10100139 CITY OF CUPERTINO :BUILDING PERMIT
BUILDING ADDRESS: 10862 LEAVESLEY PL COrITRACTOR:MARVEL BUILDERS PERMIT NO: 10100139
OWNER'S NAME: JOSEPH T AND KATHY Y LEON GUERRERO PO,3OX 4158 DATE ISSUED: 10/19/2010
NER'S PHONE: 4083662310 SAr`TA CLARA,CA 95056 PHONE NO:(408)512-2492
❑ LICENSED CONTRACTOR'S DECLARATION F
License Class Lie.#
q�5� BUILDING PERMIT INFO: BLDG ELECT PLUMB
MECH RESIDENTIAL COMMERCIAL
Contractor Date l 0
1 hereby affirm that I am licensed under the provisions f Ch pter 9 JOB DESCRIPTION: BATH REMODEL(80SQ),NEW SHOWER PAN,RECESSED
(commencing with Section 7000)of Division 3 of the Business&Professions LIGI ITING,NEW VANITY;NO RE-ROOF&NO STRUCTURAL
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 Sq.I t Floor Area: Valuation:$9000
Section 3700 of the Labor Code,for the performance of the work for whic this
permit is issued.
APT' Number:35615033.00 Occupancy Type:
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 PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes: (We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION.
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.
Issued bye:, Date:
Signature Date (OfA02mWy
❑ OWNER-BUILDER DECLARATION RE-ROOFS:
All r Hofs shall be inspected prior to any roofing material being installed.If a roof is
I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for
the following two reasons: inspection.
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, Sign 3ture of Applicant: Date:
Business&Professions Code) _
1,as owner of the property,am exclusively contracting with licensed contractors to
constrict 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: HAZARDOUS MATERIALS DISCLOSURE
I have and will maintain a Certificate of Consent to self-insure for Worker's I ha ie read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
performance of the work for which this permit is issued. com 3liance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air
cont aminants as defined by the Bay Area Air Quality Management District I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued,I shall Hea th&Safety Co e,Sections 25505,25533,and 25534.
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 Owr.er or authoriz 710 t: �'1
become subject to the Worker's Compensation provisions of the Labor Code,I must 14m, Date: (/V
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I her-by affirm that there is a construction lending agency for the performance of work's
1 certify that I have read this application and state that the above information is for v,hich this permit is issued(Sec.3097,Civ C.)
correct.I agree to comply with all city and county ordinances and state laws relating Lem ler's Name
to building construction,and hereby authorize representatives of this city to enter
u--n the above mentioned property for inspection purposes.(We)agree to save Lemler's Address
mify and keep harmless the City of Cupertino against liabilities,judgments,
_.s,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.18.
Licensed Professional
Signature Date
CITY OF CL PERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: DATE: REVIEWED BY:
APN: BP#: *VALUATION: 1$9,000
;PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY 100,1 l_ PENTAMATION 1 G RES
USE: SFD or Duplex 1 i i)t�t? r>f PERMIT TYPE:
WORK
SCOPE
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NOTE. Thesefees are based on the prefintinaq in ormation avaih rble and are only an estimate. Contact the De t or addn 7 info,
FEE ITEMS(Fee Resolution 09-051 Elf. '7;
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: -jot :
APN . 35615)33 .00
DATE ISSUED. . . . . . . : 10/19/2010
RECEIPT #. . . . . . . . . : BS000)11782
REFERENCE ID # . . . : 10100L39
SITE ADDRESS . . . . . : 10862 LEAVESLEY PL
SUBDIVISION . . . . . .
CITY CUPER'PINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : JOSEP:3 T AND KATHY Y LEON GUER
ADDRESS . . . . . . . . . . : 10862 LEAVESLEY PL
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014
RECEIVED FROM . . . . : JOE G'JERRERO
CONTRACTOR . . . . . . . : RYAN HUA LIC # 32113
COMPANY . . . . . . . . . . : MARVE:"j BUILDERS
ADDRESS . . . . . . . . . . : PO BOX 4158
CITY/STATE/ZIP . . . : SANTA CLARA, CA 95056
TELEPHONE . . . . . . . . : (408) 512-2492
FEE ID UNIT QUANTITY AM01JNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---- ------ ---------- ---------- ----------
1BCBSC VALUATION 9, 000. 00 1 . 00 0. 00 1. 00 0 .00
1BSEISMICR VALUATION 9, 000. 00 0 . 90 0. 00 0. 90 0 .00
1REMRESBAT SQ FEET 1. 00 1570 . 00 0. 00 570 . 00 0 . 00
---- ------ ---------- ---------- ----------
TOTAL PERMIT 571.90 0 . 00 571. 90 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
CASH 571 . 90
---------------
TOTAL RECEIPT 571 . 90
RESIDENTIAL PROJECT COVER SHEET
Assessor's Parcel Number:
Name of owner. ( � ��y-y 0
P
Project address.
