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07120144
PERMIT # 0 12 ('�)- DATE PROJECT cl-o-A V-- t ,/A, T � qg �,, ADDRESS 0 kLo wLe-r t--�61C V-A a Vt , --)-7 A - 1 APPLICANT V11CWki QUCO-�--- OWNER Ville, Senn ASS APN# 32io 09 0J 1P. 7A H RES. (LVNG) (GARAGE) COMM. SQ. FT. (NEW) T.I. SQ.FT. RES. REMODELJ�d CONTACT WIM6141 OUCb-% PHONE# Ll Sb 9251 3`i5-7 FAX (15b R31 3W7 VALUATION (Cost of Project) REQD. PAID NOTES: CONSTRUCTION TAX (Y) (I) SCHOOL FEES (Y) (I) HOUSING MITIG (Y) (I) HEART OF THE CITY (Y) (IV) 1 ISSUED BY DATE TOTAL FEES s. i I 9 " I I vii, mILYM tA ©_-- __-- __-. . ®_-- __-- __-- APN# 32io 09 0J 1P. 7A H RES. (LVNG) (GARAGE) COMM. SQ. FT. (NEW) T.I. SQ.FT. RES. REMODELJ�d CONTACT WIM6141 OUCb-% PHONE# Ll Sb 9251 3`i5-7 FAX (15b R31 3W7 VALUATION (Cost of Project) REQD. PAID NOTES: CONSTRUCTION TAX (Y) (I) SCHOOL FEES (Y) (I) HOUSING MITIG (Y) (I) HEART OF THE CITY (Y) (IV) 1 ISSUED BY DATE TOTAL FEES s. i BUILDING DIVISION P RNM STEAD RD, BLDG 7 A -HI TBD - TO BE DETERMINED OWNER'S NAME: VS II A CALIFORNIA LIMITED ARCWIE(TMGINEEC j O p LICENSED CONTRACTOR'S DECIA AMN u 1 booby alarm chat 1 am licensed under provisions of Chapter 9 (commencing = with Section 700% of Di n 3 of the Business and Pro[easia�Code. army license is a' ySSy in full fora and efrf 'fin Z License Lie. #. 9 Dam oCCL Contractor k NJ go ARCHrlWn DECLARA710 i 1 understand my plan shell be used as public records gyri 5 C L cenacd Professional OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Lar for the is C O following mason. (Section 70313. Business and Professions Coder: Any city or county I S V which regnirce a permit to construct. alter. improve, demolish. or repair any pructurc Z �^ prior to its issumncc, also requires the applicant for such permit to file a signed statement < that be is licensed pursuant to the provisions of the Conuactoes License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Businese and Professions Code) or S that he is exampt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five humped dollars MM ❑ I, as owner of the gopesty. or my employees with wage as their sole compensation, will do the work. and the structure is not intended or offered for sale (Sec. 7044. Business and Pmfessions Code: The Contractor's I low- Law does not apply to an owner of property who builds or improves therem and who does such wort himself orthrough his owe employees, MvWed that such improvements are not intended or offered for sale. If. however. the building or imptovemem is sold within one year of completim the owner - builder will have the bodes of proving that be did not build or improve for purpose of sale.} ❑ L as owner the property. am exclusively contracting with licensed contractors to mnratrtx l the (Sec. 7044. Business mad Professions Code:) The Contractor's Li- lenR Law d apply to an owner of psmpery who builds or improves thereon. and who con projects with a conuastor(s) licensed pursuant m the Contractor's L.icenae ❑ tun B R PPC for this maws Owner Due I F75- 5 COMPENSKCION DECLARATION I berebyAffirm order penalty of perjury we of the following declarations: ❑ 1 hate mad win maintain a Corti ime of Consent to self-Imare for Worker's Compen- sation, as provided for by Section 3700 of the Libor Code, for the performance of the wort for which this permit is issued. ❑ 1 have and will maintain Worker's Compensation Imstuma, as required by Section 3700 of the Libor Code, for the performance of the wort for which this permit is Laced. My W am emiatio Insurance carrier and Policy num—off ac Cartier. Policy Na: �I C"P& CERTIFICATE OF 00vIPIION FROM WORKERS COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($I00) or lose.) 1 certify that In the performance of the wort for which this permit is Wood l shorn not employ any person In any manner m as to become subject to the Workrw Compensation Laves of California. Dare AppOcaot NOTICE TO APPLICANT. If, after mating this Certificate of Exemption, you should become subject to the Worker's Compensation previsions of the Labor Code. you must O O forthwith comply with such provisions or this permit shall be deemed mvokcd "~ CONSTRUCTION LENDNG AGENCY (-•u 1 hereby affirm that there is a construction lending agency for the performance of (Yi .