12110034 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20278 PINNTAGE PY CONTRACTOR: PERMIT NO:12110034
OWNER'S NAME: YOON HO Y 1{ DATE ISSUED:11/06/2012
OWNER'S PHONE: t >731,c - PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION
,�+� c� BUILDING PERMIT INFO: BLDG ELECT" PLUMB
License Class Lie.# ,r/S L� !
MECH RESIDENTIAL F COMMERCIAL
Contractori_v t S L—C4c ate
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REMODEL KITCHEN(170 SQFT)AND THREE(3)BATHS
(commencing with Section 7000)of Division 3 of the Business&Professions (95
Code and that my license is in full force and effect. SQFT);NON-STRUCTURAL
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
permit is issued. Sq.Ft Floor Area: Valuation:$30000
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:36947026.00 Occupancy Type:
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, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature_ f� (c, � � Date t/- 107— 2fi'fZ Issued by: Date:
❑ OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(See.7044, inspection.
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date:
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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
performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Safety Code,Section 25532(a)should I store or handle hazardous material.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I must
forthwith comply with such provisions or this permit shall be deemed revoked. O ner or authorized gent:
7", i'G— Date-- — 20 (Z
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
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 I hereby affirm that there is a construction lending agency for the performance of mrk's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
20278 pintage park way DATE: 11/06/2012 REVIEWED BY:
PN: BP#: ��j *VALUATION: $30,000
q.. kADDRESS:
T TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY SFD or Duplex PENTAMATION 1 R3SFDREM
USE: PERMIT TYPE:
A
WORK remodel kitchen and 3 baths non structural.
SCOPE
Wech.Plan Check Plmrr b.Plan Check Dec_Plan Check
iLlech. Permit p"ec Plumh.Permit Fee: Flec. Permit fee:
Other Mch.hssp- Other Plumb Inst. Ocher Elee.Insp.
F-1 --t_
,Ikch.Insp.Fee: Phrmb. 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.). Thesefees are based on the prefinmdina information available and are only an estimate- Contact the Dept./or addn'l info,
FEE ITEMS (Fee Resolution 11-053 E . 7/1/12) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 170 s.f. Remodel,Kitchen(<=300 sf)
Suppl.PC Fee: Q Reg. ® OT 0.0 hrs $0.00 $600.00 1REMRESKIT
PME Plan Check: $0.00 95 s.f. Remodel,Bath(<=300 sf)
Permit Fee: $0.00 $600.00 LMA RESBAT
Suppl. Insp.Fee:Q Reg. Q OT0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Coilslruction Tax:
Work Without Permit? 0 Yes (j) No $0.00 E)
Advanced Planning Fee. -Residential$0.00 Select aNon
Tr mvl Do£:z.i:;7entatior- Fees: Building or Structure 0
i
Strong Motion Fee: IBSEISMICR $3.00 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC 1 $2.00
1 1
SUBTOTALS: 1 $5.001$1,200.001 TOTAL FEE: 1 $1,205.00
Revised: 10/01/2012
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE• CUPERTINO, CA 95014-3255
CUPERTINO (408) 777-3228• FAX(408)777-3333•building(E)cupertino.Org
❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT tt
PROJECT ADDRESS _ _ APN 4 I k�
2e L P � �9 2 V w �` sF I
OWNERNAMEt. PHOE�66 A/
FAX
CONTACT NAME PHO E- L
STREET ADDRESS CITY,STATE, ZIPFAX
iJ- ,9 /--/J' S Z � d ) 6G 2L06 "
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT �-CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME �✓D7 E �fL 5 L�l F� LICENSE NUMBER LICENSE TYPE BUS.LIC
COMPANY NAME E-MAIL `' FAII
SET ADDRESS CITY,STATE ZIPPH_y t4LL 44V O ll
'i� /l� mi
ARCHITECT/ENGINEER NAME E .. LICENSE NUMBER BUS.LIC k
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK
G G c 1W7.a, ic t,,C,:LI' 4A& L
Z ((� l 2 G2Z 7 -c (,a1- lG 7 tel TGtl l�''/
EXISTING USE PROPOSED USE CONSTR.TYPE R STORIES
USE TYPE OCC. SQ.FT. VALUATION(S)
E)GSTG NEW FLOOR DEMO TOTAL y P
AREA AREA AREA NET AREA ,Yf p ,7 /0, .:'3
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL AREA i d REMODEL AREA
PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH
[]ATTACH
'DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES
BEINGADDED? ❑NO ADDITION? []NO
PRE-APPLICATION r_1 YES IF YES,PROVIDE COPY OF IS THE BLDG AN El YES RECEIVED-BY ' TOTAL VALUATION:
PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO - - 4,✓ r
.". `
By my signature below,I 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 laws relating to buil ing construction. I authorise representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: v (/U Date:
SUPPLEMENTAL INFOR,4ATION REQUIRED
PLAN CHECK TYPE ROUTING SLIP `s
Lire
New SFD or Multifamily dwellings: Apply for demolition permit for o� copi\TEtt i ❑ BUILnIxGPLnrr xEVIEW.
