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14060091-D
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 907 BLAZINGWOOD AVE CONTRACTOR: TRAN JUNIOR GENERAL PERMIT NO: 14060091 CONSTRUCTION OWNER'S NAME: O'KEEFE MICK AND BHANDAL KAMAL 728 DAKOTA DR DATEI ISSUED: 12/08/2014 OWNER'S PHONE: 6505764079 SAN JOSE, CA 95111 PHONE NO: (408) 829 -17177 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ADDITION TO REAR OF SFDWL 829 SQ, FT, 64 SQ FT TO License Class Lic. # GARAGE, 77 SQ FRONT PORCH, REMODEL 1212 SQ FT OF � �,// INTERIOR DEMO, PANEL UPGRADE 200 AMP Contra r Date L4,f I hereby affirm th,t I am licensed under the provisions of Chapter 9 I (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: $290000 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 APN Number: 36920013.00 Occupancy Type: permit is issued. I V 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 18 ED 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 granting of this permit. Additionally, the applicant understands and will comply Is y: Date: with all non -point source regula ' e upertino Municipal Code, Section I 9.18. RE- ROOFS: Signature Date All roofs shall be inspe a for 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 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 25505,255i3, 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 Muuici a de, Chapter 9'12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 2553 , nd'25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authori ed agent: Date: 2�* - permit is issued. I certify that in the performance of the work for which this permit is issued, I shall C 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 9.1,8. Signature Date I � l CITY OF CUPERTINO BUILDING PERMIT r BUILDING ADDRESS: 907 BLAZINGWOOD AVE CONTRACTOR: TRAN JUNIOR GENERAL PERMIT NO: 14060091 CONSTRUCTION OWNER'S NAME: O'KEEFE MICK AND BHANDAL KAMAL 728 DAKOTA DR DATE !ISSUED: 12/08/2014 OWNER'S PHONE: 6505764079 SAN JOSE, CA 95111 j PHONE NO: (408) 829 -177,7 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL ADDITION TO REAR OF. SFDWL 829 SQFT, 64 SQ FT TO License Class NMI Lic. # GARAGE, 77 SQ FRONT PORCH, REMODEL 1212 SQ FT OF "ctor 7 — INTERIOR DEMO, PANEL UPGRADE 200 AMP Con 1 V4 Date r•. REVISION #1 FULLY DEMOLISH (E) ROOF FRAMING; RAISE (E) PLATE I hereby affirm that I am licensed under the provisions of Chapter 9 TO LOFT - ISSUED 5/7/15 (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 have and will maintain a certificate of consent to self - insure for Worker's I Compensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $290000 1 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 APN Number: 36920013.00 I Occupancy Type: I 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 + OM LAST CALLED 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: V /� granting of this permit. Additionally, the applicant understands and will cons Y with all non -point source regulations `upertino Municipal Code, SeOROIF Signature Date l �S` RE- ROOFS: All roofs shall be inspected prior to any roofmg 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: D ate: 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, ul' 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. 1 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, 534. Section 3700 of the Labor Code, for the performance of the work for which this Own or authorized agent: Ad& Date: permit is issued. I 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 i t CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION APPLIANCE / EQUIP TYPE FEE ID QTY UNITS BP FEES Piping, Gas < =4 Outlets 1PGASRES 1 # $72' t TOTALS: $72.00 ADDRESS: 907 BLAZINGWOOD AVE DATE: 02/11/2016 REVIEWED BY: ;PAUL MISC ITEMS APN: 369 20 013 BP #: 14060091 `VALUATION: I $0 "PERMIT TYPE: Plumbing Permit PLAN CHECK TYPE: Alteration / Addition / Repair 'Plumb. Plan Check PRIMARY USE: SFD or Duplex 1.