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B-2017-1642
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1642 7670 BERLAND CT CUPERTINO,CA 95014-5079(362 25 034) MARTI'S PLUMBING SERVICE CUPERTINO,CA 95014 OWNER'S NAME: HO KENNETH S AND DEBBIE Y TRUSTEE DATE ISSUED:09/22/2017 OWNER'S PHONE:408-386-9147 PHONE NO:(408)375-3190 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-36 Lic.#958020 Contractor MARTI'S PLUMBING SERVICE Date 02/28/2019 X BLDG _ELECT X PLUMB MECH X RESIDENTIAL_COMMERCIAL 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. JOB DESCRIPTION: REPLACE SEWER MAIN I hereby affirm under penalty of perjury one of the following two declarations: 1. I have and will maintain a certificate of consent to self-insure for Worker's ,C.4'°; � mpensation,as provided for by Section 3700 of the Labor Code,for the .erformance of the work for which this permit is issued. ,t- 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 this , permit is issued. Sq.Ft Floor Area: Valuation:$3650.00 .1.7,./".\............_ APPLICANT CERTIFICATION 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 362 25 034 representatives of this city to enter upon the above mentioned property for I inspection purposes. ,(We)agree to save indemnify and keep harmless the ' i City of Cupertino against liabilities,judgments,co and expenses which PERMIT EXPIRES IF WORK IS NOTSTARTED may accrue against said City in consequence oft.-granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and wi omply with all non-point N source regulations•erthe Cupertino Mun'.'•al Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signatur . ._`� Date 09-22-2017 Issued by:Kim Dunbar Date:09/22/2017 I hereby affir . that Iam : empt from the Contractor's License Law for one of the RE-ROOFS: following two •+ '... All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. I I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for I compensation,will do the work,and the structure is not intended or offered for inspection. II sale(Sec.7044,Business&Professions Code) 2. 1 'I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: ,;, contractors to construct the project(Sec.7044,Business&Professions Code). Date:09-22-2017 , , I. I hereby'affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1, 11 1 have and will maintain a Certificate of Consent to self-insure for Worker's 11 Compensation,as provided for by Section 3700 of the Labor Code,for the II performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's'Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the 1 Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous shall not employ any person in anymanner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Mana.:. ent District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal C..• •apter 9.12 and exemption;I become subject to the'Worker's Compensation provisions of the the Health&Safety Code, ,, . 25505,2 . I 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. ' Owner or authorized ag �z/ APPLICANT CERTIFICATION Date:09-22-2017 ' _ I certify that I have read this application and state that the above information is 0 A s�'}= L• L L Y correct.I agree to comply with;all city and'county ordinances and state laws I hereby affirm that there i�constr.chon lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the,City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. I understand my plans shall be used as public records. Licensed Signature Date 09-22-2017 Professional I ' CONSTRUCTION PERMIT APPLICATION t",o, • COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO,CA 95014-3255 �14,1.t93 211 - /CO ea"�' (408)777-3228 • building@cupertino.org PEMIT#B- CUPERTINOREV# DEF# ' ❑ NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T.I. MEP ❑RE-ROOF ❑SWIMMING POOL/SPA PROJECT ADDRESS „.-76-70 < / j5 e r APN# 2 —Ps- `I0 3 7 OWNER NAME l PHON 7/‘./. / 7 E-MAIL v�J�S • STREET ADDRESS7 70 & e5 �� 'r!`/ `I CITY, ATE,7[P ,q S O! 144, []- i TRACTOR NAME El OWNER-BUILDER COMPANY NAME LICENSE NU�MBER Gt O2cy LICENSE TYPE , I %)ate // A�f's 01ly,STAT5, o3G STREET ADDRESS , / // ZIP , / 9 w- eri� / G/!% GSL r !!w �!�- al ly/ I E-MAIL PHONE BUS.LIC#r�_ I El ARCHITECT El OWNER El OWNER AGENT ErCONTRACTOR AGENT El ENGINEER El DEVELOPER El TENANT ,/, ii/5, CONTACT NAMED r (\.\ • E-MAIL . emikke STREET ADDRESS CITY,STATE,ZIP P ONE _ _ C3z3j�$14-3710 DECRIPTON / / •?