Loading...
150500130 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22080 WALLACE DR CONTRACTOR: STEVE BARNES PERMIT NO: 15050013 CONSTRUCTION OWNER'S NAME: ZAMIR ITAMAR AND SHIRY 2442 PINEHURST CT DATE ISSUED: 07/09/2015 OWNER'S PHONE: 6508611013 DISCOVERY BAY, CA 94505 PHONE NO: (650) 787-7011 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL F] COMMERCIAL CONSTRUCT (N) 2 STORY SFD WITH 1,736 S.F 1ST FLR, License Class Lie. # —T-4-8 ! _671 1,393 S.F. 2ND FLR & ATTACHED GARAGE 417 S.F. ContractoJ /- -� Ld ��niFS ( �a eras% Date /, REV # 1 - ENLARGE (E) KITCHEN WINDOW - ISSUED 8119115 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: $469500 erformance 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. APN Number: 32603039.00 Occupancy Type: 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 to building construction, and hereby authorize representatives of this city to enter WITHIN 180 DAYS ®F PERMIT ISSUANCE ®R 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— 180 DAYS ED INSPECTI N. - Issued granting of this permit. tionally, the applicant understands and will comply ate: j with all non -point s rce r ulat' ts per the Cupertino Municipal Code, Section 9.18. Signature RE -ROOFS: —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 I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 I hereby affirm under penalty of perjury one of the following three California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's Health & Safety Code, Section 25532(a) should I store or handle hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the material. Additionally, should I use eq ent or devices which emit hazardous air contaminants as defined by the Ba Ar _Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the C per no M icipal Code, Chapter 9.12 and 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 the Health & Safety Code, Sections 55 , 25 , and 25534. permit is issued. Owner or authorized agent: Date: l / 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION 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 COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE,AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 • building(Dcupertino.org CION ❑ ADDITION ❑ ALTERATION / TI REVISION / DEFERRED ORIGINAL PERMIT # `S-O&'D0 13 PROJECT ADDRESS Q ®APN O 1 e_t R _a_ D1Z. # OWNERNAME Z A A nt)1p— &SHJ Ry VALUATION (S) PHONEE-MAIL esc? �- 16/7 54 W OPSItS.0®r► 17'AMAA - ZAPI e STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAMEPH .� 1 jF}lz►�rr�s AREA NE 7�7-io<► E -MA IL 5�r-6=45-80r-7-Ga Jgae-.eo STREET ADDRESS Z-� z P11-4e�/u T �; . CITY, STATE, ZIP 1A C-0V0-1�ti L 4gsos- FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE grBER BER LICENSE TYPE BUS. LIC # 5v i R-14c� copse . X66 1.9 7 L� 3cse® KPAOT Sl-tFV� 5P_" NY NAME QSE-MAIL FAX /� ,$''7Y8V x- STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # 14AM917- 4 A I C �rs COMPAI$KNAME E-MAIL FAX STRE T DRES CITVT_ATE ZIP PHONE ZZ aw�� Ia a. o �JJI�`}} S �.i� 9�3 a g ®7 -3s DESCRIPTION OF WORK Go e -4 t --e . L - z- . ri c� zo r -e u L ° e SUPPLEMENTAL INFORMATION REQUIRED _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. __Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. BldgApp_201 Ldoc revised 06121/11 USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA ' PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ODETACH ❑ ATTACH I # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? ❑ NO ADDITION? PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER _ EICHLER HOME? ❑ NO - rty owner or authorized ag o act on the erty owner's behalf. I have read this By my signature below, I certify to each of the follow' g: I thK'Itphe application and the information I have provided is c rrect. aveDescription of Work verify it is rate. I agree to comply with all applicable local ordinances and state laws relating to building,co autrepresentatives of Cupe 'n the above-ideAntified property for inspection purposes. Signature of Applicant/Agent: Date: I? p A e 0 / SUPPLEMENTAL INFORMATION REQUIRED _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. __Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. BldgApp_201 Ldoc revised 06121/11 I __7 CITY OF CUPERTINO MATOR - RIITT.nINr D7vrcTnN 1♦V1G.