The URL can be used to link to this page

14110029CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21685 REGNART RD CONTRACTOR: REHDER PERMIT NO: 141 10029 CONSTRUCTION INC OWNER'S NAME: CRUSIUS CESAR AND WEIGERT CRISTINA 211 E HACIENDA AVE DATE ISSUED: 11/05/2014 OWNER'S PHONE: 4088880985 CAMPBELL, CA 95008 PHONE NO: (408)356-1853 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ License Class Lic. #_ 79/ r2— REMODEL (E) KITCHEN (210 S.F.), REMODEL (E) MASTER & HALL BATHROOMS (162 S.F.), REMODEL LAUNDRY RM �' S TO Contractor -J Date / OFFICE, MOVE WASHER/DRYER TO GARAGE (45 S.F.) & I hereby affirm that I am licensed under the prGovisions 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: 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 Sq. Ft Floor Area: Valuation: $150000 performance of the work for which this permit is issued. l 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 APN Number: 35624039.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN I80 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter _ -- upon the above mentioned property for inspection purposes. (We) agree to save 180 D _ —�% LED INSPECTION. 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 Date: with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. // _ Signature OC.� Date / ROOFS: All roofs shall be inspected prior to anyny roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. 0 OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.I2 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this /� )— 1 Owner or authorized agent: Ar/� '-- Date: 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, 1 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18, Signature Date CUPERTINO V CONSTRUCTION PERMIT APPLICATION oO COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION \` 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building @Cupeltino.orq ❑ NEW CONSTRUCTION ❑ ADDITION ALTERATION l TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADllRESSZ I L ag �� 7_ APN # qVg OWNER NAM _ PHONE E-MAIL Ci"' Ult O S c ULKsI STREET ADDRESS CITY, STAT ZIP FAX ;L.1&85- - ;� C v t- lrtVAO CONTACT NAME PHONE ie?s= SZ �Fss3 E-MAIL STV a i0A STREET ADDRESS Xi k �. CITY, STATE, ZIP cq . 9 �S FAX 195y- 8 `OWNER OWNER❑ OWNER -BUILDER ❑ OWNER AGENT lR"CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME - LI SE NUMBER I d2 LICENSE TYPE BUS LIC H Z.Szf3 COM `Y NAME E-MAIL FAX 2t �• Gor- STREET ADDRESS CITY, STATE, ZIP 175v9 PH NE 3s7 /8b3 c 1 A ARCHITECT/ENGINEER NAMELICENSE NUMBER _i BUS. LIC H GL It M_d COMPANY NAME rI E-MAIL FAX STREET ADDRESSi Stil70-�V� Lvs 64n)5Scvo / CITY, STATE, ZIP 4-t5Gni c,4 9Ja3z PHONE L60 36 912Z - 3w - DESCRIPTION OF WORK 415 /L1 W0111- k In~ �ir►4 . RPs 4Y� , m�sr . Tfi. ?x_m pl�ic� fXIIwl VV P0A.nv.> nF ,ej Arin, %o1C" 441 L-,9 t ss, Loo 6.l diwvs t'sv t_— EXISTING USE PROPOSED USE CONSTR TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTGNEW FLOOR DEN40 TOTAL AREA Z7 0& AREA ��r� AREA NET AREA BATHROOM KITCHEN OTHER � i'i: REMODEL AREA REMODEL AREA '7 RE.MOD L AREA him PORCH AREA DECK AREA TOTAL DECKTORCH AREA GARAGE AREA. DrACH J+yAeIACH #DWFLLINGUNITS ISA SECOND UNIT ❑YES SECONDSTORY EYES BEING ADDED? Q.NO ADDITION? _20iO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YE RE TOTAL VALUATION. PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? $,X0 /Sb pva By my signature below, 1 certify to each of the following: I am the property owner or authorized age n the property own-e—r—stiekif 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 building construe n. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ 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 El MAJOR 1:1 SANITARY SEWER DISTRICT submittal Of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp 2011.doc revised 06/21;11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Deptfor addn'1 info. FEE ITEMS wee Resolution 11-053 Ef : 7/1%13) ADDRESS: 21685 REGNART RD DATE: 11/05/2014 REVIEWED BY: MELISSA APN: 356 24 039 BP#: �� `VALUATION: $150,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: Suppl. PC Fee: 0 Reg. 0 OTI PENTAMATION 1 R3SFDREM PERMIT TYPE: WORK REMODEL E KITCHEN 210 S.F.),REMODEL E MASTER & HALL BATHROOMS 162 S.F. SCOPE REMODEL LAUNDRY RM TO OFFICE, MOVE WASHER/DRYER TO GARAGE (45 S.F.) & ADD 26 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Deptfor addn'1 info. FEE ITEMS wee Resolution 11-053 Ef : 7/1%13) FEE QTY/FEE Elec. Plan Check 0.0 1 hrs $0.00 Elec. Permit Fee: 1EPERMIT Other Elec. Insp. 0.0 hrs $48.00 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Deptfor addn'1 info. FEE ITEMS wee Resolution 11-053 Ef : 7/1%13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 162 s.f. $645.00 Remodel, Bath (<=300 sf) 1REMRESBAT Suppl. PC Fee: 0 Reg. 0 OTI 0.0 hrs $0.00 PME Plan Check: $0.00 210 1 s.£ $645.00 Remodel, Kitchen (<=300 sf) 1REMRESKIT Permit Fee: $0.00 Suppl. Insp. Fee:j) Reg. Q OT 0.0 1 hrs $0.00 = s.f. Remodel, Other $431.00 IREMRESOTH PME Unit Fee: $0.00 PME Permit Fee: $48.00 26 4 $108.0011BREMFIXT Electrical Fixtures, Lighting T_T_ Administrative Fee: IADMIN $45.00 Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning_[ ee: $0.00 Select a Non -Residential Building or Structure E) 0 Travel Documentation Fee: 1TRA VDOC $48.00 Strom Motion Fee: 1BSEISMICR $19.50 Select an Administrative Item 1 Bldg Stds Commission Fee: IBCBSC $6.001 SUBTOTALS: $166.501$1,829.001 TOTAL FEE: 1 $1,995.50 Revised: 10/01/2014 CUPERTINO MAR 25 2015 BY__._______. CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino. CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOS DDRESS:21685 REGNART ROAD PFRM[T # 14110029 OWNER'S NAME: Cesar Crusius - Cristina Weigert PHONE # 408888-0985 ; GENERAL CONTRACTOR: Rehder Construction, Inc. BUSINESS LICENSE # B 791028 ADDRESS: 211 E. Hacienda Ave. CITY/ZIPCODE: Campbell, CA 95008 1 *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 X Electrical B. G. Electric (Brian Geddie) j #36120 Excavation 1 I �� Fencing Flooring / Carpeting Linoleum / Wood i� s X Glass Glazing i J. & M. Window and Glass i # 27103 -- .__. -- --- --- - - --- - - i Heating j �� Insulation Landscaping Lathing A Masonry Painting % Wallpaper 1 Paving Plastering r— x — - - Plumbing Roman's Plumbing ----f------ -- j - ---- ----- # 36051 i Roofing Septic Tank _ __. �� Sheet Metal 1----- I i x Sheet Rock Brian Thorripson Drywall # 31848 x Tile i Mercado Tile # 25845 3--23 -_1 !T - N ier / Contractor Signature Date CbA —S Vla5x Nl"� 911a='a� LOZ3— z DL cit LL M715 GoS S.. 33751 ISSN NO SO z DL cit LL