The URL can be used to link to this page

13100136 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10670 CASTINE AVE CONTRACTOR:GRIDL,EY COMPANY PERMIT NO: 13100136 OWNER'S NAME: MATT RANDAZZO 122 ORCHARD CITY DR DATE ISSUED: 10/21/2013 OWNER'S PHONE: 4087358699 CAMPBELL,CA 95008 PHONE NO:(408)374-0900 ❑ LICENSED CONTRACTOR'S DECLARATION t'7.. S 7 6' BUILDING PERMIT INFO: BLDG ELECT r— PLUMB wJ License Class Lie.4 {° r /->/?e MECH RESIDENTIAL COMMERCIAL Contractor�'r�z/�Lr( �Fj+s{n9�� Date /r I hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION:CONSTRUCT A ONE STORY ADDITION 218 SQFT, (commencing with Section 7000)of Division 3 of the Business&Professions INTERIOR Code and that my license is in full force and effect. REMODEL 405 SQFT. 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 Com -nsation,as provided for by Section 3700 of the Labor Code,for the .pirf astce of the work for which this permit is issued. ' I and will maintain Worker's Compensation Insurance,as provided for by Section 3700 ofthe Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$175000 permit is issued. APPLICANT CERTIFICATION APN Number:32643031.00 Occupancy Type: 1.5crtify 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section Signature_ Issued by: ✓i�'-i/y �L eDate:/e ,?/-/3 ❑ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed. If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS"1'O BE CLASS"A"OR BF,'1"1'ER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will 1 certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Se ions 255051 25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I / become subject to the Worker's Compensation provisions of the Labor Code,I must O�xtcr or or al; Date: �G�Z /� j forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional CONSTRUCTION PERMIT APPLICATION Ila COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•building CUPERTflYO (aDcuoertino.org ❑NEW CONSTRUCTION &ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT PROJECT ADDRESS 1 V J A) l J `//->i n J£ APN# � [ ._ /j - ,0,31 0`3/ OwN£$N �1 All jt 4 D o Jl tt J 1,/¢J i l��f�l Z Lu PHONE�� 7,35 �G 9 E-MAIL STREET ADDRESS /� CITY, STATE IP FAX (067,9 t�gairNf- A✓C � CONTACT NAMENSI G PHON U#, ,J�Z. g v 9 u E-MAIL 7 0 / 001YA L'G I�tEY of%PAA(y- (O-L STREE 2 Z RESS2 C' u `//L/ CITY,STATE,ZIP L L S U D Q FAX Z ❑OWNER ❑ OWNER-BUJLDER ❑ OWNERAGENT Iff CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECr ❑ENGINEER ❑ DEVELOPER ❑TENANT CON OR NAME /+ LICENSE NUME LICENSE TYP BUS.LIC# t 01£y C v. IJ�f�iv y /,�"0 6 3 1754 COMP NAME E-MAIL FAX Jj_ r t,�� rn %!�✓y STREET�DyRES !�G(//J ✓Lt� �/r N %L CITY, 4 M P3�GC 1 rvJ !� T9, �1 1 Q /D D ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK G EXISTING USE,F PROPOSED U E CONSTR._ PE TORIES g OCC, iYEL kis lkk=N(S) DEMO TOTAL AREAG�� AREA IAOR AREA NET AREAa6C V,t3 :. t?p.. BATHROOM KITCHEN OTHER / J - .. . . REMODEL AREA REMODEL AREA REMODEL AREA [d 7 - PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA:❑DETACH ❑ ATTACH #DWELLING UNITS: / IS A SECOND UNTr ❑YES SECOND STORY ❑YES _ _ - BEING ADDED? ❑NO ADDITION± ❑NO pR&APPIJCATION ❑ YES IF YES,PROVIDECOPY OF PLANNER'S NAME: R$C)y�IBY; TOTALY ATIOIQ: PLWNINGAPPL# NO PLANNDIG APPROVAL LETTER By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's bebalf. I have rea this application and the information I have pm ' o jnvc:t. 1 read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to ding on uthorize representatives of Cupertino to enter the above-dentified for inspection purposes. Signature of Applicant/Agent• Date: 'ry SUPPLEMEN FORMATION RE _ PLAN CHUXTYPE ROUTING-SUP _New SFD or Multif y dwellings: Apply for demolition permit for 0 OVER-TH"OUNTM �I BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. K]EXPRESS 4 PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBUC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE CQ FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. ❑ MAJOR ❑ SANITARY SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH BldgApp_201 Ldoc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10670 Castine Ave DATE: 10/21/2013 REVIEWED BY: Sean APN: BP#: / "VALUATION: 1$175,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex2nd Unit? 0 Yes :0 No PENTAMATION 1 R3SFDADD USE: =OTC? Yes QNo PERMIT TYPE: FWORK Construct a one storyaddition 218 s ft • interior remodel 405 s ft). SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,111-B,IV,V-B 218 $1,059.00 IADDPLCK $1,026.00 IADDINSP TOTALS: 218 $1,059.00 $1,026.00 MECH,HOURLY Yes .Q No, PLUMB,HOURLY C Yes E) No ELEC,HOURLY Q Yes E)No > Li NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info, FEE ITEMS (Fee Resolution 11-053 Ef: 7f 17113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,059.00 405 1 s.f. Remodel,Other Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 $488.00 1REMRESOTM PME Plan Check: $0.00 Permit Fee: $1,026.00 Suppl. Insp. Fee.0 Reg. 0 OT 0 01 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? C) Yes 0 No $0.00 0 Advanced Planning Fee: 1PLLONGR $30.52 Select a Non-Residential 0 Building or Structure �1 t-ce�>el 1)(;c��ri��'ri'�rt�nri l�`et��. 0� Strong Motion Fee: 1BSEISMICR $17.50 Select an Administrative Item Bldy Stds Commission Fee: IBCBSC $7.00 SUBTOTALS: $2,140.02 $488.00 TOTAL FEE: $2,628.02 Revised: 10/01/2013 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: l'C16 70 iw L PERMIT# OWNER'S NAME:(47fy PHONE# GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS:J Z t Olzcell -2/� CiT- 0/2 CITY/ZIPCODE: 9� *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 Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass /Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile __. 42 �j 3 Owner/Contractor Signature Date Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST 2mcp, VP'Pvaz a-.V5-5" JOB ADDRESS: PERMIT# OWNER'S NAME:,, PHONE# GENERAL CONTRACTOR: ';r ,j BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: - *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: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/ Carpeting c E� 3 0(P Z Linoleum/Wood ✓ Glass / Glazing s { a S fG Heating Insulation Landscaping Lathing Masonry Painting/ Wallpaper Paving Plastering G�p`e�y c-c 1127 93 Z, Plumbing Roofing Septic Tank Sheet Metal beet Rock .L 37Y.244 Tile �� ,ZF ' �� Owner/Contractor Signature Date