10070202 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10684 CARVER DR CONTRACTOR:GUR&JESSICA HOSHEN PERMIT NO: 10070202
OWNER'S NAME: GUR&JESSICA HOSHEN 10684 CARVER DR DATE ISSUED:01/28/2011
OWNER'S PHONE: 4088739530 CUPERTINO,CA 95014 PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG I—. ELECT r7 PLUMB r—
License Class Lic.#
MECH F RESIDENTIAL r— COMMERCIAL'
Contractor Date
I hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION:ADD SHED,ADD 2 CAR GARAGE 7 FRONT&SIDE
(commencing with Section 7000)of Division 3 of the Business&Professions EXPANSION(500SQ)&REMODEL 3 EXISTING BEDROOMS;
Code and that my license is in full force and effect. INCLUDES RE-ROOF(20SQ)&HAS STRUCTURAL-SANITARY IS
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.
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 Sq.Ft Floor Area: Valuation:$120000
permit is issued.
APPLICANT CERTIFICATION APN Number:37532014.00 Occupancy Type:
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 PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
Signature Date Issued Date i
OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that 1 am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signature of Applicant: Date:
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penalty of perjury one of the following three
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material.
Additionally,should 1 use equipment or devices which emit hazardous air
permit is issued. contaminants as defined b the Ba Area Air
y y Quality Management District I will
I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534.
Compensation laws of California. If,after making this certificate of exemption, tt
become subject to the Worker's Compensation provisions of the Labor Code,I t Owner` r uthorized agent: /
forthwith comply with such provisions or this permit shall be deemed revoked. Date: ( '
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
1 certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's
correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18• 1 understand my plans shall be used as public records.
Signature Date t�' 1 Licensed Professional
CITY OF CUPERTINO
ADDITION/REMODEL
CUPERTINO FEE SCHEDULE
APN# Date:
Is a 2° unit being added? Yes ❑ No ZI If yes, please fill out the permit hpplication for 2" unit.
Building Address:
b G r2 t Q I,v O .
Mailing Address (if different from building address):
Owner's Name: Phone# : _ ,� 0-73, 9_53L
� �
' d YL ) r SSi 7 .,
Contractor: Phone#:
9V1 36( 7
Cupertino Business License: State Contractor License#:
Contact: Phone#:
J e S5 (&g b sH�J Fax#:
Landscape Ordinance Compliance:
Landscape area in sq. ft. (includes all irrigated areas): Q�
If 2,500 sq. ft. or less, compliance with the Landscape Water-Efficiency Checklist is required.
If more than 2,500 sq. ft., a complete Landscape Project Submittal is required.
Compliance Method: ❑ Plant Type ❑ Water Budget
Building P 'rmit Info:
Bldg. [ Elect. [ - Plumb. [C] _ Mech. 9___-- Hillside ❑
Job Description:
Addition-What is being added?(Be Specific): �.� -,�T )qrV)>-r, o•,�
hQ,O S-f � 5j4£tJ
0S 2 ID' : , , FfioN ,� �
What is being remoKed (not including addition)?
� S ��' S�� '
tp 051-
Remodel Includes Re-Roof. Yes �No ❑ If yes list number of squares
Remodel Includes Structural: Yes No ❑
Do you have the pre-application planning approval? Yes Q No ❑
If yes, please provide a copy of your planning approval letter. Planners name: (10 <fw+%
Square Footnme
Addition: _ 40 — Porch:_ '?7 Dl -eek: /CE— Garage: Detached Attached , d-oo
Remodel: Kitchen Bath Other ,/J- 3
Type of Construction (Usage Class): Occupancy Type: -
1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, Q� Valuation: IS I?�o 6 a o
Please check this box if the project is a
Project Size: Express ❑ Standard Qf Large ❑ Major ❑ second-story addition ❑
Please complete relevant portion of the Green Building
Checklist & attach it to the application or if applicable, Green Building Points Achieved:
include in plan set & the sheet index.
Revised 05/18/10
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CITY OF CUPERTINO
ADDITON/REMODEL
I
CUPERTINO FEE SCHEDULE
I
Quantity Fee ID Fee Description Fee Group Permit Type
Sq Ft
ADDITIONS 1R3SFDADD
1PLLONGRNGR Long Range PL
Planning/Residential
lR31NSP Dwellings Inspections B j
1R3PLNCK Dwellings plan check B
1R3REPINSP Dwellings Repeat B
Inspection
1R3REPPLNC Dwellings Repeat Plan B
Check
1R3HINSP Dwellings Hillside B
inspection !
1R3HPLNCK Dwellings Hillside plan B
check
1R3HREINSP Dwellings Hillside B I
Repeat Ins ection
1R3HREPLNC Dwellings Hillside B
Repeat Plan Check I
1R3ALTINSP Dwellings Alternate B j
Materials Inspection
1R3ALTPLNC Dwellings Alternate B
Materials Plan Check
1PCESS Cesspool P
1PPRSEWG Ea. Private Sewage P
Disposal System
1 PRSEWER Sewers P r
I
1BPSPRINK Lawn Sprinkler/Backflow P
1BPWSVCS Main Water Service P
I
I
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE SeismicResidential B
I
I
I
1RER00FRES Residential Re-roof Each B
100 SF
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CITY OF CUPERTINO
ADDITON/REMODEL
CUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Group Permit Type
Sq Ft
DECKS 1R3SFDADD OR
1R3SFDREM
1DECKWOOD Deck(Wood)-Each B
(Each)
1 DECKRAIL Deck Railing-Each B
Each
GARAGES 1R3SFDADD OR
DETACHED 1R3SFDREM
1 GARDTW<=1 K Wood Frame up to B
1,000 SF each
1GARDTM<=1K Masonry up to 1,000 SF B
each
1BCONSTAXR Construction Tax Res
new detached garage)
PATIO'S OPEN 1R3SFDADD OR
1R3SFDREM
1PATIOWOOD Wood Frame up to 300 B
SF
1PATIOMETAL Metal Frame up to 300 B
SF
1PATIOOTHER Other Frame up to 300 SF B
PATIO'S CLOSED 1R3SFDADD OR
& SUN ROOMS 1R3SFDREM
1PATIOENCLW Enclosed Wood up to 300 B
SF
1PATIOENCLM Enclosed Metal up to 300 B
SF
1PATIOENCLO Other Enclosed Patio up B
to 300 SF .
