14060170CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20620 SCOFIFIA) DR
'0 NTRACTOR i PERMITNO: 14060170
C_
OWNEIR'S'NANIE: N,4AIZXMILL171ZKi%RYNNIANI) JANIISA
D,vrL ISSUEDI 12/18/2014
OWNER'S PHONE: 408234607)
PHONE NO:
P11 LICENSED CONTRACTOR'S DECIARATION
CO,8 LN U." RCIA L E]
License ClassIX L'ic. # S
- I
REBUILD- 1354 SQ FTADDITION TO INCLUDE, 2ND
sTORY,
Contracim koc,,e� A J%:T,±nL_ Dale_
REMODEL 1704 SQ FT OF (E) SFDWL, ADD ACCESSORY
,S1-1 E 1) 364 SQ FT.
I hereby affirm that I ani licensed under tile provisions of Chapter 9
(Commencing m1th Section 700f 0) of Division 3 of the Business & Professions
Code and that my license is in full forec and effect.
I hereby affli-In under penalty of perjury one of the following two declarations:
I have and will inainlain a certificate OfCooSeot, lo self-inSUre for Woiker's
Compensation, as provided for by Section 3700 ofthe Labor Code, for die
perkninance of the work for which this permit is issued.
Sq. Ft Flool'Area: Valuation:$450000
have and will maintain Work-cr"s Comperismion insurairce, as provided fim- by
Section 3700 of the Labor Code, for flue performance offlie %vork for NvInch this
permit is issue(f,
AI Number: 3'910009J0
OccupancyType;
APPLICANT CE IF] ON
I certily that I have read this application and state that, the above, information is
PERMIT EXPIRES, W WORK IS NOT STARTED
correct. I agree LC) Coloply Woll all city" and COLITAV ordinaircesand slate laws relating
WIT-11IN- LRQ_ DAYS OF PERMIT ISSUAWE OR
to bUddill- C011stRiCtiOn, MId hereby authorize representatives ol'this city lo einer
upoll theabove mentioned property for inSpW1011 pUrposes. (mle) agree to save
18 lrS rxmT -_,V',9T ALLED INSPECTION.
City ot'Cupertino ag
indelimil' d
y and keep harmless ffie oonst habilitics,j . 11 gn"],pins.
C(Kts, and expenses which nlay, accrue as aulst Said C'ay In Consequence ale
K'j. ;�
Date:
orantaigol'this permit A d(fitional ly, I lie appi icant undei stands and qv
%% ith all 11011-p0int sOLINC IC"kilatiOnS per tile, Cnpert.In7 1`kr UniCip,11 Code, Section
9.18.
X
RE -ROOFS:
Signature Dat Arl
-Y
AH roofs shall be Inspected prior to any roolinmaterial aterlaI being installed, If a roof is
installed without first obtainin.g an, inspection, i agree to remove all new materials for
nispeclion.
OAVNER-BUILDER DECLARATION
Si�.!n In tire o I'Appl Unle:
I hereby liffirm that I aural exempt from the Contractor's License Law fill- one of
tile following INvo reasons:
AIT ROOF COVERINGSTO BE CLASS "A" OR BETFER
i, las owner of the properly, or my employees wlth Nvages as their sole compensation,
will (to tile work, and the structure is not intended or offered for sale (Sec.7044,
Business & professions Code)
1. as owner of [Ile properly, am exclusively contracting %Nith licensed contractors to
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business A., Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety (ode, Sections 25505, 25533, and 25534. 1 will
I licreby, affirm under penalty (If`perjury one o�f tile following till -cc
maintain Compliance NNith the Cupertfirt) Municipal Code, Chapter 9,.12 and tile
(feela ra tio Im
Health & Safety Code, Section 25532(a) should I store or handle hazardous
I have and will maintain a Certificate ofConsent to self -insure for Worker's
material, Additionally, should I use equipment or devices wilich emit hazardous
Compensao . oil, as provided for by Section 3700 (7f the Labor Code, for tile
air contarninantsas dermed hy the Bay Area Air Quality Management District I
performance of the work for which this pernift is iSSUed.
will Maintain Compliance with the Cupertino Municipal Code, Chapter 9.12 and
I have and %viH maintain Worker's C.onipensation Insurance, as providQd for by
3700 offfie Labor Code, for the performance ofthe work for which this
the Health & Safety, Ce,5505,25533, and 25534,Section
agentticctialrrs`��2fj
pall "nidi. is issued.
