11110060CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7952 FOLKESTONE DR
CONTRACTO BE
PERMIT NO: 11110060
DE ED
OWNER'S NAME: GILL DOYLE
DATE ISSUED: 11/10/2011
OWNER'S PHONE: 4089967678
PHONE NO:
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIALE]
❑ LLCLI NSED CONTRACTOR'S DECLARATION
License Class Lie. #��
GENERAL REPAIRS TO 2 BEDROOMS REMOVE WALL TO
ke l f
S
CONVERT TO OFFICE, RELOCATE OFFICE WINDOW,
Contractor ieP,v n6d�Date
ADD
I hereby affirm that I in licensed under the provisions f Chap er 9
LIGHT FIXTURES AND RECEPTACLES...
(commencing with S ction 7000) of Division 3 of the Business & Professions
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
Sq. Ft Floor Area:
Valuation: $20000
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
APN Number: 36211004.00
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 STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
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 FROM LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
Issued by:,. Date: /
granting of this permit. Additionallytlfd applicant understands and will comply
with all non -point source regr}lafions per the Cupertino Municipal Co e, Section
9.18. `
//
/
RE -ROOFS:
Signature - Date �0 l
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
Signature of Applicant: Date:
I h .reby affirm that I am exempt from the Contractor's License Law for one of
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)
I, 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(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 whichthis 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, Sections 25505,2W3, and 25534
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: Date:
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
CON RUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I must
I hereby affirm that ther 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
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
gRaff
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
19
ADDRESS: 7952 folkstone dr.
DATE: 11/10/2011
REVIEWED BY: bobs.
APN:
BP#:
'VALUATION: $20,000 —�
PERMIT TYPE: Building Permiti
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
Suppl. PC Fee: Q Reg. 0 OT
PENTAMATION 1GENRES
I PERMIT TYPE:
WORK
convert 2 bedrooms into office relocat office window, add light fixtures and receptacle.
SCOPE
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District. etc.). These fees are hated on the nrelininary information available and are only at estimate. Contact the Deat for addin'l into.
FEE ITEMS (Fee Resolution 11-053 E '. 7101)
-
QTY/FEE
Elec. Plan Check 0.0 1 hrs $0.00
Plan Check Fee:
Elec. Permit Fee: IEPERMIT
$0.00
#
$260.00
Other Elec, Insp. 0.0 hrs $44.00
Suppl. PC Fee: Q Reg. 0 OT
0.0
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District. etc.). These fees are hated on the nrelininary information available and are only at estimate. Contact the Deat for addin'l into.
FEE ITEMS (Fee Resolution 11-053 E '. 7101)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
#
$260.00
New Door Opening
MooRNoNsT Non -Structural
Suppl. PC Fee: Q Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
# Window / Sliding Glass Door
$457.00 1WINNEWNST New (Non -Structural)
Permit Fee:
$0.00
Suppl. Insp. Fee:Q Reg. 0 OT
0.0
1 hrs
$0.00
�2 Electrical
$65.00 IBREMFIXT Fixtures, Lighting
PME Unit Fee:
$0.00
PME Permit Fee:
$44.00
0 #
$44.00
Electrical
IBREAMECEP Recep/Switch/Outlets
.':;rrsrfrrf°;r:�;= �' •
Administrative Fee: IADMIN
$41.00
0
''
Work Without Permit? 0 Yes 0 No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
0
0
�
Travel Documentation Fee: ITRAVDOC
$44.00
Strong Motion Fee: IBSEISMICR
$2.00
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$132.001
$826.00
TOTAL FEE:
$958.00
Revised: 10/01/2011