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B-2016-3274 CITY OF CUPERTINO BUILDING PE' I T BUILDING ADDRESS: CONTRACTOR: PE' T NO:B-2016-3274 10285 SCENIC BLVD CUPERTINO,CA 95014-2717(357 02 005) THE D&M GROUP SARATOGA,CA 95070 OWNER'S NAME: SHOENHAIR RICHARD T AND MYKLAND MARGARET M D•TE ISSUED:01/10/2017 OWNER'S PHONE:408-674-0791 PH a NE NO:(408)378-1442 LICENSED CONTRACTOR' D A ATION BUILDING PERMIT I '0: License Class a Lic.#605343 Contractor THE D&M GROUP Date 10/31/2018 X BLDG X ELECT _P UMB MECH X RESIDENT • COMMERCIAL 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. JOB DESCRIPTION: 1ST FLOOR REMODEL I F FAMILY ROOM AND POWDER ROOM TO I hereby affirm under penalty of perjury one of the following two declarations: INCLUDE NEW CONC' :TE SLAB AND COFFERED CEILING(406' i. I have and will maintain a certificate of consent to self-insure for Worker's S.F.);ADD(2)OUTLETS • (1)LIGHT TO KITCHEN;ADD(2) Compensation,as provided for by Section 3700 of the Labor Code,for the LIGHTS TO DINING ROOM. performance of the work for which this permit is issued. 2. .I have and will maintain Worker's Compensation Insurance,as provided for by tr J Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Va ation:$29000.00 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 APN Number: Oc upancy Type: and state laws relating to building construction,and hereby authorize 357 02 005 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 PERMIT EXP S IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DA S OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FRO LAST CALL I I►_ PECTION. Signature . — Date 01/10/2017 Issued by: ISSANi _ Date:01/10/2017 — = OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected p'or to any roofing material being installed.If a roof is i. I,as owner of the property,or my employees with wages as their sole installed without first obtainin_I 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 of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:01/10/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVE'' I GS 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. HAZARD•US MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous aterials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safe 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 8z Safety Code,Se tion 25532(a)should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally,sho d I use equipment or devices which emit hazardous air contaminants as defined y the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance wi the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safe, Code,Sections 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agen APPLICANT CERTIFICATION Date:01/10/2017 I certify that I have read this application and state that the above information is CONST'UCTION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is •construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this per it 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 of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARC' TECT'S DECLARATION Code,Section 9.18. I understand my plans shall be used as public records. Licensed Signature Date 01/10/2017 Professional CONSTRUCTION PERMIT APPLICATION " COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildinq{ciicupertino.orq 16-2011(0' ,' ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI El REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS WULTy ` certIL I)C1 APN# 357-02-005 OWNER NAME Margaret Mykland, Richard Shoenhair re .674 079 E Savorycity@gmail.com STREETADDRESS 10285 Scenic BIV. CITytiyTT tpO 9501 FAX CONTACT NAME G llprrHlllt 1I ff!I CA. MA Walter Chapman E0.941.6890 info@wjcda,com STREET ADDRESS 620 S. El Monte Ave CITY,STATE,ZIP Los Altos,CA. 9422 FAX D OWNER ❑ OWNERBUILDER 0 OWNER AGENT ❑ CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITEC 0 ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME,An LICENSE NUMBER LICENSE TYP• BUS,LIC# tray f�l y� /1714.141 zI-e �GI�3 3 ✓` 11 a t COMPANY NAME E-MAIL g t�`a2 At Qd r✓� FAx �VC • STREETRASIP 6 ✓d:1Ct11L i'not?`C �. _ CITY,ST_54%ZalZ q fce.;>a PHyes, 3/1 026/ ARCHITECTYENGINEERNAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK F rstfloor remodel-of 406--S-q._ -Raise Ceiling n-Family_room-- - Remodel (e) 1/2 bath to a Powder Room. EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG - NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTALDECIOPORCH AREA GARAGE AREA: ❑DETACH ❑ATTACH #DWELLING UNITS: ISA SECOND UNIT DYES SECOND STORY ❑YES BEING ADDED? ONO ADDITION? 0N PREAPPLICATION DYES IF YES,PROVIDE COPY OF ISTHE BLDGAN ❑YES _RECEIVED.By - ' : '_„ '>'• ;_.” _? TOTALVALUATION: PLANNINGAPPL# T]NO PLANNING APPROVAL LETTER EICHLERAOME? D NO — —— :555,7:5, _ — _ — 29,000 By my signature below,I certify to each of the following: I am the property owner or authorized agent et on Ie pro city owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate, I agree to comply with all applicable local ordinances and state laws relating to uild'n• ,oust uc In. I authorize representatives of Cupertino to enter the above-i'entified property for inspection proposes. Signature of Applicant/Agent:!