14030176 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21825 HYANNISPORT DR CONTRACTOR:LOS ALTOS BUILDERS PERMIT NO: 14030176
OWNER'S NAME: ED OR JULIE IRVIN 131 EEL CAM[NO REAL DATE ISSUED:03/31/2014
OWNER'S PHONE: 4083562752 MOUNTAIN VIEW,CA 94040 PHONE NO:(650)390-9615
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL F] COMMERCIAL ❑
REMODEL&RECONFIGURE (E) KITCHEN TO INCLUDE
License Class — r "f D Lic.�# �� REMOVAL OF LOAD BEARING WALL
Contractor I �z-7-0 Date `-J
1 hereby affirm that I am licensed under the provisions of Chap er 9
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
1 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
ompensation,as provided for by Section 3700 of the Labor Code,for the
.,/�2
p rformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$47500
1 have and will maintain Worker's Compensation Insurance,as provided for by
ection 3700 of the Labor Code,for the performance of the work for which this APN Number:35613045.00 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 180 DAYS F ST LED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses hich may accrue against said City in consequence of the
granting of[h er . Additionally,the applicant understands and will comply y: Date:
with all n -point urce regulations per the Cupertino Municipal Co e,Sect]
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.
❑ ILDER DECLARATION
Signature of Applicant: Dale:
1 hereby affirm that 1 am exempt from 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(Sec.7044,
Business&Professions Code)
[,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. I will
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(x)should 1 store or handle hazardous
[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 Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance wit a Cu rtino Municipal Code,ChapterkI ,,id
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,S ction 5505,25533,and 25534.
Section 3700 of the Labor Code,for die performance of the work for which this - I
permit is issued. Owner or authorized agent- Date.
—
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
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333• building(o1cupertino.orgCUPERTINO
\�
❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/Ti ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS I //1 `1 Q APN# �� _ -.7 O
OWNER NAME ( nil IV 1v PHONE-f b E-MAIL
STREET ADDRESS �� � � � /� CITY, STATE�Z � � � FAX
CONTACT NAME ` PHONE (-� E-MAIL
t1.S L I Gh� 3�G '-((o I
STREET ADDRESS CITY,STATE, ZIP, FAX
l3I NO ( 1 `fid
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME LIZ LICENSE NUMBER G i3bco 3 LICENSETYPE� �(O BUS.LIC#3235\7
COMPANY NAME (" I I E-MAIL (/ U FAX d'ers OM3`fi d 9�;-o
STREET ADDRESS 161 1 ` 'O CITY,STATE,ZIP �a PHONE 3�O p b r
I
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK
ISG`\, h-k N C.C1
ry a� 2 ,C/Cti <,.i✓"C WPI
EXISTINGUSF. PROPOSED USE. CONSTR.TYPE #STORIES
JZ,Vr C VJ "A_J kWQ . USE TYPE OCC. SQ.FT. VALUATION($)
EXISTG NEW FLOOR DEMO TOTAL
AREA AREA AREA NET AREA
BATHROOM KITCHEN OTHER
REMODELAREA N ^ REMODELAREA ) r REMODELARE n
PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: UDETACH
/V t'�- N []ATTACH
#DWELLING UNITS: IS A SECOND UNIT []YES SECOND STORY MYES
BEING ADDED? RNO ADDITION? kNO
PRE-APPLICATION []YES IF YES,PROV IDE COPY OF ISTHF.BLDGAN []YES RECE OT��ALUATIONN::
PLANNING APPL# []NO PLANNING APPROVAL LETTER EICHLER HOME? Y+NO G7
By my signature below,I certiKuilding
llowing: I am the property owner o orized agent t perty owner's b a ve read thi
application and the informations correct. 1 have read the Descr' 'a>�of Work and verify it is accurate. I agree to comp with all app' le local
ordinances and state laws relatstruction. I auth entatives of Cupertino to enter the above-Ide of led pro erty f r mspec Ito purpo
Signature of Applicant/ Date: / '
SUPPLEM TAL FO A IR-ED PLANCHECKTYPE ROUTING SLIP
New SFD Or Multlfaml lings: pply demolition permit for ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
existing building(s). Demolition permit i Ired prior to issuance of building
permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS
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 ❑ MAJOR ❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ F,IWIRONAIENTAI,HEALTH
BldgApp_2011.doe revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 21825 HYANNISPORT DR DATE: 03/31/2014 REVIEWED BY: MELISSA
APN: 356 13 045 BP#: , 0 30 `VALUATION: $47,500
FPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY SFD or Duplex PENTAMATION 1R3SFDREM
USE: PERMIT TYPE:
WORK REMODEL & RECONFIGURE E KITCHEN TO INCLUDE REMOVAL OF LOAD BEARING WALL
SCOPE
ET_
Ll L_
NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works, Fire,Sanitary Sewer District,School
District, etc.). Thesefees are based on the prelinddna information available and are only an estimate. Contact the De t or addn'1 info.