Owner or authorized :Dalle:
/ I "y
I ccilify that in the performance of the work fbir wIlich this permit is issued, I shall
not employ an), person in any manner so as to beconle subject it) tile Worker's
Compensation iaws cif C'alikmoa It, after making this certificate ofeXciliplioll, I
CONS )' RISC: TKirk LENDENG AGENCY
become sub.iect to the Worker's Coropmsation provisions offlic Labor Code, I must
I hereby, affimll that tlICTC is a consiruction lending, agency for the performance of
forilixvith comply With Site]] I)roviiions or this peTmit shall be decined revoked.
work's tbr which this permit is Issued (See. 3097, Civ C.)
ILender's Narne
A IT 1, WANT CERTIFICATION
Lender's Address
I ceilify that I have icad tris application and state that tire 11N)ve information is
correct. I agree to comply with all city and courn), ordinances and St rte taws relating
tj) budding' C(1nIStrjI6't1oo. and hereby, authorize rqm-esentatives ofilos city [a enter
open the above mentioned properly for inspection purposes. (We) agee to save
ijrdejnnif) and keep harmless the City of'Cuperfirro against liabilities, judgments7
ARCHITECT'S DECLARATION
costs, and expenses which may accrue a.-lonst said City in consequence of die
I understand my pians shalt be LIM] as public records.
granting ofthis perinit Additionally, the applkrmt understands and wA comply
\N till all non -point source regulations per the Cupertino Municipal Code, Section
Lice coed Professional
9 is
CONSTRUCTION PERMIT APPLICATION
COMMUNGTY DEVELOPMENT DEPARTMENT - BUILDNG DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-325'5 1A
(408) 777-3228 - FAY, (408) 777-3333 - buildinogcu2g��l
CUPERTNO
NEW CONST EU�CTION ADDITION ALTFR-6,TioiTi El
NT).,REVISI(),N�,DEFERR�F-DDRIC
PROJECT ADDRESS
BIdgApl,7_201 1. doc revised 4J6121/11
W." fG, I
OWNERNANI
111 m MlXKYVU(
A
ITREF-IjbF 0CI
co
CONTACT NAME
LACr kk4
sq,REET�kDDRESS r
A "t
CITY STATE, ZIP
�Sj pq I A
FAX
wimmm
44 47 Ile
rJ 0%%INER 0 OWN7R-BULDER OWNERAGEN-T CONULACTOR 13CONTKACTORAGENT )kARCHITECT
DENGWEER El DFdELOPFR 0 TFNAN'T
CONTRACTOR NAME LIC SE NUMBER
BUS, UC
T)
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS CITY, STATE, ZIP
PI- ONIE
ARC6BTECTIFNIGNEFR NAME LICE SENUMB,ER ceBUS,
2:7 n." 1 4 1
LIC r.
COMPANY NAME '2
N'TU h ()
FAX
STREET ADDRESS CITY, STATE, ZIP
DEscFjPIION OF WOP K
P-- A , ts
2cii
a
1( 6
je r
�,r04 cqlNi,
2
EXISTING USE
PROPOSE USE CONST �E
g STORIES
USE
TYPE
OCC.
SQFT.
VALUATION (S)
S"Fro—
EXiSIG NEW FLOOR
AREAAREA
rx) 4
AREA 0
A
IBATHROOM
AREA
KITC N
REMODEL ARE'
OTHERREMODEL
�IOPFLARFA
���
RCH ARE DECK A TO &LDE KIPOR AREA G A: LjDETA
i,4RA
P'tTACH
ro Y PP
9 DWELLING TS: IS A SECOND UNT E] %TS 0 1, 'gyis
0 ,
BEING ADDED? .0<0 A DITT N. []NO
PRE -APPLICATION' Ts IF YES, P. ME COPYOF IS TH E BLDG..kN
EICHLER HOME?
