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12050089COVERSHEET 12050089-D 10659 HALE PL PERMIT # %C0.5 ? DATE PROJECT ,��� �t�=nr A' /r�a��✓�ri�r�� ADDRESS APPLICANT OWNER r/i/ ��iIw* 4 R SION / EFERRED PROJECT DESCRIPTION: A r�lv-Gd' ��/i✓6 %21Y7 DATE:�-- PUBLIC WORKS ��==:CSC:==� VALUATION: SO. FT. CONTACT: PHONE: i'D�• 33� 77�8 FAX: NOTES: ISSUED BY: /BAN 4% �wDATE: �- ;�5'/a m PERMIT # %9D,5 DATEy`'8 •�oZ PROJECT ADDRESS.. ,min. %�' � ■■■�� r��� _dim WWI APN# RES.(LVNc) (OARAIM romm. SQ. Fr. omw)• REMODEL VALUATION- ter/ • r Ir •TES: CONSTkUCMON • • FM HOUSING NI c HEAU • - TM MY ISSUED 13Y DATF. TOTALFEES r CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10658 HALE PL CONTRACTOR: 360 KITCHEN N BATH PERMIT NO: 12050089 OWNER'S NAME: JUNG KEVIN Z AND AILEEN I ET AL 325 PHELAN AVE DATE ISSUED: 05/08/2012 OWNER'S PHONE: 4085061959 SAN JOSE, CA 95112 PHONE NO: (408) 283-9988 ❑ LICENSED CONTRACTOR'S DECLARATION F r License Class _Lic.# ����� BUILDING PERMIT INFO: BLDG ELECT PLUMB F r— j L / p Contractor �T TUti1. ��%���j Date .— D ` � 7/ MECH RESIDENTIAL COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: REMODEL (2) KITCHENS(299 SQFT) AND (4) BATHROOMS (commencing with Section 7000) of Division 3 of the Business & Professions IN EXISTING DUPLEX(352 SQFT). INSTALL (50) NEW Code and that my license is in full force and effect. RECESSED LIGHTS IN BOTH UNITS. REMOVE A DOOR AND 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. 1 have and will maintain Worker's Compensation Insurance, as provided for by Sq. Ft Floor Area: Valuation: $50000 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 32640012.00 Occupancy Type: APPLICANT CERTIFICATION 1 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 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 granting of this ermit. Additionally, the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non -point sour ulations per the Cupertino Municipal Code, Section 9.18. `L 7 Issued by: Date: •� % �— Signature Date ❑ OWNER -BUILDER DECLARATION RE -ROOFS: 1 hereby affirm that 1 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: I, 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 1 hereby affirm under penalty of perjury one of the following three declarations: 1 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 1 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 shall maintain 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 Health & Safety 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 must Ow horized a nt: i 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 Hork'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 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 9.18• 1 understand my plans shall be used as public records. Signature Date Licensed Professional I CITY OF CUPERTINO BUILDING PERMIT rZ - I BUILDING ADDRESS: 10658 HALE PL I CONTRACTOR: 360 KITCHEN N BATH I PERMIT NO: 12050089 1 I OWNER'S NAME: JUNG KEVIN Z AND AILEEN I ET AL 1 325 PHELAN AVE I DATE ISSUED: 05/082012 1 OWNER'S PHONE: 4085061959 1 SAN JOSE, CA 95112 1 PHONE NO: (408) 283-9988 1 ❑ LICENSED CONTRACTOR'S DECLARATION License Class_ Lic. # 2 1 D ' 3 A 4 Contractor r �,, &� t} Date 1 hereby affirm that l 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. 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 whichthis 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 1 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 so tions per the Cupertino Municipal Code, Section 9.18. Signature Date �' Z ❑ OWNER -BUILDER DECLARATION I hereby affirm that 1 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). 