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15100045CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15100045 19937 TWILIGHT CT CUPERTINO CA 95014 (316 31034): ANTHONY HODDER CONST CUPERTINO, CA 95014 OWNER'S NAME: COHEN ARIEL TRUSTEE & ET AL DATE ISSUED: 11/30/2015 OWNER'S PHONE: 408-688-6859 PHONE NO; (408) 499-5990 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class _R Lic. #4A657a_BLDG Contractor ANTHONY HODDER CONST Date 06/30/2016 _ELECT _PLUMB MECH RESIDENTIAL _ COMMERCIAL 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. JOB DESCRIPTION: CONSTRUCT (N) 2 CAR GARAGE IN BACKYARD (500 SQ FT) I hereby of n m 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 Revision # 1: Revise garage to conditioned den (446 sq ft) and new attached ompensation, as provided for by Section 3700 of the Labor Code, for the single car garage (313 sq ft) - Issued 3/14/16 performance of the work for which this permit is issued. /2. 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: $40000.00 permit is issued. APPL ICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances 316 31 034 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 Cuperf o gainst liabilities, judgments, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue gal st said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionall , the applicant understands and will c mply with all non -point esti n 9.18. source re ulatio s per the upertino Muni 'pal odeMDatv 180 DAYS FROM LAST CALLED INSPECTION. Signat re /f i 14_ 1 Issued by: ABBY AYENDE Date: 03/14/2016 ER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RF�FS All roofs shall be inspected prior to any roofing material being installed. If a roof is following two reasons: 1. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure,is not intended or offered for inspection. sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant; contractors to construct the project (Sec.7044, Business &Professions Code). Date: 03/14/2016 I herebyaffirm under penalty of perjury one of the following three declarations: P t3' P J rY ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1. 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 HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. 1 have Worker's Compensation Insurance, as provided for by he hazardous materials requirements under Chapter 3 I have read the of the 2. and will maintain California Health & Safety Code, Sections 25505, 25533, and 25534. I will Section 3700 of the Labor Code, for the performance of the work for which this maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the permit is issued. Health & Safety Code, Section 25532(a) should I store or handle hazardous 3. I certify that in the performance of the work for which this permit is issued, I material. Additionally, should Iquipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by a ay Area Air Quality Managem t District I Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the will maintain compliance wit the ertino icipai Code, h 'ter 9.1 aqd the Health & Safe Co ,Sectio 505, 25533,/adA2531"4� Labor complywith such provisions or this permit shall be deemed revoked. pwner or authorized a on Wrier Date: 03/14/2016 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 correct. I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued (Sec. 3097, Civ C:) relating to building construction, and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender`s Address judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands ARCHITECT'S DECLARATION and will comply with all non -point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code, Section 9.18. Licensed Signature Date 03/14/2016 Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(c),op��V� C U P E RT I N €? t-1 1—I �j F— NT IT (fn'MQ'rD7 TrTTnTQ 1 1 AT)TITTTO-K 1 1 AT. -PFR ATTOW / TT IXI REVISION / DEFERRED ORIGINTAL PERMIT 4 PROJECT ADDRESS APN # OWNER NAME (� 4 0 ] PHONE l I1 y0 ,6gQ-6859 EMAIL �tr�e ,CG r'@xcr �a ov, STREET ADDRESS 3'y f w r c G J CITY, STATE, ZIP isµ iN o CAa y FAX l• CONTACT NAME r PHO E-MAIL STREET ADDRESS , CITY TATE, ZI AX ❑ OWNER ❑ ORRQER-BUILDER ❑. OWNER AGENT �❑ CONTRACTOR ❑ CONTRACTOR AGENT. ECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE y''TIO ' gRIC - f2 //I.