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13120188 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7640 ERIN WAY CONTRACTOR:G.A.KAIN, PERMIT NO: 13120188 CONTRACTING OWNER'S NAME: WYLLIE WILLIAM J AND MARILYN C 15551 LOMA VISTA AVE DATE ISSUED: 12/23/2013 OWNER'S PHONE: 4082553970 LOS GATOS,CA 95032 PHONE NO:(408)356-1400 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL E] COMMERCIAL E] REMODEL(E)KITCHEN(204 S.F.).UPGRADE(E)PANEL License ClassG_(o Lic.# tv S�Z S Z TO 200 AMP& INSTALL(N)XBOX&CONDUIT FOR FUTURE EV CHARGING STATION IN GARAGE Contractor �: r �-1 fi-(h( Date�Z 2. /3 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. ereby affirm under penalty of perjury one of the following two declarations: 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:$36000 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 APN Number:35921016.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that 1 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 AST LLED 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 co Date: with all non-point so rce regulations per the Cupertino Municipal Code,Section 9.18. �� Z 3 1 - 000 RE-ROOFS: Signature Date �shallspectedprior to any roofing material being installed.If a roof is installed without first obtaining an inspection,1 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) 1,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(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 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 5505, 553 ,a rd 25 .3 Section 3700 of the Labor Code,for the performance of the work for which this r 2 permit is issued. Owner or authorized agent: Date9 3 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 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 (7� COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION \� 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•build ing(cDcupertino.org \ ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 7&Y D 1 A I APN# I _ Q OWNER NAM UJ o' �L` Pm `a ,z E-MAIL 1 STREET ADDRESS (�,� t \ C b j CITY, STATE,ZIP J FAX <F2k( Ili 7�1, r CONTACT NAME PHON�c�O� �^ ig�1, E-MAIL IL `( V STREET ADDRESS 14 CITY,STATE,ZIP X r FAX ` C ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAM LICENSE NUMBER 7Q, ENSE TYPE BUS.LIC# Cn 5R ( 1pq ' z 2- 3 C3 23 '2 2_3 COMPANY vfv c M FAX y3� i STREET ADDRESS CITY,STATE,ZIP PHOrr� _ �L�ti�� 41 S'� 4 Gd' ccl r L QS�� �(D ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK A�� l P ,-A - 4 E , CA 9 r,N - d_ s �.�c tic �- 200 , EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKTORCH AREFGARAGE REA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES RY ❑YES BEING ADDED? ❑NO []NO PRE—APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO Sud V By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on pr 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 tret1frate. I agree to comply with all applicable local ordinances and state laws relating to bd ing cons ctio . I utho ize presentatives of Cupertino to enter the above-identified property, or inspection purposes. Signature of AppIicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED pLANCHEECK TYPE o1N7tLt#7I�iG 3t t1' y f r New SFD or Multifamily dwellings: Apply for demolition permit for 'gip EW existing building(s). Demolition permit is required prior to issuance of building permit for new building. Q xtrR t1' r�� A "VIEW-11 ki _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure © sarcNn� 1GI�-�kypS Form if any Hazardous Materials are being used as part of this project. GE11111 7, _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ tea rott slarnux �ax nlsr�t+ r submittal of Building Permit application. ' Cf vvrilaxilvxax.It>itrt.xa B1dgApp 2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR— BUILDING DIVISION ADDRESS: 7640 ERIN WAY DATE: 12/23/2013 REVIEWED BY: MELISSA APN: 359 21 016 BP#: / ) 'VALUATION: 1$36,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Duplex PENTAMATION 1R3SFDREM USE: PERMIT TYPE: WORK REMODEL E KITCHEN 204 S.F. . UPGRADE E PANEL TO 200 AMP & INSTALL N J-BOX& SCOPE CONDUIT FOR FUTURE EV CHARGING STATION IN GARAGE Elec.Plan Check 0.0 hrs $0.00 Elec.Permit Fee: IEPERMIT __LOther Elea Insp. 0.0 hrs $47.00 NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These fees are based on the prefinddna information available and are only an estimate Contact the Dept for addn'l in o. FEE ITEMS (Fee Resolution 11-053 UL 711i13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. Remodel,Kitchen(<=300 sf) Suppl. PC Fee: Q Reg. Q OT r-0—.0-1hrs $0.00 $626.00 IREMRESKIT PME Plan Check: $0.00 F 17 Electrical Permit Fee: $0.00 $139.00 1BREMMISC I Conduits Suppl. Insp. Fee-O Reg. Q OT 0,0 hrs $0.00 200 J amps Electrical PME Unit Fee: $0.00 $47.00 IBELEC200 Services PME Permit Fee: T-T $47.00 f"vn,rtr<>F°trona 1i.7.�: Administrative Fee: ]ADMIN $44.00 0 Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential 0 Travel Documentation Fee: ITRAVDOC $47.00 Building or Structure 0 i Strong Motion Fee: IBSEISMICR $3.60 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $2.00 SUBTOTALS: $143.60 $812.00 TOTAL FEE:: $955.60 Revised: 10/01/2013 ............ Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERIANO Fax: 408-777-3333 CONTRACTOR SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# OWNER'S NAME: PHONE# r GENERAL CONTRACTOR:",-, j,,14, BUSINESS LICENSE# -Z ADDRESS: CITY/ZIPCODE: 4 L *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 & Millworkz 5)A _�2 7 :5 0 -ZA a Cj Cement Finishing o 1i Electrical /-A—V-V F4 C— T VpffA A -?eoc I ct P Excavation Fencing Flooring / Carpeting Linoleum/ Wood eA ;:z -2- Glass / Glazing Heating Insulation (<:41 C_ -7 T Landscaping Lathing A Kc-\A C6 3V 14? Masonry raintinN .g/Wallpaper co ?1Z Paving Plastering 2 c. Co k , -34 L4 ? 3 Plumbing A RC, C-I-)fV S"T -34 CO3 Roofing Septic Tank — Sheet Metal G0 & z ?? 2-:3 Sheet Rock k C 3 Y Y Tile AQ_CON5 f Owner Contractor Signature Date Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: 408-777-3228 C U PERTI NO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: �76 rg%4S/ co A y PERMIT# 13 ( Z 0 ( 8 OWNER'S NAME: R1 L yfl Gt-1 LLL-1 F PHONE # GENERAL CONTRACTOR: , &I BUSINESS LICENSE# 2 3 ? Z 3 ADDRESS: 13v C 'FC `Z ? CITY/ZIPCODE:/k4 60k 4,0�1 i 1 L Ys�D3 *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: V 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 r /Z Z -3 /3 Owner/Contractor Signature Date