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13010009I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10465 DEMPSTER AVE OWNER'S NAME: PROKEY NORMAN T AND BETTY L OWNER'S PHONE: 4086854754 ❑ LICENSED CONTRACTOR'S DECLARATION License Class /.1 < Lic. # _ ee l Contractor �� i' �/ Date / Z/� -� 11 I hereby affirm that I 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 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. 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 p . Additionally, the applicant understands and will comply with all non -poi x s rce regulations per the C e ino Municipal Code, Section 9.18. Signature Date ` l 07 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 (Sec.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). 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. 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. CONTRACTOR: VINCE MOFFITT PERMIT NO: 13010009 CONSTRUCTION 379 GHUREHILL PL DATE ISSUED: 01/02/2013 GILROY, CA 95020 PHONE NO: (408) 427 -1417 JOB DESCRIPTION: RESIDENTIAL u COMMERCIAL REMODEL DOWNSTAIRS BATH 60 SQ FT Sq. Ft Floor Area: I Valuation: $7800 APN Number: 32648011.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS r M LAST CALLED INSPECTION. Issued by: Date: 2 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 Applicant: 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 Area Air Quality Management District I will maintain compliance with th pertino Municipal Code, Chapter 9.12 and the Health &Safety Code, Sect' n 25505, 2553 ,V,)2, 534. Owner or authorized agent. Date: ///7/ 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 Professional CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, Schoo .n•_ r___ L.......J ., sL ,. ,.L :...,. ...0 of :n miniin/.io and nPo nntV aH o..vtimaip- Contact the Dept for addn'1 info. /Jls'ireve, CL(:. J flew L:GJ iire uuocu u. s•sc • c•••••••s... FEE ITEMS (&e Resolution 11 -053 Ef. 711%12) ADDRESS: 10465 dempster dr DATE: 01/02/2013 REVIEWED BY: MENDEZ ki APN: BP #. "VALUATION: 1$7,800 RMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Du lex USE: p P /tanrh. lusp. 1 cue: PENTAMATION 1 R3SFDREM PERMIT TYPE: WORK remodel downstairs bathroom 60 s ft SCOPE NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, Schoo .n•_ r___ L.......J ., sL ,. ,.L :...,. ...0 of :n miniin/.io and nPo nntV aH o..vtimaip- Contact the Dept for addn'1 info. /Jls'ireve, CL(:. J flew L:GJ iire uuocu u. s•sc • c•••••••s... FEE ITEMS (&e Resolution 11 -053 Ef. 711%12) Xlcch. flan Chuck 1'llw h. Phm Clw( 1, F_l <r,' Plan C;hcck i1eE,ar. 1'crnxt F, c: I'lumh, Pomrt 1ce: 1 ,1�>( Permit !c <e: r ier Afech. InV), (�It "wr PlLII'i71i IYt S'I? 0111 'J' l;Ie'C. IY7�SI). c /t. Inch 1` e P /tanrh. lusp. 1 cue: E/c�t- Insp. I'c'e. 1 NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, Schoo .n•_ r___ L.......J ., sL ,. ,.L :...,. ...0 of :n miniin/.io and nPo nntV aH o..vtimaip- Contact the Dept for addn'1 info. /Jls'ireve, CL(:. J flew L:GJ iire uuocu u. s•sc • c•••••••s... FEE ITEMS (&e Resolution 11 -053 Ef. 711%12) ... ... ... »...... ». »-- FEE --.- -- - - --- --- - QTY /FEE - - -- - - -- - - - -- MISC ITEMS Plan Check Fee: $0.00 60 s. f. $600.00 Remodel, Bath (< =300 sf) 1REMRESBAT Suppl. PC Fee: 0 Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee O Reg. Q OT 0 .'0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 ("Onsit-uction Kff.' F 'fd1ninistrative Fec.. 0 Work Without Permit? 0 Yes E) No $0.00 Advanced Planning Fee $0.00 Select a Non - Residential Building or Structure 0 Ir<�t cal L)oc�t�rrrcrrttutif rr Fces: Stroniz Motion Fee: 1BSEISMICR $0.78 Select an Administrative Item Bldp, Stds Commission Fee: IBCBSC $1.00 SUBTOTALS; $1.78 $ TOTAL FEE: $601.78 Revised: 10/01/2012 (" C) ! cl1) " u� MlhA �til`7 C 0 ent /U fvN I-- 4p GGL� ftu� ---*, 1�3 LOG SCOPE OF WORK: Bathroom Remodel Project shall comply with the 2010 California Building (Base code 2009 IBC), 2010 Residential (2009 IRC), Plumbing (2009 UPC), Mechanical (2009 UMC), Electrical (2008 NEC), Fire (2009 IFC) and Energy Codes (2008 Building Energy Efficiency Standards) Energy code mandatory lighting measures: 1. All permanently installed high efficacy luminaires shall be switched separately from low efficacy luminaires. (150(k)(7)) 2. Permanently installed luminaires in bathrooms, garages, laundry rooms and utility rooms shall be high efficacy luminaires OR are controlled by an occupant sensor(s) certified to comply