15050155 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10461 LANSDALE AVE
CONTRACTO"4 ' PERMIT NO: 15050155
DATE ISSUED:05/26/2015
OWNER'S NAME: ZEEV KALIBLOTZKY
PHONE NO:
OWNER'S PHONE: 4084105508
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL E] COMMERCIAL E]
REPLACE 7 WINDOWS IN(E)OPENINGS,I SLIDING
License Class ' Lic.# � $ GLASS
I �5� DOOR IN(E)OPENING,REPLACE(E)DOOR AT SIDE OF
Contractor J, GARAGE,REMODEVRECONFIGURE(E)MASTER
I hereby affirm that I am licensed under the provisions of Chapter 9 BATHROOM&
(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 Valuation:$75000
performance of the work for which this permit is issued. Sq.Ft Floor Area:
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:36911010 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 ALLED INSPECTION.
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYPS F
indemnify and keep harmless the City of Cupertino against liabilities,judgments, .� l
costs,and expenses which may accrue a ainst said City in consequence of the a Da e: l/(�
granting of this pe t. Additionally,t e pplicant understands and will comply
with all non-point so regulaE'ons p r Cupertino Municipal Code,Section
9 18. -ROOFS:
'.
Signature ' Date Fs" 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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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) HAZARDOUS MATERIALS DISCLOSURE
I,as owner of the property,am exclusively contracting with licensed contractors to
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 it Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with he Cupertin unicipal Code,Chapter 9.12 an
the Health&Safety Code,Sec ns 5 5, 3,and 25534.
I have and will maintain Worker's Compensation Insurance,as provided for by
2 5
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized ag 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 CONSTRUCTION LENDING AGENCY
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 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.)
forthwith comply with such provisions or this permit shall be deemed revoked. 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
k
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 150
(408)777-3228• FAX(408)777-3333•building(LDcugertino.org u
CUPERTINO
NF
SW CONSTRUCTION ❑ ADDITION ❑ TERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESSAPN# �
ICQG\ W\�
OWNERNAMEg P ONE E-MAIL
"1C•�C.t(3�-t�'rz�.�- � �f.�.�i���N�-U �C�—`{(c�—�c��6
STREET l0� S e S, T�ArTE,Z (�C) �—y_` FAX
CONTACT NAME I I � V �V\�rvy���
STREET ADDRESS CITY,STATE,ZIP FAX
❑ OWNER ❑ OWNER-BUn.DER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTORAGENT . ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CO CTOR NAMEEQ0 LICENS$ E BUS.LIC#
1\r�Vl�fj E yvl,, FAX
�STREET ADpRESSVC��w' V CR
T E,ZIP aw— CA 30_3? �I- t_Ga��7�617
ARCHrTECT/ENGINEFR NAME LICENSE NUMBER V BUS.LIC# D
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK
�?-� SVlcxi
IJI iu_ L1_ 5'7 c,CG 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 DECK/PORCH AREA GARAGE AREA: 0 DETACH
❑ATTACH
»DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES
BEING ADDED? []NO ADDITION? ❑NO
1
PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES J2ECEI VED BY a F x*'` TOTAL VALUATION:
PLANNING APPL» ❑NO PLANNING APPROVAL LETTER EICH R HOI.IE? ❑NO ?'
i
By my signature below,I certify to e the followin I am h property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I hav ro i co ect, a-, ead the Description of Work and verify it is accurate. I afire to comply with all applicable local
ordinances and state laws relating to di g stru tion. I a ri representatives of Cupertino to enter the above de tiff 'pro for inspection purposes.
Signature of Applicant/Agent: Date: S l^D
SUPPLEM=NTALFORMATION RE UI DMew SFD or MuItifags: A 1 for demolition ermit for PPY P f OVERTE�GOUIiTER G� BUILDIIVGPLAIVREVIEw Z e '
existing building(s). Demolition permit is required prior to Issuance of buildingk a a t x x ,
permit for new building. ANNINerLAiv`REIEw
4tiyi v' $°toms *s. y?yE�eNY-rf '�sM
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure Q�sTANnATiD "" , � F �1] PIrBLtcwoTucs" �� �
II2ETform if anHazardous Materials are beingused as art of this project. _
:
_Copy of Planning Approval Letter or Meeting with Planning prior to
i� MAJOIi Yi 3 cc ❑ SAIVTPAI�XSEVYER�IS�RICy " -
submittal of Building Permit application. a .
nIRONMEIQTtL'tHEAtiTHk
B1dgApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
101 FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 10461 LANSDALE AVE DATE: 05/26/2015 REVIEWED BY: PAUL
APN: 369 11 010 BP#: *VALUATION: 1$75,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY PENTAMATION 1 GENRES
USE: SFD or Duplex PERMIT TYPE: i
WORK Re lace 7 windows in E openings, 1 slidinglass door in E opening, replace E door at side of
SCOPE garage, Remodel/reconfigure (E) master bathroom& add 1 new window, Remove siding&install stucco.
r ,
,Meeh. Plan Check Plurrrh. Plan Check Elec..Plan Check
Meeh,Permit Fire: Plumb.Permit Fee: Elec. Permit Fee:
Other Hct h, Insp. Other Plumb Insp, Oder'I lec.Insp.