- -ims esumare does nor inctuaeJees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the nreliminary informatinN availahto and a— ,,.,h, — e.d.,.­ FEE ITEMS (Fee Resolution 11-053 Rff. 7/1/13) ADDRESS: 22080 WALLACE DR DATE: 08/19/2015 REVIEWED BY: MELISSA ;Ikch. 1'er'mil Fere' APN: 326 03 039 BP#: 15050013 *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIUSE. or SFD or Duplex I'Innrb. hivp. /'ee: PENTAMATION PERMIT TYPE: 1 GENRE A WORK REV # 1 - ENLARGE E KITCHEN WINDOW - ISSUED 8/19/15 SCOPE 1♦V1G.- -ims esumare does nor inctuaeJees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the nreliminary informatinN availahto and a— ,,.,h, — e.d.,.­ FEE ITEMS (Fee Resolution 11-053 Rff. 7/1/13) Mech. Ilan Check Plitnrb. 11/ara Check Elec'..P/an Check IF ;Ikch. 1'er'mil Fere' 1'lurn1;. Perm;l Fee: 11ec. Permit Fee: Other ;llech. Insp. Other Plumb Insp. Ocher l.. lec. Insp. 11ech. Ing .I'c'e: I'Innrb. hivp. /'ee: Elec. Insp. Fee: 1♦V1G.- -ims esumare does nor inctuaeJees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the nreliminary informatinN availahto and a— ,,.,h, — e.d.,.­ FEE ITEMS (Fee Resolution 11-053 Rff. 7/1/13) FEE QTY/FEE MISC ITEMS V Plan Check Fee: Hourly Only? 0 Yes Q) No $0.00 �_J hours $143.00 Plan Check, Hourly ISTPLNCK Suppl. PC Fee: (j) Reg. () OTT 0.01 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? 0 Yes Q No $0.00 Suppl. Insp. Feer Reg. Q OT0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C"onso-uCtlon Tax: Administrative Fee: 0 Work Without Permit? Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential E) Building or Structure 0 i Travel Doeufnenla ioa Fees: Strong Motion. Fee: $0.00 1.0 hrs $143.00 Inspections ISTINSP Inspection, Hourly Bldg- Stds Commission Fee: $0.00 -. _ SUBTOTALS:;; $0.00 $286.00 a TOTAL FEE j; 11 $286.00 Revised: 07/02/2015 E CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22080 WALLACE DR CONTRACTOR: ' J` � V, 01V?N55 PERMIT NO: 15050013 OWNER'S NAME: ZAMIR ITAMAR AND SHIRY�j Z lN�� ✓I��- D- DATE ISSUED: 07/09/2015 OWNER'S PHONE: 6508611013 _ PHONE NO:65-c) .' ,.' ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL n CONSTRUCT (N) 2 STORY SFD WITH 1,736 S.F 1ST FLR, License Class Lic. # y M e % 1,393 S.F. 2ND FLR & ATTACHED GARAGE 417 S.F. Contractor 5MVC- `l C70"fs' bate 7 /F// I— 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. I have Sq. Ft Floor Area: Valuation: $469500 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. APN Number: 32603039.00 Occupancy Type: 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 to building construction, and hereby authorize representatives of this city to enter WITHIN 180 DAYS OF PERMIT ISSUANCE OR 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 wh' h may accrue against said City in consequence of the granting of this perm' . itionally, the applicant understands and will comply ! n ^ / Issued by: -- Date: with all non -point ur r gulations per the Cupertino Municipal Code, Section 9.18. 7 2 % i Signature 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. ❑ 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: I, as owner of the property, or my employees with wages as their sole compensation, ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 I hereby affirm under penalty of perjury one of the following three California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's Health & Safety Code, Section 25532(a) should I store or handle hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the material. Additionally, should I use a ipment or devices which emit hazardous air contaminants as defined by the y Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the u rti Municipal Code, Chapter 9.12 and 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 the Health & Safety Code, Sectio s 2 5 5533, and 25534. permit is issued. Owner or authorized agent: Date: ! 