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11030069CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10101 0gANGE AVE CONTRACTOR: TBD - TO BE DETERMINED PERMIT NO: 11030069 OWNER'S NAME: PHONE NO: : WLICENSED CONTRACTOR'S DECLARATION r r- (— ELECT 2 License Class_ Lic. N BUILDING PERMIT INFO: BLDG PLUMB r r r MECH RESIDENTIAL COMMERCIAL Contracto 6%mv,51)ate I hereby affirm that I am licensed under the provision of C apter 9 JOB DESCRIPTION: REMODEL EXISTING KITCHEN(200SQFT),INCLUDES (commencing with Section 7000) of Division 3 of the Business & Professions LIGHTING(ELECTRICAL/ MECHANICAL/PLUMBING); Code and that my license is in full force and effect. 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 Sq. Ft Floor Area: Valuation: $11500 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION APN Number: 35716147.00 Occupancy Type: I certify that I have read this application and state that the above infoi correct. I agree to comply with all city and county ordinances and state elating 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 grantin permit. Additionally, the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. wit int source re ulations per the Cupertino Municipal Code, Section 916. Si Date 10 W( Issued bye„ Date:��/C._/� re OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I 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 1, 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. I 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. permit is issued. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued, I shal I ntain 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 H Ith & Sa Code, Sections 25505, 25533, and 25534. 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 in Date: forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I 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 Tiftkand expenses which may accrue against said City in consequence of the g of this permit. Additionally, the applicant understands and will comply ARCHITECT'S DECLARATION w. all non-point source regulations per the Cupertino Municipal Code, Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional -"-- 4 CITY OF CUPERTINO BUILDING PERMIT DATE BUILDING ADDRESS: 10101 ORANGE AVE OWNER'S NAME: ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. tl Contractor Date 1 hereby affirm that 1 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. 1 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. APPLICANT CERTIFICATION I certify that I 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 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. CONTRACTOR: EUROPEAN CABINETS BY PERMIT NO: 11030069 DESIGN *64 SAN ANTONIO RD DATE ISSUED: 03/14/2011 PALO ALTO, CA 94303 PHONE NO: (650) 918-9494 BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r MECH F RESIDENTIAL F COMMERCIAL F JOB DESCRIPTION: REMODEL EXISTING KITCHEN(200SQFT),INCLUDES LIGHTING(ELECTRICAL/ MECHANICAL/PLUMBING); NON-STRUCTURAL 3/29/11 -REV# 1 -REVISE STRUCTURAL WALL BETWEEN KITCHEN & DINING- REVtII ISS'D OVER COUNTER Sq. Ft Floor Area: I Valuation: $1.1500 APN Number: 35716147.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Signature Date Ilssued by: ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). 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 Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 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 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 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. APPLICANT CERTIFICATION 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, costs, and expenses which may accrue against said City in consequence of the 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. Date: RE -ROOFS: 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 Appl Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(x) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: Date: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of wrk's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I I understand my plans shall be used as public records. Signature Date Licensed CITY OF CUPERTINO BUILDING PERMIT a BUILDING ADDRESS: 10101 ORANGE AVE CONTRACTOR: EUROPEAN CABINETS BY PERMIT NO: 11030139 DESIGN OWNER'S NAME: PALO ALTO, CA 94303 PHONE NO: (650) 918- 4 ❑ LICENSED CONTRACTOR'S DECLARATION r F r BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class_ Lie. # I—� ���� � � g�r� 1Y{rK. Contracto � to "! � � � METH RESIDENTIAL� CO RCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: REVISE STRUCTURAL LL BETWEE HEN & (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. DINING 1 O 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: $4500 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. APN Number: 35717 571 47.00 Occupancy Type: APPLICANT CERTIFICATION 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs, an penses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. gr g of is permit. Additionally,, the applicant understands and will comply poin4sour�ce� ions per the Cupertino Municipal Code, Section �7 Issued b �-- Date: J' ( 4.41 ❑ OWNER -BUILDER DECLARATION RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection, I agree to remove all new materials for the following two reasons: inspection. 