13060016 MY OF CUIP]E][BTM BUR LIlDRNG ]PIE][BMT
BUILDING ADDRESS: 8051 PRESIDIO DR CONTRACTOR:VALLEY HOME PERMIT NO:13060016
BUILDERS,INC.
OWNER'S NAME: WENDY TOBAGUS 3466 EDWARD AVE DATE ISSUED:08/12/2013
OWNER'S PHONE: 6507878582 SANTA CLARA,CA 95054 PHONE NO:(408)248-8000
LeY LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
11License Class Lic. REMODEL(E)KITCHEN (255 S.F.),REMOVE WALL
BETWEEN KITCHEN&DINING ROOM,REMOVE(E
)
Contractor VG (1E4A1gl & �to lo- 1 -1
WINDOW
II hereby affirm that I am licensed under the provisions of Chapter 9 IN DINING AREA,UPDATE LIGHTING FIXTURES IN
(commencing with Section 7000)of Division 3 of the Business&Professions FOYER
IIg
Code and that my license is in full force and effect. REV#2-REPLACE(E)200 AMP PANEL WITH(N)200 AMP
I hereby affirm under penalty of perjury one of the following two declarations: PANEL,SAME LOCATION-HSSYIEHDIO/1/2013
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:$60000
1 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:35611072.00 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 S'j['Ag'j[']ED
correct.I agree to comply with all city and county ordinances and state laws relating �� �� ll�®����®�PERMIT ISSUANCE ®�
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 IF ]LAS ALIL]ED INSPECTION.
ION.
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 ermit. Additionally,the applicant understands and will comply HDate:
with all non-p3 t c regul 'o s per the Cupertino Municipal Code,Section
9.18.
l RE-ROOFS:
Signature Date J 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
II hereby affirm that H 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). 1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. I will
II 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 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 l
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,Sec ti r 255 5,2553 and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this Q-r
permit is issued. Owner or authorized agent: Date:
I certify that in the performance of the work for which this permit is issued,I shall Irv, V
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,1 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
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
CITY OF CUPERTINO BUffLDING PERMIT
BUILDING ADDRESS: 8051 PRESIDIO DR CONTRACTOR:VALLEY HOME PERMIT NO: 13060016
BUILDERS,INC.
OWNER'S NAME: WENDY TOBAGUS 3466 EDWARD AVE DATE ISSUED:08/12/2013
OWNER'S PHONE: 6507878582 SANTA CLARA,CA 95054 PHONE NO:(408)248-8000
LICENSED CONTRACTOR'SSDEECLAARATION JOB DESCRIPTION: RESIDENTIAL 1 ❑
COMMERCIAL
License Class Lic.# �� !`(�O REMODEL L(E)KITCHEN(255 S.F.),REMOVE WALL
4y� , ` ]BETWEEN KITCHEN&DINING ROOM,REMOVE(E)
Contractor /' d/ �a'16tYl) Date Od l WINDOW IN DINING AREA,UPDATE LIGHTING
I hereby affirm that I am licensed under the provisions of hapter 9 FIXTURES IN]FORCER
(commencing with Section 7000)of Division 3 of the Business&Professions REV#I -ENLARGE KITCHEN WINDOW FROM 6030 TO 9030-
Code and that my license is in full force and effect. ISSUED 8/26/2013
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:$60000
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:35611072.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES jai'WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN
��®����O� PERMIT��������®�
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save ll8 SAY ST CALLED ENS]PIEC TEON.
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 Issue Date:
with all non-point source r n p the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature_t; Date 2 is �3 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 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 Munici Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505, a 5534.
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authorized agent: Dater
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 CO STRUCT[ON 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
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
CITY OF CUP EI[ TI NO
FEE ESTIMATOR-BUILDING DIVISION
AIDIDRESS: 8051 PRESIDIO DR DATE: 90/09/2013 REVIEWED BY: MELISSA
APN: IBP#: c oo I `VALUJATION: $0
*PERMIT TYPE: Electrical Permit PIAN CHECK TYPE: Alteration/Addition/ Repair
PRIMARY PENTAMATION
USE: SFD or Duplex PERMIT TYPE: 1 REAP
DWoRK REV#2 - REPLACE 200 AMP PANEL WITH NEW SAME LOCATION
SCOPE
APPLIANCE/EQUIP TYPE IEEE IID QTY UNITS
Services 1 ERT<200 100 Amps $47
TOTALS: $47.00
,Rech. Plon Check Phimb. Plan Check Elec.Plan Check 0.0hrs $
Afec•li. Perna!Fee: Phimb.Permit Fee: Elec.Permit Fee: PERMIT
Oilier Afech.Insp. 011ier Plumb Insp. C Other Elec.Insp. 0.0 rs $47.00
AIcch. Insp. Fee: Plumb. Insp.Fee: Elec.Insp.Fee:
NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer Dis School
District,etc). These ees are based on the prelimina information available and are onl an estimate. Contact the De t or addn in o.