✓ `� 6 //�/J� EXISTING USE PROPOSED USE CONSTR. TYPE �j � t' Y # STORIES Z USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG AREA '.. NEW FLOG AREA DEMO AREA O TOTAL ) �l� NET AREA JF f f BATHROOM KITCHEN 6 OTHER REMODEL AREA D REMODEL AREA REMODEL AREA PORCHAREADECK AREA TOTALDECK�PORCHAR.EQ GARAGEAREA: ETACH a 6 TJ ❑ ATTACH O /STORY # D�VELLTNG UNITS: IS A SECOND UNIT ❑ YES SECOND ❑ YES t BEING ADDED' IY�NO ADDITION? (aF'NO PRE -APPLICATION S IF YES, PROVIDE COPY OF PLANNING APPROVAL LETTER IS THE BLDG AN E] -'-ES EICHLER HOTITE? ❑ NO RECEIVED BYE ;its _ � ^z TOTAL VALUATION: PLANNING APPL# ❑NO By my signature below, I certify to each of the follolving: I am property owner or authorized agent to act on the property oc�>ner's behalf. I have read this application and the information I have provided is correct, ave read the Description of �TTorIL and verify s accurate. I agree to comply Ivith all applicable local ordinances and state laws relating to building construe ' rt. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Dater l6 Signature of Applicant/Agent: SUPPLEMENT TFORMATION REQUIRED l , rLI`•clTEci ri rE _ _, VoUIc si it Vi xE COL7\TER * BUILDING PhA 72ESIEI3' INTew SFD or Multifamily dwellings: Apply for demolition pen -nit for existing building s). Demolition permit is required prior to issuance of building a permit for new building. REss fi' EXPIN L4��i�G PLATS RE�iES§p� C7sTAwAlxD; rUBLIevFOliis ; Commercial B1dQs: Provide a completed Hazardous Materials Disclosure form if any2T Hazardous Materials are being used as pari of this project. FIRE DEP a� Copy of Planning Approval Letter or Meeting with Planning prior to 7vL�aoR Q �A1IT R1 sEl� E ZDISTRICT t _ submittal of Building Permit application. - e w BldgApp_201 1. doc revised 06/21/11 Abbv Avende From: ihsia@yahoo.com Sent: Monday, March 14, 2016 4:09 PM To: Abby Ayende Subject: 19937 Twilight Court Abigaila , I hereby release Bay Area Custom Builders from the permit relating to the construction on our property. Holder Construction is our new contractor and'', can taken over the permit. Please let me know of you need anything else. Thank you. Ingrid Hsia 408-726-3090 Sent from Surface 1 ,a installed without fist obtaznmg an mspec io , g CITY OF CUPERTINO BUILDING PERMIT inspection. BUILDING ADDRESS 19937 TWILIGHT CT CONTRACTOR: BAY AREA CUSTOM PERMIT NO: 15100045 ` I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: BUILDERS INC ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER OWNER'S NAME a COHEN ARIEL TRUSTEE & ET AL 1002 S DE ANZA BLVD STE Al DATE ISSUED: 11/30/2015 will do the.work and the structure is not intended or offered for sale (Sec.7044, OWNER'S PHONE. 40868$6859 SAN JOSE, CA 95129 PHONE NO: (408) 446-1200 HAZARDOUS MATERIALS DISCLOSURE J;, T ICENSED CONTRACTOR's DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIALE] CONSTRUCT (N)-2 CAR GARAGE IN BACK YARD (500 ' License Class " Lic, #== G —( SQ FT maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Contractor ( l i rC� f �;��� f h O' 1)�iiW O Health & Safety Code, Section 25532(a) should I store or handle hazardous I have andwiil maintain a Certificate of Consent to self -insure for Worker's -- , I hereby affirm that I am licensed under the provisions of C apter 9 Compensation,.as provided forty Section 3700 of the Labor Code, for the air contaminants will maintain compliance with the Cupertino Municipal Code, Chapter .9.12 and (commencing with: Section 7000) of Division 3 of the Business & Professions the Health &Safety Code, Sections 25505, 25533, and 25534. I have and;will maintain Worker; s Compensation Insurance„ as provided for by Code and;that my license is m full force and effect. Section 3700 