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13120052CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22284 N DE ANZA CIR CONTRACTOR: RATTS CONSTRUCTION NO: 13120052 OWNER'S NAME: BLAINE RICHARD A AND SHARON TR tPERMIT 49 MARTINS BEACH RD SSUED: 12/05/2013 HALF MOON BAY, CA 94014 NO: (650) 492.5901 OWNER'S PHONE:. 4082576410 JOB DESCRIPTION: RESIDENTIAL COMMERCIAL El LICENSED CONTRACTOR'S DECLARATION Lic. # 5 Lo 31 REMODEL MASTER SUITE BATHROOM TO INCLUDE License Class ,I —21,11,ntractor-21,11,X14 Cv_ 6N Date S 3 NEW COUNTER TOPS, FIXTUERS, WIDEN DOORWAY, Co I hereby affirm that.1 am licensed under the provisions of C , apfer 9 Section 7000) of Division 3 of the Business & Professions REPLACE AND RAISE FLOOR IN SHOWER.... MODIFY LIGHTING IN (commencing with 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: $20000 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: 35602028.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the aboveinformation 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 180 DAYS IM LAST CALLED INSPECTION. upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,if costs, and expenses which may accrue against said City in consequence of the Issued by Date: °l 9 granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the C ertino Municipal Code, Section 9.18. RE -ROOFS: Date Signature Dat 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 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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) HAZARDOUS MATERIALS DISCLOSURE I, as owner of the property, am exclusively contracting with licensed contractors to the (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the I construct project California Health & Safety Code, Sections 25505, 25533, and 25534. 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 Code, Section 25532(a) should I store or handle hazardous declarations: ' I have and will maintain a Certificate of Consent to self -insure for Workers Health & Safety material. Additionally, should I use equipment or devices which emit hazardous defined by the Bay Area Air Quality Management District I Compensation, as provided for by Section 3700' of the Labor Code,:. for the air contaminants as will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and performance of the work for which this permit is. issued. the Health & Safety Code, Sectio s 25505, 25533, d 25 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 Owner or authorized agent. Date: permit is issued. 1 certify that in the performance of the work for which. this permit is issued, I shall not employ any person in any. manner soas to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I I hereby affirm that there is a construction lending agency for the performance of become subject to the Worker's Compensation provisions of the.Labor Code, I must work's for which this permit is issued (Sec. 3097, Civ C.) forthwith comply with such provisions or this permit shall be deemed revoked. 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, may accrue against said City in consequence of the I understand my plans shall be used as public records. costs, and expenses which 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 Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION r� 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUFERTCNtJ (408) 777-3228 • FAX=ALTERATION/TI 33 • building(d)cupertino.org tv� ❑ NEW CONSTRUCTION ❑ ADDITION ❑ REVISION/ DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS APN # OWNER N ° 1 Imo\ PHONE lqD 91 - �'_'� ��O E- trvrP•�ln4t_1 / S� g STREETZ C STATE, ZIP -4 I N Q ��� t FAX CONTACT NAME PHONE 7;E-nMAILGinn STREET ADDRESS .