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13110179 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10531 STOKES AVE CONTRACTOR:SEARS HOME PERMIT NO:13110179 IMPROVEMENT OWNER'S NAME: TAN TZU CHIN `: 1024 FLORIDA CENTRAL PKWY DATE ISSUED:11/27/2013 OWNER'S PHONE:4084835384 LONGWOOD,FL 32750 - PHONE NO:(925)245-2000 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIALU License ClassGtr CIO Lic.# 72- /3 7 / BATHROOM REMODEL 72 SQ FT TO INCLUDE M,E,P'S Contractor - OWt [M _ Date 1 `2 '7 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 epeance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$11035 nd will maintain Worker's Compensation Insurance,as provided for by 3700 of the Labor Code,for the performance of the work for which this APN Number:32648033.00 Occupancy Type: s 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 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 0.74 granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: �� with all non-point source regulati=. Date Code,Section 9.18. RE-ROOFS: Signature - 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. ❑ O R-BUILD DECLARATION Signature of Applicant: Date: I hereby affirm gat I a mpt frmn the Contractor's License Law for one of the following axons: 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 Manag went District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Cod apter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,an 4. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: 1 /Z7 17 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 C S ON 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 MEP COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 16� CUPERTINO (408)777-3228•FAX(408)777-3333•buildingacupertino.org MISC PLUMBING MECHANICAL ❑ELECTRICAL []MISCELLANEOUS PROJECT ADDRESS `O / ' �O APN# 2_� //F/�/ OWNER NAME �I^ L7, ��I PHONE - -S g� EG-MAIL(/ STREET ADDRESS G - CITY,STATE,ZIPFAX O 5T©Ke E C_()P-,ZC^A - 9sd CONTACT NAME BERNIE MATHESON PHONE925-245-2013 E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX 283 E. AIRWAY BLVD. j� LIVERMORE,CA 94551 925-245-2017 ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT u CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTORNAME LICENSENUMBER 721379 7 LICENSE TYPES C10 BUS.LIC# BERNIE MATHESON C17 C6 COMPANYNAME SEARS HOME IMPROVEMENT E-MAIL FAX 925-245-2017 STREETADDRESS 283 E. AIRWAY BLVD. CrFY,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 USE OF ❑SFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN W B.DLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF WORK ?'4 `QC_ _ 3 _t0,=J C A,0 ` / C 5#0"L,7 "t—ji) (krC I IG_-7 L -A A j - f /,/,/ TOTAL VALUATION: ! / `-� 2 RECEIVED By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on theperry owner's behalf. I have read this f W application and the information I have provided is correct. I have read the Description ofy it is accu e. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize represe of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: I I r Z f/ 3 CEMENT TION REQUHZED OF E USE ONLY �Ww OVER-THE-COUNTER r" ❑ EXPRESS ❑ STANDARD U a ❑ LARGE a ❑ MAJOR MEPMiscApp_201 L doe revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION M ADDRESS: 10.531 stokes ave DATE: 11/27/2013 REVIEWED BY: Mendez APN: BP#: 'VALUATION: $11,035 xPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY PENTAMATION 1 R3SFDREM USE: SFD or Duplex PERMIT TYPE: i wORK bathroom remodel 72 sq ft to include m e 's SCOPE a �F ; Mwi d1,„r 109 m.s.1E Xtech.Plan Check Plumb.Plan C'du;ck F_lec..Plan Check �fech.Permit Fee: Plumb.Permit Fee: Elec. Permit fee: rf,/,h. ;Wech.Insp. other Plumb Insp. Other Elec.Insp. Insp.Fee: Plumb. hisp.Fee: Elec.Insp.Fee: 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 prelimina information available and are only an estimate. Contact the Dept-for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef.7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 72 s.