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14010008 i CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10300 PALO VISTA RD CONTRACTnu_ 145L .y PERMIT NO: 14010008 �oNST�I_I c'n oN OWNER'S NAME: GREG&AMY EVERETT DATE ISSUED:01/02/2014 OWNER'S PHONE: 4082422611 PHONE NO: er LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL —7 REMODEL(E)MASTER BATH,80 S.F. License Class/ Lic..9 Contractormom- s/�/ ..47i'l�r Y/GLlDatef/� I hereby affirm that I am licensed under the provisions of Chapter 9 (commeucing with Section 7000)of Division 3 of the Business&Professions 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:$30000 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:35702055.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES 9-WDRK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN SOF T 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 18 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 1 granting of this permit. Additionally,the applicant understands and will compl su Date: f with all non-point source regulations per the Cupertino Municipal Code,Section 9.18, RE-ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed.If a roof is f installed without first obtaining an inspection,l agree to remove all new materials for —77 inspection. ❑ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Lawfor one of Signature of Applicant: Dale: 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(Scc.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,Seetions 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,Chapter9.I2 and the declarations: Health&Safety Code,Section 25532(x)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 Arca 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 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which thisM VU permit is issued. Owner or authorized agent: Date: �� I certify that in the performance of the work for which this permit is issued,l shall J not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. IC 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 stale 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 CONSTRUCTION PERMIT APPLICATION* �O COMMUNITY'DEVELOPMENT DEPARTMENT•BUILDING DIVISION O 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 CUPERTlNO' (408)777-3228•FAX(408)777-3333•buildinclCEDcupertino.org \ ❑NEW CONSTRUCTION ❑7 ADDITION �A/L�TTER.�A^TION 1 TI ❑ REVISION/DEFERRED ORIGIN+A�L PERMIT# PROJECT ADDRESS / /� C/ � Irf �!O l/�J/ APN4 /S - O L O�� OWNERNAE l C-]1 PHONE�Q�� E-MAIL r P 1,, r STREET ADDRESS n CITY, STATE,ZIP/yG FAX CONTACT NAME J PHONE �� Q E STREET ADDRESS� �/ CITY,STAT Z[P FAX C.CJ ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR 11 CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACrORNAME �1f., LICENSENUMBERLICENSETYPE BUS.LICN COMPANY NAME E-MAIL FAX STREET ADDRESS STAT�f� PHONE ARCHITECTIENGINEERNAME LICENSE NUMBER BUS.LIC 4 COMPANY NAME E-MAIL FAX . STREET ADDRESS CTI-Y,STATE,ZIP PHONE DESCRIPTION OF WORK EXISTING USE PAON'OSED USE CONSTR TYPE #STORIES - USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG _ NEW FL R DEMO Q/ TOTAL I AREA C�©'y`� AREA �j AREA 29,o .Vl NET AREA BATHROOM Krr CCHENN OTHER REMODEL ARPA Z"7-f4tJ I REMODEL AREA REMODEL AREA PORCHAR0 DECKARFA T4 TALDECK"RCHAREA GARAGEAREA: U DETACH ❑ATTACH d DWELLING UNITS: ISA SECOND UNIT []YES SECOND STORY YES SEINGADDED? pN0 ADDMON! []NO PRE-APPLICATION []YES IF YES,PROVIDE COPY OF ISTHEBLDGANDYES RECEI °"`' '+" YMha TOTAL VALUATION: PLANNINGAPPL(! []NO PLANNING APPROVALL.ENTFR EICHLERHONIE? ❑NO By my signature below,I certify to each of the following: I am the property owner or authorized agent to act operty owner's behalf 1 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 b •ding construction I authorize r present,41ives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applieant/Agera: Date:Z—lf - SUPI'�>;�,milyd.,Ilings: INFORMATION REQUIRED PLAT\CIHECKTYPE Y RotrTlnc s[ip' _New SFD or N(k Apply Tor demolition permit for VER THE-C9"TER ❑i BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building r _" Li k permit for new building.: s ExPREss Y � $%� �❑I4_PIr1NTdrHNIG Pi REVIEW _Commercial Bldgs: Provide a compleied Hazardous Materials Disclosure © sYANhARD 7 n P h z © puBwcwo�l form if any Han rdous Materials are being used as.part of this project. - - ti , ❑ LARGE_' L ❑ FLRIiPBFTha ), _Co of Planning Approval Letter or Meeliri witiL.Plannin prior tohti1wpr r PY g PP g g P }'0 Tin rox' V f �❑ sANrrnuY sl wr R Disrrucr submittal of Building Permit application, ! + r�w.