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10060088 - PUB I LE"I Idl 0 0 C) 0 Lr) < cr) �2 CP oq CD T) F— LO —4 0 < 0 co F— LO LLJ zo LO u LO LL- cr) M OC) LCL 0 OLO LQw (D N CD IL go E zr_ EL m CL u CD +: U d) 0 < u Jul A) LL- MM .2 To LO LO LLJ 0 2 2 (a a_ E z lul I&I ZD Z-5 (—u d) M a CL CL z 0 c u u U w -C 0 —j CD CD kA U- 2 fu w CD ZE t Idl ui LO 0 r�- z CD <_j w = ,w ui c 0 19 1 CL > < > c fu 0 rt- U- F— w -C LL. Ld c C) C=1 al c CD F— CZ 0) -0 zs LLJ L C CJ 01) CD CD LLJ 01) (L) I CIA CD a COD LU 0 CO L!3 o z -2, LL) T) cr) u IL ZD a Co u ZZ — — - N z ZD 0 c -LA CD com -i ;V- Co 01) 0 Lr) < L<. U m U C) CD CD U C CD (K (L) a) kA Q) Q) -0 C:L Cl 5 c, E F— c L, > F— E a) 0 -0 -0 (D E, IL CL -0 Cl r4 c E F- -T wCD F— u CD LL- -C M fu fu fu < :5 c -D o o L) 01 u E fa �L-- 0 CL Or m LO kA LU u a E -= = 'L- IL < w U CL 0 a� �-u CL a) d) a) a) a- Lo CL < c- U U U n cu iT- CL LL CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10895 SWEET OAK ST CONTRACTOR: -SE PERMIT NO: 10060088 -HffERIMINEE!S1 I C ed UL�t OWNER'S NAME: RICHARD FORD �d - DATE ISSUED:06/15/2010 OW ER'S PHONE: 4087367475 �G �,� C� �� PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL LJCOMMERCIALE] A-P License Class (3 Lic.# ��3 ? ( �' WL-ACE 2 WINDOWS AND SUB PANEL UPGRADE ADD 'j F-V 5 TI te. AIN n 6 �5 [a DOUBLE Contractor Date DOOR N;5T 1 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. 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. Sq.Ft Floor Area: Valuation:$7600 1 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:32651041.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION [,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 YS 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 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 granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Si Date !� f? All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,1 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 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(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 1 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 r Owner or authorized agent: 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,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 �© CITY OF CUPERTINO ADDITION/REMODEL CUPERTINO FEE SCHEDULE f APN# � 5 I (4) \ Date: � Is a 2nd unit being ??T added YesV v❑ No ❑ If yes, lease fill out the permit application for 2"d unit. Building Address: � ,WCA DA k S4' Mailing Address (if different from building address): Owner's Name: Phone# p c, Fp'p �a� ?316 �'7�75 Contractor: Phone#: 5'1 o (2 — ,Z_c 7 e V E l Le- _f 6e AJ'5` l'Q G'I" Fax#: -61 o 6 23 -- Cupertino Business License: State Contractor License#: 583 7/8 Contact: t eulgPhone#: 5-10 J (2- �(?�7 'v ut C' Fax#: Landscape Ordinance Compliance. Landscape area in sq. ft. (includes all irrigated areas): If 2,500 sq. ft. or less, compliance with the Landscape Water-Efficiency Checklist is required. If more than 2,500 sq. ft., a complete Landscape Project Submittal is required. Compliance Method: ❑ Plant Type ❑ Water Budget Building Permit Info: Bldg. rg Elect. Plumb. ❑ Mech. ❑ Hillside ❑ Job Description: Addition-What is being added?(Be Specific): A-ni') 2 k,1 i N n oWS 1,U 6A-T F(p aft s S`t[3P��e.l LiFa6R.Flt)ei g�fi� o ��u,�l��`llu6� C3grF(•. :boo 2 AiERL«ciNG WI-rc7 vo" What is being remodeled (not including addition)? Remodel Includes Re-Roof: Yes ❑ No ❑�If yes list number of squares 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 Footag Addition: Porch: Deck: Garage: Detached Attached Kitchen Bath Other Remodel: n CIO, Z (�l dRemodel: ��� � 6��,/.,� -K 5u 4 - P P Type of Construction (Usage Class): Occupancy Type: Ar,$ 1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B Valuation: 76Q-,o Please check this box if the project is a Project Size: Ex ress [9 Standard ❑ Lar e ❑ Major ❑ second-story addition ❑ 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. Revised 05/18/10 CITY OF CUPERTINO ADDITON/RElVTITODEL CUPERTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft ADDITIONS 1R3SFDADD 1PLLONGRNGR Long Range PL Plannin Residential 1 R31NSP Dwellings Inspections B 1R3PLNCK Dwellings plan check B 1R3REPINSP Dwellings Repeat B Inspection 1k3REPPLNC Dwellings Repeat Plan B Check 1R3HINSP Dwellings Hillside B inspection 1R3HPLNCK Dwellings Hillside plan B check 1R3HREINSP Dwellings Hillside B Repeat Ins ection 1R3HREPLNC Dwellings Hillside B Repeat Plan Check 1R3ALTINSP Dwellings Alternate B Materials Inspection 1R3ALTPLNC Dwellings Alternate B Materials Plan Check 1PCESS Cesspool P 1PPRSEWG Ea. Private Sewage P Dis osal System 1PRSEWER 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 1REROOFRES Residential Re-roof Each B 100 SF Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: ) OA-V— .S PERMIT# vO OWNER'S NAME: P.{C.ko4fo� ' 9—P PHONE# 08 ?;�— 7 f GENERAL CONTRACTOR: ATE V E5 fi'( ,ANS (6&,4T 4MJS1NESS LICENSE# ADDRESS: q00 4A-,gL--- `b R- -P/e),'4,04t (A- Y 537, 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 THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 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 Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date