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15120201 CITY OF CUPERTINO BUILDING PERNIIT BUILDING ADDRESS, CONTRACTOR; PERHT W 15120201 ,,2115.2-MG ERIZ RD-C'U-P-ERTINO—GA-95811(359 03-052}-- Mr&Mrs THOMAS N ®®� AND DOLORES C TRUSTEE SOSO 5630 PYRACANT14A DR CUPERTKO,CA 9501442265 O'WNER'S NAME: Mr Mrs THOMAS N AND DOLORES C TRUSTEE SOSO DATE ISSUIED:04/07/2016 OWNER'S PHONE:8311419-5941 PHONE NO:(Hl)419-5941 LICENSED CONT iTORS DECLARATION BUILDING PERMIT INFO: License Class Lic.# Contractor Mr&Mrs TH MAS N AND DOLORES C TRUSTEE SOSO Date —BLDG ELECT —PLUMB I hereby affirm that I amlicensed under the provisions of Chapter 9(cornmene ing _ NTIAL MECH_RESIDE _ COMMERCIAL -With Section 7000)of Di sion 3.of the Business:&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: CONSTRUCT(N)2 STORY SFD(3339 S.F,);FRONT PORCH I hereby affirm under penalty of perjury.one of the following two.declarations:. ($3 S,F.)WITH ATTACHED GARACrE(484 SZ) 1. 1 have and will maintain a certificate of consent to self-insure for Worker's Compensation,las provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued 2, 1 have and withe aintain Worker's Compensation Insurance,as provided for by ` Section 3700 Labor Code,for the performance of the work for which this - Permi#is issued. Sq.Ft Floor Area: Valuation:$650000.00 APPLICANT-CERTIFICATION I certify that I have read this application and state thatthe above information is correct I agree to comply withall 'all city and county ordinances ATN Number: Occupancy Type: and state laws relating W building construction and hereby authorize 35905052 representatives of this.c tyto enter upon the above mentioned property for inspection purposes. (Vle)agree to save indemnify and keep harmless the City of Cupertino agamn,t liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORD IS NOT STARTED may accrue against saiq City in consequence of the_granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicapt:understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM:LAST CALLED INSPECTION. Signature - Date 4/7/1 Issued by.'SEAN HATCH r Date•04/07!2016 ONVNER-BUILDER DEI LARAJON 1h affirm that I arch exempt from the Contractor's License Law for one of the RE-ROOFS. following two reasons: l_ All roofs shall be inspec#ed prior to any roofing material being installed.If a roof is s. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,l agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) }2. I,as owner of he property,am exclusively contracting with licensed signature of Applicant: ` contractors to onstruct the project(See-7044,Business&Professions Code)'`Date:4/7/16 I hereby affirm under-p�nalty of perjury,one of the following three declarations. ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER i. 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 � HAZARDOUS MATERIALS DISCLOSURE performance gf the work for which this permit isissued. 2.. 1 have and will,maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials,requirements under Chapter 6.95 of the Section 3700 f the Labor Code,for the p.erformance of the work fo_r which flus California Health&Safety Code,Sections.25505,25533,and 25534, 1 will permit is i sud. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&Safety Code,Section 25532(a)should I store or handle hazardous I certify that' the performance of the work for which this permit is issued,I material.Additionally,should!use equipment or devices which emit hazardous shall not gimpy any person in any manner so as to become subject to the air contaminants.as defined by the Bay Area Air Quality Management District I Worker's Co pensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534, Labor Code,I must forthwith comply with such provisions or.this permit shall be