15060087 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10121 PHAR LAP DR CONTRACTOR:REMODEL WEST PERMIT NO:15060087
CONSTRUCTION,INC
OWNER'S NAME: ROD HOO 12333 SARATOGA SUNNYVALE RD DATE ISSUED:11103/2015
OWNER'S PHONE: 4082556649 SARATOGA,CA 95070 PHONE NO:(408)257-4900
ao
LICENSED CONTRACTOR'S DECLARATIJOB DESCRIPTION:RESIDENTIAL COMMERCIAL
ON
License Class ? Lie.# REMODEL 264 S.F.AREA BY REMOVING(E)SUNROOM AND
�� .. CONSTRUCTING A(1)FAMILY ROOM IN THE SAME LOCATION(SAME
Contractor Date /% f„ FOOT PRINT)
I hereby affirm that I am licensed under the provisions of C apter 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
rformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$75000
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:32618012.00 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 D ERMIT 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. A 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 Date:
granting of this permit. Additionally,the applicant understands and will comply --
with all non-point source regulations per the Cupertino Municipal Code,Secti
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
I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date:
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR SETTER
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: f�
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 / �"' �/°��7
CUPERTIN,O (408)777-3228 FAX(408)777-3333•building(tl�cupertino.org { ✓ (/�l�VV --
NEW CONSTRUCTION ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS
APN#
OWNERNAME PHONE E-MAIL, r
.STREET ADDRESS FAX CITY,STATE,ZIP
�i,� el 15
CONTACT NAME �Pl PHONE E-MAIL
STREET ADDRESS CITY,STATE,ZIP Fp X
El OWNER ❑ OWNER-BUILDER D OWNER AGENT CONTRACTOR 1:1 CONTRACTOR AGENT 11 ARCHITECT 0 ENGINEER 11 DEVELOPER 13 TENANT
CONTRACTOR %f` "e
t LICENSE NUMBER LICENSE TYPE BUS.LIC#
COMPANY NAME .- � p { EMAIL r FAX
f'�I z A/—
STREET ADDRESS / CITY,STATE, P PHONE
C�C� ,5'p 7 ZI
ARC ECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY,r E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK r
s.
L �,o
EXISTING USE PROPOSED USE - -- CONSTR-TYPE #STORIES -USE TYPE OCC. SQ.FT. VALUATION($)
EXISTG NEW FLOOR- DEMO TOTAL - -
AREA;7_q AREA :?�!_ AREA 2_4 NET AREA
BATHROOM tE
OTHER
REMODEL AREAREA REMODELAREAPORCH AREA DECKCK/PORCH AREA GARAGE AREA: -.. DETACH
�-✓�_- 7_cy �ATTACH
#DWELLING UNITS: T YES SECONDSTORY AYES
NO !ADDITION? B`�9`r0;
PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF i5 THE BLDG AN [[�YES REC -
PLANNING APPL# ANO PLANNING APPROVAL LETTER EICHLERHOME? TIO
By my signature below,I certify to each of the following. I am the property o " r or au o act on the pro owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description ffWork and verify itis te. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I•authorize representatives of Cupertino to the above-* enti d property for inspection purposes.
Signature of Applicant/Agent Date: Y
SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ; ' ROUTINGSLiP
_New SFD or Multifamily dwellings: Apply for demolition permit for OVER_THE Coui`rrER suHDnvGPLANREVIEw
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. ❑ EXPRESS G7, eANNIrIG PIAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure Q STANDARD ❑ PUBLIC woRKs
form if any Hazardous Materials are being used as part of this project.
n,.]LARGE D.FQ2E DEPT'
_Copy of Planning Approval Letter or Meeting with Planning prior top;
MAJOR,` SANITARY sEwERnisTRLeT
submittal of Building Permit application.
