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15060189CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19967 PEAR TREE CT CONTRACTOR: THD AT-HOME PERMIT NO: 15060189 SERVICES, INC. OWNER'S NAME: MOORE RONALD 2690 CUMBERLAND PKWY STE 300 DATE ISSUED: 06/29/2015 OWNER'S PHONE: 4082531197 ATLANTA, GA 30339-3913 PHONE NO: (510) 731-1004 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL C INSTALL HARDIE SIDING OVER BOARD AND BATTEN License Class17 Lic. # NK��– ( SIDING 11 11't� na��E 5�. Zq 1 ON THE FIRST FLOOR ONLY (2100 SQ FT). Contractor 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 omp nsation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $25530 e ance of the work for which this permit is issued. and will maintain Worker's Compensation Insurance, as provided for by cti n 3700 of the Labor Code, for the performance of the work for which this APN Number' 31630085.00 ' Occupancy Type: pe t 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 FROM 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 Issu b ��✓ 47—e Date:granting of this permit. Additionally, the applicant understand will comply ed y:. with all non -point source regulations per the Cupertino icipal Code, Section 9.18. G �`G% S 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. ❑ OWN ILDER 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) 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. 1 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 Distri performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Cha and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 2553 Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized t: 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 CONSTR ENDING 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.) bender'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 12 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTI NO 1 (408) 777-3228 • FAX (408) 777-3333 • build ing(a1cupertino.orcl ❑ NEW CONSTRUCTION ❑ ADDITION f4ALTERATION / TI ❑ REVISION /DEFERRED IORIGINAL PERMIIT # PROJECT ADDRESS 'T ' APN # OWNER NAME \ / PH 0 E-MAIL FV�fv� I l I �� ��, STREET ADDRESS ?F-/kTTr�'f L --T CITY, STATE, ZIPFAX C -LI) 2-T/,) L SOl CONTACT NAME JEFF RAINEY PHONE 510-427-4260 E-MAILJEFFREY.RAINEYQATT.NET STREET ADDRESS 1069 EDGEMERE LANE CITY, STATE, ZIP HAYWARD , CA 94 54 5 FAX 510-783-1041 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR 't CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER 0 TENANT CONTRACTOR NAME LICENSE NUMBER ICENSE TYPE 713, BUS. LIC #d / 836021 C39,C13,C17 COMPANYNAME THD AT HOME SERVICES E-MAIL FAX 510-783-1041 STREETADDRESS 2456 VERNA COURT CITY, STATE, ZIP SAN LEANDRO,CA 94577 PHONE510-785-6340 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK L 2 1 !s� 5• c C/l.� r - EXISTING USE PROPOSED USE CONSTR. TYPE #STORIES W USE I')'PESQ.PT. % A[A A 1.10A i EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK ARPBEINGADDED? TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ATTACH # DWELLING UNITS: COND UNIT ❑ YES SECOND STORY ❑YES []NO ADDITION? []NO PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVE T yALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? WO 5 3 By my signature below, 1 certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf'. I have read this application and the information I have provided is correct. I have read the Description of Work and ver! i ' rate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cu enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: 2 SUPPLENtMTAL INFORMATION D PLAN CHECK TYPE ROUTING SLIP OVER-THE-COUNTER BUILDING PLAN REVIEW _ New SFD or Multifamily dwellings: r demolition permit for 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 ❑ STANDARD ❑ 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 ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06121111 1 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These_/ees are based on the preliminary information available and are only an estimate Contact the Dept for addh 7 info. FEE ITEMS (Fee Resolution 11-053 Eff.' 7,7/13) ADDRESS: 19967 Pear Tree Ct DATE: 06/29/2015 REVIEWED BY: Sean F7t' APN: BP#: *VALUATION: 1$25,530 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: -T I PENTAMATION 1 GENRES PERMIT TYPE: WORK Install hardie siding overboard and batten siding on the first floor only 2100 sq ft). 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_/ees are based on the preliminary information available and are only an estimate Contact the Dept for addh 7 info. FEE ITEMS (Fee Resolution 11-053 Eff.' 7,7/13) Xlech. Plan Check Plumb. Plan Check Elec. Plan Check F7t' wmh. Permit 1 E•7ec. Permit h< Other Alech. Irtsp. Other Plumb lnsp. Other Elec. Insp, I'lech. Insp. Fee: Phrmb. hup. Fe" Elec. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These_/ees are based on the preliminary information available and are only an estimate Contact the Dept for addh 7 info. FEE ITEMS (Fee Resolution 11-053 Eff.' 7,7/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 =s.f. $0.001 Siding 1 All Other Suppl. PC Fee: (F) 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 -0 Reg. Q OT 1 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administrative Fee: O E) Work Without Permit? © Yes (j) No $0.00 Advanced Planning Fee. $0.00 hours Inspections $286.00 ISTINSP Inspection, Hourly Q 0 Travel Docurne alaiiori fees. Strom Motion Fee: IBSEISMICR $3.32 Select an Administrative Item Bldsz Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: $5.32 $286.00 TOTAL FEE: $291.32 Revised: 05/07/2015 ��������� w�~�� "~'~~^'-- 7 PLANNING DEPT CUPERTINO S|DEALLB0ARD&8ATTENAREAS.(ALL SIDES OFH0N1,F)&SECTIONS EITHER SIDE 0FTHE FRONT BAY WINDOW. (FIRST STORY 0NL8. LEAVE (E) MASON|T[S0|NG. FLOOR PLAN FROINf fA� PEA�TREE COURT J:UN 2 APPROVED -his set of plan be kept atLe nd specifications MUST 11 to make Y CD LLi the,efrom, wit ut approval from the Building Official. SHALL NOT The Stamping this plan and specifications it or to be an approval of theviolation be held to pe S of any City 0 dinance or State Law. of any provis ry- ��������� w�~�� "~'~~^'-- 7 PLANNING DEPT CUPERTINO S|DEALLB0ARD&8ATTENAREAS.(ALL SIDES OFH0N1,F)&SECTIONS EITHER SIDE 0FTHE FRONT BAY WINDOW. (FIRST STORY 0NL8. LEAVE (E) MASON|T[S0|NG. 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