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 Lender's Address 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, ARCHITECT'S DECLARATION 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 CITY OF CUPERTINO I fl FFT F,STIMATOR — RIJILDING DIVISION OCCUPANCY TYPE: ADDRESS: 22080 WALLACE DR - DATE: 05/04/2015 REVIEWED BY: MELISSA PC FEE ID APN: 326 03 039 BP#: o *VALUATION: 1$469,500 *PERMIT TYPE: Building Permit PLAN CHECK T PE: New Construction PRIMARY USE: SFD or Duplex 2nd Unit? Yes " No PENTAMATION PERMIT TYPE: 1 R3SFDW WORK CONSTRUCT N 2 STORY SFD WITH 1,736 S.F 1ST FLR 1,393 S.F. 2ND FLR & ATTACHED SCOPE GARAGE 417 S.F. OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA (S f.) PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,111-B,IV,V-B 3,546 $3,190.71 1R3PLNCK $3,297.93 IR3INSP $0.00 PME Plan Check: $0.00 Permit Fee: $3,297.93 Suppl. Insp. Feer Reg. OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 3,546 $3,190.71 Construction Tax: IBCONSTAXR $3,297.931.. # new units Mech. Plan Check Plttmh. Plate Check Eslec, Platt Check ;Liech. 11erttu1 Foe: phimb. Permit Tire: Islet. Permit Fee: Other AIcch. Trap. Other Plumb Trap.Li Other Elee. Insp. ED--L- .-Wech, Imp. Tic:: I'luntb. Insp. T i -e- Elec. malt. Yee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School T:.. .. 1 71L ,. r .. L,. ,.4 ..... fLra"tart the Dont for addn'L Into. FEE ITEMS (Fee Resolution 11-053 Ef. . 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,190.71 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q) Reg. 0 OT 1 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $3,297.93 Suppl. Insp. Feer Reg. OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXR 1 # new units $ 677.77 Administrative Pee: 0 E) Work Without Permit? 0 Yes E) No $0.00 Advanced Planning Fee: IPLLONGR $496.44 Select a Non -Residential Building or Structure G 0 Travel Documentation Tees: Strong Motion Fee: IBSEISMICR $61.04 Select an Administrative Item Bldg. Stds Commission Fee: IBCBSC $19.00 SUBTOTALS $7,742.89 $0.00 TOTAL FEE ° $7,742.89 Revised: 04/01/2015 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE ® CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a-kupertino.org O� 0 � B N NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DFFERRFD ORIGINA1. PFRMIT ii PROJECT ADDRESS ® wok oxce Y)o APN # OWNER NAME T�(AV�/I-0.✓ 2gwt a✓ PHONE � — O �'L E-MAILS S rO7S 5- tZGtw•;r STREET ADDRESS27-® `` 0 Q C L r CITY, STATE, ZIP . H C C A FAX CONTACT NAME �' t �� W`av` �a✓2UIneVI PHONE oS-20r1-gQ 2 E-MAILto � IX (OV, I�SFiO STREET ADDRESS ,JO 2 0S CITY, STATE, ZIP LosCA g5631 FAX 11c8-37-7 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ' � ' (CENSE NUMBEI � bj J LICENSE TYPE BUS. LIC # COMPA ME ,• E-MAJ e CPS ry� '� �j FAX STREE ADDRE O • v CITY, 7TE, Zle ' PHO( " ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK r tti 8 C 0 4.l'5 tyvL CJI 0 312T EXIST GUS� �CC� P POSED SE CONSTR.TYPE #STORIES �L, USE TYPE OCC. SQ FT. VALUATION($) /VGf'!�' . /v t�p� EXISTG AREA 16b 3 NEW FLOOR AREA r� DEMO AREA T/_ / 1 la [� ' TOTAL NET AREA ? f 3 0 BATHROOM REMODEL AREA Y KITCHEN REMODEL AREA y OTHER REMODEL AREA y PO CH AREA 66 DECK AREA TOTAL DEC ORCH AREA ��' ( GAG AREA: DETACH ATTACH I 7 # DWELLING UNITS: / IS A SECOND UNIT I@ YES BEING ADDED? ❑NO SECOND STORY aYES ADDITION? i ❑NO PRE -APPLICATION YES IF YES, PROVIDE COPY OF PL NING APPL # NO PLANNING APPROVAL LE",R IS THE BLDG AN ❑ YES REC BY- OTQI� VALUATION: EICHLER HOME? ANO O i'1 `/7[/�_'/(�r �� By my signature below, I certify to eac4INFOKi wing: m the property owner or author o act on the owner's b half. I have read this application and the information I have rrec . h ead the Description of Work and verify it ' rate. I agree to comply with all applicable local ;r ordinances and state laws relating tc "i ' horize representatives of Cupertino to enthe abover'-J— f�,� nrnoerty for inspection purposes. Signature of Applicant/Agent: _Date:-- ( / 37 SUPPLEMENT uvlN FLAN CHECK TYPE ROUTING SLIP _ New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER -THE COUNTER El BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of -building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure XTANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR E3 SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_201 1. doc revised 06/21/11 ca. E CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22080 WALLACE DR CONTRACTOR: STEVE BARNES PERMIT NO: 15050013 CONSTRUCTION OWNER'S NAME: ZAMIR ITAMAR AND SHIRY 2442 PINEHURST CT DATE ISSUED: 07/09/2015 OWNER'S PHONE: 6508611013 DISCOVERY BAY, CA 94505 PHONE NO: (650) 787-7011 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL 7� CONSTRUCT (N) 2 STORY SFD WITH 1,736 S.F 1ST FLR, License Class Lic. # `g1 1,393 S.F. 2ND FLR & ATTACHED GARAGE 417 S.F. �T,e.rt z7 Contractor re c>x)Date I s Revision #2 - Stem Wall Change - Detail 1 - SD 1 - ISSUED I hereby affirm that I am licensed under the provisions of Chapter 9 8/27/2015 (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: $469500 performance of the work for which this permit is issued. 