13100147E/4
CITY OF CUF ERTINO BUILDING F E]18MffT
BUILDING ADDRESS: 21390 VAI AVE
CONTRACTOR: BOLANDER RICHARD B
PERMIT NO: 13100147
AND PATRICI
OWNER'S NAME: BOLANDER RICHARD B AND PATRICI
21390 VAI AVE
DATE ISSUED: 05/02/2014
OWNER'S PHONE: 6502698950
CUPERTINO, CA 95014-4935
PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
BEDROOM REMODEL (490 SQT); BATHROOM
License Class Lic. #
REMODEL (94
SQ FT); REMOVE AND REPLACE (1) DOOR AND (1)
Contractor Date
WINDOW; INSTALL (1) NEW WINDOW AND (1) NEW
I hereby affirm that I am licensed under the provisions of Chapter 9
DOOR;
(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: $0
performance of the work for which this permit is issued.
I have and will maintain Workers Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
APN Number: 36205027.00
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXPIRES PSS I F WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WIT ® RMIT 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
Il 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
WAYSST
s�
granting of this permit. Additionally, the applicant understands and will co5W.
ss ale:
with all non -point source regulations per the Cupertino Municipal Code ction
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, l agree to remove all new materials for
inspection.
OWNER -BUILDER DECLARATION
01
Signature of Applicant: Date:
1 hereby affirm that I am exempt from the Contractor's License Law for one of
I
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
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(x) 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
Section 3700 of the Labor Code, for the performance of the work for which this
the health & Safety Code, Sections 25505, 25.533 and 25534.
Owner or authorized agent p 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,)
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, 1 must
I hereby affirm that there is a constriction 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.
c Date
Signatur
CONSTRUCTION PERMIT APPLICATON ®�
COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION
10300 TORRE AVENUE > CUPERTINO, CA 95014-3255
CUPERTINO (408) 777-3228 ^ FAX (408) 777-3333 ^ building ckupertino.org 0
❑ NEW CONSTRUCTION [I ADDITION ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS V APN # s ®Q- s ��
OWNER NAME C ` v'rG' /�ZGt V �G PHC(V:5 ��� t 5Q E-MAILfLC }-S�3�p
STREET ADDRESS �Q� �- CITY, STATE, ZIP FAX
CONTACT NAME !! (/q� " PHONE E-MAIL
STREET ADDRESS ' 1" CITY, STATE, ZIP FAX
El OWNER OWNER -BUILDER ❑ OWNER AGENT 13 CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
11
CONTRACrORNAME
LICENSE NUMBER
LICENSETYPE
BUS. LIC 4
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
ARCHITECf/ENGFNEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
���jjj
DESCRIPTION OF WORK , / 130
eGzzd
EXISTIN US
QW,
PROPOSED USE CONSTR
TYPE
# STQRIES
USE
TYPE
OCC.
SQ.FT.
VALUATION (S)
y�
/J „NEW
5'? 'PA- -(—
t/
EXISTG
AREA J^f
FLOG
AREA
DEMO
AREA
TOTAL
NET AREA
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECKIPORCH AREA
GARAGE AREA: UDFTACH
❑ ATTACH
I
# DWELLING UNITS:
IS ASECOND UNIT ❑YES
SECONDSTORY ❑YES
BEINGADDED? []NO
ADDITION? NO
PRE -APPLICATION []YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
RECEIVED BY;ti'
TOTAL VALUATION:
PLANNING APPL# C] NO PLANNING APPROVAL LETTER
EICHLER HOME? ❑NO
"' _ �j
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. 1 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 b1Wding4OnStrUCtiOn. I thori represfe atives of Cupertino to enter the above-ideentiified/pro�jerly for inspection purposes.
Signature of Applicant/Agent:i/�i�.//i Date: /� �l `/ .l
SUPPLEMENTAL INFORMATION REQUIRED
PLAN CHECK TYPE
ROUTING SLIP
Q OVER-THE-COUNTER
❑ BUILDE'iG 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
!! t 17"'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 t0-.QMAJOR
ElSANITARY SEWER DISTRICT
submittal of Building Permit application.
.
EJ ENVIRONMENTAL HEALTH
BidgApp_2011.doC revised 06/11/11
CITY OF CUPERTINO
FEE IES7CI1\YI[A'I['OR - 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 vreliminary information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS(Fee Resolution 11-053 E . 711113)
ADDRESS: 21390 VAI AVE
DATE: 1012312013
REVIEWED BY: MELISSA
MISC ITEMS
APN: 362 05 027
BP#: Q
-VALUATION: I $0
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
)PENTAMATION 1R3SFDREM
PERMIT TYPE:
WORK
REMODEL E LVGRM AREA 460 S.F. TO CREATE N BEDROOM BATHROOM ADDITIONAL
SCOPE
80S.F. REMODEL) , CLOSET & ENTRY/VANITY AREA. CREATE (N) OPENINGS & REPLACE (E)
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 vreliminary information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS(Fee Resolution 11-053 E . 711113)
FEE
F;<'e:..P r?7 f 7u:r:
MISC ITEMS
Plan Check Fee:
$0.00
$0.00
460 s.£
$488.00
Remodel, Other
1REMRESOTH
J17,
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 vreliminary information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS(Fee Resolution 11-053 E . 711113)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
$0.00
460 s.£
$488.00
Remodel, Other
1REMRESOTH
Suppl. PC Fee: E) Reg. 0 OT
10.01
hrs
PME Plan Check:
$0.00
$0.00
EEI s.£
$626.00
Remodel, Bath (<=300 sf)
1REMRESBAT
Permit Fee:
Suppl. Insp. Fee..Q Reg. Q OT 0,0
hrs
$0.00
$0.00
® # Window / Sliding Glass Door
$418.00 1 WINREP Replacement
PME Unit Fee:
PME Permit Fee:
$0.00
C onsma No"l .7 .fx.
