12120080I CITY OF CUPERTINO BUILDING PERMIT I
IBUILDING ADDRESS: 10163 MINER PL I BARBARA CONTRACTOR: MCGUIGAN JOHN T AND I PERMIT NO: 12120080 I
OWNER'S NAME:
CUPERTINO, CA 95014-2201 PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
REMODEL ATTIC SPACE TO STORAGE SPACE (151 SQ FT);
License Class Lic. # ADD 37 SQ FT TO ATTIC/LIVING SPACE ABOVE FRONT
DOOR; ADD (5) LIGHTS IN DINING AND (4) LIGHTS IN
Contractor Date REV # 2 - REMOVE (E) SHAKE ROOF AND INSTALL (N) LIFETIME COMP ASPHALT
I hereby affirm that I am licensed under the provisions of Chapter 9 SHINGLES - 30 SQ'S - ISSUED 10/12/2015
(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:
1. 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.
2. 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
permit is issued.
APPLICANT CERTIFICATION
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,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply with
all non -point source regulations per the Cupertino Municipal Code, Section 9.18.
Signature
Date
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
1. 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
ale (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
1. 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.
2. 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
permit is issued.
3. 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
become subject to the Worker's Compensation provisions of the Labor Code, I
must forthwith comply with such provisions or this permit shall be deemed
revoked.
APPLICANT CERTIFICATION
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,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply with
all non -point source regulations per the Cupertino Municipal Code, Section 9.18.
Signature Date
Sq. Ft Floor Area: I Valuation: $10000
APN Number: 31626070.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSP CT ON.
Issued by: ?,flu L_ 5tw000 Date:
RE -ROOFS:
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.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Owr o trizcdagent: l _L _<r
Date:
v
CONSTRUCTION LENDING AGENCY
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.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
CITY OF CUPERTINO
IYi�'Jy1 FEE ESTIMATOR —BUILDING DIVISION
FEE ID ROOF AREA
s.f.
1 REROOFFRES 3,000
ADDRESS: 10163 Miner Place
DATE: 10/12/2015
REVIEWED BY: Paul
O
APN: 316 26 070
BP#:
*VALUATION: $22,250
PERMIT TYPE: Minor Building Permit
PLAN CHECK TYPE: Re -roof
PRIMARY SFD or Duplex
USE:
Num
PENTAMATION 1 SFDWLROO
PERMIT TYPE:
WORK
Rev #2 - Remove E shake roof and Install N lifetime comp asphalt shingles - 30 S 's
SCOPE
rct?Irl. Insn Fee
FEE ID ROOF AREA
s.f.
1 REROOFFRES 3,000
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 preliminary information available and are only an estimate. Contact the Dept for addh7 info.
FEE ITEMS (Fee Resolution 11-053 Eff 7,/1/13)
Gii'C /r. 1'lun C.1tdC' i
NIfir b. Pial? CliccA
Elec. Pian Check
rt P-ee
Plumb, Permit Fee:
EIec. Permit Fee:
OthertllErc'1r.11n.s �
OtherPlumb lrup.
Other Elec.
Num
tInsp.
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 preliminary information available and are only an estimate. Contact the Dept for addh7 info.
FEE ITEMS (Fee Resolution 11-053 Eff 7,/1/13)
FEE
QTY/FEE
MISC ITEMS
Pian Check Fee:
:` uppl..1'i�' Fee
Num
Permit Fee:
$51
rct?Irl. Insn Fee
".A lec'Jl.;'let
''l7f rb %`�1 ch.;`Elec Per"n7ii P'(,,e:
(,o 2sowction I`ay:
-lclrninistr ative kee:
Work Without Permit? 0 Yes E) No
$0.00
r"Ivel T)oet'vnenlolio n l`'ees.
Strom Motion Fee: IBSEISMICR
$2.89
Select an Administrativem
I
,
Bldg; Stds Comm
Commission Fee: 1BCBSC
$1.00
SUBTOTALS:
$513.89
$0.00 TOTAL FEE:
1 $5 .
7 -
Revised: 10/01/2015
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10163 MINER PL
CONTRACTOR: MCGUIGAN JOHN T AND
PERMIT NO: 12120080
BARBARA R
OWNER'S NAME:
CUPERTINO, CA 95014-2201
PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL
License Class Lic. #
REMODEL ATTIC SPACE TO STORAGE SPACE (151 SQ
FT);
Contractor Date
ADD 37 SQ FT TO ATTIC/LIVING SPACE ABOVE FRONT
I hereby affirm that I am licensed under the provisions of Chapter 9
DOOR; ADD (5) LIGHTS IN DINING AND (4) LIGHTS IN
(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: $10000
performance of the work for which this permit is issued.
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
,CPN Number: 31626070.00
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 T CALLED-DWYPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
Issued Date:
with all non-point source regulations per the Cupertino Municipal Code, Section
9.18.
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.
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
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)
1, 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, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
_ 4 !/
Owner or authorized agent: i 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
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
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 l/ l
CITY OF CUPERTINO
[ l FEE ESTIMATOR — BUILDING DIVISION
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 Preliminary information available and are onlv an estimate. Contact the Dent for addn I into.
FEE ITEMS (Fee Resolution 11-033 fff. 711112)
ADDRESS: 10163 Miner Place
DATE: 12/17/2012
REVIEWED BY: Sean
.''i%Ch I'' F^t l? T.'t ,_:.,
APN:
BP#: ��lan ),
*VALUATION: $10,000
PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Addition
PRIMARY SFD or Duplex
USE:
PENTAMATION 1 GENRES
PERMIT TYPE:
wORK
Remodel attics ace to living space 151 sq ft • add 37 sq ft to attic/living space above front door.
