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09100082 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22113 STOCKLMEIR CT CONTRACTOR:VANNI BROTHERS PERMIT NO:09100082 CONSTRUCTION O`'-NER'S NAME: PRALL,JON 18964 SARA PARK CIR DATE ISSUED: 10/13/2009 L iER'S PHONE: 4086055757 SARATOGA,CA 95070 PHONE NO:(408)253-7028 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT r— PLUMB License Class �� Lic.# MECH RESIDENTIAL COMMERCIAL Contractor Cyt rl i 6 , Date / 3-O p I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REDO KITCHEN DUE TO WATER (commencing with Section 7000)of Division 3 of the Business&Professions DAMAGE.REMOVE FLOORING, Code and that my license is in full force and effect. COUNTERTOPS,APPLIANCES,CABINETS,PLUMBING FIXTURES,REPLACE W/NEW NO CHANGES TO LAYOUT.NO 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 Sq.Ft Floor Area: Valuation:$22000 permit is issued. APPLICANT CERTIFICATION APN Number:35709045.00 Occupancy Type: 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 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 permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Issued Date:��l J Date �� '�3�� 4 y Si�natu � ' ❑ 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: 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 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. 1 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. 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 I will I certify that in the performance of the work for which this permit is issued,1 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 forthwith utho forthwith comply with such provisions or this permit shall be deemed revoked. n Date: 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 the above mentioned property for inspection purposes.(We)agree to save mify 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 with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35709045 .00 DATE ISSUED. . . . . . . : 10/13/2009 RECEIPT #. . . . . . . . . : BS000008900 REFERENCE ID # . . . 09100082 SITE ADDRESS . . . . . : 22113 STOCKLMEIR CT SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER PRALL, JON ADDRESS 22113 STOCKLMEIR CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-2727 RECEIVED FROM . . . . : NEIL F. VANNI CONTRACTOR . . . . . . . : NEIL VANNI LIC # 18307 COMPANY . . . . . . . . . . : VANNI BROTHERS CONSTRUCTION ADDRESS 18964 SARA PARK CIR CITY/STATE/ZIP . . . : SARATOGA, CA 95070 TELEPHONE (408) 253-7028 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 22, 000. 00 1. 00 0 . 00 1. 00 0 . 00 1BPFIXTURE NO OF FIXTURE 1 . 00 8 . 00 0 .00 8 . 00 0 . 00 1BSEISMICR VALUATION 22, 000 . 00 2 .20 0 .00 2 .20 0 . 00 1BUSLIC FLAT RATE 1. 00 114 . 00 0 . 00 114 . 00 0 .00 1PPERMITFE FLAT RATE 1. 00 42 . 00 0 .00 42 . 00 0 . 00 1TRAVDOC FLAT RATE 1. 00 42 . 00 0 .00 42 . 00 0 .00 ---------- ---------- ---------- ---------- TOTAL PERMIT 209 .20 0. 00 209.20 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 209 .20 VISA --------------- TOTAL RECEIPT 209 .20 CITY OF CUPERTINO CUPERTINO GENERAL BUILDING PERMIT APPLICATION FORM APN# Date: 9 Building Address: // 3 7 1 04-- Mailing Address (if different from building address): Are Hazardous Materials being used as part of this project? Yes ❑ No [ � Ili HOA: (Exterior work only) Yes tWNo PT000,I1 yes, provide letter from HOA Owner's Name: ,n 7 J Phone#; /'a f _ S Contractor: �C Phone: �,/ L I&a5' . �� Fax: '-loop-o? 5 ;20Z,? Contractor License t 537,q,? Cupertino Business License#: Contact: Phone: s � e,/' Fax: Residential Commercial Job Description: k)e jo0/4Je A, IWI)C-" c-C5 , 61�Al e 7'ST� %�jc�, �n� �k _ tee p%c. A�-a C,/1 Building Permit Info: Bldg ❑ Elect ❑ Plumb Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, I-B ❑ II/III/V-A ❑ I1/II1 B, IV-HT,V-B � Valuation: Square Footage: oZ Project Size: Express [-,Standard ❑ Large ❑ Major ❑ Green Building: Please complete relevant portion of the Green Building/LEED Checklist& attach it to the application or if applicable, include in plan set& the sheet index. Points Achieved: For help, contact Build it Green at www.buildit reen.or Revised 07/14/09 CITY OF CUPERTINO Carr OF GENERAL BUILDING APPLICATION CUPEf�TINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM 1STUCOAP Stucco Applications (up to 400 sf) B additional stucco application 1 WINREP Replacement windows/sliding glass B door (ea 8 windows) 1 WINMEWSTR New Window-structural shear B wall/masonry (includes plan ck fee) 1 EPERMITFEE Electrical Permit Fee E 1MPERMITFEE Mechanical Permit Fee M 1PPERMITFEE Plumbing Permit Fee P 1 ELCPLNCK Stand Alone Electric Pln Ck (hourly) E I MECPLNCK Stand Alone Mechanical Pln Ck(hrly) M 1PLMBLNCK Stand Alone Plumbing Pln Ck(hrly) P 1 STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B when not over counter) hourly-stand alone 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES / 1BSEISMICR Seismic Residential B 1BSEISMICO Seismic Commercial B 1 TRAVDOC Travel &Documentation B / 1BUSLIC Business License B TC- -L 5 of 5 RESIDENTIAL PROJECT COVER"SKEET Assessor's Parcel Number: Name of owner. m/z q /Y/,, Project address. I Yvc-k'l m e ',v Contact person. /V-el Phone. Z/000— 5- -5 77- S Fax. 1/o cl a s 3- ;z a 2 Net square footage of lot. Existing Proposed Square footage: First floor: Second floor: Garage: TOTAL: -e there at least two 10 foot by 20 foot clear spaces inside the garage? --Y --- Is privacy protection planting required for the project? On what floor(s) is work being done? IfIX- Brief description of work. 12to � is dam` ula{er aom 4 myve �Iai dw tiod '�'�. , C�c�c=n Code editions:2008 CBC -N)2008 CFC (Y-N)2008 CMC (Y-N) 2008 CPC -N)2008 NEC (Y -N) Ai-,i,w)VED Effective 1/l/WACC01RDAN(.t WITH THE CITY OF CUPERTINO CODES AND ORDINANCES DATE---1/6--/ - SIGNE - This set of plans and specifications MUST be kept on the fob at all times and it is cha es or alterations s unlawful to make any �9 on same without wotte'permission from m. the Building Depart- , Y The stamping of m+5 P't",.rxi speci cations SHALL NOT be heli.-,i>ermit or to be an approval of the )Ioi�'", 'Jt any provisions o1 any City C>nlW X1k e Or `.hale.law Plan Review Process Work Book Page-8-Revised 1/1/08 S-- Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 XPEt�TINO Building Department JOB ADDRESS: PERMIT # OWNER'S NAME: PHONE # s- , GENERAL CONTRACTOR: ifs, jar FAX # yoj 2 S�7o z Ste} I am not using any subcontractors: /��e9 Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date