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13120060CITY OF CUPERTINO BUILDING PERMIT I IBUILDING ADDRESS: 10563 ESQUIRE PL I AND CONTRACTOR: BARRON RICHARD P JR I PERMIT NO: 13120060 I OWNER'S NAME: BARRON RICHARD P JR AND BARBAR 10563 ESQUIRE PL DATE ISSUED: 12/06/2013 OWNER'S PHONE: 4087382713 CUPERTINO, CA 95014 -1318 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class Lic.# Contractor 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 Libor 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. 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, Sectio� 9.18. Signature Date L7 OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 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. 1\ / I. i. Sq. Ft Floor Area: I Valuation: $6250 APN Number: 32644020.00 Occupancy Type: PERMIT EXPIRES. IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAY CALLED INSPECTION. Date: 1216113 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, Sections 25505, 25533, and 25534. Owner or authorized agent:r IFMn Date:f til% 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 I CITY OF CUPERTINO BUILDING PERMIT I 1 BUILDING ADDRESS: 10563 ESQUIRE PL I AND CONTRACARBAR BARRON RICHARD P JR I PERMIT NO: 13120060 OWNER'S NAME: BARRON RICHARD P JR AND BARBAR 110563 ESQUIRE PL j DATE ISSUED: 12/06/2013 1 OWNER'S PHONE: 4087382713 1 CUPERTINO, CA 95014 -1318 1 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lie. # Contractor 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 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. 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 ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 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 BUILDING PERMIT INFO: BLDG r— ELECT r— PLUMB r- MECH r RESIDENTIAL r— COMMERCIAL r— JOB DESCRIPTION: ADD 13 (N) RECESSED LIGHT FIXTURES AND 5 (N) SWITCHES THROUGHOUT RESIDENCE Sq. Ft Floor Area: I Valuation: $6250 APN Number: 32644020.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Date: 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, Sections 25505, 25533, and 25534. Owner or authorized agent: Date: 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 Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed zsl • GENERAL PERMIT APPLICATION v �o M EP COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION I O 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 �\ �/ MISC (408) 777 -3228 • FAX (408) 777 -3333 • building(cDcupertino.org MEPMiscApp_2011.doc revised 06121111 �j CITY OF CUPERTINO IO"�IrI�S! Ti Ti Ti I QTiM A TnR — RITIT .DING DIVNION APPLIANCE / EQUIP TYPE ADDRESS: 10563 ESQUIRE PL DATE: 12/06/2013 REVIEWED BY: MELISSA UNITS APN: 326 44020 BP #: *VALUATION: $6,250 *PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: p $70 PENTAMATION 1REAP11 PERMIT TYPE: A WORK ADD 13 N RECESSED LIGHT FIXTURES AND 5 N SWITCHES THROUGHOUT RESIDENCE SCOPE 5 APPLIANCE / EQUIP TYPE FEE ID FEE ITEMS (Fee Resolution 11 -053 E . 711113) QTY UNITS BP FEES Fixtures, Lighting 1BREMFIxT 13 # $70 Recep /Switch /Outlets 1BREMRECEP $0.00 5 # $47 Suppl. Insp I ee PME Unit Fee: $117.00 PME Permit Fee: $47.00 Conswitction :Tax: TOTALS: Administrative Fee: IADMIN $44.00 $117.00 4 Xkch. Pan Check Phimb, Plan Check Elec. Plan Check 10.0 1 hrs $0.00 Lterh. Permit fire: Plumb. Permit Fee: Elec. Permit Fee: IEPERMIT Other Mech. Insp. Other Plumb Insp. Other Elec. Insp. 0.0 hrs $47.00 .41ech. Insp. Tee: Plumb. hisp. Fee: El(!c. Insp. Fee: NOTE. This estimate does not include fees due to other vepartmenrs (Le. running, ruvaac rrvrn3, Marc, .�ucueucy .,c.vcc ..��c... y ...... . District, eta ). These fees are based on the prefimina in ormadon available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11 -053 E . 711113) FEE QTY/FEE MISC ITEMS Plan Check F'ee: Suppl. PC Fee PME Plan Check: $0.00 Permit .Fee: Suppl. Insp I ee PME Unit Fee: $117.00 PME Permit Fee: $47.00 Conswitction :Tax: Administrative Fee: IADMIN $44.00 Work Without Permit? ® Yes 0 No $0.00 Advanced Planning 147ees: . Travel Documentation Fee: ITRAVDOC $47.00 Strong Motion Fee: IBSEISMICR $0.63 Select an Administrative Item Bidi Stds Commission Fee: 1BCBSC $1.00 Maw $256.63 $0.00 �,a —� $256.63 Revised: 10/01/2013 CUPERTINO OWNER- BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 - buildinpna cuoertino.ora Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: I O$�jp ;3 E� " 1% APN3 z/0 _ L1 4 — O _d BP 3I ZOO (p O CZIAf�ILE M �� OWNER D R S 1 C, DESCRIPTION OF WORK: ' 13 CAI Q � D lilj 5 We are providing you with an Owner - Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner - Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS: Please read and initial each statement below to signify you understand or verify this information.) W1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner - Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner - Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner - Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. F ns 2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. K V 3. 1 understand as an "Owner- Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. Rb 4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. W5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. R8 6. 1 understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. R7. I understand under California Contractors' State License Law, an Owner - Builder who builds single - family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. D8. I understand as an Owner - Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. 01979e7Builde1Foi771 2010.doc revised 04114110 ft 9. 1 understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1- 800 - 321 -CSLB (2752) or www.csib.ca.gov for more information about licensed contractors. Rb 10. l am aware of and consent to an Owner - Builder building permit applied for in my name, and understand that I am the parry legally and financially responsible for proposed construction activity at the site address listed above. 96 11.1 agree that, as the parry legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner - Builders as well as employers. .312. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner - Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECT IONS: Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's si atur . Property Owner's Signature: Date: --------------------------------------------------------------------------------------------------------------------------------------------- (NOTE The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner - Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner - Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Tel No Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: 01V7?eJBui1derF07?n 2010. doe revised 04114110 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: 10913 U /2,/_- PERMIT # 3 12.0 060 OWNER'S NAME: J-4. PHONE # 38 =Z� L 3 GENERAL CONTRACTOR: 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 CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information:. ►7 Owner / Contractor iature 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 ►7 Owner / Contractor iature Date s it 3 i a • `iid • .. . �. i% � M M- l �ii•TrMi WA4WYdr -- •�r� t PROMME ■■ 0 on R■■!� . ■ ■■ . . ■ ■11■■.�. 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MUM 11■,:.11N t ■[1`il�t� E M ■n ill ��■i' OMNR.NM--'A'■■■R. i ■i ■ ■■ ■ ■ ■�1 / ■��: ■ ■M iiO■E� ■■■■■■ No ■■■ ■!��!!�� o r■■ ` ■■MEMO ■MEMO■ Y■i/ ■i ss .�,,�!�!������i ■ME ■i■ ■ =ice■ ' " r � 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: � ��` >��,�, � UI%�_ �iG� OWNER'S NAME: KI ( A /1 kJ) �` �� N .��. PERMIT# -2 Z- 0 �7C�) PHONE # `f D� � � �; _ Z -4 GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS:. CITY /ZIPCODE: *Our municipal code requires all businesses working in the city to nave a k-acy of t uperuno uusu►ess �►.UMV. 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: Signature Please check applicable subcontractors and complete the following information: Date Owner / Contractor S gnature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing , Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping j Lathing r.4Paintin( Masonry / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor S gnature Date