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14030123CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10168 CASS PL CONTRACTOR: MOCELIN PERMIT NO: 14030123 CONSTRUCTION OWNER'S NAME: FUNAKI MIKIO & JUNKO 5307 CEDAR GROVE CIR DATE ISSUED: 06/05/2014 OWNER'S PHONE: 4085170426 SAN JOSE, CA 95123 PHONE NO: (408)732-6655 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL INTERIOR REMODEL (1256 SQ FT); REMODEL KITCHEN License Class_ Lic. # (300 SQ FT); REMODEL (2) BATHROOMS (190 SQ FT); DEMOLISH POOL (540 SQ FT); REDUCE SECOND STORY Contractor Ki Date 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. hey a irm under penalty of perjury one of the following two declarations: will maintain a certificate of consent to self -insure for Worker's om sation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $214000 performance of the work for which this permit is issued. 1 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: 35701033.00 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 O RMIT 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 DAYS F ALLED 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 comp) ssu ate: o r with all no oint source regulations er the Cupertino Municipal Code, Section RE -ROOFS: 9.18. Signature Date All roofs shall be in ecte or to any roofing material being installed. If a roof is installed without first o taining 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 Ar Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cup ipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety ecti s 25 , 5533, an 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized t: Date: permit is issued. I certify that in the performance of the work for which this perritit 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, 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 n_____ ______ CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingna.cupertino.org M OU . n n 710TnXT InccU7nDCrl nVT(:TMAT PPPMITt! PROJECT ADDRESS 0 ) C^ S S L n C� I.� F't ^PN " 5- - 01 - b 3 3 OWNER NAME PHOI41 �O 7 1� _ e .Z E-MAIL 3 STREET ADDRESS_ S PCy►� G CITY, STATE ZIP e� G t FAX COYT NAME _ . \ 0 �C L.11� N�, /�p� �}(�)✓S -ao�C�� p /I E X1.0 MOeLLllV /tt< ST T ADD SS raA Rte 2_ STATE, ZIP til �s 6 CA q z �y0� _ �� V ❑ OWNER ❑ OWNER-BuiLDER ❑ OWNER AGENT 5KCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT comr$A�fOOR NAME `� O ` �`JJ\\ LICF�ISE NUMBER u 0 —4 TI�J l LICE�E T BUS. LIC N CO "'moo e� � Cis-��-� �>� eMk EJM��L�11 Joe a ►� oc�, ti m al L , >�8 $09' G ST T 'TATE, ZIJPy- �S� �iSi Z3 PHONE `lois 03 ��3S ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS r 40 CITY, STATE, ZIP PHONE DESCRIPTION OF WORK, o z K c l t 2 tic, .� �� EP -t c e_ F E �P (7 t'P % r iL r 1 STI -0 6 V AL)L..r l n L I o 4 i rC� t o .1`�M . rih 4-3T , tr 3-4 c SU l - ptw � L e aT'G 2,z r� . D&Z.,� ��i�� o L_ EXISTING USE PROPOSED USE CONSTR TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION (E) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN REMODEL AREA) ?C> REMODEL AREA OTHER REMODEL - PORCH AREA TOTAL DECKTORCH AREA GARAGE AREA: DETACH ❑ ATTACH 1ME*&EA _ U # DWELLING UNITS: IS A SECOND UNrf []YES SECOND STORY OYES BEING ADDED? NO ADDITION? ]NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN PLANNING APPL # ❑ NO PLANNING APPROVAL L R EICHLER HOME?'LJ By my signature below, I to each of th foll ing: am the property onzed age to act on the pro e er's behalf. I have red this application and the info ation have provi 1 orrect. I ave read the Description of Work and ve a e. I agree to comply with all applicable local ordinances and state la relatin to ildin ruction. on representatives of Cupertino to enter the above dent`ifie property for inspection purposes. CJ Signature of Applicant/Age Date: SUPPLEMENT O N IRED PLANCHECKTYPE ROUTINGSLIP ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW _ New SFD or Multifamily d I11ngs: A ply 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 �rANDARD 1:1 PUBLICWORKS _ To—nn if any Hazardous Materials are being used as part of this project. ❑ LARGE 1:1 FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRO\'!MENTAL HEALTH BldgApp_2011.doc revised 06/21/11 ci✓t � CITY OF CUPERTINO 1�1�i+l FEE ESTIMATOR - BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the Dreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef 7%173) ADDRESS: 10168 CASS PLACE DATE: 03/20/2014 REVIEWED BY: MELISSA APN: 357 01 033 BP#: ,/03OlZ. "VALUATION: 1$214,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: 0.0 PENTAMATION 1 R3SFDREM I PERMIT TYPE: WORK CHANGE VAULTED CEILING TO SOFFIT REMODEL KITCHEN 300S.F. & 2 BATHS 190S.F. SCOPE I REMOVE POOL (540S.F), REMOVE 2 (E) FP'S & REPLACE W/(N) GAS FP, REMOVE BALCONY NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the Dreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef 7%173) FEE 1 E:I-L-ED Plund) /1;sp.Fc, MISC ITEMS NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the Dreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef 7%173) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. $4,746.00 Remodel, Other 1REMRES2 i Suppl. PC Fee: Q Reg. Q O"1' 0.0 hrs $0.00 PME Plan Check: $0.00 3,800 s.f. $608.00 Re -roof 1RER00FREs Permit Fee: $0.00 Suppl. Insp. Fee -0 Reg. O 01 0.0 lirs $0.00 0 # Swimming Pool $319.00 IDEMOPRES Demolition PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure i-< 1VI 0ocillnewaliorr Fccs: Strong Motion Fee: 1BSEISMICR $21.40 Select an Administrative Item Blda Stds Commission Fee: 1BCBSC $9.00 SUBTOTALS: 1 $30.401$5,673.00 TOTAL FEE: $5,703.40 Revised: 01/15/2014 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: (U SUBCONTRACTOR PERMIT # D 3 0/ 7-3 OWNER'S NAME: vj PHONE # - / -C> GENERAL CONTRACTOR: MCC -e -0 Cc.,s-- BUSINESS LICENSE # ADDRESS: S p G (Z S CITY/ZIPCODE: 2 *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 Please check applicable subcontractors and complete the following information: Date O o tractor Signature ate 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 O o tractor Signature ate CkN 4 C v:-� KJ C) lotL-4),Gkj (,,::)P J CAL - 9 4066 (H,V) ao3-ossti ( , 4A /I I ) TGAS'oO F -e-'2-- A -DP, 77C,. c- 7( (44 z>c- \ V1n -C`Z �(ifL CA�CT ?C-7n� A2G7 o�Sc1 717 St'�JLZ-- Au-�P�L S MAC CUPERT INO PROJECT DATA - RESIDENTIAL COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building chi cupertino.org ADD PROJECT SS o 6 c 9S PLAet APN # U33 OWNER NAME v wNA tL PHONE E-MAIL STREET ADDRESS 16166 (249SLAec CITY STAT , ZIP_ Cc�'ti3� e) CA. 9/Soi14 FAX APPLICANT NAME D EL.1 N CO✓v 3�2L)cT7o�oS HONE ao3�8S� E-MAIL -10e, oceLt S i' T A RE.' ' 3o RE' GP-DL) Ck 2 7C&(A ITYSTA-'E, ZIP ZUSc CAL 9 FAX - 81119 - -70 (oF, ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT 5rCONTRACTOR ❑ CONTRACTOR AOP:NT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT DESCRIPTION OF WORK 0-1 'Mmoo'+_ kI - R B'A'SS 0 e�srr•��t� �'GZIck �I r ,-AcesrI E'x�S� �aG vAc.ac-ten CE -t ,L-s10r-,-S 9A ---PL AcA 3 c,,, ws OV = �J t`�AvtJ t: Lc kY2 EXISTa USE . PROPOSECD� USE(Sy Jt OCCUPANCY(S): P— �" TYPE OF -0 cw D opw.'t PARCEL i 0� ' •� CONSTRUCTION: F C AREA: FIRE Y CN> R'UI AREA: Y N SPRINKLERS: FLOOD AREA: Y SIESMIC AREA: Y N Na Ncw Sc� Existin Proposed Floor Area: First Floor: s.f. s.f. Second Floor: s.f. s.f. Garage s.f. s.f. TOTAL: s.f. s.f. Are there at least two 10 feet by 20 feet clear spaces inside the garage? (5 N Is privacy protection planting required for the project? Y Governing Codes: 2010 California Building Code (based on the 2009 International Building Code) 2010 California Residential Code (based on the 2009 International Residential Code) 2010 California Plumbing Code (based on the 2009 Uniform Plumbing Code) 2010 California Mechanical Code (based on the 2009 Uniform Mechanical Code) 2010 California Electrical Code (based on the 2009 International Electrical Code) 2010 California Energy Code 2010 California Green Building Standards Code Cupertino Municipal Code ProlectData-Residential.doc revised 03/09/11 C �nA1