1 COVPORCH Porch Covered-Each B
Each V
REMODELS 1R3SFDREM
1REMRESKIT Kitchen Remodel up to B (Deduct "$"for ea plan
300 SF check
1R.EMR.ESBAT Bath Remodel up to 300 B "
SF
1REMREOTH Other Remodel up to 300 B "
SF
CITY OF CUPERTINO
ADDITON/REMODEL
CUPERYINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Group Permit Type
Sq Ft
1REMRES2 Remodel Residential B
Greater than 1000 sq ft
1REMRES3 Remodel Residential B
Greater than 2500 sq ft.
1RER00FRES Residential Re-roof Each B
100 SF
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REMODEL PLNCK
i
ISTPLNCK(1-3 for Standard Plan Check B NOT FOR OVER THE
remodel) COUNTER PLAN CKS.
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WINDOW/SLIDING 1R3SFDREM
GLASS DOOR
1 WINREP Replacement windows B i
(ea 8 windows
1 WINNEWNSTR New Window (non- B
structural
1 WINMEWSTR New Window (Structural B
Shear Wall/Masonry)
1 WINBAYSTR Bay Window (Structural) B
SKYLIGHTS 1R3SFDREM
1 SKYL<10 SF Skylight less than 10 sf B
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1 SKYL>10SF Skylight greater than 10 B
sf or structural
1STAIRS Stairs-first flight/ea addt'l B
1 EPERMITFEE Electrical Permit Fee E
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1MPERMITFEE Mechanical Permit Fee M i
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1PPERMITFEE Plumbing Permit Fee P
i
1 ELCPLNCK Stand Alone Electric Pln E j
Ck hourl
1MECPLNCK Stand Alone Mechanical M j
Pln Ck(hourly
CITY OF CUPERTINO
ADDITON/REMODEL
CUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Group Permit Type
Sq Ft
1PLMPLNCK Stand Alone Plumbing P
Pln Ck(hourly)
1BCBSC Cal Bldg Standards B ALL PERMIT 'TYPES
Commission Fee
1BSEISMICRE Seismic Residential B
1TRAVDOC Travel & Documentation B
1BUSLIC Business License B
Green Building Plan Check
Index of Green Building Points/Categories
A. Category Example of an Index or Table of Green Plan Sheet or Page Points
Building Points Categories that must be
shown and referenced on the Project
Plans See below
B. Site 9. Install H.E. Irrigation, (details/spec)* L-1 2 points
11. Permeable Paving, Note L-1 2 points
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 points
D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, detail S-2 2 points
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 2 points
F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 points
5. Tankless W.H., (Note/Spec.) A-2 2 points
11. A 2500 Gal. Tank, (Note/Spec L-1 10 points
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 points .
H. Appliances 1, Energy Star Dishwasher, (Note/Spec.) A-3 1 point
3. Energy Star Refrigerator, (Note/Spec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
M TOTAL POINTS1 40 points
Plan Review Process Work Book Page-12-Revised 3/25/08
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: DATE: REVIEWED BY:
APN: BP#: / �� *VALUATION: 1$120,000
%PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Addition / Repair
PRIMARY SFD or Duplex OVER THE APPLICATION 'I R3SFDW
USE: COUNTER. 0 Yes No
MECHANICAL ® Yes Q No PLUMBING Yes Q No ELECTRICAL Q Yes (F)No
as
O �
3 �
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR.
R-3 (Custom) II-B,111-B,IV,V-B 590 $2,349.00 IR3PLNCK $1,474.00 IR3INSP
TOTALS: 590 $2,349.00 $1,474.00
,kle:ch. Flan CheckFT I Plumb.Plan Check Llec. Plan Check
h-fech. Per??)it Fee: Plwnh.Permit Fee: Etec.Permit Fc'e:
Other Afech.Insl>• Other Pbnnh. h+sp. Othar LYec. Insp.
NOTE: Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 0.9-051 Eff.• 7%1i2D FEE QTY/FEE MISC ITEMS
Plan Check Fee: $2,349.00 1,536 s.f. Remodel, Other
Suppl. PC Fee: 0 Reg. () OT 0.0 1 hrs $0.00 $4,323.00 lREMRES2
PME Plan Check: $0.00 0 # Shed
Permit Fee: $1,474.00 $379.00 lSHED
Suppl. Insp. Feer Reg. 0 OT0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
C.'onslruclion Tux
Acoustical Fee: Q Yes Q No $0.00 0
Work Without Permit? Q Yes Q No $0.00 0
Plannin g Fee: PLLONGRNGR $76.70 Select a Non-Residential 0
Trove/Doc•urneatation Tees: Building or Structure 0
d
Strong Motion Fee: IBSEISMICR $12.00 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $5.00
SUBTOTALS: $3,916.70 $4,702.00 TOTAL FEE: 1 $8,618.70
Revised: 7/27/2010