with Section 119 that does not turn on automatically or have an always on option. (150(k)(10)) Plumbing plan notes: 3. Water closets shall have an average water consumption of not more than 1.28 gallons per flush. (CPC 402.2) 4. Shower heads shall have a water flow not to exceed 2.5 gallons per minute. (CPC 402.1.1) 5. Faucets in kitchens, wet bars, lavatories, laundry sinks, etc shall have a water flow not to exceed 2.2 gallons per minute. (CPC 402.1.2) 6. Shower stalls shall have a clear interior finish area of 7.1 sq. ft. and be able to accommodate a minimum 30 inch circle at the threshold level. These clearances shall be maintained up to a height of 70 inches above shower drain. (CPC 411.7) 7. Shower compartments and walls above bathtubs with installed shower heads shall be finished with a smooth, nonabsorbent surface to a height not less than 72 inches (6 ft). (CRC R307.2) 8. The maximum hot water temperature discharging from the bathtub, shower and whirlpool bathtub filler shall be limited to 120 degrees Fahrenheit. The water heater thermostat shall not be considered a control for meeting this provision. (CPC 414.5 & 418.0) 9. A 30 -inch clear width for water closet compartment and 24 inch clearance in front of water closet. (CPC 407.5) Electrical Plan Notes: 10. The installation of smoke alarms in all of the following areas shall be provided: (R314.3) a. On the ceiling or wall outside of each separate sleeping area in the immediate vicinity of bedrooms. b. In each room used for sleeping purposes. 11. The installation of carbon monoxide alarms in the following areas shall be provided: (R315.1) a. Approved carbon monoxide alarms shall be installed outside of each separate sleeping area in the immediate vicinity of the bedrooms and on every level including basements in dwelling units that have fuel -fired appliances or attached garages. 12. At least one 20 amp branch circuit shall be provided to supply bathroom receptacle outlets. Such circuits shall have no other outlets. (CEC 210.11(C)(3)) 13. All receptacles in bathrooms, garages, accessory buildings, outdoors, crawl spaces, unfinished basements, kitchens (where receptacles serve counter top surfaces), laundry, utility, wet bar sinks (within 6 feet of the edge of the sink), shall have ground -fault circuit interrupter (GFCI) protection. (CEC 210.8) 14. In all areas specified in 210.52, all 125 -volt, 15- and 20- ampere receptacles shall be listed tamper- resistant receptacles. (CEC 406.11) LIN CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION P� 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 o bO (408) 777 -3228 • FAX (408) 777 -3333 • buildinaC�cupertino.org ` 3 ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/Ti ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS /0 n; ��r• Ifs V A APN # p -j R / OWNER NAME �� li.�c,� PH NE Z E -MAIL \ STREET ADDRESS L CZ'rC L CITY, STATE, ZIP /, j w / _ ` /I FAX CONTACT NAME r ) i PHONE •�- E -MAIL 30 (- C / �yl STREET ADDRESS �� /� r CITY,STATE,,L LJa-/y _._ `/0 FAX ❑ OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT CONTRACTOR CONTRA OR AGENT ❑ ARCHITECT O ENGINEER ❑ DEVELOPER ❑ TENANT CONTRA OR NAME A A � ` "("�V^ LICENSE N � LICENSE YPE BUS. LIC # U,_fDRESS NAY N(A�M�_E j> E-MAIL - _ % tjW CrV AI E9 5 "— Lj PM 2 - Lr ARCH1TECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK AJ EXISTING USE PROPOSED USE CONSTR- TYPE I # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM REMODEL AREA/ KITCHEN REMODEL AREA OTHER REMODEL AREA 0 Tti PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ODETACH ❑ ATTACH it DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY MWS BEING ADDED? ❑ NO ADDMON? ❑ NO PRE - APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED Y: TOTAL V LUATIr, PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO By my signature below, I certify to each of the Plowing: I am the property owner r authorized agent to roperty owner's behalf. I have read this application and the information I have provide is correct. I h e read the escri on of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to build] g nstruction. I t e ese iv s o u rtino to enter the above -i ntifi property for inspection purposes. Signature of Applicant/Agent: /L'�'' Date: SUPPLEMENTAL ORMATION REQ PLAN CHECK TYPE ROUTING SLIP ovER_THE COUNTER BUILDING PLAN REVIEW _ 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 ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06121/11 !�(