Loading...
B-2017-0052CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PI MMIT NO: B-2017-0052 10950 LUCKY OAK ST CUPERTINO, CA 95014-0126 (326 57 006) LOS ALTOS BUILDERS MOUNTAIN VIEW, CA 94040 OWNER'S NAME: WESTON RONDO F TRUSTEE DTE ISSUED: 01/09/2017 OWNER'S PHONE: 408-385-6210 P ONE NO: (650) 390-9615 LICENSED, CONTRACTOR'S DECLARATION BUILDING PERMIT O: License Class B. C-10 Lie. #843863 Contractor LOS ALTOS BUILDERS Date 08/31/2018 X BLDG _ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing MECH X RESIDENTIAL COMMERCIAL — — with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: REMODEL KITCHEN (1 0 S.F.), LIKE FOR LIKE I hereby affirm under penalty of perjury one of the following two declarations: 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 work for which this permit is issued. 6 �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. Sq. Ft Floor Area: Valuation: $63000.00 APPLICANT CERTIFICATION 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 APN Number: Occupancy Type: and state laws relating to building construction, and hereby aohbrize 326 57 006 representatives of this city to enter upon the above mentigned property for inspection purposes. (We) agree to save indemnify an6eep harmless the City of Cupertino against liabilities, judgments, cost and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said ty i,� consequence pf'fhe granting of this permit. Additionalppli t�derstands and i comply with all non -point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source res' er t e Cupertino M ip Code, Section 9.18. 180 DAYS FRO LAST CALLED INSPECTION. Signature,? :Date 01/09/2017 Issued by: Date: 01/09/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the I ROOFC following two reasons: All roofs shallbe inspected 'or to any roofing material being installed. If a roof is 1. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature ofApplicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 01/09/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVE RINGS TO BE CLASS "A" OR BETTER 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. MATERIALS DISCLOSURE 2. 1 have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will permit is issued. maintain compliance with t e Cupertino Municipal Code, Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, St ction 25532(a) should I store or handle hazardous not employ any person in any manner so as to become subject to the material. Additionally, sho Id I use equipment or devices which emit hazardousshall air contaminants as defined by the Bay Area Air Quality Management Distract I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance w th thper ' o Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safetyode, 0 5 0 n 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized ag ." '� APPLICANT CERTIFICATION Date: 01/09/2017 I certify that I have read this application and state that the above information is CONST P.UCTION LENDING correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this per nit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence ofthe granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal ARC IHTECTIS DECN Code, Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 01/09/2017 Professional ❑ NEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISIO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 - building aQcupertino.org ❑ ADDITION I- I ALTERATION/TT I I RF.VISinN/nFFF.RRF. ORTC�TNAI PFRTATTJE PROJECT ADDRESS � � � I � � APN # OWNERNAME STREET ADDRESS gj / CITY, STATE, FAX CONTACT NAME/ j PHONE _ qn STREET ADDRESS CITY E, IP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHUECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR LICENS %gr,_6 BUS. LIC # rSFTYPE ®, COMPANY NAME v E -M IL ( /X FAX STREET ADDRESS 1 Cd, S E, ZIP �j, ®/� `� �t '�` `� V� (f PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC it COMPANY NAMF/�/4 E-MAIL FAX Z a STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK �'X/J7�•O �L ! �i �j �y� �jc / �p� EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ. FT. VALUATION ($) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL..gy�pp NET AREA� 'BATHROOM KITCHEN REMODEL AREA REMODEL AREA OTHER REMODEL AREA - PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH #DWELLINGUNITS: ISASECONDUNIT []YES SECONDSTORY ❑YES BEING ADDED? []NO ADDITION? ONO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES 'REC y";' - TOT' ALUAON: PLANNINGAPPL# ❑NO PLANNING APPROVALLETTER EICHLERHOME? ❑NO - - ((s;; 00 0 ! By my signature below, I certify to each of thefolioig: I am the property owner or authorized agen n the rty owner's behalf.l have read this application and the information I have pro, idded is coiTect. I have read the Description of Work and verify it is acc e I agree to comply with all applicable local :finding;ordinances truction. I authorize representatives of Cupertino to enter t V lentifi d pr rty for inspection purposes. ordinances and state laws relating to Signature of Applicant/Agent: Date: SUPPLE=;KL1K'F0 REDPLAN CHECK TYP ROUTINGSLIPNew - -© OVER-THE-COUNTER BUILDING PLAN REVXEW •- SFD Or Multif T demo. 'on pe It for existing building(s). Demolition permit is re re Tor to issuance of building permit for new building. Q EXPRESS - - PLANNING PLAN REVIEW - _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure © STANDARI) 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 to 0 MAJOR © SANTTARY SEWER DISTRICT submittal of Building Permit application. ❑ EN` MONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11 ti SMOKE / CARBON MONOXIDE ALARMS OWNER -CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildincupertino.org PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2016 CRC Section R314, 2016 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds . $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of X X the bedroom(s) ` i6 At, Signature ^� .............. Lie 4 ............................. ...... Date: 73 _7 -� .......... ....... On every level of a dweliing unit including basements X X Within each sleeking room X Carbon Monoxide alarms are not required. in dwellings which do not contain fuel -burning appliances and that do not have an -detached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated... In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby'certify that the alarm(s) referenced above has/have been installed"n accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms specified below have been tested and are operational, as of the elate„signed below. Address: Specify Number of Alarms: Smoke # Carbon Permit No-, l? _00S'Z I have read and aaree to comaly with the terms and conditions of this statement ._ r r Owner ent's) Signature t� f-� Date: ` 7t / / ............. Contractor Name: 2r�' 6 Sly ` i6 At, Signature ^� .............. Lie 4 ............................. ...... Date: 73 _7 -� .......... ....... Smoke and CO form.doc revised 12/15/16 z U U a U W via mUm mU mU 9oa m 'E m m � ami d �a�w wi7 m mAga m m U U U U U mmco co <o 000000 U i6 W m R zC a U - W U o - C O J N \O ;c $ m 1 _- -_ o - m3 t m o a .r wa H '- m o - o c3 r F- - m - Y� ✓. - C u V) y - m U$ E W fi3 v m 3 s `m u8 U 9 c 3 m L~ _- V v 3 c_ a � a- 12 �a m v 8 mm d o `�� 83 m `m 9 110= c rJn roV 3U m m =m r a g a ;_ c 71 =� a_ C n $ LL£� e `oE -��--� wmd C90 a 4a4ee� vo aaac`m -��Wu Zn�-osa `mU- RO ��Lua - c E 'maN = 4 E< u� mw mom.-d`.U= a LL -5; Q o2we U . . . . . . U W Q Ua c ¢U' .. .. 6 UFi.Ou .. mE ¢w 1 -Nn . . . . z U U a U W via mUm mU mU 9oa m 'E m m � ami d �a�w wi7 m mAga m m U U U U U mmco co <o 000000 U i6 Z wm S� �mLLo c¢ia<Qz YF�O W¢waE Um�QU ¢Ow�O aQ°zap C �cq¢wZ oo�oc� o<�MOE ww:EZU w >i-]wz LL 0za� M O h �UQUX z W J O O J LL z LLI cl uj U) CL O Q J i� 0 J LL z LLP 7- C) F- U) X Lj zC a C O J N \O 1 ID � V .r I r F- X - Y� ✓. - C u V) y CD 0- Z wm S� �mLLo c¢ia<Qz YF�O W¢waE Um�QU ¢Ow�O aQ°zap C �cq¢wZ oo�oc� o<�MOE ww:EZU w >i-]wz LL 0za� M O h �UQUX z W J O O J LL z LLI cl uj U) CL O Q J i� 0 J LL z LLP 7- C) F- U) X Lj � V X Z wm S� �mLLo c¢ia<Qz YF�O W¢waE Um�QU ¢Ow�O aQ°zap C �cq¢wZ oo�oc� o<�MOE ww:EZU w >i-]wz LL 0za� M O h �UQUX z W J O O J LL z LLI cl uj U) CL O Q J i� 0 J LL z LLP 7- C) F- U) X Lj