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15050167CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 23500 CRISTO REY DR UNIT 406G CONTRACTOR: BAY AREA ENTERPRISE PERMIT NO: 15050167 OWNER'S NAME: FRAZIER WAYNE M TRUSTEE & ET AL 2110 MANGIN WAY DATE ISSUED: 05/28/2015 OWN1,R'S PHONE: 6505371523 SAN JOSE, CA 95148 PHONE NO: (408)238-5043 =+' LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL E] UNIT 406G - REPLACE 22 OUTLETS, 12 SWITCHES, 2 License Class Lic. #==1 BATH FANS, ADD/REPLACE 20 LIGHT FIXTURES, Contractor &L k✓`e,6, yrpr, '—tel REPLACE Sr_Date�`s_-) SHOWER PAN/FAUCET, CLOSE OPENING TO DEN & I hereby affirm that I am licensed under the provisions of Chapter 9 CREATE (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: $11000 erformance of the work for which this permit is issued. 1 have and will maintain Worker's Compensation hisurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 34253191 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 inspecti purposes. (We) agree to save 180 DA - LED INSPECTION. indemnify and keep harmless the City of Cup i o against liabilities, judgments, costs, and expenses which may ac a agains id City in consequence of the -Issu Date: granting of this permit. Additi n I. , the ap icant understands and will comply with all non -point source reg ul s per th Cupertino Municipal Code, Section RE -ROOFS: 9 18. - �cn/ 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: I hereby affirm that I am exec !pt 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 (Sce.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 533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Munic' Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) ould s re or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equ' men or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bayrea it Quality Management District I performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by will maintain compliance with the Cu tino Municipal Code, Chapter 9.12 and , the Health & Safety Code, Sections 2 50 , 25f33, and 25534. Section 3700 of the Labor Code, for theerformance of the work for which this p Owner or authorized agent: Date: permit is issued. 1 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 I 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(@cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI M REVISION /DEFERRED ORIGUNA L PF.RMTT !! PROTECT ADDRESS -t Z1O�j C Re � e � '7' APN # 2 ,.. (� '3 -1 �7 3 57 b0 I" b e r4--,Ao 7 f OWNERN PHONE %�� �� �� E-MAIL rh2. r-arG:MJ to . 3 —1 S Z r�r a nc�•e -� STREET ADDRESS Z 35766 cAr" s k— fie' t) CITY, STATE, ZIP ZIP. FAX O C' . r CFF CONTACT NAMEPHONE yv ~ L3 y 3 FE�IL-M a S + - 6 . reel t C V 0 -4 - STREET ADDRESSCITY t -A con STATE, ZIP -14 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT 1K -I CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME C'Ne. � l `S� LICENSE LICENSENUMBER -7 ' j % LICENSEYPE BUS. LIC # COMPANY NAME E=MAIL , 'Ge, 5 C' o fL4 FAX STREET ADDRESS Z - D ±� 11'7 W a c CITY, STATE, ZIP 607, tit- PHOBF z -; o C/ ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTd f J t' wQRK ��•� C�i"/,CGe/ �G< /2 S •2 �i �l %'Or�� >11t�� lcce a0— Xemocfe,. -eceS5-ed I,F`6 A05e de e,:l'%c t frit—i hC1&Setill G �' Cz_ f/ % J 1/(% % UrV EXISTING USE PROPOSED SE CONSTR. TYPE # STORIES I USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR FDEMO TOTAL AREA AREA I AREA NET AREA BATHROOM KITCHEN OTHER REMODELAREA REMODELAREA REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GA GE AREA: DETACH []ATTACH # DWELLING UNITS: ISA SECOND UNIT YES OCONDSTORY _[]YES BEING ADDED? NO it DDITION? []NO PRE -APPLICATION []YES IF YES, PROVIDE CO YOF PLANNING APPL # []NO PLANNING APPROV L R. IS THE BLDG AN L]Y RECE EICHLER HOME? ❑ NO TOTAL VALUATIONp� By my signature below, I certify toAeachof owing I am the prop,el��weer ora Iz gent to a on th ropertyowner's behalf. I have read this e1io r applicarion and the information I hd is correc . I have read