•'FC <;..PfOn t:' 31"?"; 9 CUPERTINO GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORP,E AVENUE • CUPERTINO, CA 9501 A -3255 (408) 777 -3228 • FAX (408) 777 -3333 • bu11dln0(a-)OUDerilno.Orq PLUI D-LNIG ❑ N,ECHANTICAL, ❑ ELECTRICA -L ❑ MiISCELLAN"EOUS PROTECT ADDRESS APN T '2- �+ IP/ I ts I 0Wrr- RNAIJIE ' P'. ON, E E•1J "IL �� J STREET ADDRESS CITY, STATE, ZIP I F.kx CONFTACT NAh,E 30NE Z.1 IA TL - L C i STREETA.DDRESS CITY, STATE, ZIP n FAX A J� ❑ OtiT�t ❑ Oti1.cR -3ULD R ❑ OwhmAcmN -r [ CO?`TIP.ACTOR ❑ CONFI?ACTORAGD? T ❑ ARCHUTECT ❑ ENGINE—EM ❑ D-zlrr.LOPEt ❑ —K412"T CONTRA OR NAJ,L I LICENSE lv u/BER I LICENSE T } PE I BUS. LIC L C01JPA1 Y XAIvZE i E•MAIL P.AX CDA er STRET ADDRESS CITY, STATE, ZIP PRONE ARCPIITECT,TNGLTKEER X.U, E LICENSE NUN BER BUS. LIC T ee COIJ,PANY T?A1, E -I'LUL FAX STREET ADDRESS CITY, STATE, ZIP I PHO11'r. USE of ❑ SFD orDUPLFX ❑ IJ,ULTI- F1.A2, 1.Y PROZnCT LN wIIDLf,T'D ❑ Ys FF.07ECT N ❑ YES IS Th: BLDG AN ❑ Y=S Bu-> N'G: ❑ COA0,=, ,CLAL URBfN N'T=-RFACE AP.EA ❑ 1\10 I FLOOD ZONE ❑ NO I EICBLERHOME7 ❑ 1.0 DESCRIPTION OF WO_ v' Yom' ` n944- Rwarr 9929� TOTALVA- LUATION: J-- RrCEIV DD , �t By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on 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 relat'� o buildi g construction. I auul orize re resentarives of Cupertino to enter the above -idea i5ed prop °I for inspection purposes. Sigmzture of A.pplicant/A Pent; Date: S - PPLEMENITAL LNTF'ORMATION REQUIRED . ORFSCE i SE OhLI, A,j'EPA,j'iscA.PP_ 011.doc remised 06121111 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014 -3255 Telephone: 408 - 777 -3228 Fax: 408 - 777'3333 . JOB ADDRESS: ' PERMIT # 14 bC4 ©C OWNER'S ]NAME: PHONE # GENERAL CONTRACTOR: BUSINESS LICENSE # _ - ADDRESS: CITY /ZIPCODE: iu 7` GI *Our municipal code requires all businesses workin� in the city to have a City of Cupertino Business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing j Roofing ' U Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature NM7 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION •.'.,� "' YG ' '��' 3'n $ i -4 P . "`x Ji a ,.,r''� �$ �:' t'"" yL -'. $ i ewe' = , F i# ` �' �`: o' ADDRESS: 907 blazingwood ave DATE: 03/25/2015 REVIEWED BY: Mendez Plumb. Permit l %ee: I Elec. Permit Fee: i APN: BP #: *VALUATION: 1$5,000 ,.Ltech. Insp. Fee: *PERMIT TYPE: Building Permit- PLAN CHECK TYPE: Alteration % Repair $0.00 PRIMARY USE: SFD or Duplex PENTAMATION PERMIT TYPE: 1GENRE WORK I revision #1 full demolish a roof framing; raise a late to 10ft Permit Fee: Hourly Only? 0 Yes Q No SCOPE Suppl. Insp. Fee :E) Reg. 0 OT I I •.'.,� "' YG ' '��' 3'n $ i -4 P . "`x Ji a ,.,r''� �$ �:' t'"" yL -'. $ i ewe' = , F i# ` �' �`: o' Mech. Plan Check Phtwb. Plan Check i Elec. Plan Check :blech. Pertni! Fee: Plumb. Permit l %ee: I Elec. Permit Fee: i Other Hech. Insp. Other Plumb Insp. otlul• Elec. Insp. ,.Ltech. Insp. Fee: Plumb. Lisp. Fee: Alec. Insp. Fee: $0.00 PME Plan Check: $0.00 j Permit Fee: Hourly Only? 0 Yes Q No $0.00 Suppl. Insp. Fee :E) Reg. 0 OT I I hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Const7°uction Tax: 1 ,Idministrati ve .l' ee: Work Without Permit? 0 Yes No $0.00 •.'