14100050-D19608 PRUNERIDGE AVE
14100050
F
SFERS REAL EST UU
SCANNED BOX # 689
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19608 PRUNERIDGE AVE'
CON
RRACTOR:1 ,
PERMIT NO: 14100050
OWNER'S NAME: SFERS REAL EST CORP UU
0n i t �I�l
DATE ISSUED: 07/15/2015
O R'S PHONE: 4088739090
F9"W 1` C?
PHONE NO:
LICENSED CONTRACTORS DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
ARIOSO- CONSTRUCT NEW PATIO AREA, FENCING
License Class . " _` Lic. #
LIGHTING
r _
°
AND FIRE PIT (1800 SQ)
Contractor . Date
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
affirm under penalty of perjury one of the following two declarations:
d will maintain a certificate of consent to self -insure for Worker's
Vhereb
ation, as provided for by Section 3700 of the Labor Code, for the
Sq. Ft Floor Area:
Valuation: $153000
nce 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: 31647018.00
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that 1 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 D ROM 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
j r
granting of this pe Additi ly, the applicant understands and will comply
Issued by: 0� Date:
with all non-po' so ce reg a: o„ per the Cupertino Municipal Code, Section
9.18.
RE -ROOFS:
Signatur Date gat
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
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. 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 Ar Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with t C er unicipal Code, Chapter 9'.12 and
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
p
the Health & Safety Code, Se ion 55 33, and 25534.
'-,
T Date. '
Owner
permit is issued.
or authorized age
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
CONSTRUCTION PERMIT APPLICATION 'l��
B�
COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION r\U
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 V �
` I
CUPERTINO (408) 777-3228 r FAX (408) 777-3333 • buildingancupertino.ora . 1�
❑, NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS j f` 9j� oe
`v /G
APN # O
f `Y
OWNER NAME FSTN' c ^OQn A/ &050 m PHONE
b c
EMAIL
STRE
CiT A4
^�
c7-373-7-7TADD
p
ru ne and PR�p
1 .
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CONTACT NAME VOB �/Pr VS I GR PHONE ��/P j,/3-ceGi
V f
EOB VASOrysv {nIl(A�f EMFr/1�I. C�O�I
STREET ADDRESS
,37310 FnlIRAL MOOT PJ-4et
CITY, STATE(, ZIP
E/'t k7 a4. 9Sl
s10 Yi3-moq 7
,�,//
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT IJef CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRA OR NAME
NA cbN.57QuC�r Hd
LICENSE NUMBER
��loYY
LICENSE TYPE
BUS. LIC #
COMPANY NAME
S�htE
E-MAIL
AX
Sro' y!3^��i7
STREET ADDRES
373 a T LVD�T ,� 46E
CITY, ATE ZiP
T yA emd*xr, Rio •
HO I
5xd
ARCHITE /E NEER NA
' e,
CIE
LICENSE NUMBER
��a3aY
BUS. LIC # I
C OMPANY AME
xwd I ANAV AIS- CONE PT.5
E-MAIL
41-1 P sk&Zod.44 Al;T
S7- loor
ADDRESS
Uaw ST&co
CITRSECA. 9'YD63
CIf
;
,� �b - Z6NSr3T
DESCRIPTION OF WORK G W ri o f,4 F5A16 410?V F 96 ^ / r
f
I
I
EXISTING USE
PROPOSED USE
CONSTR. TYPE
# STORIES
I
USE
TYPE
OCC.
SQ.FT.
VALUATION ($p
i
EXLSTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOM
REMODEL AREA
KITCHEN
REMODEL AREA
OTHER
REMODEL AREA {ASCO
8DDFTACH
PORCH AREA
DECK AREA TOTAL DECK/PORCH AREA GARAGE ARE :
ATTACH
I
# DWELLING UNITS:
IS A SECOND UNIT
BEING ADDED? O
SECOND STORY ❑ FFS�
ADDITION? O
PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ Y,ES�
RECEIVED - OTAL VALUATION:
PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER
.
EICHLER HOME? O
_
/53 000,
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 ' ed is c ct. 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 u' mg co c on. I authorize representatives of Cupertino to enter the above= en 'fled property for inspection purposes.
i
Signature ofApplicant/Agent: Date: �Q 8
SUPPLEMENTAL INFORMATION REQUIRED
PLAN CHECK TYPE ..
ROUTING SLrP
❑ . OVER-z[WcouNTER
❑ BUILDING PLAN REVIEW
New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
❑ EXPRESS '
❑ PLANNING PLAN REVIEW'
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
El STANDARD.