t1;e DesBri of Wor and verify is urateI agree to comply with all applicable local ordinances and state laws relating tonstmcti I. ze representatives of Cupertino to en a abIlve-identifedproperty[[forr inspectinn.purposes_ Signature of Applicant/Agent: Date: (� , /ti 17 SUPPLEMENTAL INFO TI REQUIRED PLANCRECKTiPE ROUTING SLIP 11 OVER-THE-COUNTER ❑- BUILDIM1G PLAN REVIEW _ New SFD or Multifamily dwellings: pply for 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. ❑ LA,RGE. ` ❑ . FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior t0 El MAJOR- El SANITARY SEWER DISTRICT submittal of Building Permit application. 1:1 HEALTH BldgApp_2211.doc revised 06121111 ` eh✓'t 6(1"4 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 23500 CRISTO REY DR #406G DATE: 05/28/2015 REVIEWED BY: MELISSA APN: 342 53 191 BP#: "VALUATION: 1$11,000 *PERMIT TYPE: Building Permit I PLAN CHECK TYPE: Alteration / Repair PRIMARY Multi-Famil Dwellin Buildina is PENTAMATION 1 R2REM USE: y g >3 Stories 0 Yes 0 No PERMIT TYPE: WORK UNIT 406G - REPLACE 22 OUTLETS 12 SWITCHES 2 BATH FANS ADD/REPLACE 20 LIGHT SCOPE FIXTURES, REPLACE SHOWER PAN/FAUCET, CLOSE OPENING TO DEN & CREATE (N) NOTE: This estimate does not include fees aue to otner vepartments (ie. r[anning, �ruuuc rr urna, i -arc, uuisasu,y �-, �wss say .•... .s. ..I:... .,s s:.. ..7..bla s,d - n" lip as, peamato- Contact tho Dont for addn'l info. FEE ITEMS (Fee Resolution 11-053 E f 7/1/132 Mech. Plan Check0.0 hrs $0.00 Plumb. Plan Check 0.0 hrs $0.00 Elec. Plan Check 0.0 hrs $0.00 Mech. Permit Fee: IMPERMIT Plumb. Permit Fee: 1PPERMIT Elec. Permit Fee: 1EPERMIT FOtherMech. Insp. 0.0 hrs $48.00 Other Plumb Insp. hrs $48.00 0.0 Other Elec. Insp. hrs $48.00 0.0 , Insp. Fee: f'hunb. hasp. Fee: Elec. Insp. Fee: NOTE: This estimate does not include fees aue to otner vepartments (ie. r[anning, �ruuuc rr urna, i -arc, uuisasu,y �-, �wss say .•... .s. ..I:... .,s s:.. ..7..bla s,d - n" lip as, peamato- Contact tho Dont for addn'l info. FEE ITEMS (Fee Resolution 11-053 E f 7/1/132 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. $431.00 Remodel, Other IREMRESOTH Suppl. PC Fee: (E) Reg. 0 OT 0.0hrs $0.00 PME Plan Check: $0.00 L 2 1 # $50.00 Mechanical 1 1BREMVENF Ventilation Fan Permit Fee: $0.00 Suppl. Insp. Fee -0 Reg. 0 OT 0.0 1 hrs $0.00 = # Plumbing $10.00 1BPFMTURE Fixture set on One Trap PME Unit Fee: $0.00 PME Permit Fee: $144.00 = # Electrical $118.00 IBREMRECEP Recep/Switch/Outlets Construction Tax: T7 Administrative Fee: ]ADMIN $45.00 20 # $72.00 Electrical IBREMFIXT Fixtures, Lighting 0 0 Work Without Permit? 0 Yes 0 No $0.00 Advanced PlanninL Fee: $0.00 Select a Non -Residential Building or Structure 0 0 i Travel Documentation Fee: ITRAVDOC $48.00 Strom Motion Fee: IBSEISMICR $1.43 Select an Administrative Item Blda Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $239.43 $681.00 TOTAL, FEE: $920.43 Revised: 05/07/2015 'gr,k. tA, �,,eL_ cVk-t-4-,r 0 V,t°S C) C>�; 5f0y CUPERTIN® OFFICE COPY :Building Department - --- - - T - MAT -72 -20: P,LREVI!EVI�iEb-fin G'UDE CO;ii ID E Balcony FloF�r - i� I�5"10�jx 7"T i ®i I Tj D +, �c in-Ig =1 x i co--i�ce�, 1 -i _ i c o , 2 + Den �- z I� �� Z I I 1 !Q ' -- -- 7l „F — © --I Closet - o I- ! i r --Closet 4'11- _ -JJ° -!,71 ,-��:-- o-v-�—,�1�—(_!- W, _c _r_ r- i -4i M ISI II Jf Entry--- m >v i 0 o: (Dr ,� 2 a.� r.— _ i I Bath ��- C� m I 16'11° x 8'111 �` (i`�cher►- �— - 2' "' x 5°6" 3'6�x 2`8" T- + I I 87 � x 8''7� ° -I-1- CVd !T CL�GN '�. ZZ C-iLGY:C 'r -X "' 1 �-P jLS /Z I. y ,� 2-0 re� re- CeSsec/ �t D I�fctf/ Ctcsse ��rt �- BQev, rit�r,- 5-aFr�'t-.� close' -f- �,Jc 1/� 7�eplo�e SG�awer an Wo//S Wt �f-Gt et OL""e o'uarh 0 ® Emergency Response System ® Electrical Outlet ® Cable Television Outlet Tr Telephone Outlet = 1 foot /2�'� (// Model B One Bedroom a One and One -Half Bath � Den INTERIOR LIVING SPACE 95Square Feet BALCONY SPACE Floor plans are representative. Actual measurements and layout may vary. 106 Square Feet AT RANCHO SAN ANTONIO /LUrv1 rw�i Nj iWI'lf