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13080160 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 8015 RAINBOW DR CONTRACTOR. PERMIT NO: 13080160 Cdr s Oi'7 OWNER'S NAME: HARTING STEPHEN DATE ISSUED:08/22/2013 01 NER'S PHONE: 4082574472 PHONE NO: hd LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL License Class Lic.# E3.3g4 7 REMODEL(E)MASTER BATHROOM(70 S.F.),INCLUDING 11ff,� REMOVING(E)TUB& INSTALLING(N)SHOWER STALL ContractorGt Cc9f(� C�t,S'YY4tlJ V�ate By I hereby affirm that I am licensed under the provisions of Chapter 9 RAISING SUBFLOOR,ADDING TILE/LATH& SHOWER (commencing with Section 7000)of Division 3 of the Business&Professions PAN 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 performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$3500 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:36211046.00 Occupancy Type: permit is issued. 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,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 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 ZZ ) granting of this permit. Additionally,the applicant understands and will co y Iss y: with all non-point source re s pSr-*Cupertino Municipal Code, ectio 9.18. ® RE-ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,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��_-S Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sect534. Section 3700 of the Labor Code,for the performance of the work for which this �2 �permit is issued. Owner or authorized agent: Date: I certify that in the performance of the work for which this permit is issued,1 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,I 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 CONSTRUCTION PERMIT APPLICATION �\ Is COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O� 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 /L CUPEftTINO (408)777-3228• FAX(408)777-3333•building(o cupertino.ora ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRE �s �I n,,.y'.,`^^ < < �Gt h•V (0 lj � OWNER NAME I J(rfi' PHONE 408 2-5-74 4-7� E-MAIL STREET ADDRESS /A �C CITY, STATE,ZIP FAX CONTACT NAME /� PHONE (�IQ �� I/' E-MAIL STREET ADDRESS (' CITY,STATE,ZIP o �O FAX ❑OWNER ❑ OWNER ,--BUH-DER 1:1 OWNER AGENT 11 CONTRACTOR 0 CONTRACTOR AGENT L'7 ARCHITECT 11 ENGINEER 11 DEVELOPER El TENANT CONTRACTOR NAME �\/ ©�� Co U�4�c h LICENSE NUMBER 33 q LICENSE TYPE BUS.LIC# kC COMPANY NAMEJ&AC(�'con Cm �6� E-MAIL FAX STREET ADDRESS 2.ry�� RCAK _ /I CITY,STATE,ZIP f Ls Q q14, PHONE 0 A HITECT NGINERNQ.M� ��I ] _ � LICENSENUMBE c�'� BUS.LIC4 COMPANYNAM1 (Abet A� �I�'tftTe E-MAIL FAX STREET ADDRES,$ 1 yJ CITY,S OAT C P�4, �n PHONE o-8 31r�/ ©/ 42,02. DESCRIPTION OF WORK T o �h `r' o y) EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA _ AREA AREA NET AREA rATHROOM KITCHEN OTHERODELAREA REMODEL AREA REMODEL AREA A DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ATTACH ELLWG UNITS: IS A SECOND UNIT []YES SECOND STORY ❑YES BEING ADDED? ❑NO ADDITION? ❑NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES ED T TAL VALUATION: PLANNINGAPPL4 ❑NO PLANNING APPROVAL LETTER EICHLER HOME? NO �w By my signature below,I certify to each of the following: I am the property owner or autho ed ac roperty 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 building co ctlon. I authorize representatives of Cupertino to enter the`aabbov -identifi d property for inspection purposes. Signature of Applicant/Agent: Date: d 2-.Z i, SUPPLEMENTAL INFORMATION REQUIRED PLAN clE krE' RaIITINCrL11. - _New SFD or Multifamily dwellings: Apply for demolition permit for OVER T�CouNT x IIr Intl r AN i �w existing building(s). Demolition permit is required prior to issuance of building ` permit for new building. ❑ EXPRESS ❑ PLAANNINGPLANREVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD PUT�ucwciRKS , To—nn 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 submittal of Building Permit application. ❑ MAJOR ' SANITAAY SEWER DISTRICT 0 ENVIRONMENTAL HEALTH BldgApp_201 Ldoc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 8015 RAINBOW DR DATE: 08/22/2013 REVIEWED BY: MELISSA APN: 362 10 053 BP#: 1 &C-16?6? 