T4tVALUATION:
6' 000
PLA.1,TNING APP'L'4 ALLETTER 'oONO
NO
"1
f
,
By nil , sugnature below, I oerti�, tollach of the follow I am the Property ovmer or authori?ed Agent to act On the property o net's behalfI have read Lhis,,
is ace
criptio�n of Work and %,eFify it urate�
applicatioll and the infOrMaTi011 I have pr w d is correct. I 1jave read the Desic
0 cornp�y, Ppjieeble local
with all""'
ordinances and state laws relating to di construction. I authaiza representatives of Cupertino to enter the abmT-ideptified
n 0 5""''
p pzrty.,f6r-4nSj ectiOn purposes.
S ignature of App I icant/A Rent! Date:
SUM F,.Nl ITAL FNFCIR�4ATTON REQUIR-ED PLAN CHECK TYPE
ROUTLNG SLIP
New SF or Multifam0y dvveHinggs: Apply for demolition permit for OVER-1-HF—COUNTER
El BUILDINGPLANREVIEW'
exlstinbuilding(s). Demolition permit is required prior to issuance ofbuflding
Permit for new buiMinC.REVIEW
�b
uDP-D
Commercial Bldgs: Provide a completed Haza�-dous N4at erials Disclosre STANA
"
R -SS . ....
I"C" "W"OI.
P 'UB", IL "
fb_rrn if any Hazardous \,faterials are being used as part ofthis prr left.
FIRE
Copy of Planning Approval Letter or Nleetin.g with Planning prior to
NjITR ARY§E1NtDI' �I�PJCT
Submirta� ofBuilding Pen -nit application.
FXT�-L HEAI,TH
ENNTRON-M
BIdgApl,7_201 1. doc revised 4J6121/11
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
20626 s,cofield dr
ADDRESS. DATE. 06/26/2014 IZEN71EWED BY: Mendez
12" i APN: I BP4: p20VALUATION: [$450,000
.kPERMIT TYPE: Building Permit PLAN CHECKTYPE: New Construction
PRIMARY SFD or Duplex 2nd Unit? 0 Yes G No PENTANIATION 1 R3SFDW
USE: PERMIT TYPE:
NVORK rebuild- 1950 sq ft addition to include 2nd story, remdoel (e) 1704 sq ft , accessory structure 364 sq ft
SCOPE
OCCUPANCY TYPE:
R-3 (Custom)
TYPE OF
CONSTR.
11-B,H1-BjV,V-B
FLR AREA
(St'.)
1,950
PC FEES
$2,777.30
PC FEE ID
1R3PLNCK
BP FEES
$2,334.50
BP FEE ID
JR31ArS]j
1,764 S.f.
$'5,022,001
I- �#
L --- I —i
$417.00
Remodel, Other
]REAIRES2
Shed
11SHED
Suppl. PC Fee: (j) Reg, 0 OTI 0.0-1 hrs
PME Plan Check:
Permit Fee:
$0.00
$o-00-'
$2,334.50
Suppl. Insp. Fee. E) Reg. 0 OLILI
lirs
$0.00
PME Unit Fee:
KOO
PME Permit Fee::
$0.00
Construction Tax: 11X'0N.5TAXR
# nm
ullits
'roTALS:
1,950
$2,777.30==$2,3H.=50
NOTE: This estimate sloes not ineludefees due to other Departments (i.e. Planning, Puhfie Works, ire, Sanitary Sewer District, School
Dkti4f.t. vtt� ). 'T/www foie fjp-.o have ii nit the nPoRipybram, inini-inalif) or avin'lahlo an d ap-I, f9filly till pvthijah'. Cayrtars, thi, Dprpt fni- athin V hrfn
FEE ITEMS (&e Resolution 11-053 Eff 711113)
FEE
QTY/FEET
MISC ITEINIS
Plan Check Fee:
$2,777.30
1,764 S.f.
$'5,022,001
I- �#
L --- I —i
$417.00
Remodel, Other
]REAIRES2
Shed
11SHED
Suppl. PC Fee: (j) Reg, 0 OTI 0.0-1 hrs
PME Plan Check:
Permit Fee:
$0.00
$o-00-'
$2,334.50
Suppl. Insp. Fee. E) Reg. 0 OLILI
lirs
$0.00
PME Unit Fee:
KOO
PME Permit Fee::
$0.00
Construction Tax: 11X'0N.5TAXR
# nm
ullits
$65999El
Work Without Permit? 0 Yes (D No,
MOO
Advanced Plannim gy Fee: IPLLONGI?