.,� "' YG ' '��' 3'n $ i -4 P . "`x Ji a ,.,r''� �$ �:' t'"" yL -'. $ i ewe' = , F i# ` �' �`: o' Mech. Plan Check Phtwb. Plan Check i Elec. Plan Check :blech. Pertni! Fee: Plumb. Permit l %ee: I Elec. Permit Fee: i Other Hech. Insp. Other Plumb Insp. otlul• Elec. Insp. ,.Ltech. Insp. Fee: Plumb. Lisp. Fee: Alec. Insp. Fee: 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 nreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11 -053 E 7/1/13) . FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes (j) No $0.00 2 hours $286.00 Plan Check, Hourly ISTPLNCK Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 j Permit Fee: Hourly Only? 0 Yes Q No $0.00 Suppl. Insp. Fee :E) Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Const7°uction Tax: ,Idministrati ve .l' ee: Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee: $0.00 Select allon- Residential Building or Structure 0 Tr m,e1.1_)oeurnenlation Fees: Strong Motion Fee: IBSEISMICR $0.65 2.0 hrs $286.00 Inspections 1snmp Inspection, Hourly Bldg Stds Commission .Fee: 1BCBSC $1.00 Si1BT0T�LS� $1.65 $572.00 tTOTi`L FEE k $573.65 Revised: 02/14/2015 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building0kupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI Yf REVISION / DEFERRED ORIGINAL PERMIT # PROJECTADDRESS /�V� ve, 71y APN# v�!f�-7 OWNERNAME. MICk OV6e c � PHONE E-MAIL STREETADDRESS�/� q n L►Q, CITY STATE, ZIP • /� �I G,r FAX CONTACT NAME Q[� q , � �iI //xl PHONE (� ! - a E-MAIL &._; 4e(*h 1 /1 r4r ' vl (�/ STREET ADDRESS n7 �� ,, �� CITY, SATE /, sZ�I'P VvV S C FAX ❑ OWNER ❑ OWNER-BUILDER ❑rOWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ' N /I s' `�/��/Jr to `Jn 7 LICENSE NUMBER � LICENSE TYPE BUS. LIC # /��j / ai�IT � � /y COMPANY NAME Tim V E- MAIIf�V � Y •W enl FAX n t,V • � l�"� /G1!! /�VI'�`j sl o�% , STREET ADDRESS J Ott PHO _�� _ 77 ARCHITECTIENGINEER NAME = r o wD UV LICENSE NUMBER BUS. LIC # COMPANY NAME // E -MAIL f) �'I ��/I�r� 1Q �Vy��[/J4 i � fir , FAX STREET ADDRESS /'� �JyI /(ryr�iWf� CIT- TATF„zI•P 6+ '75i PH 'V DESC T�I°'F,Tt�N R , gI 1 "dam td11% 000 EXISTING USE PROPOSED USE CONSTR. TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NETAREA BATHROOM KITCHEN OTHER REMODELAREA REMODELAREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: []DETACH []ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY []YES BEING ADDED? ❑NO ADDITION? []NO PRE - APPLICATION []YES IF YES, PROVIDE COPY OF IS THE BLDG AN [I YES RECEIVED - . TIJT'A V- Tj7affEI?TIC?�+I PLANNING APPL # []NO PLANNING APPROVAL LETTER EICHLER HOME? []NO d By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is c rrect. 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 const cti . I authorize representatives of Cupertino to enter the above 'dde�tifired operty for inspection purposes. Signature of Applicant/Agent: Date: J_& SUPPLEMENTAL' IN RM T1ON REQUIRED .PLAN CHECK TYPE ROUTING SLIP OVER-THE-COUNTER BUH DING PLAN REVIEW New SFD or Multifamily dwellin s: A ply for demolition permit for existing building(s). Demolition permit ' required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD El PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. p LARGE El FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06121111 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISIO 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 'n �v (408) 777 -3228 • FAX (408) 777 -3333 • building(cDcupertino.orcl (' '�•� W �� O \A NEW CONSTRUCTION ADDITION ® ALTERATION / T • ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS QD �` �I 0 1e APN# I l��Jl OWNER NAME I &- e- PHONE I „(YO'• ci^t (� � i'�'il�J E MAII �O �e�� 3ZI STREET ADDRESS (� (.