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14020047�l CITY OF CUPERTINO BUILDING PERMIT 13UILDING ADDRESS: 7670 ORANGE BLOSSOM DR CONTRACTOR: CRILLY BRIGID PERMIT NO: 14020047 TRUSTEE OWNER'S NAME: CRILLY BRIGID TRUSTEE 7670 ORANGE AVE DATE ISSUED: 02/06/2014 OWNER'S PHONE: 4087465754 CUPERTINO, CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL F] COMMERCIAL KITCHEN REMODEL 80 SQ FT, REMOVE PORTION OF License Class Lic. # THE BEARING WALL BETWEEN KITCHEN AND LIVING ROOM Contractor Date 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. 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: $7000 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 36611093.00 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT ORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 1 AYS OF P IT 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 FR LAST CA 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 Issued by: Date. granting of this permit. Additionally, the applicant understands and will comply 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, I agree to remove all new materials for inspection. OWNER -BUILDER DECLARATION Signature of Applicant: Date: 1 hereby affirm that I 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) 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, 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 complianc ' h the Cupertino Municipal Code, Chapter 9.12 and 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 the Health & Safety Code, c ' ns 25505, 25533, and 25534. Owner or authorized agent: Date: permit is issued. 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I 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 pedditionally, the applicant understands and will comply with all non -point utJ rc regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. 1W L Signature Date 2' q0, CUPERTINO CONSTRUCTION PERMIT APPLICATION U_OA� COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(@cupertino.org�4�L 71 —7—T M A n,mnio n A I Tru A T11 -)M TI n RFVICICIN / DF,FFRRED ORIGINAL PERMIT # BldgApp_2011.doc revised 06/21/11 PROJECT ADDRESS _� S 0 F� I APN # 11 6q3 E Lc PHONE t E-MAIL, c air t>z I�:C�nc�., a uk - 2s RESS rET CITY, STATE, ZIP FAX AME PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK /. EXISTING USE PROPOSED USE CONSTR TYPE 1 # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA 136, REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES \11, BEING ADDED? []NO ADDITION? []NO 7 PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED BV-, TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? []NO By my signature below, I certify to ch of the following: I am the property owner or authorize to act on property owner's behalf. I have ead this application and the information I have o is correct. I have read the Description of Work and verify it Is curate. I agree to comply with all applicable local ordinances and state laws relating to buil ' g con ruction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL TON REQUIRED YLnx CHECK rYrF ROUTING SLIP ❑ OVER .Illi COUNTER ❑_ BI 1A)ING PLAN REVIEW New SFD or Multifamily dwellings: Apply for demolition permit for------- existing building(s). Demolition permit is required 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. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FF.F ESTIMATOR — BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Pire, Sanitary sewer District, scnoot n..r.., i ni, Th— Fooc oro hncod nn tho nroliminary information available and are only an estimate. Contact the Dept for addh 7 info. FEE ITEMS (lee Resolution 11-053 UL 71LIL31 ADDRESS: 7670 orange ave DATE: 02/06/2014 REVIEWED BY: Mendez APN: BP#: //4/0'.,2 Qa� "VALUATION: 1$7,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: p PENTAMATION 1 R3SFDREM PERMIT TYPE: i WORK I kitchen remodel 80 sq ftremove portion of the bearing wall between kitchen and living room SCOPE NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Pire, Sanitary sewer District, scnoot n..r.., i ni, Th— Fooc oro hncod nn tho nroliminary information available and are only an estimate. Contact the Dept for addh 7 info. FEE ITEMS (lee Resolution 11-053 UL 71LIL31 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 80 s.f. $626.00 Remodel, Kitchen (<=300 sf) 1REMRESKIT Suppl. PC Fee: (j) Reg. Q OT0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? ()Yes Q No $0.00 Suppl. Insp. Feer Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 1 0 Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure i .{ Strong Motion Fee: 1BSEISMICR $0.70 2.0 hrs $278.00 Inspections ISTINSP Inspection, Hourly Bldg Stds Commission Fee: IBCBSC $1,001 SUBTOTALS: $1.70 $904.00 TOTAL FEE: 1 $905.70 Revised: 01/15/2014 CUPERTINO July 30, 2014 BUILDING PERMIT / APPLICATION EXPIRATION LETTER COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-7606 • building@cupertino.orq CRILLY BRIGID TRUSTEE 7670 ORANGE AVE CUPERTINO CA, 95014 SUBJECT: BUILDING PERMIT EXPIRATION LETTER Site Address: 7670 ORANGE BLOSSOM DR Building Permit Application #: 14020047 Expiration Date: 2/6/2014 EXPIRED PERMIT APPLICATION: According to our records, a building permit has not been issued for your permit application (noted above). Since an extension was either not requested or not granted, your construction permit application has expired. The permit application is null and void and you have 30 days to pick up your plans and documents or they will be recycled. The permit application will be voided in our Permit Tracking System and all plans and documents pertaining to the permit application will be recycled. EXPIRED BUILDING PERMIT: Your Building Permit (noted above) has expired. Please contact our office within 10 business days to let us know your plan to re -activate the permit. Discretionary Planning Approvals are also subject to expiration. Please refer to the Planning Department to determine if a new planning reviewprocess is required. A code enforcement case will result if a construction site is left abandoned and unsafe. Please review your following options to re -activate your building permit: Construction has been suspended or abandoned less than one year. Once a permit expires, a request in writing to reactivate your building permit may be submitted, provided no changes have been made or will be made in the original plans and specification for such work. A processing fee plus one-half of the permit fees at the current rates will be due upon submittal of the request. The request will not be granted if any codes or any other pertinent laws or ordinances have changed subsequent to the date of application. Construction has been suspended or abandoned more than one year or codes have changed subsequent to the date of application. A request in writing to reactivate your building permit may be submitted. Valid reasons shall be cited for the delays on your construction schedule with a justifiable cause demonstrated to the Building Official. The request, if granted, will be for a period of not more than 180 days. A processing fee, progress inspection fee and full plan review and permit fees will be due upon submittal of the request. For projects that require plan review, six (6) new sets of plans designed to meet current code are required to be resubmitted for review. An exploratory inspection will be required to determine if any part of the existing construction can maintain vested rights with Building Codes standards in effect at the time the original building permit was issued. Sincerely, Patricia Garcia 408.777.3228 Building Department patriciag_(&Mertino.org Expiration Letter. doc revised 05128/13 CUPERTINO OWNER -BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building aalcuoertino.org Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SITE ADDRESS (� APN BP#�j���Ov! � 7 T OWNER NAMi-EEtt_� OWNER ADDRESS DESCRIPTION OF WORK: c� We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS: Please read and initial each statement below to signify you understand or verify this information.) -S- 1. 1 understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner - Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. amu. 2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. TL- 3. 1 understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. i� 4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. s i 5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. J� 6. 1 understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. -J'LL_. 7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. Ji- 8. 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. 01+'7ie7Builde7Fon772010.doc revised 04/14/10 -Li §. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or v✓ww.cslb.ca.gov for more information about licensed contractors. ,r 10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the site address listed above. -v- 11. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. -:!� 12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS: Please complete the following construction lending agency information.) hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other veriticatior� ptable to the city may be required to be presented when the permit is issued to verifv the orooerty owner's signature'. l Property Owner's Signature: Date: Date: EV4� _/A, t �Z --------------------------------------------------------------------------------------------------------------------------------------------- (NOTE: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: 014,'T1e7Bifildel Foi-771 2010.doc revised 04/14110