15080191I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15080191
20396 CLIFDEN WAY CUPERTINO CA 95014 (369 36 006) ALI'S CONSTRUCTION
& REMODELING INC
SAN JOSE, CA 95129
IOWNER'SNAME: I DATE ISSUED• 10/11/2016 1
OWNER'S PHONE: ( 1 (PHONE NO: (408) 441-0967
I III"1 / 1's 1 •., 1�
License Class GENERAL BUILDING CONTRACTOR Lic. #909433
ContractorALI'S CONSTRUCTION & REMODELING INC Date 01/31/2018
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.
I hereby affirm under penalty of perjury one of the following two declarations:
1. 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.
Q 2." 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
permit is issued.
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 upon the above mentioned property for
inspection purposes. (We) agree a indemnify and keep harmless the
City of Cupertino against liabiliti s, judg ants, costs, and expenses which
may accrue
2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
1. 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)
2. I, as owner of the property am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
i. 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.
2. 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
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 become subject to the Worker's Compensation provisions of the
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
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 upon the above mentioned property for inspection purposes. (We) agree
to save 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 with all non -point source regulations per the Cupertino Municipal
Code, Section 9.18.
Signature Date 8/3/2017
BUILDING PERMIT INFO•
—BLDG —ELECT _ PLUMB
_ MECH _ RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION
CONSTRUCT (N) 1 STORY ADDITION(1115 S.F) NEW FRONT
PORCH (50 S.F) BATHROOM REMODEL (97 S.F) KITCHEN
REMODEL (202 S.F) OTHER REMODEL AREA (750 S.F) REROOF
(1546 S.F) UPGRADE PANEL TO (1) 200 AMP PANEL, REMODEL
GARAGE (482 SQ FT).
REV #1 - REVISE SCOPE OF WORK. CONSTRUCT ONE STORY
ADDITION (1105 SQ FT); (1) FRONT PORCH (44 SQ FT); (N) REAR
PORCH (236 SQ FT); REMOVE 1/2 BATH AND LAUNDRY FROM
GARAGE, INTERIOR REMODEL (1200 SQ FT); SECOND STORY
ADDITION (661 SQ FT) WITH COVERED BALCONY (644 SQ FT);
ELECTRICAL PANEL UPGRADE (200 AMP).
**B**
Sq. Ft Floor Area: Valuation: $300000.00
"N Number- Occupancy Type:
369 36 006
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by Kim Dunbar
Date: 10/11/2016
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed
Date: 8/3/2017
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
_HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or authorized agent:
Date:/$(3 2017
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance
of work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
CITY OF CUPERTINO BUILDING PERMIT.'
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15080191
20396 CLIFDEN WAY CUPERTINO CA 95014 (369 36 006) 1 OWNER BUILDER
OWNER'S NAME:
OWNER'S PHONE: (
LICENSED..CONTRACTMS DFCLARATION
License Class Lic. #
Contractor OWNER BUILDER 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.
I hereby affirm under penalty of perjury one of the following two declarations:
1. 1 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 wort: 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
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the abode
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, costs, and expenses which
may accrue against said City in consequence of the granting of this permit..
Additionally, the applicant understands and will comply with all non -point
source regulations per the Cupertino Municipal Code, Section 9.18.
Signature Date 10111/2016
I hereby affirm that I am exempt from the Contractor's License Law for one of the
ffollowing two reasons:
1. 1, as owner of the property, or my employees with wages as their sole
compensation, will do the work, End 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 construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
1. 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. 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
permit is issued.
s. 1 certify that in the performance of the work for which this permit is issued, I
shall not employ any person is any manner so as to become subject to the
Worker's 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 forthwith comply with such provisions or this permit shall
be deemed revoked.
APPLICANT CER't'MCA11M
I certify that I have read this application and state that the above information is
correct. t 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. Mie) agree
to save 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 with all non -point source regulations per the Cupertino Municipal
Code, Section 9.18.
Date 1 0/1 11201 6
DATE TISSUED: 10/11/2016
PHONE NO:
BUILDING PERMIT INFO: '
BLDG —ELECT —PLUMB
MECH _ RESIDENTIAL COMMERCIAL
JOB DESCRIPTION:
CONSTRUCT (N) 1 STORY ADDITION(1115 S.F.) NEW FRONT
PORCH (50 S.F) BATHROOM REMODEL (97 S.F.) KITCHEN
REMODEL (202 S.F.) OTHER ;REMODELAREA (750
S.F.) REROOF (1546 S.F.) UPGRADE PANEL TO (l) 200 AMP PANEL;
REMODEL GARAGE (482 SQ FT).