79eclz Insl�. Fee: Plumb, hup. Fee: 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,eta). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 E,ff. 7/1/13) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.0011 320 1 SS. Siding
Suppl.PC Fee: Reg. OT 0.0 hrs $0.00 $431.00 ISIDEOTHER All Other
PME Plan Check: $0.008 # Window/Sliding Glass Door
Permit Fee: $0.00 $431.00 1 WINREP Replacement
Suppl.Insp.Fee-(E) Reg. Q OT 0.0 hrs $0.00 1 # Window/Sliding Glass Door
PME Unit Fee: $0.00 $503.00 1 WINNEWNST New(Non-Structural)
PME Permit Fee: $0.00 = s.f. Remodel,Bath(<=300 sf)
Construction Tax: $645.00 IREMRESBAT
Aclrninislrative.Fee: 0
Work Without Permit? ® Yes E) No $0.00
Advanced Planning Fee: $0.00 Select a Non-Residential 0
Building or Structure 0
Travel Documentation Fees: A
Strong Motion Fee_ IBSEISMICR $9.75 Select an Administrative Item
Bld¢Stds Commission Fee: IBCBSC $3.00
SUBTOfiALS� $12.75 $2,010.00 k TOTAL FEE:
; ,_ ,
Revised: 05/07/2015
Jo NORD WOLFE GENERAL CONTRACTING, INC.
17401 Lakeview Drive,Morgan Hill,CA TEL:408-688-7669
web: inordwolfe.com email: iim ,jnordwolfe.com
California State Contracting License Number B-899340
SCOPE OF WORK
Owners:
Zeev Kaliblotzlcy "
Yael Rindenau ,q� P�`Oc _KED BY
10461 Landsdale Drive
Cupertino, CA 95014 , ��'�� DAT,E S
TEL: (408)410-5508 ! PLANNI G DEPT
CUPERTINO
Job Site Location:
10461 Landsdale Drive, Cupertino, CA 95014
Code:
All work to be in comp g liance with 2013 CA buildin codes ®FICE COPY
All new windows and patio door to meet egress requirements and be tempered were required by code
All new windows will be insulated double pane Low-E argon gas filled (Marvin/Integrity and JeldWen)
Scope of work:
We hereby propose to furnish all necessary Labor and Materials to complete the project as outlined below
and that reflect the drawing provided by contractor and approved by owner.
Remove and lace all E exterior windows with N double ane Lo ! ` `
P O ( ) p r� ��4 vs using(E) locations
Remove and replace garage side entry door and patio glass sliding doo> in cations
Install(N)2x pre primed exterior window trim to all windows and of" rs �
., p
Remove(E) lap siding on front of house, install 3/8" ply, and install tly /sand finislV,-/// ��l
Repair(E) cracks in stucco, patch (N)window areas and skim coAtU#e house i+ , b�ucpo san��iy � �/Ato
Install (N)R-13 fiberglass bat installation to front wall of house ? �y pa
Install (N)R-13 value to remaining exterior walls, including garage all�vQ*lqlowni?dvllulose ��t
Install (N)R-38 value in attic with }R B'uI'LD1�NG 1DN S�N'-CUFERTIR HENT P�eC/ey coo
Refinish all interior hardwood flooring p
Remodel and reconfigure master bathroom iir-Ccgo pda� -x?i1 ee i the provided drawings < Afcp
Supply and install (5) custot clos t a met ei close,es ,
is sa tpp�ans anc�speci�icat:ons MUST he kept at the
Paint entire interior and exteror .p. liQuse
JUL;S ko UD i,i`;construction. It IS Lffllmi iful to rna,i;B any
c ancien or altos ions on sa rne, or to cieviate
thorafrom,without approval from the Building Official.
Tho stamping of this plan and srocifications S!-;AI-L 113T
be h&Id to per.-nit or to be.an approval of the vioiat on
James N. Wolfe of a provisions of any City Ordinance or State Law.
President ! LJc.I v T' ''/ � /�
BY i!
DATE _
PERMIT IVO. y c
1
(N) 6068 XO PATIO (N) 5046 FIXED (N) 4640 2XCASEMENT (N) 5036 2X CASEMENT (N) 5036 2X CASEMENT
(E) 6068 XO PATIO (E) 5046 FIXED (E) 4640 XO SLIDER (E) 8020 XOX SLIDER (E) 8020 XOX SLIDER
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(E) 157(}�NOECTf(NlA GARAGE DOOR
EXISTING WINDOW AND DOOR SIZES WITH NEW SIZES INCICATED
Ag� c�
10'-11"
4,_34„ 4'_34° 2'_32°
(E) 3020 SLIDER
ter-
in
QQ Nt $ $$
EXISTING MASTER BATHROOM
10'-11°
4'-7° 3'
(N) 2030DH TEMP OBS (N) 2030DH TEMP OBS
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31-5° 41-1° 31-5°
6°
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PROPOSED NEW MASTER BATHROOM 4/ IZ-- ILI
CUSTOM VANITY W/ MIRROR 30'X42'
MEDICINE GRANITE TOP
GFI OUTLET
CABINET TILE SHOWER FLOOR
TOILET FAUCET & WALLS TO CEILING
%HT
CONCE UM SINK W/ BENCH
(N) 2030 P OBS (N) 2030 DH TEMP OBS
4° RECESSED LED LIGHT 42' TILE PONY WALL
o
4' RECESSED LED LIGHTS
TP HOLDER
HAND HELD SPRAY WAND
® SHOWER
NICHE
FAN
SHOWER DRAIN
2668 POCKET DOOR
sa'r 1
SHOWER VALVE
FAN FRAMELESS GLASS AND HEAD
00 SHOWER DOOR W/
O� SWITCHES IV 24' TOWEL RACK
4' RECESSED LED LIGHTS TYP,
�-� �i0 a TILE FLOOR
4 ROBE HOOKS
PROPO3I9 NEW MASIRHROOM 2468 BATH DOOR ELECTRIC HEATED
�? �y TOWEL RACK
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