B-2017-0054 CITY OF CUPERTINO BUILDING PE IT
BUILDING ADDRESS: CONTRACTOR: P RMIT NO:B-2017-0054
7615 DE FOE DR CUPERTINO,CA 95014-4348(359 25 021) GRIDLEY
CONSTRUCTION INC
CAMPBELL,CA 95008
OWNER'S NAME: KOLB BRADLEYAAND ADRIAN G I) TE ISSUED:01/10/2017
OWNER'S PHONE:408-865-0943 P ONE NO:(408)374-0900
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT 1 I 0:
License Class El Lic.#575006
Contractor GRIDLEY CONSTRUCTION INC Date 08/31/2017 X BLDG _ELECT _ 'LUMB
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:
2ND FLOOR BATHROO REMODEL(50 S.F.);OFFICE REMODEL
I hereby affirm under penalty of perjury one of the following two declarations: (209 S.F.);1ST FLOOR- ' PLACE WINDOWS(5)-LIKE FOR LIKE
1. I have and will maintain a certificate of consent to self-insure for Worker's TO MEET EGRESS
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
,Cii3,8ection 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$64526.00
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: Occupancy Type:
and state laws relating to building construction,and hereby authorize 359 25 021
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 EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS 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 FROM LAST CALLED INSPECTION.
no
Signature e Date 1/10/2017 Issued by:AbbyAyende
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 inspectedrior 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 of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:1/10/2017
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF CO RINGS TO BE CLASS"A"OR BETTER
r. 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 s US MATERIALS DISCLOSURE
2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardou 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&SalSalty Code,Sections 25505,25533,and 25534. I will
permit is issued. maintain compliance with he Cupertino Municipal Code,Chapter 9.12 and the
a. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,S ction 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 define: by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance 'th the Cupertino Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Saf:ty Cod Sections 25505 25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall _ g1, K.
be deemed revoked. - Owner or authorized age t: '
APPLICANT CERTIFICATION Date:1/10/2017
I certify that I have read this application and state that the above information is CONS i'UCTION LENDING AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there i 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 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 ARCHITECT'S DECLARATION
and will comply with all non-point source regulations per the Cupertino Municipal
Code,Section 9.18. I understand my plans sha I be used as public records.
Licensed
Signature Date 1/10/2017 Professional
\\ / CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
4,..51.r9,r 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228•FAX(408)777-3333•buildinqacupertino.orq
❑NEW CONSTRUCTION 0 ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS c+[ DE_ Foe_ sR Vs,
, APN# Shc 2,5 021
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❑OWNER 0 OWNER-BUILDER 0 OWNER AGENT 0 CONTRACTOR RI CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT
CONTRACTOLAME cos4- co��v LICENSE NUMBER oe LICENSE TYPE BUS.LIC# `
COMPANY E-MAIL FAX
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ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
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DESCRIPTION OF WORK L.W..- +'MiK,0- .. j� lkr � + t�+' s r-CCAS i(,ice) iI'/ v r'�ia
`E -(- ( oNcYCP pa-e7" V11 Stiff tE V�"�'67-S
EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES
27 USE TYPE OCC. SQ.FT. VALUATION($)
EXISTG NEW FLOOR DEMO TOTAL fir► yy��
AREA AREA AREA NET AREA \ i,I' �t Ci i �},IS
BREMODEL yyyy..��..000�„ KITCHEN OTHEREMO5 '1 ` Iv6�
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECK A TOTAL DECK/PORCH AREA GARAGE AREA: 0 DETACH
❑ATTACH
#DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY DYES
BEING ADDED? ONO ADDITION? ONO
PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED PY04; - - OTAL VALUATION:
PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME?
El - --
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act o4 the property owner's behalf. I have read this
application and the information I h.ve provide,:is c+rrect. 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„b ldin•c ns rf uction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
i t i �1
Signature of Applicant/Agent: _ �,��� _ P Date: ° 1 t• (, 1
SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPEII ROUTING SLIP,
New SFD or Multifamily dwellings: Apply for demolition permit for 0 OVER-rII>-coulvTEll 0 BUILDING PLAN REVIEW
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. ❑ EXPRESS 0 PLANNING PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 0 STANDARD: 0 'PUBLIC WORRS
form if any Hazardous Materials are being used as part of this project.
LARGE - 0 FIRE DEPT :
_Copy of Planning Approval Letter or Meeting with Planning prior to 0 mAaoiz ❑ SANITARY SEWER DISTRICT,
submittal of Building Permit application.
0 ENVHRONMENTAL-HEALTH
BldgApp_2011.doc revised 06/21/11
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SCOPE OF WORK:
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Remodel one Bath & Office with Interiors
Architectural:
A -i As-Built/Demo Plan
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A-2 Proposed Plan
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- Full remodel of Jack & Jill Bath -no change to existing walls, windows or doors
A-3 Proposed Lighting/ Electrical
Plan
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- Full remodel of Office- no change to existing walls
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- New built-in desk in Office
- New skylight in existing location in Jack & Jill Bath
GENERAL NOTES:
......
-
Scale.
- Replace windows in Living Room, Dining & Office in existing location with existing size
windows Clearances required for toilet: 3o" space with 24"
- No change to plumbing location in Jack & Jill Bath clear in front. CPC 402.5 -
- New hardwood flooring in Downstairs Bedroom, Office, Guest Bedroom & Gallery to match
existing hardwood
Typical insulation at 2x4wall to be R -i3,
and R -3o for
- New hardwood with carpet runner on Stairs
- New stair railing to meet current code
ceiling insulation. Title 24
CODE EDITION:
Date:
- New lighting & electrical in remodeled areas to meet current code
- Paint all remodeled areas
2oi6 CRC
- Replace interior door hardware in remodeled areas &new closet doors in Office &Guest
P
Bedroom in existing location.
2oi6 CM2oi6 C - O
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- -
-Install hardwired smoke detectors & carbon/monoxide detectors to meet code
zoi6 NEC \
- Remodeled Area: 295 sq. ft.
- _ -
Drafted by: Lisa Cross
A-1
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SEGOND LEVEL
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0 Existing Walls to Remain
0 Walls to be Removed
- New 2 x 4 Wall
FIRST LEVEL
Note: All dimensions to be verified in field
SEGOND LEVEL
ELECTRICAL NOTES:
At least one wall receptacle outletshall be installed in bathrooms within 3 feetofoutside edge of each basin. CEC 210-
52(3)(d)
Bathroom receptacle outlets shall be supplied by at least one zo-amp branch circuit. Such circuits shall have no other
outlets. CEC 210-n(c)(3)
G 19gc
gc i n required for all bathroom outlet receptacles. CEC 210-8(a)(i)
iMMftnes` rirliathrooms shall either be high efficacy or shall be controlled by a vacancy sensor. T-6 and compact
fluorescent are high efficacy luminaries. T-zy
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