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13110131 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 23100 VIA ESPLENDOR#43 CONTRACTOR:BAY AREA ENTERPRISE PERMIT NO:13110131 OWNER'S NAME: JUDITH WILLON 2110 MANGIN WAY DATE ISSUED: 11/20/2013 O ER'S PHONE: 6505371523 SAN JOSE,CA 95148 PHONE NO:(408)238-5043 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIALE] License Class__ Lic.# $'1 q,R I REPLACE BATHROOM FANS(2),CHANGE ALL OUTLET RECEPTACLES&SWITCHES(18)&REPLACE ALL LIGHT Contractor Date P! z�' 3 FIXTURES(6) 1 hereby affirm t at 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 performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$3500 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:34255028.00 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 WITHIN 180 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 DAYS ALLED 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 Date: ZO 3 granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations pe pertino Municipal Code,Section. 9.18. RE-ROOFS: Signature Date 1t ?!? t 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 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) 1,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 stocv!icr.1 andle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or which emithazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air uanagement District I performance of the work for which this permit is issued. will maintain complia5nt. he upertino ipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Co 2 05,2 33,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this j permit is issued. Owner or authorized Date: Z/- G 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 CONSTRUCTION PERMIT APPLICATION 1 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTI NO (408)777-3228• FAX(408)777-3333•buildingC&-cugertino.org ❑NEW CONSTRUCTION ❑ DITION ❑ ALTERATION/TI REVISION/DEFERRED` ORIGINAL PERMIT# PR 10 1D R S F� � O (rV'T14 /rl� APN# �(� z—���.0 Z OWNER h PHONE,�6�.. C�rev 1 E-MAIL 2 bJ i�rr���tQY"V1QY� t Gavw STREET ADDRESS Q CITY,STATEtZ�P t FAX C I7/� e� ��to CONTACT NAMEff y PHONE V019-Z.319_ E-MAIL /may �tpr S� �.vvi STREET ADDRESS(J ( CITY,STATE,,ZIPJ FAX C 21( O 1"ltrV� I W u Ste- e c� S 1�f�j ❑ OWNER ❑ OwNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR IaCONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMIr 7 LICENSE NUMBER ITIrl LICENSE TYPE BUS.LIC# C COMPANY NAME y� E-MAIL eref FAX STREET ADDRESS2-110 Ci�,STATE,ZIP �• PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# 7 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE 71 DESCRIPTION OF WORK � L t,!itvQ 0 P0'0 rDd/* n.5n1a C, -ivy 1C ou e �to C-14 .(C( !. b I�c.� SSa 1•� �'!' S �G� 1 3 5'00 EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NErAREA BATHROOM KITCHEN OTHER REMODELAREA REMODELAREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH []ATTACH #DWELLING UNITS: IS A SECOND UNrr []YES SECOND STORY ❑YES BEING ADDED? ❑NO ADDITION? []NO PRE-APPLICATION ❑YES IF 1'ES,PROVIDE COPY F IS THE BLDG AN ❑YES Y TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL ER EICHLER HOME? ❑It ' By my signature below,I certify to each of a III owin,g: I am the prop eaut ho ac e property owner's behalf. I have rea application and the information I have s correct. I have read es pfWork d ve rate. gree to co_mply with all applicable local ordinances and state laws relatingt ild' g co cfo I autho f Cupertino to a er the rd tified pr erty for' ection purposes. Signature of Applicant/Agent: Date: SUPPLEM TAL INFORMATIO REQU D � - gouriivc sr Pa.