Contact person. d G Phon;. �
Fax.
Net square footage of lot.
Existing Proposed
Square footage: First floor: _
Second floor_
Garage: _
TOTAL:
Are there at least two 10 foot by 20 foot clear spaces insid:the garage? T'
Is privacy protection planting required for the project? N
Build it Green Total Points \
On what floor(s) is work being done? _ (46�
Brief descri tion of work. uC�J G4L' 4
Code editions: 2007 CBC -N)2007 CFC x)2007 CMC N)
2007 CPC -N)2007 NEC -1\)
eCUuj4r x
Effective 1/1/081-4
APPR()Vt�,
ACCORUAN( t itr! rrt i;ITYL.:
'ERTINO(,,,)DE
�)AMU HDINANCE_;
DATEj`(7 l 2,019
SIGNE U
set Of plans spacifica5on�
kept on the job at all times MUS J 1
nes and it i,
Oul to make any changes or alterations
same without written permission from
Building Department f`ity nt(urrtir,r,
Plan Review Process Work Book Page-8-Revised 8/05/08
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CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35615033 .00
DATE ISSUED. . . . . . . : 10/19/2010
RECEIPT #. . . . . . . . . : BS000011782
REFERENCE ID # . . . : 10100139
SITE ADDRESS . . . . . : 10862 LEAVESLEY PL
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . . CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : JOSEPH T AND KATHY Y LEON GUER
ADDRESS . 10862 LEAVESLEY PL
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014
RECEIVED FROM . . . . : JOE GUERRERO
CONTRACTOR . . . . . . . : RYAN HUA LIC # 32113
COMPANY . . . . . . . . . . : MARVEL BUILDERS
ADDRESS . . . . . . . . . . : PO BOK 4158
CITY/STATE/ZIP . . . : SANTA CLARA, CA 95056
TELEPHONE . . . . . . . . : (408) 512-2492
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 9, 000 . 00 1 . 00 0 .00 1. 00 0 . 00
1BSEISMICR VALUATION 9, 000. 00 0 . 90 0.00 0. 90 0 . 00
1REMRESBAT SQ FEET 1. 00 570 . 00 0. 00 570. 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 571 . 90 0 . 00 571. 90 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CASH 571 . 90
---------------
TOTAL RECEIPT 571 . 90
CITY OF CUPERTINO
ELM ADDITION/]ZEMODEL
CUPERTINO FEE SCHEDULE
APN# 15 033
Date:
Is•a 2n unit being added? Yes ❑ No ❑ If Yes, pie:lse fill out the permit application for 2nd unit.
Building Address: n
G� L�vis Al 4-4lle L/_� .7.5 cl
Mailing Address (if different from building ad ess):
Owner's Name: Phone# :
Contractor: Phone#:
Fax#:
Cupertino Business License: State Contractor License#: -'Z55-e7f el
Contact: 4et
Phone
4r,� Fax#:
Landscape Ordinance Compliance:
Landscape area in sq. ft. (includes all irrigated areas); /A—
If
—If 2,500 sq. ft or less, compliance with the Landscape Water-Efficiency Checklist is required.
If more than 2,500 sq. ft., a complete Landscape Project Submittal is required.
Compliance Method: ❑ Plant Type ❑ Water Budget
Building Permit Info:
Bldg. U--" Elect. [— Plumb. Mech. ❑ Hillside ❑
Job Description:
Addition-What is being added?(Be Specific):
What is being remodeled (not including addition)? ,,
Remodel Includes Re-Roof. Yes ❑ No If yes list number of squares
Remodel Includes Structural: Yes ❑ No
Do you have the pre-application planning apprOVILI? Yes ❑ No ❑
If yes, please provide a copy of your planning a -oval letter. Planners name:
Square Footage:
Addition: Porch: Deck: _ Garage: Detached Attached
Remodel: Kitchen Bath �a Other
Type of Construction (Usage Class): Occupancy Type:
1-A, 1-B ❑ H/III/V-A ❑ =B, IV-HT, V-B [ Valuation: po
Please check this box if a project is a
.'ro'ect Size: Express ( —Standard ❑ Large ❑ Ma'or ❑ second-story addition ❑
Please complete relevant portion of the Green Building;
Checklist& attach it to the application or if applicable, Green Building Points Achieved:
include in plan set& the sheet index.
Revised 05/18/10