15070160FA
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20658 SHELLY DR
CONTRACTOR: KITCHENS BY MEYER
PERMIT NO: 15070160
OWNER'S NAME: TAUBMAN CHARLES N AND BARBARA
861 E EL CAMINO REAL
DATE ISSUED: 07/22/2015
OWNER'S PHONE: 4082573251
MOUNTAIN VIEW, CA 94040
PHONE NO: (415)968-8318
�j LICENSED CONTRACTOR'SJOB
DECLARATION
DESCRIPTION: RESIDENTIAL COMMERCIAL
(."`
2
KITCHEN REMODEL (197 S.F.)
License Class Lic/. # J � O<
y�
Contractor �N S qe,Ee Z ��
I hereby a arm that I am licensed under the provisions of hapter 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: $27000
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: 35915005.00
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 D FROM LAST CALLED INSP CTI N.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
/
l
granting of this permit. Additionally, the applicant understands and will comply
Issued by: Date:
with all non -point sourc er a Cupertino Municipal Code, Section
9.18.
RE -ROOFS:
Signature Date 22// S
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
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 Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance ilk the Cupertino M icipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Cod Sectio 2 nd 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
�7
permit is issued.
Owner or authorized agen 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
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
CERTINO
CONSTRUCTION PERrviiT APPLECAT[ON
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building a0cuoertino.org
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PROJECr.ADDRESS v (x -A �-
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STREET ADDRESS r, '
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CONTACT NAMEPH
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❑ OWNTR ❑ OIAWER-BL-ILDER ❑ OWNER AGEN'C ON R -ACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME LICENSE NUMBERqO G I LICENSEME L I
J�bd
BUS. LIC 9
C0MP.1NL>APk& Nr
STREET ADDRESS
CITY 5 ATE, ZIP X
(J
I PHONE
ARCHITECTIENGINEER NA,I4E LICENSE NUMBER
BUS. LIC'
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
n
EXISTING USE PROPOSED USE CONSTR TYPE m STORIES
USE
TYPE
OCC.
SQ.FT.
VALUATION (S)
EXISTG
NEW FLOORDEMO
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOMKITCHEN
OTHER
REMODEL AREA
REMODEL AREA
"1�/
REN,ODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH KME
GARAGE .AREA: EIDETACH
❑ ATTACH
I
m DWELLING UNITS:
IS .A SECOND UNIT ❑ YES
SECOND STORY ❑YES
BEING ADDED? ❑NO
ADDITION? ❑NO
- PRE-nPPLIc4noN pa EsIFa�s. Pxo»EtoPioF
_ls_Ze_sLnc .�n ❑ YE
Il ED BY =3 F TOTAL VA-LUATION:
EICHLERHOME? [:]NO
PLAI,NINGAPPL� ❑NO PLANTL'\'GAPPROV.ALLETI'ER
By my signature below, I certify to each fo o ing: I am the property owmer or authori ..d agent to act on the property oNNmer's behalf. I have read this
application and the informatio I have o' ed rre I. I ave read the Description of Work and verify it is accurate. I agree to comply with all plicable local
ty fo i
ordinances and state laws relate ding c n ru o au horize representatives of Cupertino to enter the e-idenf pe ction purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFORMATION REQLTI D=
z CaECKTITE
wh RoZrr i�c �ilP =
New SFD or 1vlUltifamily dvv�ellings: Apply for demolition permit for
-,�'`.-e--i"zap
WIN- iRNTEli
yii ,
MN 10. Aw
existing building(s). Demolition permit is required prior to issuance of building
z
1
x
for new building.
❑ 7) PRESS ', a
' MIIJ.r NINII�GPL$11S RES I$ii' 2
permit
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
STA *DA -N X-
"all Is I'o10
_
form if any Hazardous Materials are being used as part ofthis project.
_ Copy of Planning Approval Letter or Meeting With Planning prior to
o
submittal of Building Permit application.
x. �,.w,.�.,,fx, .....�';-Tom'-'�R'
��..s.EA�i'IROTT4ENI'A%FiEAI;TA .•:kms.