❑ PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project.
❑-' LARGE
❑ FIRE DEPT
Copy of Planning Approval Letter or Meeting with Planning prior to
p ' MAJOR'
❑ SANITARY $ER ERDISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
I
BldgApp_2011.doc revised 06121111
CITY OF CUPERTINO
, FEE ESTIMATOR — BUILDING DIVISION
igADDRESS: 19608 PRUNERIDGE AVE
DATE:, 10/08/2014
REVIEWED BY: MENDEZ
APN:
BP#:
"VALUATION: 1$153,000 j
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY
USE: Multi -Family Dwelling
Buildina is
>3 Stories Q Yes Q No
PENTAMATION
PERMIT TYPE: 1GENRE i
WORK
SCOPE
ARIOSO- CONSTRUCT NEW PATIO AREA, FENCING LIGHTING AND FIRE PIT 1800 SQ
4.1
MEclr. 1'lar. Check
Pl!unb. l'lcrn (:"hc:c'k
fs'r'er:. Plan Check
?L1ec.:1 Permit Fee:
P!a,mb. Permit Fee:
i
Elec. Permi: Fee: I
i
Orher ,�Ic,c:di. Insp. Ea7__
Olher PlumbInsf".El
01her Elec. Insp.
Hech. lisp. Fee:
Pharn%,. hisp. Fee:
£lec. Insp. Fee:
NOTE: This estimate does not include fees due to other Departments (i.a Planning, Public Works, Fire, Sanitary Sewer District, Schobl
District, etc.). These.fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Ej': 7/f 1113)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee: Hourly Only? 0 Yes (a No
$0.00
hours
$286.00
Plan Check, Hourly
ISTPLNCK
Suppl. PC Fee: Q Reg. 0 OT
1 0.0
1 hrs
$0.00
PME Plan Check:
$0.00
Permit Fee: Hourly Only? Q Yes (D No
$0.00
Suppl. Insp. Fee:Q Reg. Q OT
F0.01hrs
$0.00
�
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
`
G:onsll°tiction Tar:
AdR'lh'1fS'!t'QtiVc? i`E?cJ:
I E)
Work Without Permit? 0 Yes (D No
$0.00
Advanced Plannin& Fee:
$0.00
Select a Non -Residential
Building or Structure �
i
T raved Oocairnentcaliort Fees.-
Strong Motion Fee: IBSEISM7CR
$19.89
=hrs
$429.00
Inspections
ISTINSP Inspection, Hourly
Bldg, Stds Commission Fee: MCBSC
$7.00
�
$26.89
AL SE:$715.
a
$741.89
Revised: 07/10/2014
I
RECEIVED
/ UNREASONABLE HARDSHIP EXEMPTION FORM JUN 15 �015
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
Im ALBERT SALVADOR, P.E., C.B.O„ BUILDING OFFICIAL �
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 lay
CUPERTINO
(408) 777-3228 • FAX (408) 777-3333 - build inoPcupertino.ora
(For Tenant lmorovements where the Cost of Construction does not exceed $139.934.00)
SITE ADDRESS
19608 Prunerid e Avenue
APN
316-047-018
BP#
14100050
CITY Cupertino
I ZIP 95014
TOTAL CONSTRUCTION COST A $ ...,....'1.15,000.00 .
DESCRIPTION OF WORK: Landscape Renovation, new BBQ, expand patio
The following is a list of posts to provide access features in order to comply 100% witfilhe current State Title=24 Disable Access StandaMs,(AII
cnsts to he dncijmantad by anti gal hid,, nr nthpr infnrmatinn acnantari hvthrm. Ri dlrrinn nffir.inl )
Accessible Features
Complies with
If not'. list required upgrades in order for
Cost to make feature
current standards?
features to fully comply?
full accessible?
1. Path of travel to accessible entrance.
Demolition & reconstruction of
NO
existing pool decking
$ 125,000
2. Cost of providing a primary entrance. (including but
Clubhouse egress door upgrades,
not limited to, thresholds, landings, door hardware,
No
including automatic door operation
$ 30,000
max. door pull, etc.
3. Cost of providing the primary path of travel to the
Sidewalk demolition,
Specific area of alteration, structural repair, or
NO
$ 15,000
addition.
re -build & widen
4. Cost of providing accessible restroom facilities.
Counters, fixtures; grab bars,
$ 42,000
No
stall doors
i
i
5. Cost of providing an accessible drinking fountain. (If
N/A
S
required or if a drinking fountain is provided.)