FEE ITEMS(Fee Resolution 11-053 E,(f' 711113) FEE QTY/FEE MISC ITEMS
Plan Check Fee.:
SnPI)I.PC Fee
PME Plan Check: $0.00
Permit Fee:
SupPL Insj.)Fee
PME Unit Fee: $47.00
PME Permit Fee: $47.00
Constr-netion Tax:
Administrative Fee: IADAHN 0
Work Without Permit? 0 Yes 0 No
Advanced Planning Fees.-
Travel
ees.Travel Documentation Fee: ITRAVDOC $ 0
Strong Motion Fee: $0.00 Select an Administrative Item
Bldg Stds Commission Fee: $0.00
SUBTOTALS: $185.00 $0.00 TOTAL FEE: $185.00
Revised: 08/01/2013
CITY OF cCUPERTINO
FEE lESTEMATOR—BUILDING DIVISION
ADDRESS: 8051 PRESIDIO DR DATE: 08/26/2013 REVIEWED BY: MELISSA
AP1N: 356 11 072 BP#: 13060016 *VALUATIOIN: Iso
*PERMIT TYPE: Building Permit ]PLAIN CHECK TYPE: Alteration /Repair
PRIMARY SFD or Duplex PENTAMATIOIN 1GENRES
USE: I PERMIT TYPE: �
WORK REV# 1 - ENLARGE KITCHEN WINDOW FROM 6030 TO 9030 - ISSUED 8/26/2013
SCOPE
.Wec:li. Flan Cheek Plwnb,Plan Check Elec.Plan Check
htc:ch. Permit Fee: Plumb. Peimil Fee: Laec. Permit Fee:
Other Afech.Insp. OMer Plurch Insp. EJ 011ier Elec.Insp. Ll
Hoch. Insp,Fee: Plztmb. Insp. Fee: Elec. Insp.Fee:
]VOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,eta). These ees are based on the preliWina information available and are onL an estimate Contact the De t or addn'1 info.
]FEE ITEMS (Fee Resolution 11-053 Eff 711112) ]FEE QTY/FEE MISC ITEMS
Plan Check Fee: hourly Only? C)Yes ID No $0.00 2 hours Plan Check,Hourly
Suppl. PC Fee: C) Reg. 0 OT 0.0 hrs $0.00 $278.00 ISTPLNCK
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Fee: Reg. ® OT 0 0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Construction Tarr:
A.dtninistrative.Fee: 0
Work Without Permit? 0 Yes (E) No $0.00 E)
Advanced Planning Fee: $0.00 Select a Non-Residential
Travel Doculnentation Fees: Building or Structure
i
Strong Motion Fee: $0.00 Select an Administrative Item
Bldg Stds Commission Fee: $0.00
SUBTOTALS: $0.00 $278.00 TOTAL FEE: $278.00
Revised: 07/01/2013
BUILDING ADDRESS: 8051 PRESIDIO DR CONTRACTOR:VALLEY HOME PERMIT NO: 13060016
BUILDERS,INC.
OWNER'S NAME: WENDY TOBAGUS 3466 EDWARD AVE DATE ISSUED:08/12/2013
OWNER'S PHONE: 6507878582 SANTA CLARA,CA 95054 PHONE NO:(408)248-8000
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL D COMMERCIALE]
7
License Class Lic.# �lj REMODEL(E)KITCHEN(255 S.F.),REMOVE WALL
/
BETWEEN IKl['II THEN&DINING ROOM,REMOVE(]E)
Contractor ate WINDOW
I hereby affirm that lil.licensed under the provisions of Chapter 9 IN DINING AREA,UPDATE LIGHTING FIXTURES IN
(commencing with Section 7000)of Division 3 of the Business&Professions FOYER
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:$60000
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:35611072.00 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 STAl[t')<'IED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN
� �� S®DAYS ®�PERMIT
ISSUANCE ®�
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 DA yS OM]LAST CALLED)<NS]P
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 pe it. dditionally,the applicant understands and will comply Issued by: Date:
with all non-point ur lations p thCupertino Municipal Code,Section
9.18.
f RE-ROOFS:
Signature Date 1 2-[-3 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.
❑ ER-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). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. I will
II 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 MiWicipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections �65,2553 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Owner or authorized agent: Date:
I certify that in the performance of the work for which this permit is issued,I shall j
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 CONST UCTION 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 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 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
cCffT Y OF cCUPERTINO
FEE ES'ITMA'I'OR— BUILDING DIVISION
ADDRESS: 8051 PRESIDIO DR DA'T'E: 0610412013 REVIEWED BY: MELISSA
APN: 35611072 BP#: -VALIDATION: $60,000
*]PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
]PRIMARY SFD or Duplex PENTAMATION 1GENRE
USE: PERMIT TYPE:
WORD REMODEL E KITCHEN REMOVE WALL BETWEEN KITCHEN & DINING ROOM REMOVE E
SCOPE WINDOW IN DINING AREA, UPDATE LIGHTING FIXTURES IN FOYER& FAMILY RM. ADD
Ifech. Plan Check Plumb. Plan Check Elec..Plan(:heck
Mach. Permil Fee: Pbrmb. Permit Fee; Elec. Permit Feta:
Other hfec•h.Insp. a Other Plumb Insp, 01her Elec.Insp.
.1lec•h.Insp. Fee: Plumb. Insp. Fee: Elec.Insp.Fee:
NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc). These ees are based on the prelinWna information available and are onL an estimate. Contact the Dept./or addn'1 info,
]FEE ITEMS(Fee Resolution 11-053 EA.' 7/1/12) ]FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 0 # Close Existing Openings
Suppl. PC Fee: C) Reg. OT 5A hrs $0.00 $467.00 ICLOSOPNEX I Exterior Wall
PME Plan Check: $0.00 = s.f. Remodel,Kitchen(<=300 sf)
Permit Fee: $0.00 $600.00 1 1REMRESKIT
Suppl. Insp. Feer Reg. OT 0 0 hrs $0.00 = s.f. Remodel,Other
PME Unit Fee: $0.00 $534.00 IREMRESOTH
PME Permit Fee: $0.00
Constmetion .Tarr:
Administrative.Fee: Q
Work Without Permit? 0 Yes E) No $0.00 1 0
Advanced Planning Fee: $0.00 Select a Non-Residential G
Travel Documentation Fees: Building or Structure �
i
Strong Motion Fee: IBSEISMICR $6.00 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $3.00
SUBTOTALS: $9.00 $1,601.00 TOTAL FEE: $1,610.00
4
Revised: 04/29/2013