of the Labor Code; for the performance of the work for which this Owner or authorized agent: Date: I hereby affirm under penalty'of perjury one of the following two declarations: not employ any person in anymanner,so as to become subject to the Worker's I have and'will manitam a certificate of consent to self -insure for Worker's Compensation laws of California, If,'after making this certificate of exemption, I Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of Compensation as provided for by Section 3700 of the Labor Code, for the work's for which this permit is issued (Sec. 3097, Civ C.) - ame Lender's Nam r� ,performance of the work for,which this permit is issued. Sq. Ft Floor Area: Valuation: $40000 'I have and�will maintainWorker's Compensation Insurance, '41 provided for by APN Number: 31631034.00 Occupancy Type: Section 3700 of the Labor Code; for the performance of the work for which this t, permit is issued APPLICANT CERTIFICATION I certify that I bave"read Ks -application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree'to, comply with all city and county ordinances and state laws relating WITHIN ®� F PERMIT ISSUANCE OR to building construction; and hereby authorize representatives of this city to enter AYS F CALLED INSPECTION. upon:the aboye mentioned property for inspection purposes. (We) agree to save indemnify and keep`har iless:the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City inconsequence of granting ofthis,p' ermit. `Additionally, the applicant understands and wi compl ss with all non point source regulations per the Cupertino Municipal Code, Section 9.18 RE -ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed. If a roof is t' n I a ree to remove all new materials for AP LICANT installed without fist obtaznmg an mspec io , g inspection. ❑�r OWNER BUILDER DECLARATION Date: ` I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: the following two reasons ; ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, as owner of the+property, oi'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 HAZARDOUS MATERIALS DISCLOSURE construct the projeci, (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the ' California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty, of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations'!+` Health & Safety Code, Section 25532(a) should I store or handle hazardous I have andwiil maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous as defined by the Bay Area Air Quality Management District I Compensation,.as provided forty Section 3700 of the Labor Code, for the air contaminants will maintain compliance with the Cupertino Municipal Code, Chapter .9.12 and performance of fire work `for which this permit is issued. the Health &Safety Code, Sections 25505, 25533, and 25534. 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 Owner or authorized agent: Date: 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 anymanner,so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California, If,'after making this certificate of exemption, I Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of become subject,to,the Workers forthwith comply with such provisions or this permit shall fie deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) - ame Lender's Nam APPLICANT CERTIFICATION I certify that I have {ead this;application and state that the above information is correct. I agree to comply with ail 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 $arm indemnify and keep less the City of Cupertino against liabilities, judgments, costs, and expenses which may accmc against said City inconsequence 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.' i ,kr Signature i 1 Date ,. Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERTINO I ISI NEW CON STRUCTTnN CONSTRUCTION PERMIT APPLICATION � � , COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 building Q L.