deemed re roked. %Owner or authorized a APPLICANT CERTIFICATION Date:4(7/1 TIO LENDIN A EN Y is certify that I have reap this application and state that the above information is I hereby affirm that(here is a construction fending agency for the performance correct.I agree to co ply with all.city and county ordinances and state laws of work's for which this permit is issued(Sec.3097,Civ C:) relating to building co�r struction,and hereby authorize representatives of this city Lender's Name to enter upon the abo ,e mentioned property for inspection purposes. (We)agree to save indemnify and Ikeep harmless the City of Cupertino against liabilities, i Lender's Address. judgments costs,and(Iexpenses which may accrue against said City in consequence of the gYanting of this permit. Additionally,the applicant understands ARCHITECT'S DECLARATION and will comply with al�no.n-point source regulations per the Cupertino Municipal I understand my plans shall be used,as public records, Code,Sec' 18. _ ' COMMUNITY%3 LQPM NT��ts1;1�f�t�l� �'8t�41�Jt�i�I3111��t��J 103,004ORRE AVENUE•CUPE TINO.CA 95,014-3255 CUP Epffmo { )777-0226-FAX(408)777-3333.buiidinaf guaaaln _o ?I53�KQtS1 CSTE3N. AMMON Q:AL'TASATIONIt! -0. REVISIOW7EPBR ..., ORI�IfF4LPEItkiZC�i. .. . _ _ ONO -is r ; z�cf 01 Tg?Er rc3iess 4 tom,srn ur IAX e. cotvTw rr,Ae i zat titer srx>eTraFta s crru:smm zFa . fAX ; owives Q OW Q OWMAO +r Q MVrM=R DCPRTiu 7CNr . arr 0 �ncttrrecr L3 P4"SM .°fit�yEla Vit: Cy.Trow r ., .... ... .. I.. uc !� sits ucir grapwrr�t UM �n�xlt t IIx °'STiEEI:f.ADZtfiESS CtYY,$iA'iBZSP . C`F1C}I+$.. COW"YNA ME t<xi;c DN 7� Vin... �ZPX ?`7Z'0. r C , 7p p 31REE2 •iit3 J N tog,? 8FR Aft tat 5 (SDI:( WpAK /_ _ i'4 `-1Jr1 h wt J ,�•,. r rimi� Q�t(� GJ A A Z —CA { D€f9Z'L'dGIiSE P8Plt)S�7Jti3£ - :�E TYPE' gom - . . -.__. :. .:- _ d �p . j ARBA I Am - TOTAL X33 bELA87EA. I xra�av�Lu�,s Re�co�yaxEa��� _ IDRCHByfI£.�_ ..:32ixiC AREA 3:'4°FALMEGt+.fi'(3RL'7 AZEk GA'RAl5M,'rA$EA; Ef7CE i '- J O 3. "l 0 #T$Lit I&A&feEEtilztt!I1NFT '—TEs SECOND stomY YES ADDITION? *p PitSAt�t'#.tCATI(lt3 1 WYP5;17tIS#.Yi37ECCttY 0 I3THtwxGRI+2 �''E` ' ' " - T 4LsJf�S,'i?iyTTf�t'x - PL¢Nlatt3S?A3?lFitE ,Q PLAT@tit€iA,PFRf?YAt:t:TigR. t�.,tIR.3[HlttrSS? - B 'FmY srgta#re 623Gw,T Cetti#c#o cnch of lite fv2iavting: I am the Property QV+a=e atithom�d'aPeat to aso pt eriy owner's behalf.1€iave rs ad thts aux?`cati9nanclti�sliFomtntiai:Ihavegmvidediscr�aect Ihd++ercadthei t3sxigtignofVi�prkattdverafyitiszw Ia recIcz.xiinPi3�zvithalEapptii tc:# sl ordmancesauilstala tvsielalingtobwFdingconsttuCrian Isuthnriz�tePlesent uesol upeltinQtoenlerthsa5nve ntFfi dpmpeay orimspoodonparp scs. $igiaEulGof.Ap}�GeahVElgetti c /i 5 E—i - - t?aic:_ :r �F±ITAI.FI�C)PaWNTIO N.REQ 4e.<SF D car*uWfWaily+dwellino, Apply for demolition pexmit fttr cX+snugbtc d ag .De�Ao!'stidtt perm;Fsrec i rl ptmrtos`ssuan000€ uiiding` petSFt2t fE3T IIEl?Y'i'iti FIi1tI�_ � �.�$ y 3 _irsirstmerciai BIdgS:�'mvide a cumpFeted Ha2ardqus FVFeterials I1sc[oSUIs �. .�-� x farFnafat►y'Fid-ar' FVF`at?rta.Ls.arehztzn�rls�cls�patioftiaspro��t. -_ �-` Copy of �' al titter ar �aiirz F! stein Ptt IiIng.t£g}irod eettitg anlnng stibmi€ta#.csf$ttt� I'eirrafkagpiieati4n. . .vim. a . �tdg,APp�,�fl I ,�+r retry trGlz�J 1�t i i i CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION I I ADDRESS.- -_ tl{c-C�Fe � ` ATE: 1212312015 REVIEWED BY:. PAUL_ APN 359 03 052 BP# VALUATION; $650,000 rPERMIT TYP�E: B.uiiding Permit PLAN CHECK TYPE: New ConstructionPRIMARY I 2nd Unit? ul Yes !< No PENTAMATION SFD or Duplex 1 R3SF;DV USE: I. PERMIT TYPE: WORD Con�truetN 2 Sto SFD 3339 S.f. � Front Porch 83 S.f. with Attached Garage 484 SJ, SCOPE _ -. . . .; _ TYPE OF F:LR AREA OCCUPANCY TYPE: C FEh-S PC FEE ID BP FEES BP FEE ID CONSTR. (s.£)_ R-3(custom) 11-B,i11.