Loading...
15060008 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10534 MERRIMAN RD CONTRACTOR:MICHAELS PERMIT NO: 15060008 CONSTRUCTION OWNER'S NAME: DONALD F MORRISON JR 707 LINCOLN AVE DATE ISSUED:06/02/2015 OWNER'S PHONE: 4085065149 SAN JOSE,CA 95126 PHONE NO:(408)292-4999 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL E] COMMERCIAL E] `I REPLACE 6 WINDOWS(3 ALTERED TO MEET EGRESS)& License Class LieA 1!"9 �tl 2 SLIDING GLASS DOORS(DUPLEX) Contractor 's LLS Date I hereby affirm that I am licensed under the provisions.o-Capter 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 erformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$10260 r } 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:34216094.00 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 V IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 18 O RMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter LLED INSPECTION. upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,jud ents, costs,and expenses which may accrue against said City in consequence ss Date: 6 Z granting of this permit. Additionally,the applicant understands and will comply with all non-point s rce regulation the Cup7Date o Municipal Code,Section 9 18. RE-ROOFS: SignatureW;: 6/0//v 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 Date: Signature of Applicant: 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) property,am exclusive) g HAZARDOUS MATERIALS DISCLOSURE 1,as owner of they 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 ay Area Ai Quality Management District I performance of the work for which this permit is issued. will maintain compliance with th up,rtino uni ' I Code,Chapter 9.12 and the Health&Safety Code,Secti s 55 ,2 3 a 25534. 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 Owner or authorized agent Date: v 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 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 CUPERTtt�tO (408)777-3228^ FAX(408)777-3333•building aOcupertino.org / 6 ODf 1� El NEW CONSTRUCTION ❑ ADDITION El ALTERATION/TI ❑ REVISION/DEFERRED` ORIGINAL PERMIT# PROJECT ADDRESS // _®a APN# .J _ 1 6 - 0'` Ll OWNER NAME PHONE pG '�! E-MAIL l/-` STREET ADDRESS ,0t/lj dry'.� ' lel-•7 n 1 CITY, STATE,ZIPS ��V Ge3 FAX CONTACT NAME 4��'oeggr �I v/ PHONrq V V7 rG/�4VVS- E-MAIL STREET ADDRESS -7®7 �l y�GO/a >I CITY,STATE,ZIP � F El OWNER ElOWNER-BUIIAER �"❑ OAWERAGENT CONTRACTOR CONTRACTOR AGENT • ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTORNAME Aa�'c�®`�s LICEi�TSENUMBER ®f2 spgL/ LICE YPE� BUS.LIC J ®7 7 COMPANY NAME `®�i„?� EMAIL �I�, 1,,��yj d,��- e// / FAX 2' y? STREET ADDRESS CITY,STATE,Zv1i5/_ 1 ���Jl� LC `� ARCHITECT/ENGINEERNAME LICENSENUMBER ✓!� BUS.LIC 9 7 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK �/.�I d!J �l�j✓�,,l�uN!(���/�d fid!Gly(T/ 7��/�L U1 G 'mob`C�!/v�S1 EXISTING USE PROPOSED USE CONSTR.TYPE 4 STORIES USE TYPE OCC. SQ.FT. VALUATION(S) E>aSTG 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 ARE I GARAGE AREA: DETACH ❑ATTACH 9 D WELLING UNITS: ISA SECOND UNrr ❑YES SECOND STORY ❑YES BEING ADDED? NO ADDITION? [_]NO PRE-APPLICATION ❑YEs IF YES,PROVIDE COPY OF IS THE BLDG AN ❑ CEIVED$ -` T V O PLANNING APPL,- ❑NO PLANNING APPROVAL LETTER EICHLER HOAIE? ❑NO = _ By my signature below,I certify to each of the following: I rd perty owner r authorized agent to act on the property owner's behalf. I have read this application and the information I have pr ed is co ect, avhe Description of Work and verify it is accurate. I a ee to comply with all applicable local ordinances and state lav s relating to b representatives of Cupertino to enter the above fied ope y for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMEN LORMATION IRs } QUED P-INC�CFKIIPE__ _ _ROUTIItGSLIP_- New SFD or Multifamily dNvellings: Apply for demolition permit for Q out RTi coillvTER flrBTJIIDINGPiAx4REviE« existing building(s). Demolition permit is required prior to issuance of building =4 s permit for new building. EXPxss d ❑ TLANRINGPLANREVIEw _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure QsTAxDA�zD ❑PUBLT wpRxs � form if any Hazardous Materials are being used as part of this project. _ _Copy of Planning Approval Letter or Meeting with Planning prior to ;© ,MA70R r- a SAATI`Al2Y SEWER DISTRICT... submittal of Building Permit application. t .:��.'.a;".. 5.�.'.:'?' �.-„�_��t�_„�.EIA'VIR01\'MEPLT-r1ti-HE TH."" �•' BldgApp_201 1.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10534 MERRIMAN RD DATE: 06/02/2015 REVIEWED BY: MELISSA APN: 342 16 094 BP#: *VALUATION: $10,260 *PERMIT TYPE: Building Permit =PLAN TYPE: Alteration/ Repair PENTAMATION PRIMARY 1 GENRES USE: SFD or Duplex PERMIT TYPE: WORK REPLACE 6 WINDOWS 3 ALTERED TO MEET EGRESS &2 SLIDING GLASS DOORS DUPLEX SCOPE Mech. Plurr Check Plum Plan C:'I Elec.Plan Check blech. Permit Fee: Plumb,Permit Fee; Elec. Permit Fee: Other 1/ech. tnsp. Other Plumb Imp. Other Elec.Insp. ltc:ch.Insp.Fee: Phtnab. 111sp. Fee: Elec.Insp. Pee: 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 prelimina information available and are onl an estimate Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 E{f. 7/1/13) FEE QTY, MISC ITEMS Plan Check Fee: $0.00 ® # Window/Sliding Glass Door Suppl.PC Fee: (j) Reg. Q OT 0.0 hr's $0.00 $431.00 1WINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee: Reg. Q OT0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: _T _=L Administrative Fee. 0 Work Without Permit? 0 Yes (j) No $0.00 G Advanced Planning Fee: $0.00 Select a Non-Residential E) Building or Structure Travel Doeumentativn Fees: Strong Motion Fee: IBSEISMICR $1.33 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTAL_ S:,; $2.33E$E431.00 . TOTAL FEE: 433 3 Revised: 05/07/2015 CvMkILINITY DEVELOPMENT DEPARTMENT ScooC-41 F— , . ZaaX-,e7— V�� BJILDING DIVISION - CUPERTINO .3-��t/,���vn� ���o�� ..��✓�ivG��J� ��`�� �his ��� of plans and specificationsAPPROVED ST be kept at the e6, iLzz,7f ca'04E job S + during construction. It is unlawful to make any cha ,;es or alterations on same, or to deviate c� �3 c,q. e . C4Vf-ZS JA11# %W/y 'hern••om, without approval from the Building Official, Th . amp,ing of this plan and spedficat ons SHALL NOT GSSS�j cs'lC�`�'j'Jl� -.-id to pPrmlt Cr pproval of the violation 0 on- y n - or State Law. g, CLIP r/[V© � j1 � ��`' o �6`• °16�� ° b REL/JFw'�Q �ucif$-Po776 JOIN Pevi wecteOO EP rn j. cokl v Ar JUN:..9;2 2015 SS ®R C !f PLJOT PLAN ECKED BY r� $ lVG DATE PLANNIN DEPT CUPERTINO k