14030014I CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10501 FLORENCE DR I CONTRACTOR: M.S. TORCHIO CO PERMIT NO: 14030014
OWNER'S NAME: JON HABETS 1 1188 BRITTON AVE I DATE ISSUED: 03/05/2014
OWNER'S PHONE: 4088937094 1 SAN JOSE, CA 95125 1 PHONE NO: (408)998 -5800
❑ LICENSED CONTRACTOQQR'SS DECLARATION
License Class_ Lic. # U—g Q �7
Contractor 3. fJ) (,��� 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:
r1mve 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 /ialthe against said City in consequence of the
granting of this permit. Additio applicant understands and will comply
with all non -pomt s rce%�gulaer the Cupertino Municipal Code, Section
918. �//"
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.
Date
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL E]
RECONFIGURE & REMODEL (E) KITCHEN, INCLUDING
REMOVAL OF NON -LOAD BEARING WALL. CLOSE 1 (E)
WINDOW & REPLACE 1 (E) WINDOW WITH (N) DOOR
(SAME
Sq. Ft Floor Area: I Valuation: $54000
APN Number: 32635038 00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM-rA-97 CALLED INSPECTION.
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 M nicipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 2j5f, 255f3, and 25534.
Owner or authorized agedt: / �l— Date:_T_T
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
CITY OF CUPERTINO
WARM III PP FCTIMATnR — RITILDING DIVISION
I&' ADDRESS: 10501 FLORENCE DR
FEE
DATE: 03/05/2014
REVIEWED BY: MELISSA
APN: 326 35 038
BP #:
*VALUATION: 1$54,000
*PERMIT TYPE: Building Permit
280 s.f.
$626.00
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE: p
Suppl. PC Fee: Q Reg. 0 OT
PENTAMATION 1 R3SFDREM
PERMIT TYPE:
WORK
RECONFIGURE & REMODEL E
KITCHEN INCLUDING REMOVAL OF NON -LOAD BEARING
SCOPE
WALL. CLOSE 1 (E) WINDOW & REPLACE 1 (E) WINDOW WITH (N) DOOR (SAME HEADER)
1, i n c /Pl wb. Alan Ch C
tilc(ir. Perwit Fee: f1h,,m =. Permil Fee. t 'r c _ Pe;r rii I Lie:
3r`Trc -tl -r dr. rl,V ,. Oeher Plumb Iris /.>. other ElCc. insp.
P7zrwh � Ins"),
NOTE: This estimate does not include jees due to other Departments (i e. Fianning, rumic rror/cs, Tire, aunuary .ewer "ts/r/u, w/
___1 _ .._ I ..,.., .,...b...., nof:.m.nfo /'n i—i tho nont fnr addn'I info_
FEE ITEMS (Fee Resolution 11 -053 Eff. 711113)
FEE
QTY /FEE
MISC ITEMS
Plan Check Fee:
$0.00
280 s.f.
$626.00
Remodel, Kitchen (< =300 sf)
1REMRESKIT
Suppl. PC Fee: Q Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
L-2-1 #
$418.00
Window / Sliding Glass Door
1WINREP Replacement
Permit Fee:
$0.00
Suppl. Insp. Fee: Reg. C) OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Con-,-frvcf ion
r ; irtl..rc;rt. f'
0
E)
Work Without Permit? ® Yes (F) No
$0.00
Advanced Planning 1� ee:
$0.00
Select a Non - Residential
Building or Structure
0
�
1'7_Lfi;iul l o "itiacrlfai,i n fees:
Strong Motion Fee: 1BSEISrt1ICR
$5.40
Select an Administrative Item
Bld£* Stds Commission Fee: 1BCBSC
$3.00
r
1), R��W_
$8.40
$1, 044.00
°. `� ` " TOTAL FEE:
$1,052
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:
PERMIT #
OWNER'S NAME:
PHONE #
GENERAL CONTRACTOR: s' oV v
BUSINESS LICENSE #
ADDRESS:
CITY /ZIPCODE: ` g5
*Our municipal code requires all businesses workiAg 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:
G/
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
Date
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COMMUNITY DEVEI_O ?afEr;T DrPA °TMENT
BUILDING i}fVfSiC)N - CUPERTINO
AP ate,
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This set of plans and sP8c ifications MUST b 9 kept at the
job site during * ti n. It is unlawful t
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Yn r Trom, without a I -. -° —,« W
approval from the Building Official.
A ping of thT
to permit or to
f the violation
r s of rdinance or State Law.
DATE - :P"-- =-,
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CUPERTINO
Building Department
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CAMPBELL, CA 95008 408.377.777 1
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Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014 -3255
C U P E RT I N O Telephone: 408 - 777 -3228
Fax: 408 - 777 -3333
CONTRACTOR / SUBCONTRACTOR LIST
JOB ADDRESS: 1Qg6j —
PERMIT #
OWNER'S NAME: fi PHONE # �' Z
GENERAL CONTRACTOR:
BUSINESS LICENSE # 7
ADDRESS: ? (� �(, f^ 'lc G �.J CITY /ZIPCODE: 91 ;
'Our municipal code requires all businesses worki g in the city to have a City of 01nertinn hncinPCC lirnnen
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDuL- E 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:
✓
SUBCONTRACTOR
BUSINESS NAME
j L, – , -
BVS- -INESS LICENSE #
/J
/
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
— <
Date
11