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. ❑ E�REss PLANNINGPLAxRE«w
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure =❑ sTANAARD ❑ PUBLICwoRrs
form if any Hazardous Materials are being used as part of this project.
LARGE ❑ FIRE DEPT
_Copy of PIanning Approval Letter or Meeting with Planning prior to
submittal of Building Permit application.
`❑ DIAJOR ❑ SAI4ITARYSERERDISTRICT
.ENViRONl•1ENIALHEALTH
Bldgr4pp_2011.doc revised 06/21/11
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P E RT I ® Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: 2cqZ7q, A -- PERMIT# -
OWNER'S NAME: cpA PHONE# "
GENERAL CONTRACTOR: q b i/ • L Z BUSINESS LICENSE#
ADDRESS: 26 ®1_ CITY/ZIPCODE:
*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 VE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
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
Owner/Contractor Signature Date
ADDITIONAL CODE REQUIRMENTS
Energy code mandatory lighting measures:
1. All permanently installed high efficacy luminaires shall be switched separately,from low efficacy
luminaires. (150(k)(7))
2. Permanently installed lighting in Kitchens shall be high efficacy luminaires. Up to 50%of the
wattage of permanently installed lighting in kitchens may be in lights that are not high efficacy.
(150(k)(8))
3. Permanently installed luminaires in bathrooms,garages,laundry rooms and utility rooms shall be
high efficacy luminaires OR are controlled by an occupant sensor(s)certified to comply with Section
119 that does not turn on automatically or have an always on option. (150(k)(10))
Plumbing plan notes:
4. Water closets shall have an average water consumption of not more than 1.28 gallons per flush. (CPC
402.2)
5. Shower heads shall have a water flow not to exceed 2.5 gallons per minute. (CPC 402.1.1)
6. Faucets in kitchens,wet bars,lavatories, laundry sinks, etc shall have a water flow not to exceed 2.2
gallons per minute. (CPC 402.1.2)
7. Shower stalls shall have a clear interior finish area of 7.1 sq. ft. and be able to accommodate a
minimum 30 inch circle at the threshold level. These clearances shall be maintained up to a height of
70 inches above shower drain. (CPC 411.7)
8. Shower compartments and walls above bathtubs with installed shower heads shall be finished with a
smooth,nonabsorbent surface to a height not less than 72 inches(6 ft). (CRC R307.2)
9. The maximum hot water temperature discharging from the bathtub,shower and whirlpool bathtub
filler shall be limited to 120 degrees Fahrenheit. The water heater thermostat shall not be considered
a control for meeting this provision. (CPC 414.5&418.0)
10. A 30-inch clear width for water closet compartment and 24 inch clearance in front of water closet.
(CPC 407.5)
Electrical Plan Notes:
11. The installation of smoke alarms in all of the following areas shall be provided: (8314.3)
a. On the ceiling or wall outside of each separate sleeping area in the immediate vicinity of
bedrooms.
b. In each room used for sleeping purposes.
12. The installation of carbon monoxide alarms in the following areas shall be provided: (R315.1)
a. Approved carbon monoxide alarms shall be installed outside of each separate sleeping area in
the immediate vicinity of the bedrooms and on every level including basements in dwelling
units that have fuel-fired appliances or attached garages.
13. A minimum of two 20 amp small appliance branch circuits shall be provided for all receptacle outlets
in the kitchen, dining room,pantry,or other similar areas. (CEC 210.11(C)(1))
14. At least one 20 amp branch circuit shall be provided to supply bathroom receptacle outlets. Such
circuits shall have no other outlets. (CEC 210.11(C)(3))
15. In every dwelling unit,fixed appliances such as food waste grinders, dishwashers,washing machines,
dryers,laundry tray locations,built-in refrigerators or freezers,furnaces,AC units,built-in heaters or
any other fixed appliance with a motor of 1/4 h.p. or larger shall be on a separate 20 amp. branch
circuit.
16. All receptacles in bathrooms,garages,accessory buildings, outdoors, crawl spaces,unfinished
basements,kitchens(where receptacles serve counter top surfaces), laundry,utility,wet bar sinks
(within 6 feet of the edge of the sink), shall have ground-fault circuit interrupter(GFCI)protection.
(CEC 210.8)
17. In all areas specified in 210.52,all 125-volt, 15-and 20- ampere receptacles shall be listed tamper-
resistant receptacles. (CEC 406.11)
ResKitBathPolicy_2012.doc revised 09/01/12
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