Bldg4pp_2011.doc revised 06/21/11
CITY OF CUPERTINO ISM j60
FEE ESTIMATOR — BUILDING DIVISION
1AADDRESS:
20658 SHELLY DRIVE
DATE: 07/22/2015
REVIEWED BY: PAUL
Llech. 1.
APN: 35915 005
BP#:
'VALUATION: 1$27,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Addition
PRIMARY SFD or Duplex
USE:
_,.. 1,'v��. f ""
PENTAMATION 1 R3SFDREM
PERMIT TYPE: A
WORK
Kitchen Remodel 197 S.f.
SCOPE
Suppl. Insp. Feer Reg. Q OT
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 nreliminary information available and are only an estimate. Contact the DeDt for addh 7 info.
FEE ITEMS (Fee Resolution 11-053 E,tf 7/1%13)
Xtech. Plan Check
1''lzurrb. Plan Check
t:lec. Plan Check
Llech. 1.
Plumb. 1 <,�atrt �z:.
Ekc. i'cu,�ra ke"
Other Hech. Insp.
Other Plumb Insp.Li
t jim� Elec. Imp. E]__L_
tvle< t r 1 z,
_,.. 1,'v��. f ""
..c _ js.. 1"c
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 nreliminary information available and are only an estimate. Contact the DeDt for addh 7 info.
FEE ITEMS (Fee Resolution 11-053 E,tf 7/1%13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
s.f. Remodel, Kitchen (<=300 sf)
$645.00 IREMRESKIT
Suppl. PC Fee: (j) Reg. OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Feer Reg. Q OT
0 0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
("OnstruLtion Tax:
Administrative Fee:
O
0
Work Without Permit? Yes (j) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential O
Building or Structure
Trut�el I)oi•u7nc�nlalr,>rt Fees:�
Strong Motion Fee: IBSEISMICR
$3.51
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$2.00
SUBTOTALS:
$5.51
$645.00 TOTAL FEE:
1 $650.51
Revised: 07/02/2015
l* ✓ !ice
KTTCHEN6 & 4-
278 C..tto Street,
MIDU=Lk YieA CA 94041
650. 968. 7866
DESIGN • SALES • INSTALLATION '"`"`
JOB SITE SITE TAUBMAN RESIDENCE
20658 SHELLY DRIVE
CUPERTINO, CA 95014
RECEIVED
JUL 2 2 2015
CONTRACTOR: KITCHENS BY MEYER
861 E. EL CAMINO REAL
MOUNTAIN VIEW, CA 94040
CONTACT: ROD MEYER
650-279-816
SCOPE OF WK: BASIC R & R OF KITCHEN, PLUMBING UPGRADE AND ELECTRICAL TO BRING TO CODE.
SHEET INDEX: D-1: KITCHEN FLOOR PLAN, D-2: ELECTRICAL PLAN
CODES: CBC, CRC, CEC, CMC, CPC, CALIF. ENERGY CODE, FIRE CODE, CUPERTINO MUNI CODE 2014'>'
CUPERTINO
~ I Building Department
JUL 2 2 2015
REVIEWED FOR CODE COMPLIANCE
Reviewed By: Tft*o��"�w
OFFICE COPY
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION - CUPERTINO
APPROVED
This set of plans and specifications MUST be kept at the
job siie during construction. it is unlawful to make any
chances or alterations on same, or to deviate
therefrom, without approval from the Building Official.
The stamping of this plan and specifications SHALL NOT
be held to permit or to be an approval of the violation
Of, of any City Ordinance or State Law.
��
BY
DATE .� o�0157
PERMIT NO. ,
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All dimensions _size designationsT ' is an original design and must
given are subject to verification on TECHNOLOGIES not be released or copied unless
job site and adjustment to fit job applicable fee has been paid or job
conditions. order placed.
Chuck and Barbara (2).kit JLegend
Designed: 3/9/2015
Printed: 5/11/2015
Drawing #: 1 I No Scale.