6. Cost of providing accessible public telephones (if
S
provided)
N/A
7. Cost of providing other accessible features, including
Parking lot repaving, restriping, ramp
S
but not limited to, parking, storage, alarms etc.
No,
upgrades, signage
25,000
TOTAL COST OF ACCESS FEATURES (B):
$ 237,000
Has the same tenant performed work in the o
same tenants ace within the fast three ears? No Calculate (B A) z 100 /0 206.10 0
Description of access features to be provided:
New walkway. pate and ramp. Provide sianaae.
TOTAL COST OF 29 00o PERCENTAGE (20% minimum �`►
PROPOSED UPGRADE expenditure is required) 25.2
ARCHITECT OR ENGINEER OF RECORD INFORMATION: I certify that the above noted information is true and correct.
Name (print): Bruce A. Chan Signature: Date: R V��W�b F
Firm address. 923 Arguello Street, Redwood City CA 94063 Title; Landscape Architect Phone:650-346-7645 Rdvlowe
_.___.—_----------------�__ __ _—.—_ FOR DEPARTMENT USE ONLY --_ _ _-_---------------_—___W_ —_�_ _----
0 The above named project has been denied an unreasonable hardship exemption under 2010 CBC Section 1 1341]1.2.1.
0 The above named project has been granted an unreasonable hardship exemption from the requirements of the State of California CCR-Title 24
(Regulation for the Accommodation of the Disabled) pursuant to.2010 CBC Section.1134B.2.1.
COMMENTS:
Building Official Designee'(print)` �Pq�Signature:
ate: & '17' 1!
KardsliipF- emptioiiForni_2012.doc revised 10117113
UNREASONABLE HARDSHIP EXEMPTION FORM
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O„ BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building()cupertino.orq
(For Tenant ImnrnvPmants whPrP thin Cost of Constnictinn dnes not exceed R119 934_001
SITE ADDRESS
APN
BP#
19608 Prunerid a Avenue
316-047-018
14100050
CITY Cupertino
ZIP
TOTAL CONSTRUCTION COST A $........ T15,QQQ,QQ....................
DESCRIPTION OF WORK: Landscape Renovation, new BBQ, expand patio
Accessible Features
Complies with
current standards?
If not, list required upgrades in order for
features to fully comply?
Cost to make feature
fully accessible?
1. Path of travel to accessible entrance.
No
Concrete walkway
$ 11,000
2. Cost of providing a primary entrance, (Including but
not limited to, thresholds, landings, door hardware,
max, door pull, etc.
�LG
G /Y%/� d l��/y%�
$
3. Cost of providing the primary path of travel to the
specific area of alteration, structural repair, or
addition,
4. Cost of providing accessible restroom facilities.
No
Counters, fixtures, grab bars,
stall doors
$ 42,000
5. Cost of providing an accessible drinking fountain. (If
required or if a drinking fountain is provided.)
$
6. Cost of providing accessible public telephones (if
provided)
$
7. Cost of providing other accessible features, including
but not limited to, parking, storage, alarms etc.
No
Parking lot repaving, restriping, ramp
upgrades, signage
$ 25,000
TOTAL COST OF ACCESS FEATURES (B):
J\
$ 78,000
Has the same tenant performed work in the
same tenants ace within the last three ears?
No
Calculate (B i A) x 100%
67.8 %
Description of access features to be provided:
TOTAL COST OF
PROPOSED UPGRADE
I
$�D�TO� /to L�GYE/YI� 5
PERCENTAGE (20% minimum
ex enditure is required)
°
/O
'O Ott f//fIYC
ARCHITECT OR ENGINEER OF RECORD INFORMATION: I certify that the above noted Information is true and correct.
Name (print): Bruce A. Chan
Signature:
Date:
Firm address: 923 Arguello Street, Redwood City CA 94063 Title: Landscape Architect Phone:650-346-7645
—__-------- ---.____ �_�___------_—_ FOR DEPARTMENT USE ONLY--
❑ The above named project has been denied an unreasonable hardship exemption under 2010 CBC Section 1134B.2.1.
0 The above named project has been granted an unreasonable hardship exemption from the requirements of the Slate of California CCR-Title 24
(Regulation for the Accommodation of the Disabled) pursuant to 2010 CBC Section 113413 2.1.
COMMENTS;
Building Official Designee (print):
Signature: Date:
NardshipFrernplionForm 2012.doc revised 10117113
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