-cupe tino.org I AT)T)TTTOW n AT.TT=RATMV/TT I inI RF.VTST(1N/1lRFFRRTz.n r1RVTiTTAT P7R1ufT'Ty PROM Cf APN l� /4% OWNER NAME /- PHONEGd E-MAIL e�6 628—Q STREET ADDRESSY Cl CITY, STATE, ZIP I FAX V �7(nelGj � G�, C�P��UrI� CONTACT NAME ? PHONE E-MAIL vel"CD3603 OZ33 f'loGls14 V STREET ADDRESS :750 /eJ /, �� 1 2J CA [C❑GOA'A�RAGENTZ CITY, STATE, Z C4 �1&0 1❑!ENGINEER FAX 0\VNER 11 OWNER -BUILDER 0 CONTRACTOR ❑ CONTRACTOR AGENT ARCHITECT ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER I LICENSE TYPE BUS. LIC COMPANY NAME EMAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE -4,R-C-In•, JENGINEFR 211AME SGL A LICENSE N1WMER BUS. LIC m COMPANY NAME E-MAIL ,,/ /'I FAX STREET ADDRESS C TATE; ZIP �yyy CAI 0 ��J! {1 1 // �f / f v DESCRIPTION OF WORK 4117 y EXISTiNGUSE PROPOSED USE - - CONS TRTYPESTORIEs t) USE TYPE OCC. ( SQ.FT.. vALUATION(Sj EXISTG NEW FLOOR DEMO ',. TOTAL AREA AREA AREA. NEf AREA. - BATHROOM REMODEL AREA KITCHEN MIODELAAEA /� OTHER REMODEL AREA PORCHAREA DECK AT TOTAL DECK/PORCHAREA. GARAGEAREA: ETACH - - ,�[ .ATTACH 4DWELLINGUNITS: ISA SECOND UNIT E3 YES SECOND STORY YES- - -- - - BEING ADDED? M -NO ADDITION? ANO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES -EIUEDBY : ✓ � !�-. -� TOTAL VALUATION: - PLANNINGAPPL? ANO PLANNING APPROVAL: LETTER ( EICHLERHOME? []TO .. -r--; (s>✓_c) By my signature below, I certify to each of the following: I am the property er or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read - escription of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I au e- representatives -of Cupertino to enter the above -identified' property for inspection purposes. Signature of Applicant/Agent: Date: Zffkar-1 � SUPPLEMENTARIRMATXON REQUIRED 1 _s 3t0T3TIRGSLIP New SFD or Multifamily dNvellings: Apply for demolition permit,for I] OFER T�coTIItTEx $uavLnerL Nt��1EVT- ezisting building(s). Demolition permit is required prior to issuance of building - permit for new building.�ExPxEss 3 - PL�nI;rLsTlvaEw _ Commercial Bldgs: Provide ,a completed Hazardous Materials Disclosure EsTAnDAx = z3PUBLTev+oTiTcs { form if any Hazardous Materials are being used. as part of this projects 9 Copy of Planning Approval Letter or Meeting with Planning prior to ©S3ASQR� sTxrcr3:' _ submittal of Building Permit application. SANTPr]RYSg �� �`` .� EI�'VII2oI3n'iEI�T4L.HEAITEI , � _ Bldk*p_20 11. doc revised 06/21/11 k- kv CITY OF CUPERTINO� FEE ESTIMATOR — BUILDING DIVISION _,> > ADDREimSS: 19937 Twilight Gt. DATE: 10/06/2015 REVIEWED BY: PAUL APN: 31631034 BP#: *VALUATION: 1$40,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY USE: SFD or Duplex 2nd Unit? - Yes '' No OTC? 0 Yes E) No PENTAMATION PERMIT TYPE: 1 U WORK Contruct N 2 Car Garage in Back Yard 500 S.f. SCOPE PME Plan Check; OCCUPANCY TYPE: TYPE OF FLR AREA CONSTR. s.f. PC FEES PC FEE ID BP FEES BP FEE ID U (Private Gar/Ag Bldg) II-B,111-B,IV,V-B 500 $0.00 IUIPLNCK $1,290.00 1UIINSP I TOTALS: 500 I $0.00 $1,290.00 ( q 1 Ale& Plan Check, IL•'ell, I)ermit hee:Plumb, Other AJech- Insp. � Vfeci. Insp. Fee:Phvr,&, Phonb. Plon Check Perinit Fee:flec. Ofher.Plult2b.1f'sp, Irv. Fee: Elec. Plan Check P erwit F,e: Othef Flee, hisrp.. 15"iec. Imp. fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.. These - W are based on the preliminar information available and are only an estimate. Contact the De t or addn'l info, FEE ITEMS (Fee Resolution 11-053 E . 7/U13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Mise Bldg/Structure or Element of a Building Supp/. PC Fee: Reg. OT 0.0 hrs $0.00 PME Plan Check; $0.00 Permit Fee: $1,290.00 Suppl. Insp. Fee: Reg. 0 OT— 0,0 hrs $0;00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction 7` u: F-1 AdPl inistrative ,F e Work Without Permit? 0 Yes No $0.00 Advanced. Planning Fee: IPLLONGR $70.00 Select a Non -Residential Building or Structure / ?t€t c l rr3c ura�'tictii1.Ic?.�.