� the wort for which this permit is issued (Sec. 3097, Civ. C.) W Q Lender's Name �+ Z Leader's Address U O 1 certify that I have need this application and state that the above imformetion is p4 — corrccL I aper to empty with all city and county ordinances and state Inn relating to O building construction. and hereby authorize representatives of this city to cater upon the v above- property for Inspection puq— (Waftnee to ave, indemnify and keep harmless the City of Cupertino agadmt t•r to ilabilldmj Is. emu and expenses which may In any way acme against aid City U 7 Ise the gr=Wog of this poral. rte• AP U ERSTANDS AND WILL COMPLY WITH ALL NON -POINT S ONS. Signs = tractor Date HMATERIALSARDOUS MATERIALS DISCLOSURE Will applicant or future building occupant store or hulk hazardous material as nkflned by the Cupertino M Code, Chapter 9.12. and the Health and Safety Code, section 25532(+)7 ❑ Yes No Will the applicant or future building occupant use equipment or devices; which emit hazardous air contaminants fined by the Bay Area Air Quality Management District? ❑lies No 1 read the hazardous materials mquiremmu render Clepier 6.95 of the Califor- nia Health ctyCode. Swtimm 25505.25533 uW 2.5534.1 understand tlm if ibe building dao have a twnt. Wal It is my responsibility to notify dna occupant of the mg must be met prior to iss...� of a Certificate of Occupancy. Owner or d agent Dae REMODEL -NEW DECK RAILS, Sq. Issued by: Re -roofs Type of Roof Area anuses i tvu. 07120144 PMXMIT EWE DATE 07/08/2008 SANITARY NO. CONTROL NO. BUTLDINO PERMIT INFO BLDG ELECT PLUMB MECH Required Inspections I =�_77419ri Tyne Date I-/— OrG 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. Signature of Applicant Date . All roof coverings to be Class 'V' or better v r CITY of CUPEkTINO CITY OF CUPERTINO ADDITION/REMODEL PERMIT APPLICATION FORM O 0/Y�4 APN # 3Z` — 04 — O 6(* Date:!/cC�-�b�i✓ Building Address: .20s00 o tom. Mailing Address (if different from building address): 19oo SotA� �4ftksr. tear Svc Is0i 5r+h gJ03 Owner's Name: C,% C,;,vt q Phone # : Contractor: Phone #: Q WA—Pbk- �7�li�C Fax #: SIO 5Z5—(>SS5 Contractor License #: Cupertino Business License #: T5D Contact: Phone #: i i 4VMle'` uk&Ct i Fax #: V 50 9 31- 34+51 Building Permit Info: Bldg. / Elect. [� Plumb. [� Mech. Hillside ❑ Job Description: What is being added? AAA%A4%A41d1� woAvvveh44jve' f bvA kA\--\ �� w�-}in � pP �` c•�.bk...1ec-�cl �—,-� � �tv�,M,bi �,�. What is being remodeled?�,��, rte,►' S I 5'1� 1i1O•• 1�S aWJ�-- % Remodel Includes Re -Roof: Yes No [/ If yes list number of squares Remodel Includes Structural: Yes No ❑ Square Footage: c i rj6T Garage: Addition: Remodel: Porch: Deck: Other: S Type of Construction (Usage Class): Occupancy Type: 1 FR, 11FR ❑ 11, 111, V-lHR ❑ 11, 111, 1V V -N [� 6 Valuation:/� 0 % Please check this box if the project is a � second -story addition ❑ Green Building Check list must be completed and attached to the plans. Green Building Points Achieved: ***For Office Use Only*** Over -the -Counter ❑ CITY OF CUPERTINO ADDITION/REMODEL CUPEk INO FEE SCHEDULE Quantity Sq Ft Fee ED Fee Description Fee Group Permit Type ADDITIONS 1R3SFDADD PLLONGRNGR Long Range Planning/Residential PL 1RKNSP Dwellings Inspections B 1R3PLNCK Dwellings plan check B 1R3REPINSP Dwellings Repeat Inspection B 1R3REPPLNC Dwellings Repeat Plan Check B 1R3HINSP Dwellings Hillside inspection B 1R3HPLNCK Dwellings Hillside plan check B 1 R3HREINSP Dwellings Hillside Repeat Inspection B 1R3HREPLNC Dwellings Hillside Repeat Plan Check B 1R3ALTINSP Dwellings Alternate Materials Inspection B 1R3ALTPLNC Dwellings Alternate Materials -Plan Check B 1PCESS Cesspool P 1PPRSEWG Ea. Private Sewage Disposal System P 1 PRSEWER Sewers P 1 BP SPRINK Lawn Sprinkler/Backflow P 1BPWSVCS Main Water Service P 1BSEISMICRE SeismicResidential B DECKS 1R3SFDAD OR 1R3SFDRE 1DECjK00 Deck (Wood) B f �� 1DE ( Deck Railing B l< J CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE Quantity Fee.1D Fee Description Fee Group Permit Type Sg Ft GARAGES 1R3SFDADD OR 1R3SFDREM 1 GARDTW<=1K Wood Frame up to B 1,000 SF 1GARDTM<=1K Masonry up to 1,000 B SF PATIO'S OPEN 1R3SFDADD OR 1R3SFDREM IPATIOWOOD Wood Frame up to 300 B SF 1PATIOMETAL Metal Frame up to 300 B SF 1PATIOOTHER Other Frame up to 300 B SF PATIO'S CLOSED 1R3SFDADD OR 1R3SFDREM 1PATIOENCLW Enclosed Wood up to B 300 SF 1PATIOENCLM Enclosed Metal up to B 300 SF _ 1PATIOENCLO - -- - -- - -- Other Enclosed Patio . UP to 300 SF 1 COVPORCH Porch Covered B 1REROOFRES Residential Re -roof B Each 1.00 SF REMODELS 1R3 SFDREM 1REMRESKIT Kitchen Remodel up to B 300 SF 1REMRESBAT Bath Remodel up to B 300 SF 1 REMREOTH Other Remodel up to B 300 SF REMODEL PLNCK 1 STPLNCK Standard Plan Check B NOT FOR OVER THE COUNTER PLAN CKS. 3 of 3 CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE �A a,+T�L e 4 of 3 M Quantity Sq Ft Fee ID Fee Description Fee Group Permit Type WINDOW/SLIDING 1R3SFDREM GLASS DOOR 1 VIE REp Replacement windows (ea 8 windows) B 1 W`DTNEWNSTR New Window (non- structural) B 1WU,4 V WSTR New Window (Structural Shear WalUMasonry) B 1WINBAYSTR Bay Window (Structural) B 1BUSLIC Business License B �A a,+T�L e 4 of 3 M