$273.00
Select a Non -Residential
Building or Structure
0
A
Strong Motion Fee: IBSEISAHCR
$45'.00
Select an Administrative Item
1
TOTAL FEE =$11,54 ,79
Bldg Stds Commission Fee: JBCBSC
SPA BToTALS.
$moo
$611:107,791$5,439-001
ME, "EM. mill
BUILDING ADDRESS: 20626 SCOFIELD DR
CONTRACTOR: HIJ MM L L C 0STO M PERMITNO: 14060170
CONSTROCTION
OWNER'S NAME. MARXMILLER KARYN NI AND JAMES A
606 N CLOVER AVE DATE ISSUED: 12/18t2014
OWNER'SPHONE: 4082346075
SAN JOSE, CA 95128 PHONE NO: (408) 483-0323
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTILAL COMMERCIAL Ej
3 7o
REBUILD- 1.354 SQ FT ADDITION TO INCLUDE 21ND
License Class__f1)____ Lie. tt_7
STORY,
Contractor Date
REMODEL 1704 SQ FT OF (E) SFDWL, ADD ACCESSORY
_:ILL..6L
SHED 364 SQ FT.
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 fit full force and effect.
I hereby affirm tinder 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 tire
performance of the work for which this I)enllit is issued.
Sq. Ft Floor Area: nation: $450000
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 tins
pernut is issued.
APN Number: 35910009.00 OccupancyType:
APPLICANT CERTIFICATION
I certify that I 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 180 DAYS OF PERMIT ISSUANCE OR
to building construction, mid hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. ('Are) agree to saveA
180 DYS FROM j,kSr ",LED INSPE CTIO'N.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs,and expenses which may accrue against said City in consequence of the
6 �,IE
granting of this permit. Additionally, tire applicant understands and will cornply
D
with all non -point source regulations per the Cupertino Municipal Code, Section
14
9,18,
Signature, Date 1��' Ile
RE -ROOFS.
All roofs shal 1 be inspected , prior (oany roofing material being installed. If roof is
installed without first obtaining an inspection, I agree to remove all nevi materials for
inspection.
n OWNER -BUILDER DECLARATION
Signature of ,Applicant: Date:
I hereby affirm that I am exempt front 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 (See. 7044,
Business & Professions Code)
1, 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, 1 will
I hereby affirm tinder 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. Additional[),, 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 9,12 and
I have and will maintain Worker's Compensation 1115UFance, as, provided for by
the Health & Safety Code, Sectimni_ 5505,25533, and 25534,
Section 3700 of tire Labor Code, for the performance of the work for which this
Owner or authorized agent- Date:
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
no( 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
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Conipensation provisions of tile 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
Lender's Address
APPLICANT CERTIFICATION
I certify that I have read this application mid state that the above information is
correct. I agree to coniply 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 harnfless the City of Cupertino against liabilities, judgments,
ARCHI'l ECT'S DECLARATION
costs, and expenses which may accrue against said City it) 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
CONTRACTOR / SUBCONTRACTOR LIST
Building Department
City Of (.'uperfino
10300 Torre Avenue
CUPCI-6110, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-33,33
*Our municipal code requires till businesses working in the city to have as C.'ity ot'Cupertino business license,
NO BUILDIN('m'
FINAL OR FINAL
()C(-,"1JPANC"t' INSPECTION(S) NAVILL, BE
scnEDIJI.,ED UNTIL THE
GENERAL
CONTRACTOR AND
ALL SUBCONTRACTORS HAVE OBTAINED
A CITV OF 0.1PERTIICI
BUSINESS
I, CE
I am not
usingany subcontractors:
6- -1 signature
Date
Please
clieckapplicable subcontractor's
and coinplete the following information:
V
SUBCONTRACTOR
BUSINESS NAME
..........
BUSINESS LICENSE #
C'abinets & Millwork
C'ement Finishing
------ . . . . ............. . . ..............
. . . . . ....... . ......... — — — --- - -------- - -- -
Electrical
Excavation
Fencing
Flooringf (",arpeting
- ------------------- ----
............. . . ..........__..W..
Linoleum / Wood
... .......... .. . ...........
Glass / Glazing
.... ....... . .....