* axta� ,r L {t• J L' aENVIRONMENTAL•HEALTHt;'- Bfdg.4pp 011.doc revised 196/21/11 CI'T'Y OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10300 PALO VISTA RD DATE: 01/02/2014 REVIEWED BY: MELISSA APN: 357 02 055 BP#: �?' -VALUATION: 1$30,000 "PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration 1 Repair PRIMARY PENTAMATION USE: 7 1 SFD or Duplex PERMIT TYPE: 1 R3SFDREM WORK I REMODEL E MASTER BATH 80 S.F. SCOPE Much. Plum Check Phrmb.Plun Check Elec.Plan Check rllech.Permit Fee: P11102h. Permit Pee: Elec. Permit fere: Oflier Alech.Insp. 0djer Plumb Insp. Other L'lec.Insp. Meth.Insp.Fee: Phunb, Inst).Fee: Elec,Insp.Fee: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,eta). Theseees are based on the prefintina information available and are only an estintare. Contact the De f or addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 80 s.f Remodel,Bath(<=300 sfl Suppl. PC Fee: Q Reg. 0 OT 0.0 ht's $0.00 $626.00 IREMRE0,4T PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Adninistr•alive Fee: Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee. $0.00 Select a Non-Residential Q Ti-cmel Documentation Fees: Building or Structure 0 Strong Motion Fee: IBSEISMICR $3.00 Select an Administrative Item Bldg_Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: $5.00 $626.00 TOTAL FEE: 1 $631.001 Revised: 10/01/2013 Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 its Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR 1 SUBCONTRACTOR LIST JOB ADDRESS: 1030 a PERMIT# d I GUS OWNER'S NAME:C' w v y PHONE# W Z V Z 2 6 J GENERAL CONTRACTOR: ` . — �� .� ��-- , ��, , i• � t��U BUSINESS LICENSE#, n4- ADDRESS: 4ADDRESS: / ; .7 ��j E� fU>`i / CITY/ZIPCODE: 0,117(fly' W *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) 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- q� V SUBCONTRACTOR BUSINESS NAM 4t{ - BUSINESS LICENSE# Cabinets&Millwork Cement Finishing ✓ Electrical' g L P/�reD tfIL Excavation Fencing Flooring/Carpeting Linoleum/Wood V Glass/ Glazing ( Heating Insulation Landscaping Lathing Masonry Painting /Wallpaper Paving Plastering / V,' Plumbing Roofing Septic Tank Sheet Metal 10 k Sheet Rock / j, s V Tile C J' Owner 1 Contractor Signature w Date 4 —� Building Department City Of Cupertino La 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone:408-777-3228 C U P E RT 1 N O Fax:408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: (0300 GL PERMIT# 0 1 000 OWNER'S NAME: G e r-ei tr PZ. GENERAL CONTRACTOR: BUSINESS LICENSE# 3 " ADDRESS: -4�22 e CITY/ZlPCODE: T 1 1�_-W -41-f�> *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 Owner/Contractor SFrg ature ✓ Date Everett Bath Layout Eve rete va n i ty Wa l l 158" 158" 131 82" 35" 3' ( 4", 83" 4-1 35" recessed lighting above sinks \ S Pratte` ,•<: GFt \ ' .� Mirror from backsplash to Protected FioorTile: 3/8x12x24 porcelain ceiling/insert mirror cabs �.,. �,,,....... ,:. centered on sinks ® Los All California v M Shower pan sliced river rock Return left wall will have mosaic 12x12 glass mosaic to ceiling Email:jim@kellyfinehomes.com bight switches on that Phone 650-965-9052 Two shower benches topped `\ » return wall ax - - , with slab file skirts ,a F :650 965 9072 r a Shower curb/niches and Licen #633307 y ? pony caps slab - < 00 , c \ rn :;_.:. \Irl Fortez " map. Three ower se r aY s Steam shower has porcelain on and Showerhe d ceiling and walls o ' 42"pony wall on shower side Capped with slab Vanity has slab and integrated o zo Pull-0 _ sinks from slab Vanity: Paint grade Satin Black Window Bench topped with two pull outs on either side of 3 doors 2x8 clear glass tiles offset. with full extension drawers inside c r Vanity counter is honed black granite face of cab has wood/doors Y M for storage. with integrated sinks fabricated by slab fabricator. 20 - $" 202/ 20 213" 213" 1 8" 82 1 r�iufii 1! 211$" 1„ 21J8" Everett Bay Window Wall 45 1/4' r-�J v , 158„ 39" 82 p AIN rc Repeat 3 sh Dwer spray \` and one sh werhead .�..� 4 , on I e x .. ' us -, o, W T OIL I I .;ti"ao ``: `w t� r.w 00 071 Storage under wndow bench r; Glass mosaic on this 82 pony wail facing door other walls of pony are Everett To et Wall a I drywall and a pullout drawer on end ofponywall. Everett Shower Wind®W Wall _ Revisions: 94 St8" 70 5t8" -� 24'° �T �_— 945/81, 3�„ 7" 34" 33" 312/3" fi I .,, 'k ` , Shower Window wall M Entire shower is in the Grande ` } � Cultured Brie k Blend of modern Basalt 6x 24 Ln This mosaic wraps onto the ceiling z , This is a steam shawer �w , } ww E m .z.:. , ,. - o Return 11 with notes on tile: Onepony wall capped with slab N I two benches capped with slab glass tele :o ceiling from two niches slab shelves. counter da € Windowsill and interior walls slab. 1 Masten Bath will „ use porcelain :, .. r ..._ t. Curb slab 10 tiles on floor and shower walls. Y w 2 Shower an is a natural river rock p c mosaic Jin feller Design 3 Countertop is granite slab used on backs lash U L Uhtain View, California caps for pony walls and curb and bench seats r M i Date: December 20 2413 , 4 Clear glass mosaic focal on one side of pony wall \ ..... and return wall to ceiling at vanity. g ■ 5 Clear glass subway file on window seat top. \ � � ` � � � � � � scale refer t0 a 6