Sq. Ft Floor Area: I Valuation: $300000.00
APN Number: Occupancy Type:
369 36 006
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Kim Dunbar
Date: 10/11/2016
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.
Signature of Applicant:
Date: 10/11/2016
ALL ROOF COVERINGS TO BE CLASS "A"
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should Luse equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or authorized agent:
Date: 10111/201
I hereby affirm that there is a constructs lending agency for the performance
of work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lenders Address
ARCHITECT'S DECLA
I understand my plans shall be used as public records.
CITY OF CUPERTINO
EEE ESTIMATOR — BUILDING DI`
ADDRESS: 20395 Gilfden Way DATE: 08/27/2015
APN: 369 36 006 1 BP:
REVIEWED BY: PAUL
*VALUATION: $300,000
PERMIT TYPE: Building Permit ! PLAN CHECK TYPE: Addition
PRIMARY SFD or Duplex 2nd Unit? Yes ' No PENTAMATION 1 R3SFDADD
USE: OTC?Yes No PERMIT TYPE:
WORK Construct N) 1 story addition 1115 S.f. New Front Porch 50 S. Bathroom Remodel 97 S.Q Kitchen
SCOPE Remodel (202 S.f.) Other Remodel Area (750 S.f.) Reroof (1546 S.f.) Upgrade panel to (N) 200 Amp
OCCUPANCY TYPE:
TYPE OF
CONSTR..
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
R-3 (Custom)
11-6,111-B,1V"V-B
1,165
$2,695.26
IR3PLNCK
$1,813.82
IR3INSP
202 s.f.
$645.00
Remodel, Kitchen (<=300sf)
1 IREMRESKIT
Permit Fee:
$1,813.82
Suppl. Insp. Fee -(F) Reg. 0 OT 0.0 hrs
$0.00
750 s.f Remodel, Other
$575.00 IREMRESOTH
PME Unit Fee:
$0.00
PME Permit Fee:
$48.00
1,546 s.f. Re -roof
$272.00 IREROOFRES
C.'ortsit°uctir�r 1c.x:
_;&hninisfrati e P'ee':
200 1 amps
$48.00
Electrical,
IBELEC200 11 Services
TOTALS:
I 1,165
1 $2,695.26
�
$1,813.82
' .
MECJII,-1YOURI. ' -Y�s No I�L€11 B, HOURI Y Yes es ELEG, � 1 RLYv Yes zl No
tlech'. I'laH Check 1'I t,.nl;. MOW ("he ;,. Elec. Plan Check 0.0 hrs $0.00
Wech. i'erikz it hee: Pf im . I'er ff r Fee: Elec. Permit Fee: IEPERMIT
t11 cr.;tlr ,i..f ,:slx 0i,,er Plafffft .IMP. Other Elec. Insp.0.0 ��s$48.00
i % /a. lies 1. I t;e:a "'b. I np. hee: I7 fe_ ivnj'' Fee.
NOTE: This estimate does not includefees due to other Departments (i.e. Planning, Public Works, Fire; Sanitary Sewer District, School
�; 1 a•� s.. E... --1 'i-mitart the Dont for addn'l into.
w
FEE ITEMS (Fee Resolution 11-053 E . 7/1/131
FEE
QTY/FEE
MISC ITEMS
Plan Cheek Fee:
$2;695.26
97 s.f.
$645.00
Remodel, Bath (<=300 s f)
iREMRESBAT
Suppl. PC Fee: Reg. 0 OT 0.0 hrs
$0.00
PME Plan Check:
$0.00
202 s.f.
$645.00
Remodel, Kitchen (<=300sf)
1 IREMRESKIT
Permit Fee:
$1,813.82
Suppl. Insp. Fee -(F) Reg. 0 OT 0.0 hrs
$0.00
750 s.f Remodel, Other
$575.00 IREMRESOTH
PME Unit Fee:
$0.00
PME Permit Fee:
$48.00
1,546 s.f. Re -roof
$272.00 IREROOFRES
C.'ortsit°uctir�r 1c.x:
_;&hninisfrati e P'ee':
200 1 amps
$48.00
Electrical,
IBELEC200 11 Services
Work Without Permit? Cl Yes No
$0.00
Advanced. Planning Fee: IPLLONGR
$163.10
�'"
d
Select a Non -Residential
Building or Structure
Travel Documentation Fee: ITRA VDOC
$48.00
Strom Motion Fee: IBSEISMICR
$39.00
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$12.00
SIIIAG:
$4,819.18
$2,185.00
TQTLFEE:
$7,004.18
RCVIJCU. vuvuzv fv