14050006 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11672 VINEYARD SPRING CT CONTRACTOR:AVA CONSTRUCTION PERMIT NO: 14050006
OWNER'S NAME: SAM&NADA GEHA 21060 HOMESTEAD RD APT 216 DATE ISSUED:05/01/2014
OWNER'S PHONE: 4083969568 CUPERTINO,CA 95014 PHONE NO:(408)387-0999
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL
KITCHEN REMODEL(200 SQ FT)
License Class nn ,, c Lic.#/ o 3
Contractorl�t"� �C� Date L9_0L41
y
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
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$15000
VAI 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:36654010 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 UANCE 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 DAY ED 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 Is b
with all non-point source re ulations per the Cupertino Municipal Code,Section
9 18.
RE-ROOFS:
Signature -12Date 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)
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 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 505,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which thisI
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 00
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 \
CUPERTINIO (408)777-3228• FAX(408)777-3333•buildinga-cupertino.org
❑NEW CONSTRUCTION ❑ ADDITION X ALTERATION/TI ❑ REVISION/DEFERRED\ ORIGINAL PERMIT#
PROJECT ADDRESS I t/ 4_1 1 I _ �I Av, I SF ri C-4 APN N �/ �' l� '0/6
OWNER NAME Salts a�,r� YV /��Q��C� eIvel (PHONE y0g_31(-Is6� E-M7AIL
STREET ADDRESS II / VihQ�ar 1 n G,� CITY, STATE,ZIP cofel,_„J ZK.., CA Iyal FAX
CONTACT NAME C�ao� O v r PHONE L.�DlQ^�'�` p E-MAIL( CoLIS1
Q _r
�fGL�. CIrJCCt�c K.C'914%
STREET ADDRESS �'o/ 9W�sfC�J 2E
CITY,STATE, ZIP CA
❑ OWNER ❑ OWNER-(BuiLDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME 7 'v ('„KS�!'a/ _I ``a� LICEN1SENUMBERc1q��/ 13 LICENSETYPE BUS.LIC k
COMPANY NAME V s C E-MAIL n� `�-'/a k FAX
STREET ADDRESS 2(o 6 e3 cop a V_'A-SJ-45!�r d I p J/2 CITY,STATE,ZIP C r+, nfJ' PHONE
ARCHITECT/ENGINEERNAME I` IMICENSENUMBER `j BUS.LIC`4
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK
EXISEI USE PROP USE CONSTR #STORIES
V l USE TYPE OCC. SQ.FT. VALUATION($)
FMSTG NEW FLOOR DEMO TOTAL
AREA AREA AREA NET AREA /fir:���„/
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECK/PORCH ARE I GARAGE AREA: DETACH
❑ATTACH
#DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY [-]YES
/ BEING ADDED? JW ADDITION? Iffivo
PRE-APPLICATION ❑ S IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED'' TOTAL VALUATION:
PLANNING APPL# PLANNING APPROVAL LETTER EICHLERHOME? yf1Q6 �� ,� .
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I have vided 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 Wilding construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
I
Signature of Applicant/Agent: Date: I.,;
SUPPLEMENTAL INFORMATION.REQUIRED =AMN. g 0� .'
��. ���J3ECK;TYPE� _�Y � 20UTI3\G,.SL3$�,
New SFD or Multifamily dwellings: Apply for demolition permit for
UILD}A
existing building(s). Demolition permit is required prior to issuance of building � �� ��'
permit for new building. s aPii>ss s ' j � � vt ORWIMg
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure L7 js D �` usT Ic woxxs
form if any Hazardous Materials are being used as part of this project. '
_Copy of Planning Approval Letter or Meeting withPlaiming prior to = �
�Ofl SAA 9RYSEi1R•DSSTRTCT �
submittal of Building Pen-nit application.
�• n_+�i., � ,. ax�'� `l]."EN�'IROl\'➢4EI�T '"JiEALTAI�_wha3 :
BldgApp_201 1.doc revised 06/21/11
CITY OF CUPERTINO
IIFEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 11672 Vineyard Spring Ct DATE: 05/01/2014 REVIEWED BY: Sean
APN: BP#: VALUATION: $15,000
PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
P
PRIMARY ENTAMATION 1 R3SFDREM
USE: SFD or Duplex PERMIT TYPE:
WORK Kitchen Remodel 200 sq ft
SCOPE
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PERMIT NO. P329324 � v
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CO OD
1�-568" 32" 38" i�718"
219;"
CUPERTINO
HUildin, Deoa q rtment
MAY 9
REVIEVVEL; _UK i;UUE (;OMPI-fAIVCE
Reviewed By �fs,� frr
All dimensions-size designations �(� �. This is an original design and must Designed:4/22/201
given are subject to verification on TsexNoiocPes not be released or copied unless Printed:5/1/2014
job site and adjustment to fit job applicable fee has been paid or job
conditions. order placed.
