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14070139CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7670 BERLAND CT CONTRACTOR: DON WILLIAMS PERMIT NO: 14070139 REMODELING OWNER'S NAME: HO KENNETH S AND DEBBIE Y 14950 CAMDEN AVE DATE ISSUED: 07/31/2014 OWNER'S PHONE: 4088134058 SAN JOSE, CA 95124 PHONE NO: (408) 813-4455 25 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL E] REMODEL (E) KITCHEN (145 S.F.). CHANGE (E) KITCHEN License Class 1L 1 Lic. # WINDOW TO (N) BAY WINDOW Contractor Do .tet C,,11'11, 0 : -,r 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: 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 Sq. Ft Floor Area: Valuation: $0 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 APN Number: 36225034 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 DAYS ROM 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 granting of this permit. Additionally, the applicant understands and will comply Date: with all non -point source regulations per the Cupertino Municipal Code, Sec 9 18. --- ;7Z2 '/ 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- atethe I hereby affirm that I am exempt from the Contractor's License Law for one of thefollowing 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 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agenDate: 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 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(acupertino.org U NEW CONSTRUCTION U ADDITION U ALTERATION / Ti U REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 7-6 1 e,rK (� APN # 3 I7� 6 - Z,!�- — D -3 OWNERNAME PHONE I E-MAIL etc S11.3-4,1 kers.?- & A C ". c©tti STREET ADDRESS CITY, STATE, ZIP G� S� / FAX '16�z� of to, 6v e, / 1c ° Y CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX Q�s "Ove ❑ OWNER ❑ OWNER-BUBAER ❑ OwNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME �/ E•MAII, FAX /:)bn C 1 10 1"'1r �i✓YIG�f /v/ �W!/I etG%?J /00 S/U CD `/0 *i �/�(� STREET ADDRESS CITY, STATE, ZIP PHONE �i/5,� o Ganioreh Ai(e �� So�� cA Asp ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK 1, ( A/1 i 1 del i / C 1/1 �✓1 Loi o a, / - /V o .s 4 .- v C7U -c,_ C4 Cc W USE I TYPE I OCC. I SQ.FT. I VALUATION ($) EXISTG NEW FLOOR DEMOTOTAL BEINGADDED? ❑NO ADDITION? ❑NO PRE -APPLICATION []YES IF YES, PROVIDE COPY OF AREA AREA AREA EICHLER HOME? O NET AREA By my Signature below, I certify to each of the following: I am the property owner or au a agent. ct on erty owner's behalf. I have read this BATHROOM is accurate. I agree to comply with all applicable local KITCHEN Signature of Applicant/AgenW— + OTHER REMODEL AREA REMODEL AREA + O S REMODEL AREA # DWELLING UNITS: IS A SECOND UNrr ❑YES SECOND STORY ❑ YLS BEINGADDED? ❑NO ADDITION? ❑NO PRE -APPLICATION []YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ T:ECI; _ -' TOTAL VALUATION: PLANNING APPL # []NO PLANNING APPROVAL LETTER EICHLER HOME? O , O By my Signature below, I certify to each of the following: I am the property owner or au a agent. ct on erty owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and va&y4ir is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/AgenW— + Date: B1dgApp_2011.doc revised 06/21/11 � CITY OF CUPERTINO W rU T IV 4Z TTM A rrnP — III TII .iIINC DIVICInN LAIADDRESS: 7670 BERLAND CT DATE: 07/31/2014 REVIEWED BY: MELISSA APN: 362 25 034 BP#: *VALUATION: 1$25,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: p Remodel, Kitchen (<=300 sf) IREMRESKIT PENTAMATION 1 R3SFDREM PERMIT TYPE: WORK REMODEL E KITCHEN 145 S.F.. CHANGE E KITCHEN WINDOW TON BAY WINDOW SCOPE $0.00 1'leu;;b, 1 hin ('heci t'tumn. Pt,,rfnill'ee: Other Plumb Inv f1her"11), ln,}p. Fee: it ber? b"Sp NOTE: This estimate does not include fees due to other Departments (i.e. Planning, ruouc n'ortcs, rise, aunttury. ewe. "LJtLtLt, JLLL— mc _ _ !___ _ _ L.......J ,. 11... .. ,.1:......* --,...:o.0 . nf; L- L, nilnhla and nro nnhi nn act;mata Contact the Dent for addn7 info. FEE ITEMS (Fee Resolution 11-053 Ef. 7f /1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 DiEl s.f. $645.00 Remodel, Kitchen (<=300 sf) IREMRESKIT Suppl. PC Fee: Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.001 # $431.00 Window / Sliding Glass Door 1 1WINREP Replacement Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 1'onsfn,,,,11 L ,. PIT.' L E) Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee- $0.00 Select a Non -Residential Building or Structure 0 0 � ri`<d1=g% T)(t('t,Gi�'tc'fi1CXr'1£f7'T I'c'E=.s': Strong Motion Fee: IBSEISMICR $3.25 Select an Administrative Item Bldp, Stds Commission Fee: 1BCBSC $1.00 5 $4.25 $1,076.00. TOTAL FEE: $1,080.25 Revised: 07/10/2014 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: 7 670 '73 C f PERMIT # l YO 5LO / 3 OWNER'S NAME: r-" PHONE # o 8ij - y Y -s— GENERAL CONTRACTOR: o ,� [,� / s BUSINESS LICENSE #-rS'ua' ADDRESS: �� �, „�� N �� �,� 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: g Signature Date Please check applicable subcontractors and complete the following information: Owner / Contractor Signature Date 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 T EJC 1 5T INS 767D 13�51�1—ANo C1- 00FrzAr/1vp, G11- 9rorI KI i GN EN iZ>Lt'► oor;FL No S112VLf u�,�,i �N�1�V�cS CWAN0—E_ 5flYk evmvOow -m GX(,)ZEfi WIIY��aw f AREA OF INTERIOR IMPROVEMENTS: l N S Sl rt CODES IN EFFECT: -2013 CALIFORNIA RESIDENTIAL CODE -2013 CALIFORNIA GREEN BUILDING CODE -2013 CALIFORNIA PLUMBING CODE -2013 CALIFORNIA MECHANICAL CODE -2013 CALIFORNIA ELECTR -2013 CALIFORNIA FIRE C CUPERr/ E3uilding De �� �p JUL Pel�eRt JUL REVIEWS Q FOS r 1 Reviewed By.COQE CQMPLtAN PLOT PLANb CHECKED BY DATE LANNING DEPT. I- iz7-�,q- DATE Cc A/ TRAc T TWO 20AMP SMALL APPLIANCE CIRCUITS ALL RECEPTACLES GFCl/TAMPERPROOF ALL LED LIGHT FIXTURES DEDICATED MICROWAVE CKT. DEDICATED DISHWASHER CKT. DEDICATE DISPOSER CKT. I'D D r '7670 /3/5R/-/4/vrj CT copF_Ri1/Vo v 5�,o/'/ r 31 0 lll O 10 S W I LLI,'AM LGNT+ti�i�i JI>