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14060036 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22356 RANCHO DEEP CLIFF DR CONTRACTOR:SILICON VALLEY PERMIT NO: 14060036 BUILDERS GROUP OWNER'S NAME: MARY BARRY 1961 OLD MIDDLEFIELD WAY DATE ISSUED:06/13/2014 OWNER'S PHONE. 4082551989 MOUNTAIN VIEW,CA 94043 PHONE NO:(408)6274177 ❑ LICENSED CONTRACTOR'S DECLARATION f— r— r— BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# r r r MECH RESIDENTIAL COMMERCIAL Contractor Date JOB DESCRIPTION:CLUB HOUSE-REMOVE REPLACE WOOD DECK& I hereby affirm that I am licensed under the provisions of Chapter 9 STAIRS(750SF) (commencing with Section 7000)of Division 3 of the Business&Professions REVISION#I OTC(6/23/14):REDUCE WIDTH OF STAIRS AND Code and that my license is in full force and effect. INCLUDE CODE REQUIREMENTS ON PLAN. 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:$31000 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:35602047.00 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 FROM LAST CALLED 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 comply Issued by: Date: 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 installed without first obtaining an inspection,1 agree to remove all new materials for inspection. 13OWNER-BUILDERDECLARATION 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). 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(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 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 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: permit is issued. 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 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 1 have read this application and state that the above information is correct. 1 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 Dcupertino.org CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESSI ,m `, APN I�-6 ® ,y OWN'ERNA E ¢9 PHONE E-MAIL STREET ADDRESS f CITY, STATE,ZIP FAX i4� CONTACT NAME PHO O : E-MAIL e-t S(/ II rjmup0 STREETADDRESS C STAT, ZIP F. r +` C' L996 -3 ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTR,4TOR NAME LICENS.F,NUMBER LICENSE ODI TY E BUS.Y� COMPANY �KE E-MAIL F STREET ADDRESS a C1 STATE,ZJf PHONE bbt— Q CA ARCHITECTIENGINEER NAME LICENSE NUMBER BUS.LIC k COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK 0 EXISTING U0.SE PROP ED USE CONSTR.TYPE #STORIES �E� � USE TYPE OCC. SQ.FT. VALUATION ) (£W ) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NErAREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH 0 []ATTACH k DWELLING UMTS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? NO ADDITION? KNO PRE-APPLICATION [:]YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES ;R_ ECEIVED BY yam, .'x k' '`x y` TOTAL VALUATION: PLANNING APPL 9 KNO PLANNING APPROVAL LE-17ER EICHLERHOME? NO at,' ��'�'� e �' �� ',���• By my signature below,l certify to each of the following: I am the property Owner or authorized agent to act on the property 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 accurate. I agree to comply with all applicable local ordinances and state lays relating to building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: (/ SUPPLEMENTAL INFORMATION IRED •-`' � PlA.N-CHEG'KT]TE�-;'� 7��.._.-:.s � t.,?..•:ROUTII�G'SLIP�; I .,+ 4f X' +i"i N,.CV y.4 1 q k' F 4... F 3",.� 5 New SFD or Multifamily dwellings: Apply for demolition permit for � �� � z � �� � � � � � ��� �� VER-TRF { BUILbU\GPLAT REYTEW} _a y existing building(s). Demolition permit is required prior to issuance of building _ M s permit for new building. ❑�EaPRESS �, tip# I i© PLANNLNNGPLAn REVIER' ; t. !MP'Ot d- ��..4`� '4'�- 43 .-I� _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure l]�sTnin�AxD�t' 'F "afl PUBLic wolucs� „Ak form if any Hazardous Materials are being used as part of this project, y "„Y m`r, }43Y 7 2 a ��f L�RGEz = . �I' �. flFIREDEKTi�' a �a' i + -�� +: r ` _Copy of Planning Approval Letter or Meeting with Planning prior to x� , , ARS-ices g 7. � T1E170Rr +rte SANITSERERDISTRICT submittal ofBuilding Permit application. y? � .. tr � a ME LCf,ENVIRONMENTAL FIEALTFI x B1dgApp_2011.doc revised 06/21/11 CffTY OF CU P]EIEB'>('INO BUILDING lP]EllMl[T BUILDING ADDRESS: 22356 RANCHO DEEP CLIFF DR CONTRACTOR:SILICON VALLEY PERMIT NO: 14060036 BUILDERS GROUP OWNER'S NAME: MARY BARRY 1961 OLD MIDDLEFIELD WAY DATE ISSUED:06/13/2014 OWNER'S PHONE: 4082551989 MOUNTAIN VIEW,CA 94043 PHONE NO:(408)627-4177 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL CLUB HOUSE-REMOVE&REPLACE WOOD DECK& License Class_ Lic.# STAIRS (750 SQ FT). Contractor�,l�`eo,, 11((�� i/�G�GDate 6 I hereby affirm that I am licensed undAhe 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. 