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 whichthis 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 inany 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. JOB DESCRIPTION: RESIDENTIAL a COMMERCIAL REMODEL (2) KITCHENS(299 SQFT) AND (4) BATHROOMS IN EXISTING DUPLEX(352 SQFT). INSTALL (50) NEW RECESSED LIGHTS IN BOTH UNITS. REMOVE A DOOR AND REVISION #I- ADD BEAM AT DINING ROOM—ISSD 5/25/12 Sq. Ft Floor Area: I Valuation: $50000 APN Number: 32640012.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: ��4-5r'IfAl 4�1Date: Jl RE-ROOFS: All roofs shall be inspected prior to any roofing material berg installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I 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(a) 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 Cu Pepno icipal Code, Chapter 9.12 and the Health & Safety Code, Sectio 0 , 25533, nd 25534. yS Jr Owner or authorized agent: Date: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Date CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(d.cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION_ It ALTERATION / TI ❑ REVISION / DMW= ORIGINAL PERMTT # PROTECT ADDRESS D / SO .p (p APN ��l {' OWNER NAME (r/ PHONE �(N A/ STREET ADDRESS 6 / , 1L, P �� CITY. STATE, ZIP FAX C7(i AL • Gf CONTACT NAME now A� Ca�viz�t� o Z PHO E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME �i �� / �u ( LICENSE NUMBER LICENSE BUS. LIC # COMPANY NAMJl(_ I�E j1 N 7 E-MAIL �/ / a FAX STREET ADDRESS? ARC=CT/ENGINEER NAME G LICENSE LICENSE NUMBER � D �y BUS. LIC t COMPANY NAM$ E MAb to FAX S- RE r ADDRESS /DJ 3 l�'Yegt' v �L�v�� ✓' �/ STY. STATE, ZIP ^ L 7rd ' 9 ��� PRONE DESCRD*TION OF WORK //V':S 7;A4i- CSoP10W Z (!7 EXISTING U Res�� PROPOSED USE CONSTR L ��� TYPE V,7) 9 STORIES r USE TYPE OCG SQFT. VALUATION N EXETO AREA NEWEWFLOOR AREA DEMO AREA TOTAL NET AREA BATHROOM REMODEL AREA �J KITCHEN REMODEL AREA c� OTHER REMODEL AREA PORCH AREA DECK AREA TOTAL DECKNORCH AREA GARAGE AREA: U DETACH []ATTACH , # DWELLN UNTIE IS A SECOND UNIT YES THE31%(G ADDED? NO SECOND STORY ❑ YES ADDITION? .v�r�,0 PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF PLANNING APPL # ❑NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? `{y�NO RED70T�V VALUATION: _ /O O O By ray signature below, I certify to each of the full I am the property owner or authorized agent to act on the prMerty.Owner's behalf. T have read this application and the information I have provided is correct 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 ia`g ction authorize representatives of Cupertino to enter the above-identifed property for inspection proposes. / Signature of Applicant/Agent: Date: �— SUPPLEMEWAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP OM-TBE-COUNTER ElBVLLDnvG PLAN Raw 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. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial. Bldgs: Provide a completed Hazardous Materials Disclosure ❑ srAND� ❑ PUBLIC WORIO form if any Hazardous Materials are being'used as part of this project ❑ LARGE ❑ FIHE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY 9EwER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL BRAL.TH . as, B1dgApp 2011.doc revised 06121111 CUPERTINO CONSTRUCTION PERMIT APPLICA'T'i0'h1SION'#-1- COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a,cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI X REVISION / DEFERRED ORIGINAL PERMIT # 6_ G�� 7 PROJECT ADDRESS % /o � APN # O D ('b r OWNER NAME PHONE E-RAIL O LtW �uw061 STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAME n ,� PHONE 2 E-RAIL �V STREET ADDRESS CITY, STATE, ZIP7 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ✓t77 CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME b `© LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS 2 / D� f�„ r ( CITY, STATE ZIP1-0PHO / -�3 1 - ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WO EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA. DETACH []ATTACH # DWELLING UNITS: IS A SECOND UNIT []YES SECOND STORY ❑ YES BEING ADDED? ❑NO ADDITION? ❑NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO _r/ By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the prdperty owner's behalf. I have read this application and the information I have provided is 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 ng co ction. authorize representatives of Cupertino to enter the above -identified property inspection purposes. y7for Signature of Applicant/Agent: Date: ,� —,2 J C_ SUPPLEMENTAL INFORMAfION REQUTRED PLAN CHECK TYPE ROUTING SLIP _ New SFD or Multifamily dwellings: Apply for demolition permit for OVER-THF-COUNTER BUILDING PLANREVIEW existing building(s). Demolition permit is required prior to issuance of building / permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ I =DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANTTARY SEWER DISTRICT Submittal of Building Permit application. ❑ ENVIRONMENTAL EOZALTH BldgApp_2011.doc revised 06121111 FM-7 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10658 HALE PLACE DATE: 05/25/2012 REVIEWED BY: SEAN APN: BP#: 'VALUATION: Iso %PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: PENTAMATION 1GENRES PERMIT TYPE: WORK REVISION #1: ADD BEAM AT DINING ROOM. SCOPE r. Plan Check 1'hu; . (: i /ec:. 1'icrr, A( L1,�ck P"t-wa Pcc: I''1� F_ltx Ptinrrir I'Cc.: i)fbcl- AfvP 'h. Ins[). Otber Numb) LJ Odwr El(- ". 1nq.). Li 'sk<k /h). Pl'umh. ra. p. I'A'd.. lnsp. 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 Dreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Q Yes (j) No $0.00 0 hours $0.00 Plan Check, Hourly Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? O Yes 0 No $0.00 Suppl. Insp. Fee-0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 �L'/if2lFrf.ttl'Ut7L'c' Fee: 0 E) Work Without Permit? 0 Yes (E) No $0.00 Advanced Planning Fee: $0.00 1 hours Inspections $130.00 ISTINSP Inspection, Hourly 0 0 Tr -_ / Documentation Fee.S': Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.001 $130.00 TOTAL FEE: $130.00 Revised: 05/01 /2012 FM-7 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 10658 Hale Place DATE: 05/08/2012 REVIEWED BY: Sean APN: BP#: 'VALUATION: 1$50,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Du Duplex USE: PENTAMATION 1R3SFDREM PERMIT TYPE: wORK Remodel 2 kitchens and 4 bathrooms in existing duplex. Install 50 new recessed lights in both SCOPE units. Remove a door and (2) windows in kitchen and replace with (2) 2X3 windows and remove and 0 Much. Plan Check Plun,b. Plug CheckElec. Plan Check 0.0 1 hrs $0.00 bFI ,. Pern,i! Fee FIT, Plumb. Pcrmir FCC: Elec. Permit Fee: IEPERMIT Other Atcch_ Insp. Other Plurnh /"..T.Li Other Elec. Insp. L0.0 j hrs $44.00 1de'cl,. Insp. Fte: Plumb, hasp. Fee: Elec. In.v'. Pk-e. NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, eta). These fees are based on the Dreliminary information available and are only an estimate Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Et. 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 299 s.f. $588.00 Remodel, Kitchen (<=300 sf) IREMRESKIT Suppl. PC Fee: (E) Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 F352 s.f. $457.00 Remodel, Other IREMRESOTH Permit Fee: $0.00 Suppl. Insp. Fee-0 Reg. © OT 0.0 hrs $0.00 = Electrical $185.00 IBREMFIXT Fixtures, Lighting PME Unit Fee: $0.00 PME Permit Fee: $44.00 0 # $392.00 Window 1 Sliding Glass Door 1WINREP Replacement Construction Ta.r. Administrative Fee: IADMIN $41.00 Q E) Work Without Permit? 0 Yes (E) 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 $5.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: $136.00 $1,622.00 TOTAL FEE: 1 $1,758.00 Revised: 04/01 /2012