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11110062CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20627 CRAIG CT I CONTRACTOR: GLC CONSTRUCTION I PERMIT NO: 11 1 10062 1 OWNER'S NAME: 1 REDWOOD CITY, CA 94062 I PHONE NO: (650) 364-1098 LICENSED CONTRACTOR'S DECLARATION License Class 3 Lic. tl ! 0 T 7 C7T Contractor Cie yfrt��7�,,Date O Pf /Z 1 hereby affirm that 1 am licensed under the provisions of Chapter 9 (eommencing 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 wor for which this permit is issued. APPLICANTCERTIFICATION 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. / Signature �Date [ �L ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 (See.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 1 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. 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. 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. Signature Date BUILDING PERMIT INFO: BLDG ELECT r PLUMB MECH r RESIDENTIAL r COMMERCIAL JOB DESCRIPTION: ADD 586 SQ 171' TO KITCHEN, I:AMILY DINING & FOYFR, ADD 38 SQ 1"f "1'0 PORCH, REMODEL 81 SQ FT TO BATH, 60 SQ FT LAUNDRY, ADD 1890 SQ FT OF LINEAL. FOOTING /*Z-LA5 G A S fe P ZA/ S e- QT QUJ Sq. Ft Floor Area: I Valuation: $250000 APN Number: 35915013.00 1 Occupancy'1'ype: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: %—D Date: RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. 11'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 "A" OR BF,TFER 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. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should 1 store or handle hazardous material. Additionally, should 1 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: �Z CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance ol'work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Ad ARCHITECT'S DECLARA'PION I understand my plans shall be used as public records. Licensed Professional Fm_� CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 20627 craig ct. DATE: 11/10/2011 REVIEWED BY: bobs. PC FEE ID APN: K13P:#:/ O "VALUATION: $250,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Du lex USE: p 2nd Unit? • Yes No OTC? 0 Yes E)No PENTAMATION 1R3SFDADD PERMIT TYPE: WORK add 586 s.f. kitchen famil dinin fo er 38 s.f. orch remodel 81s.f. bathroom 60 s.f. laundSCOPE �sfdd 1890 I.f. siding, 1838 s.f. re -roof, replace 3 windows amd 1 door, add W/H, lights and receptacles. OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,111-B,IV,V-B 624 $2,420.00 IR3PLNCK $1,519.00 IR31NSP PME Plan Check: $0.00F-1,8970s.f. Siding $1,176.00 ISIDEOTHER All Other Permit Fee: $1,519.00 Suppl. Insp. Fee,0 Reg. Q OT 0,0 hrs $0.00 F 81 s.f. Remodel, Bath (<=300 so $588.00 IREMRESBAT PME Unit Fee: $0.00 PME Permit Fee: $44.00 60 s.f. $392.00 Remodel, Other 1REMRESOTH 7� TOTALS: 624 $2,420.00 $1,519.00 Plumbing 1PRWHEATR Water Heater MECH, HOURLY 0 Yes 0 No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY Q Yes Q No MISC ITEMS Plumb. Plan Check 0.0 1 hrs $0.00 t G -.77Plumb. Permit Fee: IPPERMIT Re -roof iPEROOFRES Other Plumbinsp. 0.0 hrs $44.00 lthcf ,-,1f;, r.•..;;.ET hrs $0.00 PME Plan Check: NOTE: This estimate does not Include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the nreliminan information available and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff. 711,111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,420.001,838 s.f. $266.00 Re -roof iPEROOFRES Suppl. PC Fee: (F) Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00F-1,8970s.f. Siding $1,176.00 ISIDEOTHER All Other Permit Fee: $1,519.00 Suppl. Insp. Fee,0 Reg. Q OT 0,0 hrs $0.00 F 81 s.f. Remodel, Bath (<=300 so $588.00 IREMRESBAT PME Unit Fee: $0.00 PME Permit Fee: $44.00 60 s.f. $392.00 Remodel, Other 1REMRESOTH 7� ; 1 ;r.=;. .. 1 # $26.00 Plumbing 1PRWHEATR Water Heater 0 Work Without Permit? Yes No $0.00 Advanced Planning Fee: PLLONGRNGR $81.12 Select a Non -Residential Building or Structure O 0 A Travel Documentation Fee: ITRA VDOC $44.00 Strong Motion Fee: IBSEISNnCR $25.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC 1 $10.00 SUBTOTALS: I $4,143.12 $2,448.00 TOTAL FEE: T $6,591.12 Revised: 10/01/2011 ����� CITY OF CUPERTINO RI IFEE ESTIMATOR - BUILDING DIVISION 19 ADDRESS: • oZ Cray DATE. REVIEWED BY: APN: P#: 0 a- "VALUATION: $0 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: 0.0 1 PENTAMATION 1GENRES PERMIT TYPE: WORK PME Plan Check: SCOPE $0.00 Elec. Plan Check 10.0 1 hrs $0.00 Elec. Permit Fee: IEPERMIT Other Elec. lnsp.0.0 hrs $44.00 NOTE: This estimate does not include fees due to other Departments (Le, Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 L 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 4 # $392.00 Window / Sliding Glass Door /WINREP Replacement Suppl. PC Fee: Q Reg. () OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 F 14 Electrical $44.00 IBREMIMECEP Recep/Switch/Outlets Permit Fee: $0.00 Suppl. Insp. Fee -0 Reg. Q OT 0.0 hrs $0.00 F 6 Electrical $65.00 IBREMFIXT Fixtures, Lighting PME Unit Fee: $0.00 PME Permit Fee: $44.00 rnit�'lrrt Iit�l] 7 1,� Administrative Fee: 0 0 Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) 0 Travel Documentation Fee: Strong Motion Fee: $0.00 Select an Administrative Item Bldg; Stds Commission Fee: $0.00 SUBTOTALS: $129.00 $501.00 TOTAL FEE: $630.00 Revised: 101011201 5q,5.