` Strong Motion Fee: IBSEISMICR $5.20 / ( Select an Administrative Item IM Bldg Stds Commission Fee: IBCBSC $2.00 _IxBT(JTAL- OALEE. $1, 367.20 $1,367.20 $0.00 . ,ain Revised: 10/01/2015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15100045 19937 TWILIGHT CT CUPERTINO CA 95014 (316 31034) ANTHONY HODDER CONST CUPERTINO, CA 95014 OWNER'S NAME: COHEN ARIEL TRUSTEE & ET AL DATE ISSUED: 11/30/2015 OWNER'S PHONE: 408-688-6859 PHONE NO: (408) 499-5990 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic. #446573 Contractor ANTHONY HODDER CONST Date 06/30/2016 — BLDG —ELECT —PLUMB MECH RESIDENTIAL COMMERCIAL 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. JOB DESCRIPTION: CONSTRUCT (I) 2 CAR GARAGE IN BACK YARD (500 SQ FT) I hereby affirm under penalty of perjury one of the following two declarations: 1. I have and will maintain a certificate of consent to self -insure for Worker's Revision #1: Revise garage to conditioned den (446 sq ft) and new attached Compensation, as provided for by Section 3700 of the Labor Code, for the for is issued. single car garage (313 sq ft) - Issued 3/14/16 performance of the work which this permit I have and will maintain Worker's Compensation Insurance, as provided for by REVISION #2: INSTALL 1 HOUR FIRE RATED "FIREFREE 88" Section 3700 of the Labor Code, for the performance of the work for which this MATERIAL AT REAR AND SID WALL OF DEN ADDITION permit is issued. g S V �O F/Z / 14 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 Sq. Ft Floor Area: Valuation: 540000.00 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 APN Number: Occupancy Type: may accrue again id City in consequence of the granting of this permit. 316 31 034 Additionally, the pp' nt understands and will mply with all non -point source regula ' ns p r the Cup ino Munici I ode, S ction �18, PERMIT EXPIRES IF WORK IS NOT STARTED Signature ate WITHIN 180 DAYS OF PERMIT ISSUANCE OR OWNER -BUILD .R DECLARATION 180 DAYS FROM LAST CALLED INSPECTION. I hereby affirm that I am exempt from the Contractor's License Law for one of the Issued by: MELIP-1 $L-1 following two reasons: Date: 11/30 t. 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) z. I, as owner of the property, am exclusively contracting with licensed RF -ROOFS: All roofs shall inspected prior to any roofing material being installed. If roof is contractors to construct the project (Sec.7044, Business & Professions Code). rials for installed withoutt first obtaining an inspection, I agree to remove all new materials inspection. I hereby affirm under penalty of perjury one of the following three declarations: 1. I have and will maintain a Certificate of Consent to self -insure for Worker's Signature of Applicant: Compensation, as provided for by Section 3700 of the Labor Code, for the Date: 08/02/2016 performance of the work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance, as provided for by ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 3. 1 certify that in the performance of the work for which this permit is issued, I HAZARDOUS MATERIALS DISCLOSURE shall not employ any person in any manner so as to become subject to the I have read the hazardous materials requirements under Chapter 6.95 of the Worker's Compensation laws of California. If, after making this certificate of California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the exemption, I become subject to the Worker's Compensation provisions of the Health & Safety Code, Section 25532(a) should I store or handle hazardous Labor Code, I must forthwith comply with such provisions or this permit shall material. Additionally, should I use quiprnent or devices which emit hazardous be deemed revoked. air contaminants as defined by t y Area Air Quality Management District I will maintain compliance with e C pertino Municipal Code, C apter 9.12 and APPLICANT CERTLFiCATION I certify that I have read this application and state that the above information is ode, ectiaus 25 O5, 25533, d 55 the Health & Ss7tt: 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 Owner or authorized ag to enter upon the above mentioned property for inspection purposes. (We) agree Date: 08/02/2016 to save indemnify