�C �e ` roo J. � CIT� STATE, ,ZIIPP c 1A 01 S01 FAX V ] Ir 1 CONTACT NAME `"1e69 /1 ,-,l PHONE mss„ X292 �\ E -MAIL C�e�� I�GGi"Io STREET ADDRESS �/]I C ` °� jy\( Q�,j► CITY, STATE, �1IZIP�an f �C ,l cq /'\S I e FAX I, 1 ` 1 G 1 J J peslc���leJr I ❑ OWNER ❑ OWNER - BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHI per ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE AI` CT/ENGINEER NAME ���, ^RA LICENSE NUMBER BUS. LIC # COMPccA�,NYNAME y.1 �IYY�f � E- MAIL �QS` � FAX STREET ADDRESS � 1 . if 1,'%b. CITY, STATE, ZIP t1t I l �C CI /Ii� �JI \� PHONE4y�fr_2geZ - 39 i 1 DESCRIPTION OF WO , q � � � '� i _ rM ��j , P r �e �b� V(0 5� °LW ��t e�, �r✓�Sd M d 1�1�! f -Fv�rcllh . t Vmrl ► (f� Ti*f-c"icr i s EXISTING U PROPOSED US CONSTR. TYPE # STO,RIES I USE TYPE OCC. SQ.FT. VALUATION ($) L EXISTG NEW FLOOR DEMO TOTAL AREA { 1 `� �2 AREA AREA NET AREA 1 i BATHROOM KITCHEN �'",�,,� OTHER b el REMODEL AREAS REMODEL AREA l ✓ REMODEL A PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: []DETACH QATTACH # DW11G UNITS: IS A SECOND l� �❑ YES SECOND STORY ❑YES , BEING ADDED? ENO ADDITION? O PRE - APPLICATION []YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED BY: TOTAL VALUATION: ' ' PLANNING APPL # []NO PLANNING APPROVAL LETTER EICHLER HOME ?, ❑ NO (� -CIO, V 000,Q-0 By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on 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 constructio la, 'ze representatives of Cupertino to enter the above -idenf led rope, for inspection purposes. Signature of Applicant /Agent: Date: SUPPLEMENTAL INFORM ION QUIRED PliANGHCKTiPE, ` ROUTINGSLH' New SFD or Multifamily dwellings: Ap fo emolition permit for [] oVER -THE COUNTER ❑ G PLAN REVIEW, existing building(s). Demolition permit is required prior to issuance of building permit for new building. 0` EXIRESS D I, LANREV[EV Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD UBLte woxxs form if any Hazardous Materials are being used as part of this project. E3 - -LARGE RIRE DEPT, Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR, 'J SANITARY SEWER nIS'RICT submittal of Building Permit application. ❑ ;ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION im, ADDRESS: 907 blazingwood ave DATE: 06/13/2014 REVIEWED BY :� Mendez PC FEES APN: BP #: , LODf *VALUATION: 1$290,000 j *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition 0,her 1'1u7nb' /risv. PRIMARY USE: SFD or Duplex 2nd Unit? OTC?' Yes E) No 0 Yes (E)No PENTAMATION PERMIT TYPE: i 1 R3SFDADD WORK addition to rear of sfdwl 829,sq ft 64 sq ft to garage 77 sq front porch, remodel 1212 sq ft of interiors SCOPE demo, panel upgrade 200 amp Permit Fee: $1,617.00 OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R -3 (Custom) II- B,111- B,IV,V -B 970 0,her 1'1u7nb' /risv. 1 IR3PLNCK $1,617.00 Ph n bL. hisp. Vee: IR3INSP PME Plan Check: $0.00 i Permit Fee: $1,617.00 Suppl. Insp. Fee:) Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $47.00 ,i I CUft,Sl`]'ilC'liUYt .l �1: TOTALS: 970 $2,577.00 $1,617.00 '„ e ME CH; HOURLY `y Yes: 'No )PLUMB'HOURLY Yes.iF ", Noy' ELEC, HOURLY. , �° Yes . No., Ifech. Plan Check Pli.rrnh. i'laa C /Irc( Elec. Plan Check 0.0 firs $0.00 �1lcrcii. t'erw:ti1 Fee: stun /i. Peralit Tee: Elec. PermitFee: IEPERMIT Or/rner Uc:ch. Imp. 0,her 1'1u7nb' /risv. I Other Elec. Insp. 0.0 hrs $47.00 .,ihzcl:. Insn. I'ee: Ph n bL. hisp. Vee: 1slc;c, Also. 1 "ee: 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 Deptfor addn'1 info. FEE ITEMS (Fee Resolution 11 -053 Ef: 7J !1113) FEE QTY /FEE MISC ITEMS Plan Check Fee: $2,577.00 200 amps $47.00 Electrical IBELEC200 Services j Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 i Permit Fee: $1,617.00 Suppl. Insp. Fee:) Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $47.00 ,i I CUft,Sl`]'ilC'liUYt .l �1: A.ebninc; rr otiv�-� Fee: Q G Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee: IPLLONGR $135.80 Select a Non- Residlential Building or Structure Travel Documentation Fee: ITRAVDOC $47.00 Strong Motion Fee: IBSEISMICR $29.00 Select an Administrative Item Bldg Stds Commission .Fee: IBCBSC $12.00 SUBTOTALS $4,464.80 $47.00 TOTAL FEE: 0 Revised: 04/01/2014