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: 32603039.00 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, 180S FROM LAST CALLED INSPECTION. costs, and expenses whit ay accrue against said City in consequence of the (�( 2 Issued by: Date: granting a this permi Ad ition , the applicant understands and will comply with all non -points rte gul ns per the Cupertino Municipal Code, Section RE-ROOFS: 9.18. �j Signature Date 0 Z! / 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) 1, 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(x) 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 Quality Management District 1 performance of the work for which this permit is issued. will maintain compliance witunicipal Code, Chapter 9.12 and 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 &Bret the Health & Safety Code, Se3, and 25534. Z-7//- or authorized agent:Date: permit is issued.Owner 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 r' CONSTRUCTION PERMIT APPLICATION RV# COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228• FAX (408) 777-3333 • buildin4(aDcupertino.ong ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI REVISION / DEFERRED ORIGINAL PERMIT 4 PROJECf ADDRESS Z Z�QO APN # OWNER NAME PHONE E-MAIL 7-4ryfY2, 7-4ft,,2JW STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAMEPHONE EM IL 8 De Z: ( O _ • � 79-7-701/ avOF_ F STREET ADDRESSn CITY STATE, ZIP { FAX ; �❑ 13 OWNER ❑ OWNER -BUILDER OWNERAGENT P!CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME AA--, LICENSE E� 7 LICENSE T BUS. LIC # 6 3 7 O COMPANY 'AME E-MAIL_ FAQ{ TLsth3 w, `rs �u 7?�ZJ� OZ Z Roe_• 0.44 STREET ADDRESS P a-6— CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # vc�N �9 AN G 66 ?1) COMPANY ME E-MAIL P�� w C_owi FAQ{ STREET DRESSCITY ZZ26)>4( O o L �-- . STATE, ZIP 01,5 C-0 P ONE 7 S$ -3,55 Z DESCRIPTION OF WORK s,—!- 0 C.T'yx-�'� .!7 C�5'�9-� L l - l lZi�l� /.S I c - EXISTING USE PROPOSED USE CONSTR TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR, DEMO TOTAL AREA AREA AREA NET AREA -. BATHROOM. KITCHEN. OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: 0 DETACH ❑ ATTACH I # DWELLINGUNTTS: IS A SECOND UNrr ❑YES SECOND STORY ❑YES BEING ADDED? NO ADDITION? ❑NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF S THE BLDG AN ❑ YESD $y . ,� -_ � TOTAL V ATION: PLANNING APPL # ❑ H 4 NO PLANNING APPROVAL LETTE CHLER E? NO T ry � F = - '- By my signature below, I certify to each of the fol wing: a perty owner or authorized agent to act on the property owner's behalf. I hafe read this application and the information I have provided i c the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building truc ' n. rize re entatives of Cupertino to enter the above-identifi d propeiy for inspection purposes. Signature Applicant/Agent: �' L 7 J of Date: SUPPLEMENTAL INFORMATION REQUIRED Q PLAN CHECKTITE'_ LROiITII�GSLIE kti 5 OVER THIrCOTJhTER x BUILDING PLAN REVI ' New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. L 0 `�� o ��XPRESS �'�� �,PLANAIIrGPLANREVI&�V �,�� .,.� Commercial Bldgs: Provide a completed Hazardous Materials Disclosure a ci' D STANDAxD� {r HSy13 P� . _ form if any Hazardous Materials are being used as part of this project.056 aPUBLICV�soRKS RARKNL43 RAM _ Copy of Planning Approval Letter or Meeting with Planning prior to WMA0� � ��� 6 � ;� � -� M,�'^•�-��,�:�;��; submittal of Building Permit application.70 axsAI.?TARYsRDrsTRrc E11'VIROIe'MENT.+'f.L,FiEALTAs BldgApp_2011.doc revised 06/21/11 -0A'J CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION kaADDRESS: 22080 Wallace Dr. DATE: 08/27/2015 REVIEWED BY: PAUL Mech. Permit hee: APN: 326 03 039 BP#: 15050013 *VALUATION: Iso °PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: 0.0 PENTAMATION 1GENRE PERMIT TYPE: WORK Revision #2 - Stem Wall Change - Detail 1 - SD 1 SCOPE $0.00 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addh7 info. FEE ITEMS ('Fee Resolution I1-053 E(. 