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14010103 CITY OF CUPERTINO BUILDING PERMIT BUILDING PHONE NO: ❑ LICENSED CONTRACTOWS'DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL II License Class Lic.# REMODEL GUEST BATHROOM,1/2 BATHROOM AND I�ZREMOVE Contrac Date AND REPLACE WATER HEATER 70 SQ FT I hereby affirm that Iceased 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. a 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:$16000 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:32644041.00 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 countyordinances avid state laws relating WITHIN 180 ELAYS 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 F 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 granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: / with all Cupertino Municipal Code,Section 918. RE-ROOFS: Signature Date '' 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 fvpges 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. 1 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: - 9 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 Management District I performance of the work for which this permit is issued. will maintain compliance with the`Cupe ' o Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,, 25534. Section 3700 of the Labor Code,.for the performance of the work for which this Owner or authorized agen Date:1 r L4.~j 7 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 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. .. 'onally,the applicant understands and will comply with all non-point sour regu do er the Cupertino Municipal Code,Section Licensed Professional 9.18. Signatur Date 1��1� CONSTRUCTION PERMIT APPLICATION % [1 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION \v 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildingCaD-cupertino.org ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESSD�� � �/� L� APN# -.?__1 Z r Ij LL [o/w6R NAME /7 ` ET ADDRESS CITY, STATE,ZIP FAX /MAI /J r \^,CC 0157- CO C Cc✓� IL ��O(� PHONE 31 Y a G �lGy �S .�GGY✓�lD/L C.�S �X J /VGT" STREET ADDRESS s C/4 CITY,STATE,ZIP 7 FcOnN.,CYNAME OwNER-BUB.DER ❑ owNER AGENT CONTRACTOR. ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT AME LIC E NUI,oiBER LIC YPE BUS.LIC# 7/1 E-MAII 'OWI 11 vG ON C/h TREET ADDRESS CITY,STATE,ZIP PHONE ARCHITECTIENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK %2 45� A10 v✓ a EXISTING WSE PROPO,ED USE STR TYPE #STORIES ` S� USE TYPE OCC. SQ.FT. VALUATI NEW FLOOR DEMO AREAL !D AREA OV//,f AREA _729 NETAREA-51f� 0&�J BATHROOMA KITC OTHER REMODEL AREA 7tJ REMODEL AREA REMODEL AREa„------ ���J_ `7 r� B o o PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH 0�- � I .^moi ATTACH IA�r- -,..� CJo�• CP #DWELLING UNITS: IS A SECOND uNrr YES SECOND STORY AYES V V BEING ADDED? ADDITION? NO i PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN 13YES ItBCETVED Y Tout VALUATION: PLANNING APPL# ®NO PLANNING APPROVAL LETTER EICHLER HOME? O a z= By my signature below,I certify to each of the followin the property owner or authorized age act o e property owner's behalf I have read this application and the information I have provided is eorre . I ha read cription of Work and erify itis acc te. I agree to comply with all applicable local ordinances and state laws relating to buildin ction. o' re sentatives of Cupertino abov -identified property for inspe on purposes. Signature of Applicant/Agent: Date: f `l(ta ���L SUPPLEMENTAL INFORMATI D P Hou tuvc sLlr _New SFD or Multifamily dwellings: Apply for demo Rion permit for oa ` existing building(s). Demolition permit is required prior to issuance of buildin "$mtDnrG_PLniv REvn�w permit for new building. QyExi�REss © I! GM REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ©„slaz�Da to. ❑ ruBLICWORKs form if any Hazardous Materials are being used as part of this project. LARGE ❑ FfItE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to sAxtrARY sEwz x nIsTRECT submittal of Building Permit application. ter? � �,`ENVIRObiMENTALHEALT� CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10550'cast!no In DATE: 01/16/2014 REVIEWED BY: Mendez APN: BP#: *VALUATION: 1$16,000 *PERMIT TYPE: Building,Permit PLAN CHECK TYPE: Alteration / Repair PRIMARYPENTAMATION USE: SFD or Duplex PERMIT TYPE: 1 R3SFDRE i WORK remodel questbathroorn, 1/2 bathroom and remove and replace water heater SCOPE :tech.Plan Check Plumb.Plan Check 0.0 hrs $0.00 Elec.Plan Check .kfech.Permit Fee: Plumb.Permit Fee: IPPERMIT Elec. Permit ree: r1" Alech.Insp. Other Plumb Insp. 0.0 hrs $47.00 Other Elec.Insp. .Insp.Fee: Plumb. Insp.fee: Elec.Insp.Fee: NOTE:This estimate does not Mclude fees due to other Departments(Le Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Thesefees arebased on the prefindna information available and are only an estimate Contact the De t or addn'l info, FEE ITEMS(Fee Resolution I P-053 E . 7� FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 70 s.£ Remodel,Bath(<=300 sf) Suppl.PC Fee: O Reg. .O OT 0.0 I hrs $0.00 $626.00 1REMRESBAT PME Plan Check: $0.00 F1 # Plumbing Permit Fee: $0.00 $28.00 1PRWHEATR Water Heater Suppl.Insp.Feer Reg.. O OT'. 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $47.00 Construction :Tax Administrative Fee: 1ADMIN $44.00 O Work Without Permit? O Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential O Travel Documentation Fee: ITRAVDOC $47.00 Building or Structure O i Strong Motion Fee: 1BSE/SMICR $1.60 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 $140.601 $654.00 $794.60 Revised: 01/15/2014 OFFICE OF COUNTY ASSESSOR SANTA CLARA COUNTY, CALIFORNIA 326 44 Lu Scpm or WaR-K- a ® 4—DRIVE— vl n l YeMy^} 1 ^ �,VA\ �, 5.71 3/ G5 G4 o95' Y L/ ' `�1I _12Zvo• 1 — � ��. z 'Cf`• �Q �1N :9 g � "" ��P.M. 1 loo291-M-211 METEOR—e e s�� /JU /� 21498 114)8 1/958 Y/93B t14Y1 Y/D% 'j21°2 ,2I'—• G6 G3 33 r ofZ mc> � �� F� �` � a ! sso7 z i s I s9.3o seas 11$80 7 G 20 —� -43 53 r l0 2 3 1 4 a — j .? �g 1 ��92 XI l09 $P 29 G'I 1 6295 94 _^ a L------- ° 34 w93 92 n49 90 rI I ° 54 /r1 E Lf4I�Ti'• \ {�•- , \L . 7sas X614 zn, I PCL.299../7z.3g 1'" 95 'd/ '" --_--t----- 1� = 100 14 13 I 12 I I I I; 9 2173 21.a/ Ir r? a a 01 95 — y„j M /5 81 ��--io9—_ W c�^ 28 68 I GI - A �' i"' X 63 8i 6/ $ii 10 7a.4�/ SB --,--- 9- - - Ig I a ° Ojv_�+� 'l"i L- - , S R Y �l c-_ r v�, F x�u 1251 L 16�r+'fS o� ��-r S� B -I .,;. 8, 9 W - #9 _ -- - loo 74 22 . Too —�---io;-- — „a // 82 Nla os.ao Ill 27 Efl rl GO 36 .a �r°--'--- ° I' W 11411 P/411 11465 10_°/41511 2N91 L • 51 Y21 yL.g 1-' 20. ?0.22 z 6 Nth' �— MILLARD --- -- �L---- --- _ _ 1.Mp 21410 n M.rp LANE ss _86 �O 8dw 9fo.a �° 73 23 o as s6.zo N --Tp�— a ioo P/94p Q i zbtr p5,4 IS i a �IoS./Y° 26 59 37 ""n' U n RI I I .I 1.41.oe�\ 36 lel ��o a4y 5• `\ +"_I 39 57 V a ; sv ; s/ ; s2 $1 s '1 sa .� ' r \� 83 r" `� 70 «s-- I =1 ^I I 33 A"r -r // /$° /2 \�� 24 /�' 2S \\a ��-- $ 60.04 I I j� ` 58 7!7 3= GREENLEAF R 4Y' 1 I 2 1 3 4 72 74 \ / c _ 2 I I ee 12.80 1 ._0• � 9Q 47 / 165.99 _ V 103.03 Iy AA 120.64 N TRACT Ng 8062 --- N�� = X10 MOD .S RECEIVED A CUPERTINO JAN 16 2014 wilding Department BY JAN 16 2014 ..d REVIEWED FOR CODE COMPLIANCE 4E?vio,r,�pt'j '7 INTERIOR REMODEL FOR: 2 , bu1LD1r,,'G/, ,��, -R i IIo . 7 S 10550 CASTINE AVE CUPERTINO CA 95014-1311 ' This t of plans and spe.cifica'Ionc MUST he kept at the jCJ J co; sti actio it.' t 'li t\V' 11 `.0 =1Ii'any L ' circ' ^ham:, or tC .i Ii�.UE) CONSTRUCTION CMS DESIGNS th^;4 z,) ,Uvith©ut a:;�prow i-j vi she Buiici^;:I Official. 1 SCALE: 1/4" . 1 OF�` ICE 1011 :11t)Inq of thiss pian cart s '. till.atl JY'. /'I+/'\I I NOT ro 1,IQi Oith IJ ob'e^i O�117 VIl}l U;ln DATE• O.`z..1y(3,C v;o. Ons of any aI y a ciI nance OI &--ate- i aw. � APPROVED: DATE DRAWN B cE ,l, i I NO. PAGE: 1 1, AJO s � rig 03 ���so QTc.+!• zI(� 4 v 4C 2 i w ® sMtc,.Ta ST /f N � w►+ �,,nvf� R�N ray 98: INTERIOR REMODEL FOR: Mr3-T of w,Q, 6>000"'I fr �ie�,9At� oyC AVE �U �L' CUPERTINO, CA 95014-1311 i` '``' ftw?i �C� _ Auildinq Denar.ment CONSTRUCTION CMS DESIGNS TITLE 24 RESIDENTIAL LIGHTING CONSIDERATIONS __.. --0AN i ?u14 SCALE: 1/4" = 110" All lighting(hardwired)must be high-efficacy.Exceptions Note.• Eledronic Ballast for a//lamps rated 73w or higher. ��v i E vv E� FUR k �U�� CU�N�iAN CE DATE: jD— Recessed luminaries in all insulated ceilings approved for zero clearance(IC)"airtight". i-reviewed Switch all high from low E.lighting. APPROVED: At least SO%of the installed wattage must be high E.luminaries in kitchens DRAWN BY: Lighting in adjoining areas considered"KITCHEN"unless controlled by separate switch. Alternate option in bathrooms manuol-on/aut"ff vacancy sensors Bedrooms,living controlled by dimmers PAGE• TAMPER RESISTANT RECEPTACLES ONLY. All Bedrooms require smoke alarms and all hallways leading to bedrooms require smoke and CO alarm.