1 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:$31000 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:35602047.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 certify that I have read this application and state that the above information is PERMIT IE WORK IS NOT STARTED correct.1 agree to comply with all city and county ordinances and state laws relating WITHIN 1 DAYS ® PERMIT ISSUANCE ®R 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 1(DAYS IF M ILAS CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of theI granting of this permit. Additionally,the applicant understands and will comply Issued by: Date:�• with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date I 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. ❑ OWNER-BUILDER DECLARATION I hereby affirm that 1 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). 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(a)should 1 store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 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 1 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 this / permit is issued. Owner or authorized agent: Date:6 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 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 1 certify that 1 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 1 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 e BUILDING DIVISION 10300 TORRE AVENUE^CUPERTINO, CA 95014-3255 C�1PE�3Yl�0 (408) 777-3228 ^ FAX(408)777-3333^building(a)cupertino.orq Sy0��0�/_ ❑NEW CONSTRUCTION ❑ ADDITION LTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS � G � � �> APN# OWNERNAME HO G E-MAIL STREET ADDRESS CITY, STATE,ZIP FAX [� CONTACT NAME PHO Ya ���� ^�� E-MAIL stj b U ' 0 STREET ADDRESS V CITY,STATE, ZIP (J� F ��� — V-s ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR 2 CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER (7❑ DEVELOPER ❑ TENANT rO NTRACfOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# d COMPANY NAM E-MAIL F s<<r as o)1 o G STREET ADDRESS CITY TATE,ZIP 1��� � ^ PHO 'q 1/� C of J v ARCHITECTIENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX ,�qq STREET ADDRESS CITY,STATE,ZIP PHONE " DESCRIPTION OF WORK e-,e ! �r l� J V \ Q/ yr 2 Q EXISTING USEPROPOSED USE CONSTR.TYPE #STORIES CGZp r ! ;0 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 DECK/PORCH AREA GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT []YES SECOND STORY ❑YES BEING ADDED? �NO ADDITION? )I NO PRE-APPLICATION I]YES IF YES,PROVIDE COPY OF IS IS THE BLDG AN )Q NO YES RECEIVF,H BY: • / COTAL VALUATIOI`-, - PLANNING APPL# 'FANO PLANNING APPROVAL LETTER EICHLER HOME? / NO - G, /- '� 0046)DO�'� By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the properly owner's behalf. I ve 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 building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: 64611 SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPEROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-TiliCOUNTER UILDINGPLA NREVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS PLANNING PLAN REVIEW _forCommercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD . ElPUBLIc,WOIus m 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 ❑ submittal of Building Permit application. SANITARY SEWER DISTRIcr ❑ ENVIRONAIENTAL HEALTH' B1dgApp_2011.doc revised 06/21/11 CITY OF CUP ElEBUND FEE IESTMATOR— BUM NG DffVffSffON ADDRESS: 22356 Rancho Deep Cliff Dr. DATE: 06/06/2014 REVIEWED BY: Sean APN: IBP#: �jODv *VALUATION: 1$31,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1GENRES USE: PERMIT TYPE: d WORK Club House: Remove and replace wood deck and stairs 750 sq ft SCOPE Pl,nul- Ylorr(1` c;! Elec. Plan Check �:i al',r.rid l 7'lrariir Perinir Fr": Flee. Pernrrir/ee- El _L_ /nsn (Jrhrr l'Ir nl,lns�. U7/ter Elcc.Insp, l'owh Irislr. Fe".. Llec. Insp. l,Pe: NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works, Fire,Sanitary Sewer District,School District,etc. . These ees are based on the relimina information available and are onLy an estimate Contact the De t or addn 7 info. FEE ITEMS (Fee Resolution 11-053 Eff" 711113) FEE QTY/FEE MIISC ITEMS Plan Check Fee: $0.00 0 # Deck/Deck Railing Suppl. PC Fee: (2) Reg. ® OT 0.0 hrs $0.00 $976.00 IDECKWOOD I Deck&Deck Railing PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. C) OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? ® Yes No $0.00 Advanced Plannin>?Fee: $0.00 Select a Non-Residential Building or Structure Strong Motion Fee: IBSEISMICR $3.10 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: $5.10 $976.00 TOTAL FEE: $981.10 Revised: 04101/2014