>. „LA17,CHEKT,YP n _New SFD or Multifamily dwellings: App f demolition permit for � R `> ` a VERT�Oi3�1YTEl��a ©�UI>DINGPLANTREYIEW� A< existing building s). Demolition permit is required prior to issuance of building ON permit for new building. REss 1 'P MINGpLaNlzEylEvy` 5 INA _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure x �DARD Q UBLIcysORxs z form if any Hazardous Materials are being used as part of this project. �ti ` Q FIRE DEPT�a r Copy of Planning Approval Letter or Meeting with Planning Prior to su_bmittal T�R'I�CT7 of Building Permit application. • � „�� :©�-ENVIRONIIIENTAI;HEALTH"=:c,-<z BldgApp_2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 23100 VIA ESPLENDOR V43 DATE: 11/20/2013 REVIEWED BY: MELISSA its I APN: 342 55 028 BP#: *VALUATION: $3,500 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY Building is PENTAMATION 1 RMAP8 USE: Multi-Family Dwelling >3 Stories ® Yes (E) No PERMIT TYPE: i WORK REPLACE BATHROOM FANS 2 CHANGE ALL OUTLET RECEPTACLES & SWITCHES 18 & SCOPE REPLACE ALL LIGHT FIXTURES (6) ,., !74-241-il IN d 12 Mech.Plan Check 0.0 hrs $0.00 Plumb, Plan Check Elec.Plan Check 0.0 hrs $0.00 Mech.Permit Fee: IMPERMIT Plumb.Permil lee: Elec.Permit Fee: 1EPERMIT --t Other Mech.Insp. hrs $47.00 Outer Plumb Insp. Other Elec.Insp. L. hrs $47.00 0.0 -1Jech.Insp. Fire: Plumb, hrsl�.Fee" Dec.Insp. Fee: NOTE.This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). Theseees are based on the p relimina information available and are only an estimate. Contact the De t or addn'1 in o. FEE ITEMS(Fee Resolution 11-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F-2 -1 # Mechanical Suppl.PC Fee: Q Reg. ® OT 0.0 hrs $0.00 $48.00 IBREMVENF I Ventilation Fan PME Plan Check: $0.00 18 Electrical Permit Fee: $0.00 $470 I .0BREWECEP Recep/Switch/Outlets Suppl. Insp.Fee-0 Reg. Q OT 0,0 hrs $0.00 © Electrical PME Unit Fee: $0.00 $70.00 IBREMFUT I Fixtures,Lighting PME Permit Fee: $94.00 t;ons1r-uc°iion Tax: Administrative Fee: IADMIN $44.00 Work Without Permit? ®Yes (F) No $0.00 0 Advanced Planning Fee: $0.00 Select a Non-Residential (E) Travel Documentation Fee: 1TRAVDOC $47.00 Building or Structure ®, Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 g_ wwg $186.501 $165.00 ToL FEES_ $351.50 Revised: 10/01/2013 Building Department City Of Cupertino 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: �/`�( Gt - 7-3106 ,e RMIT# t.3!/6 OWNER'S NAME: .Fe • PHONE# GENERAL CONTRACTOR: Ba Av--" Uev4- v Y' BUSINESS LICENSE# ADDRESS: -2-116 t" h CITY/ZIPCODE: .5 Ca 9S/ *Our municipal code requires all bu nesses working in the city to have a City of<Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIO (S LL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBC TRACTO OBTAINED A.CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors. � imsicte na a DatePlease check applicable subcontract rs and the fo lowing information: %/ 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 F i,e C,-f t'CCJ W►fin L�� Y'e cel s� =-'-�-- — ---- -------- --- -- -- ---Master-Bedroom -- Nev 6f�)-VVWN ®c cLiving-Room _ ©_ 095(1-0-W --Passage x4'9" 12'0 x 9'4' — -- Bath -V -- - -- -- 1 x 51!10 'f19 ift s 4? _ o � - - ---Toyer UiC4IV ,C)'s� O K1tCen. -— --- 9'0"k 9'4 I,�� o,� ,o coy gas '►'. ' T `1': ,i'g aWL - -- 0/ 1 Vi0 110 e _- inen�- 6' ` - --`1 x ice• .__ M a soe fO fo a p pf B� °�`Ap - - ° •� /_`S' ,o; �QJ' - - -8'-1 x-2 3" garage- 12 0"x 20'a -- -- - ° --Bedroom- -- - - -122 x-1�6 CVP Via! Building + © -- --- -— --- 4 Dpp 2 0 2013 : A l=a R`ieviewed �+ ,CODE COMPUA. C .._- ` Emergency Response System ° Electrical Outlet ° Cable Television Outlet 7r Telephone Outlet =1 foot Standard Center Villa INTERIOR LIVING SPACE I,280 Square Feet Two Bedrooms a Two Baths OTAL DECK SPACE AT RANCHO SAN ANTONIO Floor plans are representative.Actual measurements and layout may vary. KOO qq nn 2310 Vl`& E75P lfen4,r , \/V NOV 20 2013 By i`rp-C �G^ - �Cf' �t�iV lel u�z