7/1/13,) alech..Ptan Check "lamb . I'lun Chec=k glee. Plan Cheek Mech. Permit hee: Plumb. Pewit: , . Elec. Perrot fee: (1','her ilfech. .Insp. )(iter Plumb 111s?,LL] 01!�'-'r LIP", li"ip Li Imp. 1PL': Suppl. PC Fee: 0 Reg. ® OT 0.0 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addh7 info. FEE ITEMS ('Fee Resolution I1-053 E(. 7/1/13,) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes (F) No $0.00 0 hours $143.00 Plan Check, Hourly ISTPLNCK Suppl. PC Fee: 0 Reg. ® OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? () Yes Q No $0.00 Suppl. Insp. Fee:Q Reg. 0 OT F0,0 f hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 s_'r��r:�lr°ztc:tiott trrx: lil)77inisirative F'ee: E) Work Without Permit? 0 Yes (D No $0.00 Advanced Planning Fee: $0.00 0 hours $143.00 Inspections ISTINSP Inspection, Hourly E) 0 �V1WVel Docurnentrztion Strong Motion Fee: $0.00 0 # $0.00 Revisions IREVSFDWL SFDWL Bldg; Stds Commission Fee: $0.00 FSUBTOTALS: $0.00 $286.00 TOTAL FEE: $286.00 Revised: 07/02/2015 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 Z U 8 a PERMIT # 1 -S-0 0'Cl 0 1 3 OWNER'S NAME: -T:--r,4 r'1 l9 9- it- S N-1 iz Z A 11, M. PHONE # G SO - 7 © i GENERAL CONTRACTOR: 5. r vcT 3 i iL-Q dS cvAJS r. BUSINESS LICENSE # �a ADDRESS: 2 LIyr C -r 0 CITY/ZIPCODE: Jr 5 c -v vesjz , Q 4; *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: Signature Please check applicable subcontractors and complete the following information: Date 6/ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing N 110 Gt r Electrical 110 k '� .— Excavation lL4:; rac�'re-re« eoo,� - t�egn. a 3 q, L 5- � fr'- Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating C c>GAjP4 0-1 1 C -A -L- .� Insulation SV I I NSw (-^-r' ON O y Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing P c.crr4-L, k4 e �+ 011 y L Roofing Septic Tank Sheet Metal M C— t--► e&t4* N t +/ o Ll g O Sheet Rock IE Tile Owner / Contracto("'Signature Date DS CALGREEN RESIDENTIAL CHECKLIST - MANDATORY ITEMS U ( COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CUPERTINO ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(aa cuyertino.org PURPOSE: The 2013 CalGreen Code applies to additions or alterations of existing residential buildings where the addition or alteration increases the building's conditioned area, volume, or size and also applies to all new low-rise residential buildings, high-rise residential buildings, or both. Existing site and landscaping improvements that are not otherwise disturbed are not subject to the requirements of CALGreen. Project Name: Custom House Project Address: 22080 Wallace Drive Cupertino Project Description: New Single Family House Instructions: 1. The Owner or the Owner's agent shall employ a licensed professional experienced with the California Green Building Standards Codes to verify and assure that all required work described herein is properly planned and implemented in the project. 2. The licensed professional, in collaboration with the owner and the design professional shall initial Column 2 of this checklist, sign and date Section 1 - Design Verification at the end of this checklist and have the checklist printed on the approved plans for the project. 3. Prior to final inspection by the Building Department, the licensed professional shall complete Column 3 and sign and date Section 2 - Implementation Verification at the end of this checklist and submit the completed form to the Building Inspector. Column 2 Column 3 MANDATORY FEATURE OR MEASURE Project Verification Requirements Planning and Design - Site Development 4.106.2 Storm water drainage and retention during construction. A plan is developed and implemented to manage storm water drainage during construction. 