SCOPE
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 Preliminary information available and are onlv an estimate. Contact the Dent for addn I into.
FEE ITEMS (Fee Resolution 11-033 fff. 711112)
'leen. Alan Cheer:
Pium11. Piao € r'recl.
<:. I'Ic:>; C:her;n
.''i%Ch I'' F^t l? T.'t ,_:.,
/y?itrrl;. E'f r it i7 I'""
r J Permit F<
Otlw ilfch' lav,
r^1e r 1111f?:h I1,S,Li
I
Suppl. PC Fee: ) Reg. 0 OT0.0
hrs
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 Preliminary information available and are onlv an estimate. Contact the Dent for addn I into.
FEE ITEMS (Fee Resolution 11-033 fff. 711112)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee: Hourly Only? () Yes Q No
$0.00
hours
$266.00
Plan Check, Hourly
ISTPLNCK
Suppl. PC Fee: ) Reg. 0 OT0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee: Hourly Only? ()Yes Q No
$0.00
Suppl. Insp. Feer Reg. Q OTT—O.
07hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
C'onstruct'ion .,lax:
0
Work Without Permit? Q Yes (D No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential Q
Building or Structure
i
'ravel.L)ocumentalion Jf'c, :-.
Strong Motion Fee: IBSEISMICR
$1.00
4.0 hrs
$532.00
Inspections
ISTINSP Inspection, Hourly
Bldg Stds Commission Fee: 1BCBSC
$1.00
SUBTOTALS:
$2.00
$798.00
__F_
TOTAL FEE:
$800.00
Revised: 10/01/2012
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10163 MINER PL
CONTRACTOR: MCGUIGAN JOHN T AND
PERMIT NO: 12120080
BARBARA R
OWNER'S NAME:
CUPERTINO, CA 95014-2201
PHONE NO:
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL
❑ LICENSED CONTRACTOR'S DECLARATION
REMODEL ATTIC SPACE TO STORAGE SPACE (151 SQ
License Class Lic. #
FT);
Contractor Date
ADD 37 SQ FT TO ATTIC/LIVING SPACE ABOVE FRONT
I hereby affirm that I am licensed under the provisions of Chapter 9
DOOR; ADD (5) LIGHTS IN DINING AND (4) LIGHTS IN
(commencing with Section 7000) of Division 3 of the Business & Professions
REV # 1 - ROOF RAFTER RETROFIT, SEISMIC UPGRADES TO
Code and that my license is in full force and effect.
GARAGE, ADD 7 (N) OUTLET & 5 (N) LIGHT FIXTURES & 1 (N)
SKYLIGHT IN GARAGE - ISSUED 9/13/2013
1 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: $10000
I have and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 31626070.00
Occupancy Type:
Section 3700 of the Labor Code, for the performance of the work for which this
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 D OF PERMIT ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
180 DA SPECTION.
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
Date: 3
granting of this permit. Additionally, the applicant understands and will comply
Y
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
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.
DECLARATION
OWNER -BUILDER
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, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: _ `/' 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
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.
Date 771
Signature
CITY OF CUPERTINO
POPME FEE ESTIMATOR — BUILDING DIVISION
Elec. Plan Check 0.0 hrs $0.00
Elec. Permit Fee' EPERMIT
Other Elea Insp. OA h s $47.00
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, SchooYV
1i:ctr:rt otr ) Th— fooc aro hacod nn tho nroliminmw infnrntatian availahlo and are nnly an estimate_ Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13)
10163 Miner Place
DATE: 09/13/2013
REVIEWED BY: Sean
jigADDRESS:
APN:
BP#: 12120080
VALUATION:
^PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
$47.00
PENTAMATION 1 REAP10
PERMIT TYPE:
WORK
Revision #1: Roof rafter retrofit; seismic upgrades to garage; finish the garage interior with 7 new
SCOPE
outlets and (5) additional light fixtures and installation of a skylight.
Elec. Plan Check 0.0 hrs $0.00
Elec. Permit Fee' EPERMIT
Other Elea Insp. OA h s $47.00
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, SchooYV
1i:ctr:rt otr ) Th— fooc aro hacod nn tho nroliminmw infnrntatian availahlo and are nnly an estimate_ Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00 �7 #
Electrical
Suppl. PC Fee: (F)Reg. 0 OT 0.0 hrs
$0.00
$47.00
IBREMRECEP Recep/Switch/Outlets
PME Plan Check:
$0.00
�5
Electrical
Permit Fee: Hourly Only? 0 Yes Q No
$0.00
$70.00
IBREMFIXT Fixtures, Lighting
Reg. Q OT ,Q hrs
Suppl. Insp. Fee:(F) O
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$47.00
Administrative Fee: IADt6
$44.00
0
Work Without Permit? 0 Yes (F)
0.00
G
Advanced Planning Fee:
hours Inspections
G
Travel Documentation Fee: ITRA vDo
$47.00
8.00
ISTINSP Inspection, Hourly
0
Strong Motion Fee:
Select an Administrative Item
Bldg Stds Commission Fee:
$0.00
SUBTOTALS: 1
$138.001
$395.00
TOTAL FEE:
$533.00
Revised: 08/01/2013