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15050091 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10590 CASTINE AVE CONTRACTOR: PERMIT NO: 15050091 ..Xhel3 . OWNER'S NAME: LAWRENCE&DEANNA WIEBE DATE ISSUED:05/15/2015 OWNER'S PHONE: 4086170933 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ���� REMODEL(E)252 S.F.KITCHEN,REMOVE DROPPED License Class_ Lic.# CEILING&RECONFIGURE PANTRY AREA,UPDATE REMAINING KITCHEN Contractor Z eX6 Cfepate 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 Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$70000 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:32644044 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 DAYS FRO LED 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 D granting of this permit. Additionally,the applicant understands and will comply ate: with all non-point source regulations per the Cupertino Municipal Code,Section 918. RE-ROOFS: Signature �►J7W Date .S All roofs shall be inspecte prior to any roofing material being installed.If a roof is (thinstalled 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 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. 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 with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505, 3 ,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized ageOt��Dater permit is issued. !2_ I certify that in the performance of the work for which this permit is issued,I shall t 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 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 918. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 b (408)777-3228• FAX(408)777-3333•building(a)cupertino.org ` CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ❑ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 0 t W�l Q APN# OWNERNAME/.rtV �e,a T PHO EMAIL T STREET ADDRESS G4,` CITY,STA ,ZIP QrO� FAX a . 7�J CONTACT NAM ' IP&S),;93_33y6 E-MAIL STREET ADDRESS G C STAT ZtP w F / '910 666es-0-115 ❑ OWNER ❑ OWNER-BUDAER ❑OIAWERAGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTORNAwhLICENS E LICT E BUS.LIC# COMPANY NAW I E-MAIL FAK COW STREET ADDRESSL CITY ATE ZIP - �� PHONE men ARCHITECT/ENGINEER NAME o LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK AA letllll 4 ✓ Z Ad e ki 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: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? []NO ADDITION? []NO PRE-APPLICATION El YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES ���-�� ATION: PLANNING APPL# E]NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO _-- - = ..* 'a ( O By my signature below,I certify to each of the following: I am the property o uth Ized agent t2Zc6Pn 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 verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building cons do . I authorize representatives of C pertino enter the above-ident'Ied roperty for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL ORMATIONREQUIREDNINE& 0 �oui�r sig° n - No 0-1 New SFD or Multifamily dwellings: Apply for demolition permit for g » � L OVE =THE OUNT�Rs"� �fl BU¢DINGPLANREYIEW existing building(s). Demolition permit is required prior to issuance of building �� k 5 permit for new building. 1] s = �r 1-0 mom rLA7vxEEVIEw 01119 'saw' _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑c T axD , L] B Licwo �' � form if any Hazardous Materials are being used as part of this project. v g� _ Copy of Planning Approval Letter or Meeting with Planning prior to g submittal of Building Permit application. _ °RAR is - w I :dc:. .v� �'��,��ENjYII2oI�*MENT.A7;;HEA�LTaCs_ BldgApp_201 1.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10590 CASTINE AVE DATE: 05/15/2015 REVIEWED BY: MELISSA APN: 326 44 044 BP#: "VALUATION: $70,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1 R3SFDREM USE: p PERMIT TYPE: i WORK REMODEL E 252 S.F. KITCHEN REMOVE DROPPED CEILING & RECONFIGURE PANTRY SCOPE AREA, UPDATE REMAINING KITCHEN a mp i .. b = z Meeh. Plan(heck Plumb. Plan Check Elec.Pian Check rblech. Permit Fee; I Plumb, Permit Fee: tslec. Permit Fe (Jtiser Vech. Insp, Other Plumb Insp. Other Elec.Insp. ldecfa. Insp. bee: Phimb. Insp.,bee: L.lec_Insp, Fee: NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These -fees are based on the prelfinina information available and are only an estimate. Contact the Dept for addn 7 in o. FEE ITEMS(Fee Resolution 11-053 Ef. 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F252 s.f. Remodel,Kitchen(<=300 sf) Suppl.PC Fee: (F) Reg. ® OT 0.0 hrs $0.00 $645.00 1REMRESKIT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. ®OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: F71 Administrative Fee: Work Without Permit? ® Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential 0 Building or Structure TrOvel Documenlation Fees: Strong Motion Fee: 1BSEISMICR $9.10 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $3.00 $12.10 $645.00 T3 AL Ec $657.10 Revised: 05/07/2015 CUpERTNO g4ilding ®e�?artment SCOPE OF WORK: is ® REVIEWEp FOR OoDt �-- COMti9UNl7`., (1) Demo existing kitchen cabinets, counters, dropped SUILDin, VELOPME Reviewed BY VISION - CUF EPgRTMENT ceiling and flooring. Remove framed pantry. Jhbissetof A�'�'RQVED ERTINO site duan; (2) Install new electrical circuits plugs, switches under�l,an p` ' " specifications h1UST ';rUctio be ke � p g � ' Sts o,- n. It is ung ,�ful pt at the therefrom w.; �tlons on san1e to make an cabinet fluorescent lights, recessed LED ceiling lights. The Stam 3 ,proval from , or to deviate be held to Iny ✓ h' "'n an,-+ `F�e Suildin (SO%' of lighting wattage shall be high efficiency) of an Pe or tie specir;cat;ons Official. Y Pro Vis, 3p�� SHALL NOT BYJr the violation (3) Install new subpanel in garage. PE _ or State Law. (4) Relocate waters and drain to new sink location R>�"T# replace sink. Install water line to refrigerator. °ted 0j (S) Replace existing hood duct with 8 " diameter duct. R O (6) Install R-13 insulation at exposed exterior wall. G Sheet :rock, tape and texture. nCE4,jVED (7) Install new cabinets, countertops and backsplash. (8) Install new hardwood flooring in kitchen, nook and SAY 15 2015 l entry. ' (9) Install new appliances and hookups as per manufacturer 's specifications and requirements. (10) All new sheet rock surfaces and exterior stucco patches shall be aimed to match existing. � '� �� �� -4r p SCALE: � �� /� X APPROVED BY: DRAWN BYT�te (11) Clean jobsite and remove all fob debris. DATE: - / ,�at 1 REVISED x c Cvdlne A fty x tom.: DRAWING NUMBER 3� xax (4�' /�°R° o xxo Com} 1,903 Ko-Y \ 511vl{ DW /rCUPERTINO RUildirng DI-?gat-,-;ent MAY 15 2015 C REVIEWED FOR CODE Cc)IviP__!:^ Reviewed By. i -5 DOOP13ED CE / I re)a o �,. REFER Pik k uA# s ♦/ A040&c L SCALE: «� tp /MI�fM TDRAWN BY DATE: car V REVISED !e KrT , ����� DRAWING NUMBER W (6) /,02 O.YXO (k) f93 xox Y Y 1 i i I i h CeYiZer -sit4 wid vi I ou/ r AWAKFAS g k/7- tf ECJ /N) CARWE S it COUN-r Ps 44Y 15?0 ��'ar�,(? t , ReVj�we @ Cp4�C� 4104 Tf Fr5 6 t 1 � i KIPE14LL SCALE: ft l m DRAWN BY� � DATE: /Z)esm ► s(eAe REVISED r SED k1 7, #6,V ACM0 D E L /0,6-90. ve, DRAWING NUMBER . �'� ���shy°;' �, 6 S"��f .►I"