=- , ' 17/7e# • SINGLE-FAMILY/DUPLEX 0 MULTI-FAMILY ❑INDUSTRIAL 0 COMMERCIAL • I EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES# TOTAL NET SF USE TYPE OCC ' SQ.FT. . VALUATION($) REMODEL REMODEL KITCHEN; REMODEL OTHR GARAGE 0 ATTACHED BATHROOM SF SF 1 SF SF 0 DETACHED ' • EXISING 0 YES "EICHLER ❑'YES SECOND STORY ADDITION FIRE SPRINKLERS 0 NO ❑';NO NO ' DWELLING SECOND DWELLING OYES'„❑ATTACHED 0 DETACHED OTHER uNTTS# UNIT ADDITON: ONO; 1 S F POOLS' ❑FIBERGLASS ❑VINYLLINED ❑GUNITE ❑PREFABRICATED • POOL-SF SPA-SF I SPA ATTACHED❑YES 0 NO TOTAL-SF ' RE�� Y: fATOTAL VALUATION: Commercial or Multi-Family Buildinss with Public Sw,mniimi Pools requires Department of Environmental Heath approval )65-7 / ©,Gly RE-ROOF'EXISTING ROOF TYPE: ❑BUILT-UP ROOF El ASPHALT SHINGLES WOOD SHAKES❑WOOD SHINGLES❑TILE OTHER(SPECIFY), v REMOVE/REPLACE❑NO IF NO, i I,; ' ' PLYWOOD 1=1 1h- ❑3/8" PLYWOOD TYPE: PITCH: ' ROOF CLASS ❑YES #OF LAYERS ' THICKNESS❑5/8" OTHER ❑OSE ❑CDX OTHER :12 ' A PROPOSED ROOF TYPE:❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES❑WOOD SHINGLES 0 OTHER , *Provide a signed copy of the{C •upertinos Tear-Off Policy SF #of SQUARES By my signature below I certify,tdileach Of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application'arid,theiiriformation 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 construction. I authorize representatives of Cupertino to enter the above-identified property for inspec..n pur.oses. I acknowledge and authorize all information contained on this application form to be made available for public,r- ^2..e, / / �/—7 Signature of Applicant/Agerit<i '. %�sL��i/ Date: SUPPLEMENTAL INFORMATION EQUI ED ., ! ' *New SFD/Second Dwelling UnitS/Multifarruly Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction. *Commercial Buildings: Provide'a;eompleted Hazardous Materials Disclosure form if any Hazardous Materials are being used as part,of this project. *Copy of Planning Approval Letter 8i.Meeting with Planning prior to submittal of Building Permit application. *HOA-Provide a letter of approval from!the Home Owner's Association I! ' I' j, BldgApp_2017.doc revised 08/01/17 1 Y ti p SM1NlrARy CUPERTINO SANITARY DISTRICT a'' S 20863 Stevens Creek Blvd#100, Cupertino, CA 95014 <�.a. Tel(408)253-7071 • Fax(408)253-5173 '4EusxEc+ti''' CUPERTINO SANITARY DISTRICT PERMIT LETTER Cupertino Sanitary District has adopted Resolution No. 1263. Building Permit Request (Over-the-Counter) ®'Single Family Project E Multi-Family Project ❑ Commercial Project Project Address: 76'7e, Re,-low-b. GT eipp„-/1/4-0 e(/-- dl 510/4-1,Permit Number: 6--zo t'1 -/(p cl Z ®" Scope of Work: pr77e-i- . I �t , --�> Owner/Applicant Name: J-� Phd'ne:(.e 3) gl' - 3 26' Address: Date: 9-z --z7 Prepared By: .(.6f.m. J ' City Authorized Representative I, as property oWner or authorized agent acknowledge:that all Cupertino Sanitary District requirements will be met and all required fees will be paid prior to the appro,- o final inspection for,proposed project. Date: gf�t°1` /1 Signature: `- Owner/Authorized Agent CUPERTINO SANITA'i DISTRICT OFFICE USE,ONLY, ! n Pre-inspection Required LITH 'Final Inspection:Required ; Date Scheduled: ; Date'::(177:7 2 - ,.—,( Conditional Approval By: G it 'II+I• ' Authorize;: epresentative , Cupertino;Sanitary District ' i Distnctiwill notify owner of the required fee within 5 days after Pre-Inspection hasibeen completed arid Cc City of Cupertino., , ,, ' KJ Inspection — tion Fee Paid Date Paid: 1--.,:? Inspection Frees : 174 ! 1 $25,Q/unit'-Single Family Residential already connected, but new cleanout is required 1 MI ,;; $1150/uniti-Single Family Residential already connected with existing cleanout in working order D ;,I $35',0 Minimum-Commercial and Retail Actual Amount: i i 0 !, $120,10/ea4i-Disconnect and/or abandon lateral service , ;, j ; Connection'Permit Fees: D ,i $350 /unit- Single Family Residential connecting to existing lateral Li ,;j $650/unit—Sin'gle Family Residential connecting with new lateral 0 'I $1,00/unit—Multi,Hotel, Living Units, etc. Actual Amount: , = �l $500/connection-Commercial and Retail Actual Amount: Connection ��Use Fees(See Attached Calculation Sheet): 0 I I Area.and,Frontage Fees Amount: CI '; Re'sidential Excess Fees over 3.5 unit/acre Amount: CQ ; Coinmer'cial and Retail Connection Fees Amount: 0 ! Coinmer,cial and Retail Change in Use Fees Amount: Date:! T —11 Final Approval By: -6w4 - Authorized presentative Cupertino,Sanitary District A ft ime V ed e, 1• .. License#,958020 peavtVA* .1 10260 Imperial Avenue, Cupertino, CA 95014 Email: martisplumb@gmail.com Phone: (408) 375-3190 Fax: (408) 873 7552 To Whom It May Concern: I Victor Martinez, Owner of Marti's Plumbing Service, Inc. authorize Daniel Moreno to pull permits on behalf of myself and the above referenced company. . Victor Martinez, Owner\1 Kristena Martinez, Fiocial Offic r1, 1),.________,_, . , • N TRUSTWORTHY • RELIABLE • EFFICIENT i ;