ADDITIONAL CODE REQUIRMENTS
Energy code mandatory Whting measures:
1. All permanently installed high efficacy luminaires shall be switched separately from low efficacy
luminaires. (150(k)(7))
2. Permanently installed lighting in Kitchens shall be high efficacy luminaires. Up to 50%of the
wattage of permanently installed lighting in kitchens may be in lights that are not high efficacy.
(150(k)(8))
3. Permanently installed luminaires in bathrooms,garages,laundry rooms and utility rooms shall be
high efficacy luminaires OR are controlled by an occupant sensor(s)certified to comply with Section
119 that does not turn on automatically or have an always on option. (150(k)(10))
Plumbing plan notes:
4. Water closets shall have an average water consumption of not more than 1.28 gallons per flush. (CPC
403.2)
5. Shower heads shall have a water flow not to exceed 2.0 gallons per minute @ 80 psi. (CPC 408.2)
6. Faucets in kitchens,wet bars,lavatories, laundry sinks,etc shall have a water flow not to exceed 1.8
gallons per minute @ 60 psi. (CPC 403.6)
7. Shower stalls shall have a clear interior finish area of 7.1 sq. ft. and be able to accommodate a
minimum 30 inch circle at the threshold level. These clearances shall be maintained up to a height of
70 inches above shower drain. (CPC 408.6)
8. Shower compartments and walls above bathtubs with installed shower heads shall be finished with a
smooth,nonabsorbent surface to a height not less than 72 inches(6 ft). (CRC R307.2)
9. The maximum hot water temperature discharging from the bathtub, shower and whirlpool bathtub
filler shall be limited to 120 degrees Fahrenheit. The water heater thermostat shall not be considered
a control for meeting this provision. (CPC 409.4&408.3)
10. A 30-inch clear width for water closet compartment and 24 inch clearance in front of water closet.
(CPC 402.5)
Electrical Plan Notes:
11. The installation of smoke alarms in all of the following areas shall be provided: (CRC R314.3)
a. On the ceiling or wall outside of each separate sleeping area in the immediate vicinity of
bedrooms.
b. In each room used for sleeping purposes.
12. The installation of carbon monoxide alarms in the following areas shall be provided: (CRC R315.1)
a. Approved carbon monoxide alarms shall be installed outside of each separate sleeping area in
the immediate vicinity of the bedrooms and on every level including basements in dwelling
units that have fuel-fired appliances or attached garages.
13. A minimum of two 20 amp small appliance branch circuits shall be provided for all receptacle outlets
in the kitchen,dining room,pantry,or other similar areas. (CEC 210.11(C)(1))
14. At least one 20 amp branch circuit shall be provided to supply bathroom receptacle outlets. Such
circuits shall have no other outlets. (CEC 210.1 l(C)(3))
15. In every dwelling unit,fixed appliances such as food waste grinders, dishwashers,washing machines,
dryers, laundry tray locations,built-in refrigerators or freezers,furnaces,AC units,built-in heaters or
any other fixed appliance with a motor of'/h.p. or larger shall be on a separate 20 amp.branch
circuit.
16. All receptacles in bathrooms,garages, accessory buildings, outdoors,crawl spaces,unfinished
basements,kitchens(where receptacles serve counter top surfaces), laundry,utility,wet bar sinks
(within 6 feet of the edge of the sink), shall have ground-fault circuit interrupter(GFCI)protection.
(CEC 210.8(A))
17. In all areas specified in 210.52, all non-locking type 125-volt, 15-and 20-ampere receptacles shall be
listed tamper-resistant receptacles. (CEC 406.12)
ResKitBathPolicy_2014.doc revised 01/15/14
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: 2 �,� (r�,, PERMIT# V05 e
OWNER'S NAME: ��„� (a,e PHONE# d�- 3°!'6
GENERAL CONTRACTOR: N ti Y o BUSINESS LICENSE#
ADDRESS: -6- OV-%e { 2- CITY/ZIPCODE:
*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: F
0 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
Landscaping
Lathing
Masonry
Painting/Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal -
Sheet Rock
Tile
Owner/Contractor Signature Date