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, Signature of Applicant: Date: Business & Professions Code) 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: HAZARDOUS MATERIALS DISCLOSURE I have and will maintain a Certificate of Consent to self -insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation, as provided for by Section 3700 of the Labor Code, for the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & 1 have and will maintain Worker's Compensation Insurance, as provided for by Safety Code, Section 25532(a) should I store or handle hazardous material. Section 3700 of the Labor Code, for the performance of the work for which this Additionally, should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 1 certify that in the performance of the work for which this permit is issued, I shall Safety Code, Sections 25505, 25533, and 25534. 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, l become subject to the Worker's Compensation provisions of the Labor Code, I must Date`I forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION 1 hereby affirm that there is a construction lending agency for the performance of wrk's certify that 1 have read this application and state that the above information is for which this permit is issued (Sec. 3097, Civ C.) correct. I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save Lender's Address 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 ARCHITECT'S DECLARATION with all non -point source regulations per the Cupertino Municipal Code, Section 1 understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date • • C FM -7 - CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION NOTE: These fees are based on the oreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 09-051 Eff 7;1/10) ADDRESS: 10101 orange ave. DATE: 03/14/2011 REVIEWED BY: bobs. AN: BP#: -VALUATION: 1$11,500 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: )'; wl!b. !r,sp, £ ;gyp•, PENTAMATION 1 R3SFDREM PERMIT TYPE: WORK kitchen remodel non structural include M E Ps. SCOPE PME Plan Check: NOTE: These fees are based on the oreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 09-051 Eff 7;1/10) FEE QTY/FEE MISC ITEMS Plan Check Fee: t1'itt�.-11c�•lr.lvtsj>. UJir�� P-,..., ;, Inv, bee" )'; wl!b. !r,sp, £ ;gyp•, f141. , NOTE: These fees are based on the oreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 09-051 Eff 7;1/10) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 200 s.f. $570.00 Remodel, Kitchen (<=300 so /REMRESKIT Suppl. PC Fee: 0 Reg. 0 OT 0.0 1 hs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 ('i3ust.r1!vrion To,k Acoustical Fee: 0 Yes E) No $0.00 Q 0 Work Without Permit? 0 Yes 0 No $0.00 Planning Fee: $0.00 Select a Non -Residential Building or Structure Q 0 Travel I)oc invni"Itia1.1,ct,e4 Stront; Motion Fee: IBSEISAIICR $1.15 Select an Administrative Item Bldg_Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $2.151 $570.00 TOTAL FEE, $572.15 Revised: 01/15/2011 CUPERTINO r CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPART 'BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(8cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION/ ALTERATION Z REVISION / DEFERRED SUBMITTAL // U (P9 PROJECT ADDI;FyS� • 1pjZ4W r, (Jc APN a -7/ J / V-7 OWNERNAME /' tC PHO E-MAIL SffiRksS �� STAIF�ZIP- FAX APP Ned;WU fG�/`/ F aoS/6+1(AQ/� STRE�I�4DD /� ' STATE, ZIP L -/Z) C/,--rer FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT NTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER DEVELOPER ❑ TENANT CVIE LI� LICENSE BUS. LIC a IVr,� j�/N(i`/� Gov ' �l �J�l�� FAX �r"iJ?' rS , EI ADD S , v 7VllJ �/V H ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC a COMPANY NAME E-MAIL. FAX STREET ADDRESS CITY, STATE, ZIP PHONE D'£SCRIPTIQIti.JF WO � _.. EXISTING USE PROPOSED USE CONSTIL TYPE B STORIES OFFICE "t. Y TYEF DESCRIr ON Fr VALUATIONr AREA AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA l[IL V "A"•"I,li C/ BATHROOM REMODELAREA KITCHEN REMODEL AREA OTHER REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑ DETACH ❑ ATTACH I1 _ !DWELLING llT7f1'S IS A SECOND UNR❑ YES BEING ADDED? ❑ NO SECOND STORY ❑YES ADDrnONT ❑ NO _ I PRF.APPWCATION ❑ YES MANNING APPL! NO ❑ �YERPROVmECOPY01 PLANNING APPROVAL LETTER PLANNER'SNMiL BY - aLCElVEE7I1Y- .a :{Y= T V .1TWN By my signature below, I certify of the following: I am the property owner or authorized agent to act on the property, owner's behalf. have read this application and the informatio v 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 ting t ding con ioI authorize representatives of Cupertino to enter the abov identif d property for inspection purposes. Signature ofApplicant/A ent: Date: SUPPLE NTAL O TI REQUIRED _ 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. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. OFFICE Ust o", ",Or. - PLAN CHECK TYPE; ROLITIN SLIP 0 0111'HE-COUNITER 0 EXPRESS ' ❑ ST:tYDARD i7 1,,1,RCE t] MAJOR arl.DsvG PLA 14 REVIFw d PLANNG :N PLAY kEvrr;'W.'; - PUBLIC WORKS PtHF; DEPT Cl- i,NVIRQNMENTAL v=• ••, TH B1dgApp_2011.doc revised 03/03/11 04