_. Date: 12/1 /7016 SUPPLEMENTAL INFORMATION REQUIRED, '- CilgtitTYPE: ROUTIIvGaLIP:--.?si';:; =:SI New SFD or Multifamily dwellings: Applyfor demolition permit for = - i�`���•'�- - — existing building(s). Demolition permit is required prior to issuance of building OVER - permitfornewbuildin . i .-:.''::, ::: a;'.;;.;:;- ;0 P.ANING IIE\iE � `EXPRESS ::..:.::...i:.._1TIING.PI.,AI�T._.. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. ❑'LARGE ::":_;�;�`.;.:}: ._... ❑ FIRE DEPT.... . Copy of Planning Approl,al Letter or Meetingwith Planning prior to SANITARI:SBYigH.URICr~ :'submittal of Building Permit application. ...........................................................: ;.,:,;.:�._._:_v_::F.�==:=_:r;:::,`:r_-:,�._;.:=,�:: :-❑°cEM!IRON19EiVTAIHEALTH=:.-_-.<�c: BldgApp_2011.doe revised 06/21/11 PEI :COI PURPOSE 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 building(d)cupertino.org MIT CANNOT BE FII\TALEI) UN _ THIS CERTIFICATE HAS BEET VLETEIX3, .` Ni)` T TRNED TO THE BIHDINC AMSIOT This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2016 CRC Section 8314, 8315, 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, R315, 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 the bedroom(s) — (Smoke alarms shall not be located within 3 feet of bathroom door) X X On every level of a dwelling unit including basements and habitable attics X ! X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings, which do not contain fuel -burning appliances and that do not have an attached 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 in 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 date signed below. Address: "(10 Z &5' Sce`I r C Elyo Permit No. -0 -2016, � 2 f'� Specify Number of Alarms: # Smoke Alarms: I 7 1 # Carbon Monoxide Detectors: F77 i hailp raart and anree to romnly with the terms and conditions of this statement Owner (or Owner Agent's) Name: Signature..................................................... ............................................. I ......... :....... Date: .................. Contractor Name: Signature ................° Lic.#...................................... Date:6. '... . Smoke and COfbmtdoc revised 01/10/2017 14111MARX911 WATER -CONSERVING PLUMBING FIXTURES OWNER -CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingC@cupertino.org Owner Name (t' (1,519b erg (4 ,,- 112 Permit No. f � 3 z2 i`, Address 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. -No Go to Question 2. Z. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its plumbing, installation of water -conserving plumbing -fixtures is not technically feasible? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. _-, j4 No Go to Question 3. i 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. EX No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ No My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. N Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. 5. Please check ONE of the following: My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non- compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ My property is a multifamily residential real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water - conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). ❑ My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). I, as the owner or owner's agent of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and that the water -conserving plumbing fixtures comply with the requirements as indicated in the table on the following page.--, Owner or Owner Agent's Signature: _-�_7_Date:NVYJ -f7 I Uncn comnleting and signing this Certificate. please return it to the Building Division in order to final your building permit. SB4072015.doc revised 08/26115 11 l I I I I I I I I I I I I I I `-L� recce I I IllI )E) GARAGE I I I I — L oR I I � I ' EpGE OF 1HEP — rc AVE-ryIENT � _ " d PRGPERiY. . 0 S GE�v/-eRDF � I ctw1c B�Vo. RDgp SITE PLAN GENERAL NOTES PROPERTY DESCRIPTION El �ER T�AToLL OWNER RICHHRD GHOENHAIRk NoiTi N vrei reT TnreT r.. rerc MARGARETMYKLAND - -_ OoNEus cus evseeEoeucEeveR ADDRESS 102855CENIG BLVD. ELJ } CUPERTIONO, CA. 95014 oA ATT—I-E—A. rvAu ee P4RCEL 357 -D2 -D05 ❑° '.TIRIEUT ACREAGE 0.301 @R. 111V— To suecauTIAITcresinniEoinTEI ZONING R1-10 PROJECT INTERIOR REIAODELING OF DESCRIPTION FAMILY RM. W/(N) POWDER RMSITE . E] --ll EN NOTES VICINITY MAP E] FAT -1 Ell -11. El—Ri El R: E -, oITI N,A E] -IR.Hl E uRRA� 111E mK oArcs 1.IEE 11. E] TREER II.TEITE,oreR�N��ous.R��T�u E] N E] 1u11APE —T— E oreRNo�reus.R�cTreu Lu V o ^ Z O Lu N Q o CONSULTANT DIRECTORY SHEET INDEX IREEvoR u,A_< p Qz uu z ,A NEERuj- E ET FREORI IEICreRT1N.EL c� vNEER IIA ITRIITTRAT 111A 11 1EE1111 '111 ATIll —1 EY@AIEA3-1D, ElElAL11TEs E—EY FIR -A—lAlE FIR TABULATIONS T � _ ,E, -- ,E, --E TETA �RRRE,IreREE aTre�osoET Q z dv�� 0y. D COVERAGE & F.A.R. APPLICABLE CODES JJJJ .ITEP-T= T- IRIIEIT ITAIL IR RE -RE -H. 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