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14100137-PUBLIC7818 ORION LN 14100137 F CRACKNELL DAVID H AND GLENDA SCANNED BOX #598 I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 7818 ORION LN I CONTRACTOR: GRIDLEY COMPANY I PERMIT NO: 14100137 I OWNER'S NAME: CRACKNELL DAV ID H AND GLENDA 1122 ORCHARD CITY DR I DATE ISSUED: 12/02/2014 I OWNER'S PHONE: 4082534370 1 CAMPBELL, CA 95008 j PHONE NO: (408)374-0900 1 Q, LICENSED CONTRACTOR'S DECLARATION License Class+Lie. Contractor Contractor a �i C�Ii/'✓7 Date �L z 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 Workers Compensation, as provided for by Section 3700 of the Labor Code, for the (.erformance of the work for which this permit is issued. l 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. 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, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulati per the Cupertino Municipal Code, Section 9.18. Signatur Date �Z Z ❑ OWNEIZ-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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 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. 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ENCLOSE FRONT PORCH AREA (54 S.F.); INTERIOR REMODEL (900 SQ FT); RE -ROOF (E) 25 SQ'S; REPLACE (3) WINDOWS AND (2) DOORS; RELOCATE/REPLACE (5) Sq. Ft Floor Area: I Valuation: $208000 APN Number: 36220015.00 1 Occupaney Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM ALLED INSPECTION. Issued b� Z Z 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.I2 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipol Code, Chapter 9.12 and the Health & Safety Code, Sections �5,3 d 25534. Owner or authorized agent: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Ad .ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional 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(Mcupertino.org ❑ NEW CONSTRUCTION 91 ADDITION ❑ ALTERATION 1 TI ❑ REVISION 1 DEFERRED ORIGINAL PERMIT 9 PROJECT ADDRESS -7818 ����� ���� APN N J 0 OWNAME._NERK � 0� f� c� P � E-MAll` 7 �7 STREET ADDRESS ��,p CITY, STATE, ZIP FAX CONTACT NAME ` If'�N �% /3/a PHO ' j E-MAIL u0`�/,���U dGU'� ,�,C�ili✓f� �-'il7LL` .C/�J.�+t STREET ADDRESS CITY, STATE, ZIP FAX 1,?2- •r .z. C�I/I' '6'a ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACT9A NAME LICENSE MBLR LICENSE PE BUS LIClf C PANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP P NE ARCHITECT/ENGINEERNAME -7 LICENSE NUM ? BUS LIC9 0 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTIO F/✓ RK r, ��J ✓-J :-�o�� r�J i�i� �sn. �c� r _ EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) 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 9 DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEINGADDED? ONO ADDITION? ONO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RE Y_ :; TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO _ I7� / Jr j „y By my signature below, I certify to each of the following: I am the property owner or authorized a. to act a property owner's be If. I have read this application and the information I have provided is correct. I ha v read the Description of Work and v is accurate. I agree to comply ith all applicable local ordinances and state laws relating to buildin traction. thorize representatives of Cuperti o to enter the above identified property r inspection purposes. Signature of Applicant/Agent: Date: SUPPLEM AL INFORMATION REQUIRED _t. . YTAIV CAEcr TYPE t" : ROUTING sLI New SFD or Multifamily dwellings: Apply for demolition permit for'I THE ❑ _ existing building(s). Demolition permit is required prior to issuance of building OVER COUNTER BUILDING'YLAN REVIEW permit for new building. WNIN�p ANREVIEwx _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosures sTALnarRD PUBLIC WORKS: form if any Hazardous Materials are being used as part of this project. ? LARGE 4 d FIRE DEPTi � _ Copy of Planning Approval Letter or Meeting with Planning prior to � � � �"'� MATOR _ � -- SANI)'AR7�SrEVERDISTRICT submittal of Building Permit application. 1 . ❑ iENVIRONIVIENTALHEALLA .' Lott C 4J411� BldgApp_201 Ldoc revised 06121111 CITY OF CLTPERTINO N M-7 FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 7818 ORION LN DATE: 10/22/2014 REVIEWED BY: MELISSA APN: 362 20 015 BP#: / -31 *VALUATION: 1$208,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: 2nd Unit? Yes No OTC? 0 Yes No PENTAMATION 1 R3SFDADD PERMIT TYPE: WORK ENCLOSE FRONT PORCH AREA 54 S.F.),RECONFIGURE & REMODEL E INTERIOR 900 S.F. SCOPE RE -ROOF (E) 25 SQ'S & INSTALL 3 (N) GAS LINES, REPLACE 3 WINDOWS/2 DOORS (LIKE FOR OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,III-B,WN-B 54 $1,091.00 IADDPLCK $1,057.00 IADDINSP TOTALS: 54 $1,091.00 $1,057.00 MECH, HOURLY © Yes (2) No PLUMB, HOURLY ® Yes (F) No ELEC, HOURLY © Yes Q No Plumb. Plan Check 0.0 1 hrs $0.00 Plumb. Permit Fee: IPPERMIT Other Plumb Insp. 0.0 hrs $48.00 Lj 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 tlae Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 7%I%73) FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,091.00 900 s.f. $575.00 Remodel, Other IRE,LIRESOTH Suppl, PC Fee: Q Reg. Q OT Q.Q hrs $0.00 PME Plan Check: $0.00 2,500 s.f. $425.00 Re -roof IREROOFRES Permit Fee: $1,057.00 Suppl. Insp. Fee: Reg. Q OT Fo.Q hrs $0.00 # Plumbing $72.00 IPGASRES Piping, Gas <=4 Outlets PME Unit Fee: $0.00 PME Permit Fee: $48.00 # $431.00 Window / Sliding Glass Door 1WINREP Replacement T_T_ 5 # $2,515.00 Window / Sliding Glass Door IWINNEWNST New (Non -Structural) 0 Work Without Permit? ® Yes (j) No $0.00 Advanced Planning Fee: IPLLONGR $7.56 Select a Non -Residential Building or Structure Travel Documentation Fee: ITRAVDOC $48.00 Strong Motion Fee: IBSEISMICR $27.04 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $9.00 SUBTOTALS: 1 $2,287.60 $4,018.00 TOTAL FEE.F $6,305.60 Revised: 08/20/2014 RECEIVED Building Department City Of Cupertino APR 2 7 2015 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O BY Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: FeI8 InelUr✓ PERMIT # OWNER'S NAME: a9k✓C 6i�✓0'GG PHONE # y0/9) �-3 4J-?o GENERAL CONTRACTOR: ei.�'iv[ F Gor" / '✓ BUSINESS LICENSE # _ ADDRESS: ,12Z Lf2�4Ai.2 G>ry 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: Signature Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR Cabinets & Millwork ` Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping f Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing y/ Roofing Septic Tank Sheet Metal Sheet Rock Tile BUSINESS NAME ,-44T-/� j /* /.e G-r'�ST C'n,�ST L� OG z�s✓ Si`�F3T� �i7✓'c-G 0 K F4 Paun1 Tl 1J ,ryJWq ✓ p4y1-1AZ'L Date BUSINESS LICENSE # C><o2<5 `31SSo 22614 .2v73Z ,3! C) $ 5 i yvs zcc er l Contractor Signature /1 11 1 y Date