-B IV,V-B 3,906 $3,273.15 IR3PLNCK $3,488.45 1R3INSi aP _. TOTALS: 31906 $3,27315 ,_; $3,488.45 L s�z b,P:adJ '� t? s.:i r,f t1f1a i'.L?: I <u. �)1ti�'Y"III,�lf.a�:#r2S`{:. i i3tt e}jisC n . �it�rt:l,t�t,:14,:': _ I-1rarrtl.�.I�tsv fw�: x't:e..fYrs� l-rst-: _XoTE This es imate does not include fees due to ot/aer Departments 0 e.Planning,Public Works,;Fire:Sanitary Sewer District,School Distract,.etc.). These ees are based on the. velamina information available and are onl zrrx estirrtate, Contact the DS t or addn'l info. FEYITEMS (Fee Resolution.1.1-053 Ffl`7,�1/13t FEE QTY/FEE MISC ITEMS Plan Cheek F e $3,273,1-5 -Select a Misc Bldg/Structure - or Element of a Building Suppl.PC Fee: (j) Reg. OT 0.0 hrs $0,00 PINE Plan Check: $0.00 Permit Fee: C $3,488.45 Suppl.InsP.Fee: Reg. 0.07 $00a - - PME Unit Fee: $0.00 PME Permit�ee: $0;00 now Construction Tax:' IBCONST X " 'f units $687.10 Work Without Permit? Q Yes E) No Advanced I'lnniAg_Ve_ � tPLLONGIt $546..8..4 Select a Non-Residential €• Buildb?g or Structure 0 Stroli Motio6 Fee: IBSEISMICR $84.50 Select an'Admin Arat ue Item Bldg Stds GoxnmissionFee: 1BCBSC $26.00 106.04 s , I3TaTAL $8,106.040 00 u, OxFl $8, Revise 10101120 CITY OF CUPERTINO BUILDING PERMIT i BUILDING ADDRESS: CONTRACTOR: PERMIT NO:15120201 21152 MCCLELLAN RD CUPERTINO CA 95014(359 03 052) Mr&Mrs THOMAS N AND DOLORES C TRUSTEESOSO 5630 PYRACANTHA DR CUPERTINO,CA 95014-4265 OWNER'S NAME: Mr&Mrs THOMAS N AND DOLORES C TRUSTEE SOSO DATE ISSUED:04/07/2016 i OWNER'S PHONE:831-419-5941 PHONE NO:(831)419-5941 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class Lic.# Contractor Mr&Mrs THOMAS N AND DOLORES C TRUSTEE SOSO Date _BLDG _ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing _ MECH_RESIDENTIAL_COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: CONSTRUCT(N)2 STORY SFD(3339 S.F.);FRONT PORCH I hereby affirm under penalty of perjury one of the following two declarations:• (83 S.F.)WITH ATTACHED GARAGE(484 S.F.) 1. 1 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. Sq.Ft Floor Area: Valuation:$650000.00 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 5903 052 Number: Occupancy Type: 3 and state laws relating to building construction,and hereby authorize 359 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180DAYS FROM LAST CALLED INSPECTION. Signature Date 4/7/16 Issued by:SEAN HATCH �p Date:04/07/2016 / lf✓ yl% � OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: All roofs.shall be inspected prior to any roofing material.being installed.If a roof is 1. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) } 2. I,as owner of the property,am exclusively Contracting with licensed Signature of Applicant: contractors to construct the project(See.7044,Business&Professions Code)\' Date:4/7/16 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&Safety Code,Section 25532(a)should I store or handle hazardous 3. I certify that in the performance of the work for which this permit is issued,I material. Additionally,should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534, Labor Code,I must forthwith comply with such provisions or this permit shall r\ be deemed revolted. /l Owner or authorized a APPLICANT CERTIFICATION Date:4%7/1 I certify that,I have read this application and state that the above information is CTIONLENDINGA en Y correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments,costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands ARCHITECT'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code,Sect' 18. --- CONSTucrrc� PERMIT APPLICATION, C I COMMUNrty DEVELOPMEW DEPARTMENT•BUILDING 13ItttIWN 103047 T4RRE AVENUE-CUPERTINO,CA 95014-3255 C PERTINO (408)777-3228-FAX(408)777--3:333 (ti�HInctftcuagajnO.orxt WE.Y CONSMUCnON C3 A,MMON © ORIGINAL I'ERMFT 31 PROJE-cr ADDA�SS b y rz rlir2 s C G e t APIA -`:3( 4(Crr37E-14AI 0c� STFtEeT AMR= FAx titF7TAt:T NAME FHOIVE rs.erAa. SUM-TAOMMSS CT'Y STATE,ZIP FAX sc� C2 5 b v 1 owNM Q o."W-e=)fa 0 octmsu A=4T ©oxymAcrox 0 counzAcroxAGxvr 0 Ancwwr 13 e4 aNeM , t3 J)_-VE.omx. II rE'kA,trs CONTRA rORNAME. _ .. I.iCENSSM& IM LM_wgS _aB 8t35.LiGaY C0114ANYNAME E MAIL FAX StS�T ADDRESS CI'CY.51'A'tB;Z{P Pf 1t}NE, Ax CiT?t L CwsEM'MEx Buss e COMPANYNAME &MAn FAX ..aiREE2 ...._ CtrY,3TAtE.