� C STATE, ZIP ( I FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT WICONTRACTOR CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT C NTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # s 3 COMPANY NAME I E-MAIL - FAX EXISTING USE PROPOSED USE CONSTR. TYPE I #STORIES USE TYPE OCC. SQ.FT. VALUATION (�) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN T OTHER REMODEL AREA Q D REMODEL AREA REMODEL AREA []ATTACH BldgApp_2011.doC revised 06121111 STREET ADDRESS S � CITY, l E, ZIP rygO i PH01\�y ARCMTECT,TNGINEER NAME LICENSE NUMBER BUS. LLIIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK` / I " / ( ( 1 k EXISTING USE PROPOSED USE CONSTR. TYPE I #STORIES USE TYPE OCC. SQ.FT. VALUATION (�) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN T OTHER REMODEL AREA Q D REMODEL AREA REMODEL AREA []ATTACH BldgApp_2011.doC revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 22284 n de anza cir DATE: 12/05/2013 REVIEWED BY: mendez APN: BP #: -VALUATION: $20,000 *PERMIT TYPE: Building Permit' PLAN CHECK TYPE: Alteration / Repair PRIMARY PENTAMATION 1 R3SFDREM USE: SFD or Duplex PERMIT TYPE: WORK remodel master suite bathroom to include new counter tops, fixtuers widen doorway, replace and raise SCOPE I floor in shower_..modify lighting in master suite.. 80 sq ft Ltech. Plan ("heck Phimb. Plan Check Elec. Plan Check �1ech. Permit Fee: Plumb. Permit fire: Elec. Permit 1,ee: t)ilrer ;b9ec Fc. Insp.E171- Other Plumb 7rup. Other Elec. Insp. Li dlech. Insp. Fee: Plumb. Insp. Fee: Elec. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (Le, Planning, Public Works, Fire, Sanitary Sewer District, School 4— n_, fns nddn l in fin_ FEE $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Iugle unu "Io u u -- --- - - QTY/FEE MISC ITEMS 80 s.£ Remodel, Bath (<=300 sf) $626.00 I REMRESBAT $2.00 $1.00 $3.00 $626.00 0 Select a Non -Residential 0 -1 Building or Structure Select an Administrative Item EE , $629.00 Revised: 10/01/2013 FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13) Plan Check Fee: Suppl. PC Fee: Q Reg. Q OT 0.0 hrs PME Plan Check: Permit Fee: Suppl. Insp. Fee -.0 Reg. Q OT. 00:0 hrs PME Unit Fee: PME Permit Fee: Construction Tax: Administrative .F'ee: Work Without Permit? ® Yes (j) No Advanced Planniniz Feer Trai>el Documentation Fees: Strom Motion -Fee: IBSEISMICR Bldg Stds Commission Fee: IBCBSC FEE $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Iugle unu "Io u u -- --- - - QTY/FEE MISC ITEMS 80 s.£ Remodel, Bath (<=300 sf) $626.00 I REMRESBAT $2.00 $1.00 $3.00 $626.00 0 Select a Non -Residential 0 -1 Building or Structure Select an Administrative Item EE , $629.00 Revised: 10/01/2013 Codes: 1. 2010 California building Code w 2. 2010 California Mechanical Code o 3. 2010 California Plumbing Code 4. 2010 California Electrical Code `.,. <„ , ', , .,r, i.t „. ,:ii . v, „f ,.. , x', . , ,v.`: 5. T24, Para 6. California Energy Code (20 10) m CLOSET -- 6. 2010 California Residential Code 7. 