and keep harmless the City of Cupertino against liabilities, CONSTRUCTION LENDINGAGENCY judgments, costs, and expenses which may accrue against said City in I hereby affirm that there is a construction lending agency for the performance consequence of the granting of this permit. Additionally, the applicant understands of work's for which this permit is issued (Sec. 3097, Civ C.) and will comply with all non -point source regulations per the Cupertino Municipal Lender's Name Code, Section 9.18. Lender's Address Signature Date 08/02/2016 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. CONSTRUCTION PERMIT APPLICATIREVISION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 C U P E RTI N O (408) 777-3228 • FAX (408) 777-3333 • buildin cu ertino.or ❑ NEW CONSTRUCTION ADDITION ❑ ALTERATION / TI V REVISION / DEFERRED ORIGINAL PERMIT # t'5I00 CJ PROJECT ADDRESS pyne7 T- 1 `L_t C,0,vg'-r APN # OWNER NAME A n k� -7o PHONE E-MAIL V y IA D r; � � (rl STREET ADDRESS 07 Q ` I,� �j� CITY, STA ,ZIP �Q fv I /! FAX ` ( WCo CONTACT NAME A- ; k 6 8 e 69sl_/E PHONE Y _Q o a 1`( a_). STREET ADDRES CrrY TATE, � Q� FAX �` OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT 11 CONTRACTOR ❑ CONTRACTOR AGENT 11/ARCHITECT ❑ ENGINEER 11 DEVELOPER ❑ TENANT CONTRACTOR NAME LICENS 23 LICENSE TYPE BUS. LIC # COMPANY NAME A%. LL& 614 E-MAIL FAX STREET ADDRESS CITY, S A E, ZIP �� PHONE ARCHIT /ENGINEER NAME LICENSE NUMBER BUS. LIC # vZ COMPANY NAME E-MAIL FAX ILI 4, ST T RES 7o L ATE, 1 6 DESCRIPTION OF WORK Va--� 6G a.I--- EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE Il'PE OCC SQ.FT. VALUATION ($) 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 H ATTACH # DWELLING UNITS: ISA SECOND UNIT ❑ YES SECOND STORY YES BEING ADDED? ❑ NO ADDITION? []NO PRE -APPLICATION []YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES XIDEIVED BY: TOTAL LUATION: PLANNING APPL # []NO PLANNING APPROVAL LEITER EICHLER HOME? ❑ NO By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. Iave read this application and the information I have provided is correct. 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 building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. ` ��� Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED P N CHECK TYPE ROUTING SLIT' New SFD or Multifamily dwellings: Apply for demolition permit for _ existing building(s). Demolition permit is required prior to issuance of building OVER-THE-COUNTER BUILDING PLAN REY'11:\\ permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REFI I \\ _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure El STANDARD El 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 El MAJOR ❑ SANITARY SEWER DISTRIC I Submittal of Building Permit application. ❑ ES\ IItUN)il.\T:\L IIF.:\LIII B/dgApp_2011.doc revised 06/21/11 RE4'If V�'ED t -OR CCOUE COiMF'L,Ir/, o c. Reviewed Bp: Beam Calculation OFFICE COPY Section Drawing - Tributary Width f-== yam. 'A/ Q 0 A Beam Spam - L 20.00 ft Tributary Width 10.00 Ift Live Load & Dead Load - Load x Tributary Width Live Load (Tributary Width x 20 psf) 200 Ib/ft Dead Load @ Roof Roof Extantion (Rafters / Plywood) 3.00 psf Composition Tile / Wood shingle 3.50 psf Plywood 1.50 psf Roof Rafter 1.50 psf Misc. 1 1.00 1 psf Total DL @ Roof 10.50 psf 105 Ib/ft Dead Load @ Ceiling W(DLC) Ceiling Joist 0.00 psf Sheetrock 0.00 psf Insulation 0.00 psf Mechanical 0.00 psf Misc. 0.00 psf Total DL @ Roof 0.00 psf 0 Ib/ft Total Distributed Load 305 Ib/ft Shear & Moment Diagram Max. Shear (0.5 x Beam Spam x Total Disributed Load) 3,050.00 lbs Max. Moment (0.5 x Beam Spam) x (Max. Shear / 2) 15,250.00 Ib-ft Variables & Factors Beam Size I b= 5.25 d= 11.88 in E = 2,000,000.00 psi S = (1/6)bd^2 123.39 in13 I = (1/12)bd^3 732.62 in^4 Bending Stress - M/S Bending Stress - Actual psi Bending Stress - Allow • ��- CbRF1,483.12 2,900.00 Ipsi Z;.bDef ec�ion`- L^ 84E1 Deflection - Actual 0.75 lin Deflection - Allowable (L. i 1.00 in RE4'If V�'ED t -OR CCOUE COiMF'L,Ir/, o c. Reviewed Bp: