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14070108 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7538 NORMANDY WAY CONTRACTOR:UNITED FIELD PERMIT NO: 14070108 REMODELING DBA OWNER'S NAME: LEI PHIL AND CORRADI JEAN 17855 VANOWEN ST DATE ISSUED:07/23/2014 OWNER'S PHONE: 4082027007 RESEDA,CA 91335 PHONE NO:(818)402-5656 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL E] COMMERCIAL E] BATHROOM REMODEL 42 SQ FT License Class_ Lic.# l ,J Contractor (� �/ Aate 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:$5500 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:36617067 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 1DAYS 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 LAST CALLED I SPE TON. 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. Additiona9l , e applicant understands and will comply Issued by: Da te: with all non-point source regulat per the Cupertino Municipal Code,Section 9 18. RE-ROOFS: Signature Date ��/1 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 I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,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 Qualtipy Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Munic' 1 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, d 2255 , Section 3700 of the Labor Code,for the performance of the work for which this 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 v COMMUNITY DEVELOPMENT.DEPARTMENT• BUILDING DIVISION — �0 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255— (408) 7/7-3228• FAX(408) /7-3333• buildina a(-.cuoertino.oro CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATI01\I/TI ❑ REVISION/DEFERRED ORIGII TAL PERMIT n PROJECT.ADDRESS /,_ n '''PN n '7 /^1.6D- OVJNERNAME _ /7/ PHONE Q ��o�E-MAIL STREFI ADDRESS I CITY, STATE,ZI_P / I FAX CONTACT NAME PHONE E-MAIL STREET.ADDRESS CITY,STATE,ZIP I FAX o)xNmR ❑ owNER-BIIIIAER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTORAGT`T ❑ ARC:=--cT ❑ENGD.TEER ❑ i)EvELoPER ❑ TENANT CONTRACTOR NAME a� LICENSE NUMBER / I LICENSE TYPE I BUS.LIC, COMPANY NAME E-MAIL I F.4x STREET ADDRESS CITY,STATE,ZIP I PHONE ARCHrrECT/ENGD\TEER NA.\4E LICENSE NUMBER I BUS.LIC' COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP' PHONE DESCRIPTION OF WORK E)USTING USE PROPOSED USE CONSTR.TYPE 1 R STORIES USE TYPE I OCC. SQ.FT. ( VALUATION(S) EXISTG $ARPEA D' TOTAL AREA AREA NET AREA �� OTHER REMODEL�4AR;p / REMODEL AREA REMODEL AREA PORCHAREA OTALDECKIPORCH AREA GARAGE AREA: DETACH ATTACH DV.'ELLD.'G UNITSOND UNIT ❑YBS SECOND STORY ❑YES DDED? ❑NO ADDITION? []NO PREf3PtI£4OIv—D1€S—��TS.PROSIDES9PLOF I_ISTHEBLDGAN tiltsECDIi D TOT.AL VALUATION: PLANNING APPL R ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO By my signature below,I certify to each of the following: I am roperty owner or authori d Went to act on the property ovmer's behalf. I have read this application and the information I have provided is correct. I h ead the Description of Work a verify it is accurate. I agree to comply Tith all applicable local ordinances and state laws relating to buildina construction. thori representatives of Cupertino to enter the above-identified p e;ty f'11insgection purposes. S iglature of App]icant/Agent: Date: !//J SUPPLEMENTAL lI\rFORMATION REQUIRED ecl�r1PE r � �x_ ROzrrinG r _ New SFD or Multifamily dwellings: Apply for demolition permit for pyo 1 RTEDcoamTExBDIIbLNTGPLA'�REi�v existing building(s). Demolition permit is required prior to issuance of building 4 permit for new building. ®5LS RESsH PLKim 19150& C; geg _Commercial Bldgs: Provide a completed Hazardous Materials Disclosures AEtD YIJBLIc woxs form if any Hazardous Materials are being used as part of this project. f RGE _lEPT _Copy of Planning Approval Letter or Meeting with Planning prior 9SAMEDIV Dlsxrer _ submittal of Building Permit application. IN—= J � - � � - � =��EnENNN.�E�rPt Bldg4pp_2011.doc revised 06/21/11 I CITY OF CUPERTINO �� /�✓ FEE ESTIMATOR-BUILDING DIVISION C ADDRESS: 7538 NORMANDY WAY DATE: 07/23/2014 REVIEWED BY: MENDEZ APN: BP 0: *VALUATION: 1$5,500 xPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1 R3SFDREM USE: p PERMIT TYPE: A WORK BATHROOM REMODEL 42 SQ FT SCOPE " ,J), pl("Yt t reek t'Frrru,h, Plrnr C'iaE ct f 'e::.i' a t r' c; tP,.wil fere: Plumb. Perm,;/Il ee: Ch" /V,,>"3- =7- Other ph'imb/:t:5,{7. t f'-r.'3`�rc ��'S�'. /,"'. l'htwh hasp. Fee: NOTE:This estimate does not include fees due to other Departments(Le.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 Eff. 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 42 s.f. Remodel,Bath(<=300 sf) Suppl. PC Fee: Reg. ® OT 0.0hrs $0.00 $645.00 1REMRESBAT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 7-7:1 tion "lax: F71 - 0 Work Without Permit? ® Yes (E) No $0.00 E) Advanced Plannin&Fee: $0.00 Select a Non-Residential 0 Building or Structure 0 1`f'es A Strong Motion Fee: IBSEISMICR $0.72 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 $1.72 $645.00 ' TOTAL FEE; $646.72 Revised: 07/10/2014 P DEVELOPMENT I EPART S APPROVE 'ans and specificationsUST.rye kept at the ;a ceanstruction. It is u , I`to make any ...:.,waFlaratloffson same,o - ;withcjut aIaproval from the Building Official. <, �I_,;;rn,'this plan and specifications SHALL NOT srrnit r to be an approval of the violation r,: i:vrS.ion of iy Oity Ordinance or State Law. oj 77 7:5737L A Cy I CUPERTINO ,.W _. Hilelinq Department Reviewed 13v: '