£ Remodel,Bath(<=300 sf) Suppl.PC Fee: Reg. ® OT 0.0 hrs $0.00 $626.00 IREAfl?ESBAT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee-0 Reg. Q OT Q,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consttztction 1 pax: Administrative.Fee: Work Without Permit? ®Yes (E) No $0.00 Advanced Planning Fee:.. $0.00 Select a Non-Residential 0 Building or Structure 0 !ravel Documentation Fees: Strong Motion Fee: 1BSEISAECR $1.10 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 �, $2.10 $626.00 ,._ . Ai�'�E $628.10 � � Revised: 10/01/2013 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10.531 stokes ave DATE: 11/27/2013 REVIEWED BY: Mendez APN: BP#: `'VALUATION: 1$11,035 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Duplex PENTAMATION 1 R3SFDREM USE: p PERMIT TYPE: A WORK bathroom remodel 72 sq ft to include m e 's SCOPE r ,a MOVE t A llech. Plan Check PluniL Plan Check Elec.Plan Check Adech.Permit Fee: Plumb.Permit 1'ee: Elec. Permit Fee: Fhl',h. Li Ifech.In.sp. Other Plumb Insp. ET 011rer Elec.InImp. Fee: PlurnlJ. hrslr.Fee: Elec.Insp. Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,eta). These ees are based on the prelimina information 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 Fee: $0.00 72 s.f. Remodel,Bath(<=300 sf) Suppl. PC Fee: Q Reg. .® OT 0:0 1 hrs $0.00 $626.00 IREMRESBAT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Feer Reg. ®OT0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: F-1 I L Administrative Fee: Work Without Permit? ®Yes G No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential 0 TrUv xl Doetanentation Fees: Building or Structure Strong Motion Fee: IBSEISMICR $1.10 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 9 s $2.10 $626.00 $628.10 Revised: 10/01/2013 • U sc Z_ Cn I— U O O O d O CM r M 27- pp s. l� Cl- p m 7 7Q ,z U - - Q CD LU Z LU (N)TOILET w a (N)SHOWER&SURROUND W/ ,� 1 o o VALVE CHANGE-OUT (N)FAN w (E) (E)(E) (E)LIGHT TO REMAIN Y a0 ' (E)CLOSET i� w_-r A ENT r .y-LO?AAENT pEPTING LUrn mU � jNASION-CUPER C-:) ROVED '��� kept at the — ''-' ifications MUST p _ - ,�.S and spec ul to make-any - -- � �R ilda c.D o is s a p nstruction. It is unl0 0 � ' z' b site dur►res ce or to deviate Building©epalnent ,�, _ cc changes or alterations on same, pf;Icial- r- w approval from the Building �°- erefrom,w1thout app 1 ®13 0 ifications SHPT-L 40T PROPOSED G� r C-3 e romping of this plan anad SPW of the violation BATHROOM DETAIL ��^^ - CC)iviPL.IANCE CAT, 11.19.13 be =' t� �Rr11t Or anbe City Ordinance or State l e�• I:OF' 000a SCALE `f 'ra'�iti'iJions REVIEW` o� NISI✓ B OFAWN BY DKW ,3 Reviewed y' SCOPE OF WORK: -r JOB 16386904Az P;M (N)SHOWER&SURROUND REPLACEMENT W/ BFEE< � � VALVE CHANGE-OUT.(N)TOILET&(N)FAN. A-2 F�L y U Z U I— U o C3o cl- C rM 00 8-Ou+ C Lo Q Lu C:) U J r >O Q w (E)TOILET TO BE °- w - o ac (E)SHOWER&SURROUND REPLACED +i 2i o N TO BE REPLACED M = r Lu cn (E) (E)(E) � (E)LIGHT TO REMAIN 10 (E)CLOSET s Lu 114- T 17-1TINo z Lu Lo o LLpart hent ,s o �40� 2 , 2013 z � o� ��L.IANCE � r•!7C " REV ED FOR o IEWCODE CO° -/J,a_/* T EXISTING U Reviewed BY: BATHROOM DETAIL DATE 11.19.13 SCALE NTS aAYMBY DKW SCOPE OF WORK: " 16386904A (N)SHOWER&SURROUND REPLACEMENT W/ VALVE CHANGE-OUT.(N)TOILET&(N)FAN. SHEET A-1