0 *VALUATION: 1$3,500 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1 R3SFDREM USE: PERMIT TYPE: WORK REMODEL E MASTER BATHROOM 70 S.F. INCLUDING REMOVING E TUB & INSTALLING N SCOPE SHOWER STALL BY RAISING SUBFLOOR, ADDING "TILE/LATH & SHOWER PAN E17-- ET 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 Eff 7/1%121 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. Remodel,Bath(<=300 sf) Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 $626.00 IREMRESBAT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-E) Reg. Q OT f 0.0 T hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 iCllDiii!rSll'[(;'IL'r "� '. 4 Work Without Permit? 0 Yes Q No $0.00 G Advanced Planning Fee: $0.00 Select a Non-Residential E) Building or Structure 0 1 7Y/i i', l loo F=%Yr 'pii(ar tl%i t'i_'f'.r`. Strom;Motion Fee: 1BSErSMICR $0.50 Select an Administrative Item BldgStds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.501 $626.00 TOTAL FEE $627.50 Revised: 07/01/2013 8015 RAINBOW DR 13080160 F/P HARTING STEPHAN SCANNED BOX #557 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 8015 RAINBOW DR CONTRACTOR. PERMIT NO: 13080160 �&0,174r_ OWNER'S NAME: HARTING STEPHEN DATE ISSUED: 08/22/2013 01 NER'S PHONE: 4082574472 PHONE NO: hd LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL License Class Lic. # E3.3g4 7 REMODEL (E) MASTER BATHROOM (70 S.F.), INCLUDING 1 13 22 REMOVING (E) TUB & INSTALLING (N) SHOWER STALL ContractorGt Cc9f(� Cg+ t�Sr YY4t!} y date By I hereby affirm that I am licensed under the provisions of Chapter 9 RAISING SUBFLOOR, ADDING TILE/LATH & SHOWER (commencing with Section 7000) of Division 3 of the Business & Professions PAN 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: $3500 performance of the work for which this permit is issued. 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: 36211046.00 Occupancy Type: permit is issued. 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, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 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 ZZ granting of this permit. Additionally, the applicant understands and will co y Iss y: j with all non-point source re s p� Cupertino Municipal Code, ectio � 9.18. % p RE-ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ 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 I, 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 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 2 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date. �2 �3 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, I 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 CONSTRUCTION PERMIT APPLICATION �\ Is COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION O� 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 /L CUPEftTINO (408) 777-3228 • FAX (408) 777-3333 • buildingna,cupertino.org��] ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT # PROJECT ADDRE �t r '. W APN # /' Z �j OWNER NAME %J(Arh ( r, _ (/1 0., PHONE O c' �7, -7� Zj E-MAIL STREET ADDRESS ;5.A rr :_ �' CITY, STATE, ZIPFAX CONTACT NAME PHONE (� (Q "il I L o J� �O E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR u CONTRACTOR AGENT L'1 ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME R!