FEE ITEMS (Fee Resolution 11-053 Eff 7/1./13) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 D0Es.f. Remodel,Kitchen(<=300 sf)
Suppl. PC Fee: Q Reg. Q OTT0.0 hrs $0.00 $626.00 IREMRESKIT
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Fee-(F) Reg. 0 OT0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
t uiz� 7u I;nrT f cLi
r1C/r111t1t.�"l1'c11iCt'/-co:
Work Without Permit? 0 Yes (F) No $0.00 (F)
Advanced Planning Fee: $0.00 Select a Non-Residential (F)
7rcrv(,ll)ot rnncrnturinn Fc'..), I
Building or Structure
i
Strong Motion Fee: IBSEISMICR $4.75 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $2.00
SUBTOTALS: $6.75 $626.00 TOTAL FEE: $632.75
Revised: 01/15/2014
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:j(- ?,25 M \ f-� Or. PERMIT# -q
OWNER'S NAME:�v � V1t2 L✓C( PHONE# < `I S"
GENERAL CONTRACTOR: S BUSINESS LICENSE# J--S
ADDRESS: t, 6 2,A,rjao Cn I CITY/ZIl'CODE: 140go 11/1C1 V
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPAN INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBC RACTORS HAVE OBTAINED A CITY OF CUP RTINO
BUSINESS LICENSE.
I am not using any subcontractors: /
S Sig ure Date
Please check applicable subcontractors Mcl'complete the following information:
V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring/ Carpeting 1117
Linoleum/Wood
Glass /Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting/Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
CITY HALL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
C U P E RT I N O (408)777-3228 • FAX(408)777-3333
SCOPE OF WORK: Kitchen Remodel.
1. Project shall comply with the 2013 California Building Code (Base code 2012 IBC), 2013 CA
Residential (2012 IRC), 2013 CA Plumbing (2012 UPC), 2013 CA Mechanical (2012 UMC),
2013 CA Electrical (2011 NEC), 2013 CA Fire (2012 IFC) and 2010 CA Energy Code (2008
Building Energy Efficiency Standards).
Energy code mandatory lighting measures:
1. All permanently installed high efficacy luminaires shall be switched separately from low
efficacy luminaires. (150(k)(7))
2. Permanently installed lighting in Kitchens shall be high efficacy luminaires. Up to 50% of
the wattage of permanently installed lighting in kitchens may be in lights that are not high
efficacy. (150(k)(8))
Plumbinq plan notes:
1. The maximum flow rate of kitchen faucets shall not exceed 1.8 gallons per minute at 60 psi.
(CalGreen 4.303.1.4:4)
Electrical Plan Notes:
1. The installation of smoke alarms in all of the following areas shall be provided: (R314.3)
a. On the ceiling or wall outside of each separate sleeping area in the immediate
vicinity of bedrooms.
b. In each room used for sleeping purposes.
2. The installation of carbon monoxide alarms in the following areas shall be provided:
(R315.1)
a. Approved carbon monoxide alarms shall be installed outside of each separate
sleeping area in the immediate vicinity of the bedrooms and on every level
including basements in dwelling units that have fuel-fired appliances or attached
garages.
3. A minimum of two 20 amp small appliance branch circuits shall be provided for all
receptacle outlets in the kitchen, dining room, pantry, or other similar areas. (CEC
210.11(C)(1))
4. In every dwelling unit, fixed appliances such as food waste grinders, dishwashers, washing
machines, dryers, laundry tray locations, built-in refrigerators or freezers, furnaces, AC
units, built-in heaters or any other fixed appliance with a motor of'/ h.p. or larger shall be
on a separate 20 amp. branch circuit.
5. All receptacles in bathrooms, garages, accessory buildings, outdoors, crawl spaces,
unfinished basements, kitchens (where receptacles serve counter top surfaces), laundry,
utility, wet bar sinks (within 6 feet of the edge of the sink), shall have ground-fault circuit
interrupter (GFCI) protection. (CEC 210.8)
6. In all areas specified in 210.52, all 125-volt, 15-and 20-ampere receptacles shall be listed
tamper-resistant receptacles. (CEC 406.11)
,I
4