�LP . . nPSc�#P7ttxapFwoRx.�-.j_= E e assG4 -t-6tai e'd1. t �j m 5 ,: ur s[ PLC e.r, e,/Xs; (e c a- h wt tt� sim resr`c n w d 2-CAA, _ MxKR 14GTISE vlopo5.F77m £ TYPE 95MRMS -._ __... _. . SMZ Mr. -rYM occ, SQST. VALUATION > WOSTG I .. NEIGFtAOA ➢EMQ TOT AItFh _ ASSAAI 333 `7 ,,t A X33 BATHROOM - oTr2l3c REMODMARE1. - REMOMiLAREA REMODEL AREXry27 _ 'PDRL LAgAPA:- I}ECiCAR,EA "TO'rALDSOMORCMAXPA GAAAoZAREJJJJ:I:J.. ECAC}i .. #OWEZLDMUMjFS: r&ASSM"UNFr YES Szoo1YD&'r#}RY . YES 1. B1:IMCAMM? Aourriol? O PRFAI"PLIC:ATtOt? 01YES ffYES,t4t4YrgECOYYffF` 15TTi5ffi;IlGrtti TOTAI„V,1UUATJFfi P"MinG"ri,ft ©NO P"MMnit�APPROYALLETM =CEEL=RONF? ( i6WWW"', , ltlel Ghia oQ� l3ytrry sis ahu8 below,}certify tomb offt foilem ing: I am the property owneror authorized agent to act on the property owner's b&a df,t hwe rcadthis application and the inion ation I Iweprocided is correct. I have read the Description of Work and verify it is accurate. T agree to comply with aft applicable IM1 ordinances and state tacos relating to building eonstrtrttion d authorize representatives afCupetn no to sneer ttio above-iderttifed property for insspw ion pnrpvA*. _ .. - SUiTPLEIV1Ei+t2'�1,I.1NF(3%.I�IA"IIE)I�3 I2E(�[TERED ..- ' , ��;_ -. y ,.� 7 ' New SFD orMultifamily dwellings; Apply fh,demolition permit for t"tnvz tt St -' eX stung building(s). Demolition permit is:required prior to issuanceofbuilding permit for new building- -xwwim _Commercial Bldgs: Provide a completed Ha=dous Materials Disclosure F form if any Hazardous Matwials.am being used as part of this project. Copy ofpIanning Approve]Letter or Meeting with Planning prior to submitta#ufBtuil.tdirzg Permit application- . ; HidgApp-_201 L d is revised 000111 t i CITY OF CUPERTINO � FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 21152 Mc Clellan Rd DATE: 12/23/2015 REVIEWED BY: PAUL APN: 359 03 052BP#: *VALUATION: 1$650,000 ''PERMIT TYPE: Building Permit - PLAN CHECK TYPE: New Construction PRIMARY 2nd Unit? C5 Yes No PENTAMATION 1 R3SFDW USE: SFD or Duplex PERMIT TYPE: r WORK Construct N 2 Sto SFD 3339 S.f. " Front Porch 83 SJ.)with Attached Garage 484 S.f. SCOPE TYPE OF F.LR AREA OCCUPANCY TYPE: C FEES PC FEE ID BP FEES BP FEE ID CONSTR. R-3(Custom) II-8,111-13jV,V-13 3,906 $3,273.15 IR3PLNCK $3,488.45 IR3INSP TOTALS: 3,906 $3,273.15 $3,488.45 El vP.,..t<..pe¢ '1 E a Fee, „ -.. ..... :dt ;.. £�'. zL'i"A4,is E>'%:fit. oth;r'I't,im"',in'st", tstt.E> � - NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School _ T District,etc.). These.fees are based on the erelimina information available and are only an estimate. Contact the De t for addn'l into. FEEITEMS (Fee Resolution 11-053 F_f:'7,-7113} FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,273.15 Select a Misc Bldg/Structure Suppl.PC Fee: Q Reg. OT 0.0T7= hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $3,488.45 Suppl.Insp.Feer Reg. Q OT �61hif $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 #new $687.10 - Construction Tax: IBCOMSTAXR 1 wiits Work Without Permit? Q Yes E) No $0.00 Advanced.Plannin Fee: IPLLONGR $546.84 Select allon-Residential Building or Structure Q Strom Motion Fee: IBSEISMICR $84.50 Select an Administrative Item Bids Suds Commission Fee: IBCBSC $26.00 'SUBTOTAL :. $8,106.04 $0.00 TOTAL FSE.. $8,106.04 RevisA1010112:0,tV