\/,� ©`J.� �f� 1^�CI O h `�� /JkAe LICENSE NUMBER 33 q© LICENSE TYPE BUS. LIC # COMPANY NAME ,r LAC �� �`� y�_ E-MAIL FAX _ /I� STREET ADDRESS 2. ry H6 R�K CITY, STATE, ZIP } _� ItsA /y�� G/� l PHONE f 3� A HITECT NG ERN,`�1'M, ] _ � 't(J1 LICENSENUMBE BUS .LIC 4 - PAV, COMPANY NAMFj � l�0 I �, _ (f/ �e E-MAIL FAX STREET ADDRE/G 1��^ yJ T CITY, S OAT// P ��� �© 2-3 P HONE ®'S f I DESCRIPTION OF WORK �-h �'o oM leo S'( ITW C -a 5 T1+ VL- LEXISTING EXISTINGUSE PROPOSED USE CONSTR. TYPE #STORIES USE TYPE OCC, SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA _ AREA AREA NET AREA ATHROOM KITCHEN REMODEL AREA REMODEL AREA OTHER REMODEL AREA 35�� POR A DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ATTACH #DWELLI GUNITS: IS ASECOND -UNIT []YES SECONDSTORV OYES BEING ADDED? []NO ADDITION? []NO , PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES D T TAL VALUATION: PLANNING APPL # []NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO �V By my signature below, I certify to each of the following: I am the property owner or autho ed acroperty 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 building co ctlon. I authorize representatives of Cupertino to enter the`aabbov-identifi d property for inspection purposes. Signature of Applicant/Agent: Date: d � 3 SUPPLEMENTAL INFORMATION REQUIRED Pr.>NctEr RalirtxSL ; bvEx TBCovNTE ❑ 13TntgiNtl PUArIItrVTEw. _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building h permit for new building. ❑ EXPRESS ❑ PLA;*INGPLA14"VIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD 0 PUBLtCV�aittt5 , 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 © MA36R ❑ SANITAlKi SEWER DISTp[CT submittal of Building Permit application. CJ ENWRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO Fm_� FEE ESTIMATOR — BUILDING DIVISION V, lv� i, E3 , i ,LibFV�, /'CC NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Wwrirt etc )_ Theso fees are hased an the nroliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/121 ADDRESS: 8015 RAINBOW DR QTY/FEE DATE: 08/22/2013 REVIEWED BY: MELISSA Plan Check Fee: APN: 36210 053 BP#: 1 &C -)A? 0 *VALUATION: 1$3,500 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: 1 hrs $0.00 PENTAMATION 1 R3SFDREM PERMIT TYPE: WORK REMODEL E MASTER BATHROOM 70 S.F. INCLUDING REMOVING E TUB & INSTALLING N SCOPE SHOWER STALL BY RAISING SUBFLOOR, ADDING TILE/LATH & SHOWER PAN V, lv� i, E3 , i ,LibFV�, /'CC NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Wwrirt etc )_ Theso fees are hased an the nroliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/121 FEE QTY/FEE I MISC ITEMS Plan Check Fee: $0.00 F70 s.f. $626.00 Remodel, Bath (<=300 sfl IREMRESBAT Suppl. PC Fee: Q Reg. OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -E) Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 iC%dD it!r't7l'c1;'7l'r / L '. 1 0 G Work Without Permit? Yes Q No $0.00 Advanced Planning Fee: $0.001 Select a Non -Residential Building or Structure 0 0 � r i7"i/i'i'! .'OtF€%Yr�pii,aft)%i f'i"r'S`: Strong; Motion Fee: IBSEISMICR $0.50 Select an Administrative Item B1dyStds Commission Fee: IBCBSC $1.00 SUBTOTALS: F si-5ol $626.00 TOTAL FEE 1 $627.50 Revised: 07/01/2013 7��cfl s6 _ trT056 VJ ouluadn3 `anp mogUleB S208 : ssazm3N. inuraao,sax . �maaawwoa �usaaix� . aaniaaaexaar `�'�- � b3MOHS M3N HAM Uni 9NUSIX3 3O iN31NDVld38 -. 13pOW3N H1V9 tf012331N1 1{}BnH.. X zs o k s - �9 I O 1 s t s r t t _ g N 0L cn7 n x l I N i76 8 � �. A 5 VE P 0 VF �ipi Imuttz a 3xpE E fallLU e W '2 4� X 9F s dl} tc� I lT xd1 NS_ �IIi p of g$ T K Q it? Z g €" 9� S US 3 3@F - RR a a hk pp� _.._— W '2 4� X 9F s dl} tc� I lT xd1 NS_ �IIi p of a