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09090205- PUB �-:)j 411 k:l I 1-0.11 1 a�'11,�I 1?.11` 11111,, 1ki,11 -1 Iv-11 ldl' Y i W N H 0 7i w d V 00 x H LOCD U .i W H d 0 x as Ls v u a p — a Lb w LO m zn CO :2; O U) z N 0 O H L9 H W M 7 F 9 H H W > W Z J O F+ m 0 T O H AW 0 U ` Z -1 a W H LO �0 � x U w W o O cL O cr) LO PO a) w0 a a p cr CD 0 CD a _ a A Z O L) 0 q U :3 , 4 cx zn TI U L x4) a E fa %tn d) N 4) w � _0 a) cn J U Q � c�j O. Q U I I 3 J I ip iO �L - a d c 1�1 CL ,_V a a ¢ U �d� Lo �dl U l C a� 0 0 0 O r 2 J O W O (.D ..�.�! ~ .O ti .� ! � a O Ld 2: o 1 0 Q v -� p d 7 m W H' f� Q °a- LO LLI � LL, O� O 2 J m' m pC 4�, rt oa ° OD M ° m _ d a mC11 CD aaiC U m (\j (\j LO � , LO -; 4 Q LO CD U�� o o – j 4) "+ Q) N 47 7 N Ic ro OL a a � '° a m fu v E a N c E E .a12 Z a+ =11 V > w ¢) o $ t L c - q 21 :3 :3 16v 4) ¢) O _0 O +v V Li 2 c v 2E a O v U E 0 a. E a wfu a`) (u 0 a o m cn a� o a) Ci tr) a- Q d U U U a- a Il.. c LL CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10410 STOKES AVE CONTRACTOR:DWK CONSTRUCTION PERMIT NO:09090205 OWNER'S NAME: O'RIORDAN THOMAS L AND VIRGINI 18665 LOREE AVE DATE ISSUED:02/08/2010 OWNER'S PHONE: 4087817671 CUPERTINO,CA 95014 PHONE NO:(408)996-1186 ❑ LICENSED CONTRACTOR'S DECLARATIONr- 11�� *7 BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class 9 Lic.#�_)00:X � � I— / MECH RESIDENTIAL COMMERCIAL Contractor ' crosoarn4-1/ Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:ADD 167 SK NOOK,RERROFING 25 SQS REMOVE WOOD (commencing with Section 7000)of Division 3 of the Business&Professions SHAKE AND REPLACE WITH COMPOSITION SHINGLE, Code and that my license is in full force and effect. KITCHEN REMODEL,HALF BATH CONVERSION TO FULL BATH 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 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 Sq.Ft Floor Area: Valuation:$50000 permit is issued. APPLICANT CERTIFICATION APN Number:32647019.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. / Signature G -Yt/ Date,Fr -G Z--� tissued by: Date: Cs7 CJ ❑ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. 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 Owner or authorize agent: forthwith comply with such provisions or this permit shall be deemed revoked. Date:�jD� APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY - I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Datefl�a^ 8�� Licensed Professional CITY OF CUPERTINO d at ADDITION/REMODEL CUPEVI INO PERMIT APPLICATION FORM APN# TDa Ll A9 Is a 2" unit being added? Yes ❑ No ❑ If yes, please fill out the permit application for 2" unit. Building Address: 1c>V 0 5fol(ex Mailing Address (if different from building address): Owner's Name: Phone# DZvid `�sa 1. eg) 78-1— 767/ Contractor: Phone#: �K Gniv�T�'�CTi d�✓ Fax #: Contractor License#: Cupertino Business License#:afAd Contact: Phone#: Building Permit Info: 4108 Bldg. Elect. ® Plumb. Mech. ❑ Hillside ❑ Job Description: Addition-What is being added?(Be Specific)- �v Wt e r Iaee J as��-ii s le) rL What is bein remodeled(not including addition)? r,rnadGl, tl�l Thr k c"'VeW tv I all bajc Remodel Includes Re-Roof: Yes No ❑ If yes list number of squares s% S Remodel Includes Structural: Yes No ❑ Do you have the pre-application planning approval? Yes ❑ No ❑ If yes, please provide a copy of your planning approval letter. Planners name: Square Footage: Addition: 1,67 Porch: Deck: Garage: Detached Attached Remodel: Kitchen IC0Bath Other Type of Construction (Usage Class): Occupancy Type: I-A, I-B ❑ II/III/V-A ❑ IUIII B, IV-HT, V-B Q vl__� Valuation: $So,000 IvePlease check this box if the project is a second-story addition ❑ Project Size: Express Di'�§tdard ❑ Large ❑ Major ❑ Please complete relevant portion of the Green Building Checklist& attach it to the application or if applicable, Green Building Points Achieved: include in plan set & the sheet index. ***For Office Use Only*** Over-the-Counter 0 Revised 07/06/09 CITY OF CUPERTINO ADDITION/REMODEL CUPERTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft ADDITIONS 1R3SFI)ADD ` 1PLLONGRNGR Long Range PL �b Planning/Residential lR3INSP Dwellings Inspections B f�^ 1R3PLNCK Dwellings plan check B 1R3REPINSP Dwellings Repeat B- Ins ection 1R3REPPLNC Dwellings Repeat Plan B Check 1R3HINSP Dwellings Hillside B inspection 1R3HPLNCK Dwellings Hillside plan B check 1R3HREINSP Dwellings Hillside B Repeat Inspection 1R3HREPLNC Dwellings Hillside B Repeat Plan Check 1R3ALTINSP Dwellings Alternate B Materials Inspection 1R3ALTPL]14C Dwellings Alternate B Materials Plan Check 1PCESS Cesspool P 1PPRSEWG Ea. Private Sewage P Disposal System 1 PRSEWER Sewers P 1BPSPRINK Lawn Sprinkler/Backflow P 1BPWSVCS Main Water Service P 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE SeismicResidential B 1RER00FRES Residential Re-roof'Each B 100 SF Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 -- CITY OF ._ Fax(408)777-3333 CUPEI�TINO Building Department JOB ADDRESS: PERMIT # �.qvd spokes Aue. D AL ID OWNER'S NAME: DaAbj 7S70-I' PHONE # ( CVS oq—3 Q s GENERAL CONTRACTOR: T..D 6 FAX# ( S) I am not using any subcontractors: �Date Signature Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile �- --Q Owner/Contractor Signa Date