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13090131 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1228 YORKSHIRE DR CONTRACTOR:ALLIANCE PERMIT NO: 13090131 CONSTRUCTION OWNER'S NAME: ADAM SMITHLINE 2118 SAVERIO CT DATE ISSUED: 11/05/2013 OWNER'S PHONE: 4083484955 CAMPBELL,CA 95008 PHONE NO:(408)374-2100 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL Ll COMMERCIAL License Class__�J Lic.tl U d�—� 1 � ENCLOSE 2 PORCH AREAS TO ENLARGE MASTER BEDRM & Contractor 'apt _ 6sn5'r9wf raJ Date {—S• I� BATH(70 S.F.).CREATE 1 (N)WINDOW OPENING IN I herebv affirm that I am licensed under the provisions of Chapter 9 MASTERBDRM (commencing 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: 1 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:$50000 Wave 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:36210015.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 certify that 1 have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.1 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 CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which ay accrue against said City in consequence of the granting of this permit. itionaBy,the applicant understands and will comply Date: with all non-point s reteulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signatur a+ Date All roofs shall be inspected prior 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 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) 1,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. 1 will I hereby affirm undet penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: 1Health&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 rea Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupe tino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Codpe S.90 550 , 5533,and 25534. Section 3700 of the labor Code,for the performance of the work for which this S' . permit is issued. Owner or authorized agent � Date://' 1 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 1 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 j CONSTRUCTION PERMIT APPLICATION ELI] COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 j CUPERT[NC? (408)777-3228• FAX(408)777-3333 • buildingaacupertino.ora \M l ❑NEW CONSTRUCTION ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# a PROJECT ADDRESS APN fl�3 f 0 f9 1 J OWNER NAME PHONE �+ 1?4Lr1 _ ry► y� It '"�`f "Y 5` yN j,rt I ry�t��I a�� Ito STREET ADDRESS I2 f CITY,S ATE,ZIP FAX CONTAC NAME PHONEIL (I �ruC�so STREET ADDRESS CITY,STAT ZIP FAX ZI r 0 RS4d ffv�'3 ��'Z4 0() ❑ OWNER ❑ OWNFR-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR PCONTRACTOR AGENT ❑ ARCHTTECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONT CTOR NAME LICENSE NUivIBER L CENSE TYPE BUS.LIC# `Z COMPAN NAME -MAILFAX ave _ OLt�t0.vl Cj2_UTAS�YUCC •(vaA a - 3"-q'1 1 o C STREET ADDRESS CIT ,STATE,ZIP PHONE I t 8 tr t �J, t t 11 Cq Ct l;_o �� `� ' ZI OCA AR iITECT/E�L�jGINEERNAME LICENSE NUMBER BUS.LIC# COMPANY NAIME E-MAIL FAX i STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK ,,��••--j_ oew^ a X41, o>, EXISTING USE PROPOSED USE CONSTR.TYPE 1 d STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NETAREA BATHROOM KITCHEN OTHER REMODELAREA RLMODELAREA REMODEL AREA PORCH AREA DECKAREA TOTALDECKiPORCHAREA GARAGEAREA: DETACH I []ATTACH DWELLING VNrrS: IS A SECOND UNIT ❑YES SECOND STORY []YES BEING ADDED? []NO ADDITION? ❑NO PRE-APPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN E]YES •C Y. TOTAL VALUATION: PLAN^IING APPL 0 F]NO PLANNING APPROVAL LETTER EICHLER HOME? Lah1O 1`a 0,3,1 By my signature below,I certify to each of the fol wing: I am the property owner or a agent to a D the pro owner's behalf. I have read this application and the information I have provid ect. I have read the Description of Work and verify tis ac I agree to comply with all applicable local ordinances and state laws Blatin to buildi cons ion. I authorize representatives of Cupertino to enter a above-identified property for inspection proposes. Signature of Applieanr'AgenI Date: o/ SUPPLEMEN L NFOR TION REQUIRED PLAN CHECK TYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ��❑lf�]EXPRESS ❑ PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure t�I—',STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project, i❑ LARGE ❑ FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SE\\ER DISTRICT submittal of Building Pen-nit application. ❑ EN\IIRONMENTAL HEALTH BldgApp_2011.doc l-evised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 1228 YORKSHIRE DR DATE: 09/17/2013 REVIEWED BY: MELISSA APN: 362 10 015 BP#: 3L� 'VALUATION: 1$50,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex 2nd Unit? 0 Yes No PENTAMATION 1 R3SFDADD USE: OTC. 0 Yes 0 N PERMIT TYPE: WORK ENCLOSE 2 PORCH AREAS TO ENLARGE MASTER BEDRM & BATH 70 S.F. . CREATE 1 N SCOPE WINDOW OPENING IN MASTERBDRM OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,111-B,IV,V-B 70 $1,059.00 IADDPLCK $1,026.00 IADDINSP TOTALS: 70 $1,059.00 $1,026.00 MECH, HOURLY ® Yes O No PLUMB,HOURLY Q Yes (F) No ELEC,HOURLY Q Yes Q No .. f'lamb. Permit F,;. L7i:r. Pirn�il/'Nr.': Other h9ech. El Other Plumb Insp. Other Elec.Insp.ELl L AIM?.In-sp. j c Plumb. hasp. Fere: Etee Insp.Fee: 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 prelimina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,059.00 1 1 # Window/Sliding Glass Door Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 $834.00 1WINMEWSTR New(ShearwalUMasonry) PME Plan Check: $0.00 Permit Fee: $1,026.00 Suppl. Insp. Fee.e Reg. Q OT Q,Qhrs $0.00 1 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tay.- L Administrative Fee: Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: 1PLLONGR $9.80 Select a Non-Residential Building or Structure i`:!-1 °�`O �r.i.�iurratrtlii�n f��c.1�: � Strong Motion Fee: IBSEISMICR $5.00 Select an Administrative Item Bldg. Stds Commission Fee: IBCBSC $2.001 1 SUBTOTALS: $2,101.801 $834.00 TOTAL FEE: 1 $2,935.80 Revised: 08/01/2013 Building Department i City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 CUPERTlNO Telephone: 408-777-3228 Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: t'Z2 w 0Kk.5F +'K r PERMIT# 3 C5 UU/ OWNER'S NAME: ,4 l i' ti PHONE# Y d°v - 3y 8 - `(I?5S GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: /& Cq _,-z C. C,q. ,6be if CITY/ZIPCODE: S7�o *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: 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 /Contractor Signature Date Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 C O P E RT I N O Telephone: 408-777-3228 Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: yck ks PERMIT# 3, / U/ OWNER'S NAME: A ,)A ' PHONE#1/0 - 81 - yci`SS GENERAL CONTRACTOR:,. BUSINESS LICENSE# ADDRESS: �� . j '! CITY/ZIPCODE:C..4 , ,ti t; %'s`r *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 e -'f el Fencing Flooring/Carpeting Linoleum /Wood Glass /Glazing Heating - ' Insulation lIlac? e { i Landscaping pp Lathing f Masonry I Painting/Wallpaper Paving Plastering �- PIumbing S`—u Z Roofing f I" Septic Tank Sheet MetalAJ Sheet Rock Tile Owner/Contractor Signature Date I . r