4.106.3 Grading and paving. The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how site grading or a drainage system will manage all surface water flows. Page 1 of 5 CalGreen_2014.doc revised 11104/14 A4.2 General 4.201.1 Low-rise residential buildings shall meet or exceed the minimum standard design required by the California Energy Standards. A4.3 WATER EFFICIENCY AND CONSERVATION Indoor Water Use 4.303.1 Water conserving plumbing fixtures and fittings. Plumbing fixtures (water closets and urinals) and fittings (faucets and showerheads) shall comply with the following: 4.303.1.3.2 Water Closets. The effective flush volume of all water closets shall not exceed 1.28 gallons per flush. Tank -type water closets shall be certified to the performance criteria of the U.S. EPA WaterSense Specifications for Tank -type Toilets. ❑ 4.303.1.3.2 Urinals. The effective flush volume of urinals shall not exceed 0.5 gallons per flush. IN 4.303.1.3.1 Single Showerheads. Showerheads shall have a maximum flow rate of not more than 2.0 gallons per minute at 80 psi. Showerheads shall be certified to the performance criteria of the U.S. EPA WaterSense Specification for showerheads. IN 4.303.1.3.2 Multiple Showerheads serving one shower. When a shower is served by more than one showerhead, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute at 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. X 4.303.1.4.1 Residential lavatory faucets. The maximum flow rate of residential lavatory faucets shall not exceed 1.5 gallons per minute at 60 psi. The minimum flow rate of residential lavatory faucets shall not be less than 0.8 gallons per minute at 20 psi. ❑ 4.303.1.3.2 Lavatory faucets in common and public use areas. The maximum flow rate of lavatory faucets installed in common and public use areas (outside of dwellings or sleeping units) in residential buildings shall not exceed 0.5 gallons per minute at 60 psi. ❑ 4.303.1.4.3 Metering faucets. Metering faucets when installed in residential buildings shall not deliver more than 0.25 gallons per cycle. 4.303.1.4.4 Kitchen Faucets. The maximum flow rate of kitchen faucets shall not exceed 1.8 gallons per minute at 60 psi. Kitchen faucets may temporarily increase the flow above the maximum rate, but not to exceed 2.2 gallons per minute at 60 psi, and must default to a maximum flow rate of 1.8 gallons per minute at 60 psi. 4.303.2 Standards for plumbing fixtures and fittings. Plumbing fixtures and fittings shall be installed in accordance with the California Plumbing Code, and shall meet the applicable standards referenced in Table 1401.1 of the California Plumbing Code. Page 2 of 5 CalGreen_2014.doc revised 11104114 Outdoor Water Use 4.304.1 Irrigation controllers. Automatic irrigation systems installed at the time of final inspection shall be weather -based. 4.304.1.1 Controllers shall be weather- or soil moisture -based controllers that automatically adjust irrigation in response to changes in plants' needs as weather conditions change. ❑ 4.304.1.2 Weather -based controllers without integral rain sensors or communication systems that account for local rainfall shall have a separate wired or wireless rain sensor which connects or communicated with the controller(s). Soil moisture -based controllers are not required to have rain sensor input. ... MATERIAL CONSERVATIONAND RESOURCE Enhanced Durability and Reduced Maintenance 4.406.1 Rodent proofing. Annular spaces around pipes, electric cables, conduits, or other openings in plates at exterior walls shall be protected N/A against the passage of rodents by closing such openings with cement mortar, concrete masonry or similar method acceptable to the enforcing agency. No pentrations at lower plate Construction Waste Reduction, Disposal and Recycling 4.408.2 Construction waste management plan. Where a local jurisdiction does not have a construction and demolition waste management ordinance, a El ffl UJ construction waste management plan shall be submitted for approval to the enforcing agency. Building Maintenance and Operation 4.410.1 Operation and maintenance manual. At the time of final inspection, an operation and maintenance manual shall be provided to the building El El occupant or owner. .. .5 ENVIRONMENTAL QUALITY Fireplaces 4.503.1 General. Install only a direct -vent sealed -combustion gas or sealed wood -burning fireplace, or a sealed woodstove. Pollutant Control 4.504.1 Covering of duct openings and protection of mechanical equipment during construction. Duct openings and other related air distribution component openings shall be covered during construction. 4.504.2.1 Adhesives, sealants and caulks. Adhesives, sealants and caulks shall be compliant with VOC and other toxic compound limits. 4.504.2.2 Paints and coatings. Paints, stains and other coatings shall be 1p - KI compliant with VOC limits. 