Heating
. .........
111SUlation
Landscaping
Lathing
masonry
. . . .. ... ... ............ . ..
. . ...........
Painting Wallpaper
. ............
. .. . . . ............
Paving
Plastering
Plumbing
. ......................... — - - - ---------------
.................. ..
Roofing
Septic Tank
Sheet Metal
Sheet Roick
. . ...............
Ti I
___.........._W_
.. . ......... ......... ...
Owner / Contractor Signature Date
FREMONTUINJON HIGH SCHOOL DISTRICT
589 WEST FR OOT AVENUE
SUNNYVALE, CALIFORNIA 94087
408-522-2200
Developer Impact Fee Compliance
Building permits will not be issued without a completed Certificate of Compliance
The City of has received a request for a Building Permit described as follows:
New Residential DevelopmentResidential Addition (501) sq. ft, or more Commercial Development
Project Address: Lot/Parcei #
Square Footage-, Description:
Permit / Plan Check #
Date: r r y:
ra!ll
Square footage verified by the city prior to issuance of a building permit; fees may be adjusted accordingly.
Feeder Elementary District
....................... ................ ................ .........
The authorized representativeo)"the Fremont Union High School District has reviewed the
City of .. . . . ........
Building Permit Request described above and hereby certifies that the developer or authorized representative, has
met the requirements of the District's Poveloper Impact Fee requirements.
Dated: By: V/ . ... .
Fremiant Union High Sch6ofbistrict
Authorized Representative
Distributiow Facilities Planning —White City — YeHow
Fee $
Req,uestor — Pink Accounting— Gold
Dev. Impact Fee Compliance (Rev. 11/22/05) [12/08 —1i 001
A
Cupertino Union School District 46'
10301 Vista Drive, Cupertino, CA 95014
Tel (408) 252-3000 - Fax (408) 865-0326
DeNrela�per Impaot Pee Campliance
The Cupertino Union School District has adopted Resolution Nos. 1403 and 1404, imposing
developer impact fee pursuant to Government Code 53080.
BLAilding Permit Request
The City of,.-.- has received a request for a Builftg Permit described as follows:
R' sidential Development Project Commercial/Industrial Deve9opment Project
Date: By.
City Authorized IRepresentative
Square footage will be verifled by the city prior to issuance of a building perrnit; fees may be adjusted accordingly.
Important NoUce:
Cupertino Union School D' strict gives no credit for total demolition of existing square, footage area, which makes
way for new construction as mandated in the Government Code Sections, 53080, 53080.6 and 65995.
SCHOOL DISTRICT DEVELOPER IMPACT FEE
CERTIFICATE, OF COMPLIANCE
The c'nilhorized rel-n-esentative (?I'tl?e Cupertino 07ion School Distrief has reviewed the
1' )u
cit) � 0/'
.� . . . . . . . . ./'"................. ......................... -
BuiWing.Pennil Request (,16'crihed abm,,e and herehY certrfies that the ddevelol,,wi- or authorized relwesentath,,e has
inet therequh-emenis ol'the Dislricl,° Develolier linpael]-ee reqairetnents.
mated: By:
Atitlio�m ize(iR'el)i-esentative
Cupertino Union School District
Certificate not valid without
District seal, initial, and (late.
Fee: $
Check No.:
Facilities Planning - While City - Yellow Requestor - Pink Accounting - Gold
MEME,
R ff 17-Trq Effif U- M-
1011 Channing Ave
Palo Alto, CA 9'4301
650 400-5873
cH;ffordzreek(54nsn.ccm
After reviewing the remodeling plans for your front yard, I have determined that there is insufficient
growing space for a new tree. There are already two city street tree's (Platanus acerifolia or London
Plane) in the parkway easement that are providing screening of your property. There are no second
story windows or deck to be concealed from' the neighbors or the street by planting a new tree in the
small front yard lawn.
Furthermore, a new tree planting in a few years, would interfere with the roof of your home and the
canopy of the city street tree. It is too crowded here once the remodeling is completed. Besides, the
new flagpole that is intended for the front yard here would be obscured by the foliage of a newly
planted 12' tall tree.
If you have any questions regarding my report, please contact me.
Thank you,
Clifford A Greek
C
%J`
'D 1A1, tq (7N