$0.00
0
Work Without Permit? ® Yes C) No
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
(D
0
Strong Motion Fee:
,
5'Z)$6'0U
Select an Administrative Item
Bldg Stds Commission Fee:
SUBTOTALS:
$0.00
$1,532.00F.
TOTAIL FEE
$1, 532.00
7 S U Revised: 10/01/2013
15-33, S -D
cCONMACMR / SUB CON7RAcCTGR ILES7
>E u lding Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: 'Z
v 'r- PERMIT # 1
OWNER'S NAME: ' f, ` dr4-c�
PHONE
GENERAL CONTRACTOR:
BUSINESS LICENSE #
ADDRESS:
CITY/ZIPCODE:
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR ]FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL 7HE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature Date
]Please check apnp fleable subcontractors and complete the ffollownng inffornmtlon:
V
SUBCONTRACTOR
BUSINESS DAME
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
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner / Contractor Signature Date
0
IF
JOSE FERNAN)(DEZ P.E.
408.512.8400
APRIL 18, 2014
RE: Permit Number 13100147 — RICK BO1AiSI)CD1ER RESIDENCE
21390 Vai Ave.,
Cupertino, to 95014
For:
Building inspection Department City Of Cupertino
Thi's letter with the new sets of structural and architecturall plans has been provided and
submitted by JF Consulting on behalf of the owner lir. lBolander to address all the comments
given from the building departments for the above mentioned project.
This letter is un response to the Building Permit Plan Check Comments for above mentioned
project.
1. Owner met with Sean Hatch November 8, 2013 to review red lines and comments. Plans not
consolidates as requested. (page 1 and 2)
2. The modifications was Previously approved.
Architectural sheet A-1 has been provided with all the following information:
Site plan for the Parcel. =�
X Job address and the Assessors parcel number.
c� Owners name, address and phone number.
J
)Occupancy group R-3 for residence.
Construction type V =B
Exact scope of work, project type and area of work.
\g) The plan notes regarding to 2013 California Building Code has been added to
Architectural Sheet A-1.
Ilk Sheet index with clearly re -labeled sheet numbers has been provided.
4. The complete floor plan of the residence with clearly labeled size, type and location of all
the existing doors and windows in the area to be remodeled has been provided on
Architectural Sheet A-1.1.
ago u The 'installation of smoke alarms inside and outside the remodeled bedroom and
e installation of a Carbon monoxide alarm outside of sleeping area per CRC R314 and
R315 has been provided and shown on Proposed Floor Plan Sheet A-1.1.
The previously crossed out floor plan at the counter has been removed.
The size (amps) of the proposed sub panel has been indicated in Architectural Sheet A-1.1.
The required energy requirements and plan sheet notes has been provided.
a) The note has been added under electrical notes.
b) The note has been added under electrical notes.
The previously provided plumbing note has been revised and the additional notes has been
added.
a) The note has been added under plumbing notes.
21060 WEST HOMESTEAD ROAD ^ SUITE 21.2 - CUPERTINO, CA o 95014
PH0NE: 408.512.8400 o FAX 408.800.4038
0
,r
b) The note has been added under plumbing notes.
C) The note has been added wider plumbing notes.
The installation of smoke alarms inside and outside the remodeled bedroom and the
installation of a Carbon monoxide alarm outside of sleeping area per CRC R314 and R315
has been provided and shown on Proposed Floor Plan Sheet A-1.1.
The wall receptacle outlet has been provided in the bathroom to meet the a) and b)
minimum requirements.
The structural Sheet S-3 clarifies the location of the support post with details provided.
On enlarge Proposed Floor Plan sheet A-1.1 existing and new windows and doors has been
identified using the standard method of width and then height.
The Wall Detail Section on sheet A-2 indicates the installation of R-13 insulation un the
walls per the mandatory measures of the 2013 Energy Code.
14. The Landing has been indicated on the enlarged floor plan.
15. The revised plan shows the compliance to the code minimum of 2 inches clearance from
the sides and 4 inch clearance from the back of the fireplace. The backside of fireplace to
be walled.
Ni. The required information for the fireplace has been added to Architectural Sheet A-2.
b Owner to provide full purchase information un case of additional information needed.
The requirement has been added to the existing fireplace chimney locations on the floor
plan Sheet A-1.1.
The notes has been in Architectural Sheet A-2.
a) The note has been added under floor plan notes.
Gb) The note has been added under floor plan notes.
c) The note has been added under floor plan notes.
Wall Detail has been provided un Architectural Sheet A-2 to call out for the method of
construction of the interior walls.
20. New sets of plans has been submitted to clarify the fratuing details.
21. The Hydronic Tubing to be only installed for new bathroom area.
22. The Existing fireplace shown un Architectural Sheet A-2 located in the Bedroom is Direct -
Vent gas fireplace.
23. The location of the shower head to show conformity according to CPC 411.10 has been
provided on Architectural Sheet A-2.
If you have any questions, please call me. �4y"' S -JU
Sincerel Z
o C 7639
z�
EXP 12/31/14
Jose C. Fernandez CIVIL �4
408.512.8400 OF
21060 WEST HOMESTEAD ROAD ^ SUITE 212 o CUPERTINO, CA 0 95014
PHONE: 408.512.8400 ° FAX 408.800.4038