2010 California Fre Code � 1 ( 8. Cupertino Municipal Ordinances z 9'-4" x 2'-2" 15' 0 Scope: o i 1. Replace and raise floor In shower 2. Widen doorway to master bath to 3068 3. Replace vanities and counter tops o z ----T W Nr ° OFIr"ICE 4. Modify lighting in master bedroom i 5. Replace fixtures over vanities 6. New 20A dedicated circuit for bathroom vanity 7. Add Occupancy Sensors for lights COro 5' FIV N 01 0 X N MASTER B D R M - 8.Install CO detectors per 8315.1 9. Install Smoke Detectors per 8314.3 O FEol) CV m mENT CUPERTINO 04 \ APPROVEo u y... , . jobSited J PIZ" and specificati MUST be e ging ons kept 1� 22'-10° at the construction. It is unlawful to make an changes or alterations on same,y therefrom, without r r\--2 -- a royal from to PP Existing deviate the 9 Official. The Stamp- of this � plan and by hold to specifications SHALL NOT permit or to N " be an approval of the violation of a1Y provisi sof any Ci tY Ordinance z °" o m � a � -2 or State Law. �e E v d' NOON 2868 THE ® C' •s J �l vOi a U N m W Oo O ui „ R"'AIT No. Z c0 ovi G= z� M E N N O. z 0. h to NU Q ILL f>. 4068< 4M 15' G �/ �W (M 2 1 "69 34E °k. 3z5. �/ t l OC I MASTER BDRM a' ; �n" gP,yE rA�°``�..• y�� �- / 1-011 1 11 15x14-1 I:~ `sj L n \ a -- -_ D U xC 2 co AT 00 O M rJ 4 `� �'° ,. ,- ..�� DE 4 ACIRCf,E \ y CUPERTINO a a �� Building D[)c;r 71ef1( s. / De 44 11/20/2013 SCALE: - --_ -—-- �w i .. e. R`<e salt' i l i w r WWr i Km`xRv?.%a...:.ye YY%4i,•Y.,.�s,iiti.+✓'�d. �,i,..:f..tir9'�Yl. E,11.1 Mt?tlS 14Pe..:':;4 Y x Z$'X12.:,...jrS'Sai,J•'tiyi'l�.irL�,-.• REVIEWED FOR Y ODE of NCP L...I�, ��IM17 / 1/4" _ 1 ;!i. Y" .1. %4h i't�':M.V`f.,:..2 = 2 F:'iyrN ,.a. ,..•J 3': e!.,R., Reviewed B R � SHEET: t--- 22'-10° A-1 Proposed W a m z 0 knz i i FF I b o -...v...._ z Elevation 1 Section of (E) shower floor ®®q n M I n®® Scale 1/2" = 1' m _ 0 O 0 g c 0 U 4..D( 8153'21 82432E 1 DB1832 B2432R4D( 81532 � t LTJ Cut (E) tile 12" above FF, L-J o£ preserve waterproofing �- and wire Elevation 4 ® Scale 1/2"= T Y' __ -- Slope (N) floor 1/4" per 1' to drain i FF z N (N) floor framing under shower 0 o Uu C O V) 2 UQ m CO y O �b Elevation 2 °zgw E W o X n, 2 Section of (N) shower floor ( CUPERTINO 3 tr�i�a m Scale 1/2" = 1'W' �:M ( Buildin g Deparn_nent REVlEw ic C U 20,E OR CODE COMPI..►!.,NCF o ReviemEd By. 0 (E) Wire `" o � (E) Waterproofing layer —--____— = L > 0 w u (N) Wire, tuck behind (E) wireUL 2 a U m m Z 4-Jrnmo., � ♦iU� S� (N) Waterproofing membrane floor. ; Bring 12" min. up _- 1 DB36126 wall and tuck 11/20/2013 behind (E) waterproofing SCALE: See Elevations Shower floor waterproofing tie in Elevation 5 SHEET: Scale 1/2" = 1' A-2 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: Z -22 -'?y e 0— PERMIT # (':S 12, Q 0!9'2, OWNER'S NAME: PHONE # '-k)-2-9) GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: * A19 Mk&l CITY/ZIPCODE: 2 *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 Please check applicable subcontractors and complete the following information: Date 6/ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / GlazingAa&lefi-L':9 13!5 Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper 'r / _ ©� `'-00I533 Paving Plastering Plumbing pp �W,tt` ,V AC obi Roofing Septic Tank Sheet Metal Sheet Rock Tile`o e - P (,c� Owner / Contractor Signature Date CUPERTINO SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building )cupertino.org Z gam/ . A /' Permit No. 131 z 6003 7— Address 2 C 7 /U� • ��1n: -'s 4 # of Alarms Smoke: S Carbon Monoxide: 'Z - PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CSC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. I have read and aaree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: Signature.................................................. .............. ........................................ I........ Date:................... Contractor Name: � lZo11 'h1S r! Signature...(... Lic.# .../...?.1.fA...I.......... Date: ..�1�..1... Smoke and COform.doc revised 03/18/14