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10080128 - PUB
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Zi Z Z y n _ - ro d v w 0. ° o n � w O d Lo U O w O 4 w Lo w < w U U U a (D a LL FL CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10953 SWEET OAK ST CONTRACTOR:BAY AREA CUSTOM PERMIT NO: 10080128 BUILDERS INC OWNER'S NAME: G1G1 LUGONJA 1002 S DE ANZA BLVD STE Al DATE ISSUED:08/18/2010 OWNER'S PHONE: 6502699907 SAN JOSE,CA 95129 PHONE NO:(408)446-1200 ❑ LICENSED CONTRACTOR'S DECLARATION F i BUILDING PERMIT INFO: BLDG � ELECT '-" PLUMB License Class >/� Lie.# GI 2 L �]� d !. g MECH RESIDENTIAL COMMERCIAL Contractor) T/�Z�i �`1 fiI ��h�t�Date I hereby affirm that I am licensed under the provisions of Chapter 9(11 JOB DESCRIPTION:REMODEL KITCHEN(140SQ);NO RE-ROOF&NO (commencing with Section 7000)of Division 3 of the Business&Professions STRUCTURAL 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 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$10000 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 0 a f APN Number:32651014.00 Occupancy Type: APPLICANT CERTIFICATION 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section " e` L 9.18. Issued by--.-,,,— Dat Signature Date hf p ❑ OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.if a roof is 1 hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. 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, Signature of Applicant: Date: Business&Professions Code) 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 HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,l shall Health&Safety Code,Sections 25505,25533,and 25534. 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 Owner or authorized ag nt: become subject to the Worker's Compensation provisions of the Labor Code,l must L,d hcT 1�bCL 4 -Date: forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION l hereby affirm that there is a constriction lending agency for the performance of work's I certify that l have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.l agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address 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 ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date e2 0 I �o � � 1Zg CITY OF CUPE ADDITION MODEL CUPERTINO FEE SCHEDULE APN# ff � ` Date: �_ l Is a2 d unit being added? Yes No ❑ If yes, please fill out the permit application for 2"d unit. Building Address: D 9�5'. S cue el o a IAC S-f , Cit e-e tI no CA 9 s o l 4 Mailing Address (if different from building address): Owner's Name: L Uoni Phone# : 5 T 2 G -- " `j J-�- Contractor: Phone#: `�`t _ 12-0.0 /3a area C&ASt-001 13uUlj 'erg Fax#: 4f-)S) Z/Y6 l2- `f Cupertino Business License: State Contractor License#: 2_0 41 Contact: r'c j � n.0Phone#: Lfok) 413 q — 6 `f o 4 f JFax#: Landscape Ordinance Compliance: Landscape area in sq. ft. (includes all irrigated areas): r. 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. ❑ Elect. Plumb. Mech. ] Hillside ❑ Job Description: Addition-What is being added?(Be Specific): What is being remodeled(not including addition)?. RGiyur,I &f k1464eij Remodel Includes Re-Roof. Yes ❑ No S. If yes list number of squares Remodel Includes Structural: Yes ❑ No Do you have the pre-application planning approval? Yes ❑ No E;_. If yes, please provide a copy of your planning approval letter. Planners name: Square Footage: Addition: Porch: Deck: Garage: Detached Attached Remodel: Kitchen��_ Bath Other Type of Construction(Usage Class): Occupancy Type: 1-A, 1-B ❑ II II/V-A ❑ II/III B, IV-HT, V-B Valuation: v.�)o . v Please check this box if the project is a Project S' e: ress Standard E] Large ❑ major Elsecond-storyaddition ❑ Please coloete 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 CThY OF CUPERTINO ADDTI'ON/REMODEL CUPERTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft ADDITIONS IR3S]FDADD '1PLLONGRNGR Long Range PL Planning/Residential 1 R31NSP Dwellings Inspections B 1R3PLNCK Dwellings plan check B 1R3REPINSP Dwellings Repeat B Inspection lk3REPPLNC 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 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 1REROOFRES Residential Re-roof Each B 100 SF a. CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: 'VALUATION: $10,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY SFD or Duplex 70coyltUNTER? R THE • PENTAMATION/�35* USE: E) 0 Yes No PERMIT TYPE: WORK SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,111-B,IV,V-B 0 $0.00 $0.00 TOTALS: 0 $0.00 $0.00 MECH,HOURLY 0 Yes 0 No PLUMB,HOURLY © Yes Q No ELEC,HOURLY Q Yes (F)No Lfecit. 7']c -Check, 1 hmjh. Plan(7wck Flet:. Plan Ch:cr Ffech. Perwil Fee: Nwnh. 1'ertnil Fee: ern�t.(;] r ec. f 1�re; o her a/ecki. 1nsp. 0lher 11hmh,17r,sP. 01/?Lr E7ec.Insp. dlech. 111sp. Fce: P]unrh, Lisp. Fce: I:1ec.Insp. Fce: NOTE. These ees are based on the preliminary information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS(Fee Resolrltion 09-051 Eff 7/1/10) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 140 s.f. Remodel,Kitchen(<=300 sf) Suppl.PC Fee: E) Reg. 0 OT 0.0 T hrs $0.00 $570.00 IREMRESKIT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Feer Reg. 0 OT 10.01 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Con,YImctio" 7_41-V Acoustical Fee: 0 Yes 0 No $0.00 0 Work Without Permit? O Yes 0 No $0.00 G Planning Fee: $0.00 Select a Non-Residential Q 71-urel C)oc;tllnerntctorl Fi;e.S`� Building or Structure 0 Strong Motion Fee: 1BSEISMICR $1.00 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $2.00 $570.00 TOTAL FEE: $572.00 Revised: 8/17/2010 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: Swee,f oa t< S PERMIT# �Q/2 OWNER'S NAME: ( PHONE# G^ D - ZG `!- `19 o GENERAL CONTRACTOR: lgteA Cl--1 hIP, Pt, USINESS LICENSE# 2 v G Lf ADDRESS: S. Qg 4h 2-cl 1 M • ,\h `15f2-S 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: ✓ 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