4.504.2.3 Aerosol paints and coatings. Aerosol paints and other coatings shall be compliant with product weighted MIR Limits for ROC and other toxic compounds. Page 3 of 5 CalGreen_2014.doe revised 11104114 4.504.2.4 Verification. Documentation shall be provided to verify that compliant VOC limit finish materials have been used. 4.504.3 Carpet Systems. Carpet and carpet systems shall be compliant with VOC limits. 4.504.4 Resilient flooring systems. Eighty (80) percent of floor area receiving resilient flooring shall comply with the VOC-emission limits defined in the Collaborative for High Performance Schools (CHPS) Low-emitting N/A Materials List or be certified under the Resilient Floor Covering Institute (RCFI) FloorScore program. No resilient flooring 4.504.5 Composite wood products. Particleboard, medium density fiberboard (MDF), and hardwood plywood used in interior finish systems shall comply with low formaldehyde emission standards. Interior Moisture Control 4.505.2 Concrete slab foundation. Required vapor retarders and capillary N/A breaks are also required to comply with CalGreen Section 4.505.2.1. 4.505.3 Moisture content of building materials. Moisture content of building p7 �I materials used in wall and floor framing is checked before enclosure. Indoor Air Quality and Exhaust 4.506.1 Bathroom exhaust fans. Exhaust fans which terminate outside the building are provided in every bathroom. Environmental Comfort 4.507.2. Duct systems are sized and designed and equipment is selected using the following methods: 1. Establish heat loss and heat gain values according to ACCA Manual J or equivalent. 2. Size duct systems according to ACCA 29-D (Manual D) or equivalent. 3. Select heating and cooling equipment according to ACCA 36-S (Manual S) or equivalent. INSTALLER AND SPECIAL INSPECTOR OUALIFICATIONS Qualifications 702.1 Installer training. HVAC system installers are trained and certified in the proper installation of HVAC systems. Mc Mechanical 929S91 702.2 Special inspection. The Licensed Professional responsible to verify CALGreen compliance is qualified and able to demonstrate competence in the discipline they inspect and verify. Verifications 703.1 Documentation. Verification of compliance with CALGreen may include construction documents, plans, specifications, builder or installer certification, inspection reports, or other methods acceptable to the enforcing agency which show substantial conformance. Implementation verification shall be submitted to the Building Department after implementation of all required measures and prior to final inspection approval. Page 4 of 5 CalGreen_2014.doe revised 11/04/14 CALGREEN SIGNATURE DECLARATIONS Project Name: Custom House Project Address: 22080 Wallace Drive, Cupertino Project Description: New Single Family House SECTION 1 - DESIGN VERIFICATION Complete all lines of Section 1 — "Design Verification" and submit the completed checklist (Columns 1 and 2) with the plans and building permit application to the Building Department. The owner and design professional responsible for compliance with CalGreen Standards have revised the plans and certify that the items checked above are hereby incorporated into the project plans and will be implemented into the project in accordance with the requirements set forth in the 2013 California Green Building Standards Code as adopted by the City of Cupertino. Owner's Signature Date Owner's Name (Please Print) Design Professional's Signature Date Design Professional's Name (Please Print) Signature of License Professional responsible for CalGreen compliance Date Name of License Professional responsible for CalGreen compliance (Please Print) Phone Email Address for License Professional responsible for CalGreen compliance SECTION 2 - IMPLEMENTATION VERIFICATION Complete, sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the worts and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2013,Califo "a Green Buil ode as adopted by the City of Cupertino. (�. June 14, 2016 Signature of License ProVessional responsible for CalGreen compliance Date Edward (Rick) Cowperthwaite, ICC # 1063271 Rick's Energy Solutions 707-578-5380 Name of License Professional responsible for CalGreen compliance (Please Print) Phone Rick@rc-networks.biz Email Address for License Professional responsible for CalGreen compliance Page 5 of 5 CalGreen 2014.doc revised 11104/14