viewed°.xSIQ9'._— - — - ._ _..---- - . _ Living Room 610' x 6'10' _ . - - --- -© - 14'0' x 110' ---.. _.._ — _...-115' x 12'5' --- -._. ............... . a — Closet -- Dining -Room- 3'9'x6'5'- ___--.. ...._..14.0.°x.8.3'. p i _High.Ceiling-- _--- y atTop Floor Closet . __ . - -----I � - - -j- ,�- - --4'5' x gig• ! Bath • e M !� c F E �. r ��E I� 1. 'tom" Emergency Response System p Electrical Outlet —TI?is set of plans and specifications MUST be kept at the job site during construction. It is unlawful to make any changes or alterations on same, -or to deviate therefrom, without approval from the Building Official. The Stamping of this plan and specifications SHALL NOT be held to permit or to be an approval of the violation. Cf any provisioIs of any City Ordinance or State Law. By SyV� � 1 I �n�..a�• /Ir Tplpnhnne Outlet �- = 1 foot INTERIOR LIVING SPACE Model C 1020 Square Feet BALCONY SPACE Two Bedrooms o Two Baths 95 Square Feet STORAGE SPACE 7 Square Feet Al I Floor plaits are represenradve. Actual meanaemew and layout may uay. . j� 1 13 a t)o C tr-0&+o � R� tL&t � ,2L � � � ref' ��. < F'�'-u�1 W if -e r11. a YI L(e g5c-ly