The URL can be used to link to this page

14030004 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10846 LINDA VISTA DR CONTRACTOR:DMD GENERAL PERMIT NO: 14030004 CONSTRUCTION OWNER'S NAME: ANAT-GILLER SACHS 4697 CLARENDON DR DATE ISSUED:03/03/2014 OWNER'S PHONE: 4082198175 SAN JOSE,CA 95129 PHONE NO:(408)373-2911 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL _ REMODEL(E)HALL BATH,INCLUDING APPLIANCES& License Class Lic.# �� FIXTURES(47 S.F.) Contractor 01-W12 CEA66+ Cf9J'JAA10atea/y _y 2 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 erformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$10000 Mhave 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:35614049 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 DACALLED 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 com Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9 18. ��y 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 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 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 Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this 3 Zp/ Owner or authorized agent: Date: 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.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 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION A, 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 GIJptR"`t"INO (408)777-3228•FAX(408)777-3333•buildinga-cupertino.org U� ❑NEW CONSTRUCTION ❑ ADDITION ❑ALTERATION/TI ❑ REVISION/DEFERRED `ORIGINAL PERMIT# PROJECT ADDRESS (� t r 4r_ APN# /I (" / ' 04 9 OWNER NAME PHONE n 2/ _7�('O�_ &MAIL _` F}NVt I Lt — S�1GH �A STREET ADDRESS CITY, STATE,ZIP FAX 14 6I/N D,4V1!;—,A D 2 P :/,,10 9510/4 CONTACT NAME ��SS PHONE,, HONATE,^ZD�? J �y / "NDODv,7Kt OG�NEe/tt Y,`HQ0-G,'7 FAX STREET GAD ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENr CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAMEHA - LICENSE NUMBER LICENSE TYPE BUS.LIC# ( COMPANY NAME �� E-MAIL FAX ?u71) G�e�fP.fK S�, l NC Dt� G�C2fiC Y.9arbo, cor! SIRE T�DDRESS CITY,STATE,ZIP PHONE 6 X 2Ae-: Q r?A c!9- 4570 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK er pop /sifr16 ell;-9C 00/7 ►tja&-6 iv 140,3 Ee N r 4 .v� uE �yA�irU6 aim; EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NEr AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA - PORCH AREA DECK AREA I TOTAL DECK/PORCH AREA I GARAGE AREA: Q DETACH ATTACH #DWELLING UNITS: ISA SECOND UNIT ❑YES SECOND STORY ❑YES BEINGADDED? [JNO ADDITION? [3NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES AL VALUATION: PLANNING APPL# NO PLANNING APPROVAL LETTER EICHLER HOME? NO r'I.O Q By my signature below,I certify to each of the following: I am the property owner or auth to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to bui din construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLE >051TAL INFO TION REQUIRED '= CIS ; i New SFD or Multifamily dwellings: Apply for demolition Permit for � � -za; � - >u•, "j� existing building(s). Demolition permit is required prior to issuance of building permit for new building. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ' form if any Hazardous Materials are being used as part of this project. t• '' t _Copy of Planning Approval Letter or Meeting withPlanning prior to submittal of Building Permit a lication.Pp � � . BldgApp_201 Ldoc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10846 LINDA VISTA DR DATE: 03/03/2014 REVIEWED BY: MELISSA APN: 356 14 049 BP#: *VALUATION: 1$10,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair ________[PRIMARY PENTAMATION 1 R3SFDREM USE: SFD or Duplex PERMIT TYPE: WORK REMODEL E HALL BATH INCLUDING APPLIANCES & FIXTURES 47 S.F. SCOPE ... , r b9cti. 1'fura C'dicr 111,1w1h. Plait t:'hecA tileca_ f'crririt Ic>>; Plydrn,h. Termlt 1<ee,; I,i;r r'�rt =� z Ins;1 0fl,W•Pliimti his, Utliei Lcr r e uisjl. I°�3 . I hinih. Iaisp.Tea: 5fef:_Ins'n f :e: 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 E . 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 47 SX. Remodel,Bath(<=300 s fl Suppl. PC Fee: Q Reg. ® OT F07 his $0.00 $626.00 1REMRESBAT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee:(D Reg. Q OT 0,0 his $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? ® Yes Q) No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential E) Building or Structure Travel/1 )("Ifi crif(t7ion Fees: � Strong Motion Fee: 1BSEISMICR $1.00 Select an Administrative Item Bldu Stds Commission Fee: IBCBSC $1.00 $2.00 $626.00 TOTAL FEE: $628.00 Revised: 01/15/2014 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: jo,846 LI PD4- vi.a a9ZTWo c,4- PERMIT# 1q0-7000 OWNER'S NAME: CWCR — 57,4C6 PHONE# 140e -31-13---0911- GENERAL CONTRACTOR: VID• qACtok 6DI4 . IPC BUSINESS LICENSE#:. ADDRESS: 4647- Ct,4Cri1,,Dop 2ke 5,4,E osl' CA X119 CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of,Cupertmo 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: a� 1�14 Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/Glazing Heating Insulation J zz Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date PriQA t' 10806 Lrrvl.r4 Ct-4 PE2 7 r N0 CR q 5171� r l +� -►o ;-WA T t Ar T o Icy i EX[ Z I N �Rr N��7 1 fsclo . 'u I N�� FxN+1u� i=A:1 t�ts��iJ� �Cs•►�s� �I�itt�C+ I �t Si�Ivb St'�tlirs�i li K}-fli6�i M ' s ' T t-,a, 1 I _. I I 4 N y VAG05 i �t I COMMUNITY DEVELOPMENT DEPARTMENT ' (POST 1 rw Sffocs E vs'�tV� BUILDING DIVISION-CUPERTINO APPROVED 't.�Dd i`Yur�g�N6t,v� rr�s:c4GL ,titJ ThIS set of plans and specifications MUST be kept at the jab site during construction. It is unlawful to make any e='L4 C�e FXt 57(yj G cl ranges or alterations on same,or to deviate t�"S<r4L therefrom,without approval from the Building Official. ► 1=1 ©` ` r'� v4,v 1'`7 Tho stamping of this plan and specifications SHALL NOT ' l ` L S/to� -EF— `'EC``f) bo held to permit oLULbslm l of the violation � 649ao fv . of any nsice or State Law. DATE � t, 3 13 ! q PE191WT.NO. UUPERTINO �3uilding Department0 FF� 3� Ad" AR 0 3 2014 F 4 REVIEWED FOR CODE COMPLIANCE Reviewed By. �_"