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14050118CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10240 DUBON AVE CONTRACTOR: UNITED FIELD PERMIT NO: 14050118 REMODELING DBA OWNER'S NAME: JANET GEIGER 17855 VANOWEN ST DATE ISSUED: 05/20/2014 OWNER'S PHONE: 4088004038 RESEDA, CA 91335 PHONE NO: (818) 402-5656 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E]COMMERCIAL F-1License Class Lic. # I ` I.,-- ,.}�- REVISION #1: ADD (9) LIGHTS AND (2) OUTLETS TO KITCHEN. Contractor �1'�'�\L �y"� Date I 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: $10000 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: 34214049 00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 I certify that 1 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 FROM 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 Issued b � �lc-�`1 granting of this pe Additionally, the applicant understands and will comply Y z 'G N �T Date: with all non-point sou regulations per the Cupertino Municipal CI (ode, Section 9 18. 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. ❑ OW -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 an 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 this Owner or authorized agent: Date: 1 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 CONSTRUCTION LENDING AGENCY 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 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 �LJI�'E'ti`t'I F�IO GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3225 - FAX (403) 777-3333 - building.0cuoerino.ora 71nTIThmT>,Tr: F7WPrWA),TI(-A7. $&.R..CTRICAL 71,9SCELLANEOUS PROTLCrADDRESS \ 1�. \ C/ I APN / / e7'1 G : / 0W INiR)tfi1Ji PRONE L-Vd� STREETADDRESS I CITY, STATE, ZIP. I FAX ` COIjTACT N.'Q'm I PHO?\E I E -]✓SIT S TP.LiT ADDRESS CITY, STAi's, ZIP FAX ❑ OWh�t ❑ 11?ER•BU2D=R ❑ OR1tAC—=,,T ❑ COV- ❑ COh?RICTORACc1�T ❑ ARCrIII CT ❑ L't4GTt LnR ❑ D10?� ❑ T_N+��'I CONTP.ACTORNAIJ=. I LICENSENUaER I LICENSETYPE I BUS. LIC COMPANY NAl✓� E-1,LAIL I FAX STREET ADDP ESS `�-� , / v J.� } Q \ V 'lv J I Crl Y, STATE, ZIP !J /� C 1 A \\�•1 L/ 1l C� I PHO> S ARCHITECT/ENGINEEP. NA YM LICLT�SE NGT MER. I BUS. LIC n CO1JP/vdYA?AI✓b E 1JAII I FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF 1) -!;FD or DUPLEX ❑ MULTI -FAMILY I PROJECT A WILDLAND ❑ YES I PROJECT IN ❑ YES BIJII_DING: 6 COI✓.N,E u&L URBAN IN=- ACE AREA O FLOOD ZONE )P110 IS TF.'E BLDG ATT ❑ � rS Elcl=Hobs? ly-1110 DESCRIPTION OF WORK \ \ (z) \ c • `+J 7c'5' v— ` \ ` v TOTP.LVALUATION; `�©U . I.�LrC�I DB - I— By my si=nature below, I certify to each of the following: I am tie property owner or authorized agent to act on the property ovmer's behalf. I have read this application and the information I have provided is Cvject. I have read the Description of Work and verify it is acct ate. I agree to comply with all applicable local ordinances and state lavvs relating to buil ' truc ' n. I authorizz representatives of Cupertino to enter the Fbbov- identi'e proper), for inspection purposes. S i --nature of Applican /Agent: Date: T SLTPPLF—Ta INFOR. LkTION REQTJ-=D OMAN' ESs �- --_. M3E4'E� �- MOO . 1✓EPh1flsc1,pp_2011.doc revised 06/21111 CITY OF CUPERTINO II''NW IFUT IV4Zr"1Vi A TnlP _ RTTTT ,D1Nf i11V141ON Li,ADDRESS: 10240 Dubon Ave DATE: 07/07/2014 REVIEWED BY: Sean APN: BP#: 14050118 `VALUATION: $1,200 PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: p PENTAMATION 1 REAP11 PERMIT TYPE: WORK Revision #1: Add 9 lights and 2 outlets to kitchen. SCOPE Recep/Switch/Outlets APPLIANCE / EQUIP TYPE FEE ID QTY/FEE QTY UNITS BP FEES Fixtures, Lighting 1BREMFIXT 9 # $70 Recep/Switch/Outlets 1BREMRECEP 2 # $47 PME Unit Fee: $117.00 PME Permit Fee: $47.00 CCo lstr oc tion '111x: Administrative Fee: IADMIN $44.00 Work Without Permit? 0 Yes (F) No $0.00 TOTALS: Travel Documentation Fee: ITRAVDOC $117.00 Stron,R Motion Fee: IBSEISMICR "f -" ,_ Penult Fee: Oflicr° JWccYh. frr,�n WC611, fav)- Fee: t'Tzt}0). Nan Chcc{ f himb. Perinv Fee: Other Pfufflb frrs°p- P ttrzai3. hisp. Fee Elec. Plan Check 0.0 hrs $0.00 Elec. Permit Fee: IEPERMIT Other Elec. Insp. 10.0 1 hrs $47.00 NOTE: This estimate does not include fees due to other Departments (/.e. r/ann/ng, run//c wor/cs, rtre, auntlury sewer utstrtu, .3cnuut i mr_ --- r--- --- t.,...,.,I -- sL,. .—i nrn nnly nH octimato- Cnntart the Dent for addn'l info. FEE ITEMS (lee Resolution 11-053 E f 7/1/13) FEE QTY/FEE MISC ITEMS Phan Check PME Plan Check: $0.00 PME Unit Fee: $117.00 PME Permit Fee: $47.00 CCo lstr oc tion '111x: Administrative Fee: IADMIN $44.00 Work Without Permit? 0 Yes (F) No $0.00 Planning Fees: Travel Documentation Fee: ITRAVDOC $47.00 Stron,R Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission .Fee: IBCBSC $1.00 ' $256.50 $0.00 TOTAL FEE: $256.50 Revised: 07/01/2014 Scope of work for 10240 Dubon Ave. Cupertino Ca. JUL 0 7 2014 1. Remove the two existing 5 inch cans above the kitchen sink BY and install one new IC rated 6 inch can with L.E.D. Trim. 2. Remove the two 12x48 inch florescent light fixtures in kitchen area and install six new IC Rated cans with L.E.D. Trims. 3. Install two new pendent lights over center island add new switch. 4. Remove 3 -way switching (not done to code) 5. Install two new 20 amp recepticals next to new door one on the inside and one on the outside G.F.C.I. Protected. 6. Install new smoke detectors and carbon alarms. COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION - CUPERTINO Thi- set of plans and specifications MUST be kept at the jou Slia during construction. It is unlawful to make any changes or alterations on same, or to deviate then ofrom, without approval from the Building Official. Tho stamping of this plan and specifications SHALL NOT L, hre'd to permit or to be an approval of the violation of any provisions of any City -rdinance or State Law. BY lye D;TE 7-7 PERMilT NO. REVISION ! Remove 2ea 5 inch cans over kitchen sink. Remove 2ea 12x48 inch florescent fixtures. Existing Electrical a New 6 inch can with L.E.D. Trim two new pendent lights new switch New Electrical _------- 4. Add two new 20 amp recepticals one inside one outside G.F.C.I.protectec i I New switch for pendent lights 6ea New 6 inch cans with L.E.D. trims Job Address: 10240 Dubon Ave Cupertino Ca.