ENVIRONMENTAL HEALTH
BldgApp 2011.doc revised 06/21/11
IjCITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10121 PHARLAP DR DATE: 06/11/2016 REVIEWED BY: MELISSA
APN: 326 18 012 BP#: *VALUATION: $75,000—�
TYPE: Building Permit PLAN CHECK TYPE: Alteration/Repair
PRIMARY SFD or Duplex PENTAMATION
PERMIT TYPE: 1 R3SFDRE;
WORK REMODEL E SUNROOM BY REMOVING IT AND CONSTRUCTING A N FAMILY ROOM IN THE
SCOPE SAME LOCATION (SAME FOOT PRINT) 264 S.F.
i1e<:rf Pd'.rri Check 1'Irtt;t; plai'l{-tc:c; Elee.Pian Check
F717-11,
.I .,ti. 1'r>;',frit ny r-h 1'L r;rn,r I`c'e: t re c.Perini-1`ee.
rile Gt< . rrtsn Cltlzer 1'Ir ln,;/r.s;r;. fir't;e,'I Ic .In11.1. Li I
i�ie{;ti.Ii V.'). Pe(-. 111,1111117.I isp. Pee: 1s76c.Iiz3t?.Fee:
NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc.). These ees are based on the prefimina information available and are OnLy an estimate. Contact the De t or addn'l into.
FEE ITEMS (Fee Resolution 11-053 E ff 711113) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 EEKI s.f. Remodel,Other
Suppl.PC Fee: Reg. 0 OT E0j hrs $0.00 $431.00 MEMRESOTH
PME Plan Check: $0.00
Permit Fee: $0.00
SuPP1. Insp. Fee: Reg. � OT 0.0hrs
$0.00
PME Unit Fee:. $0.00
PME Permit Fee: $0.00
construction Terv:
Administrative Fee. �
Work Without Permit? 0 Yes Q No $0.00 E
Advanced Planning Fee: $0.00 Select a Non-Residential
Building or Structure 0
Strong Motion Fee: 1BSEISMICR $9.75 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $3.00
SITBTt3TAh ;:
$12.75 $431.00 DOTAL FES: $443.75
Revised: 05/07/2015
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228=FAX(408)777-3333 building(ftupertino.ora
erm
�-- c� l ( (� c� �c� P cti �;;j`tno cel lPtN&: t� C)
.ciclaess #of�larn s Sin ake: ,earbou M-c oxide: )
PER--VHT CAh'1NOT BE PT ALED A.1NID COINJPIETE.D uNTIL THIS CERTIFICA
HAS IiEE1' EINE 14 }R3 `i I11ET3 TO T HE bT� TN G i}I ?ION
PURPOSE
This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxid Alarms for
compliance with 2013 CRC Section R314,2013 CBC Sections 420.6 and 907.2.11.2 where no interioi access for
inspections are required.
GENERAL INFORMATION
Existing sungle-family and multi-family dwellings shall be provided with Smoke Alarms and Carbon
Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds
$1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon
Monoxide Alarms be installed in the following locations:
AREA SMOKE ALARM C 0 ALARM
Outside of each separate sleeping area in the immediate vicinity of the X X
bedroom(s)
On every level of a dwelling unit including basements ' X X
Within each sleeping room X'
Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that
do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with
t
CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal.
Power Supply:In dwelling units with no commercial power supply,alarm(s)may be solely battery operated.
In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do
not result in the removal of wall and ceiling finishes or there is no access by means of attic,basement or crawl
space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6,2._An electrical permit is required for
alarms which must be connected to the building wiring.
As owner of the above-referenced property,I hereby certify that the alarm(s)referenced above ha /have been
installed in accordance with.the manufacturer's instructions and in compliance with the CaliforniaBuilding
and California Residential Codes.The alarms have been tested and are operational, as of the date signed
below.
t have read and agree to comp!y with the terms and conditions of this statement
E c to r of OWaer Age€fs)Name W
1. D to}
Confracfor-Name:
si'at a —}
......... ......... ......... ......... ............ .. ..::..... ......._........bay ...................
Smoke and CO form.d c revised 03/18/14,