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15030189-D CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10640 GLENVIEW AVE CONTRACTOR:&C'/ NO9PU PERMIT NO:15030189 OWNER'S NAME: BHAGWAT YOGESH A AND BHAGYASHREE Y DATE ISSUED:05/04/2015 OWNER'S PHONE: 5103661833 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL ❑ _ CONSTRUCT ONE STORE'ADDITIONS(317 SQ FT); License Clash ie Lic.# /S BATHROOM REMODEL(60 SQ FT); OTHER REMODEL(338 ��r SQ Contractor LA � ' ✓:; Date I FT);ELEC PANEL UPGRADE(200 AMP). 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. Sq.Ft Floor Area: Valuation:$150000 ii 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 APN Number:36925001.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this 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 BVITIIIN 180 D RMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DA O LLED PECTION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the S granting of this permit. Additionally,the applicant understands and will comply ue Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature : Date 4444-741-5 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. ❑ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE construct the project(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 and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25 ,25 3,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized age �.�-�"'� Date:1�'�:il �L�f^ permit is issued. V_ 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 C STRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address - 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, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional i 9.18. I Signature Date I CITY OF CUPERTINO BUILDING PERMIT BUILDING,ADDRESS: 10640 GLENVIEW AVE CONTRACTOR:LEI WEN PERMIT NO: 15030189 CONSTRUCTION OWNER'S NAME: BHAGWAT YOGESH A AND BHAGYASHREE Y 432 HONOLULU CIR DATE ISSUED:05/04/2015 OWNER'S PHONE: 5103661833 UNION CITY,CA 94587 PHONE NO:(408)509-9700 I, LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑ CONSTRUCT ONE STORY ADDITIONS(317 SQ FT); License Class_ Lic.# ��U�'/S BATHROOM REMODEL(60 SQ FT); OTHER REMODEL(338 Contractor /(?/ l t/t?/) Date `3- ya/S- SQ FT); ELEC PANEL UPGRADE(200 AMP). �J REV#2-ELIMINATE 2 CEILING BEAMS OVER FAMILY I hereby affirm that I am licensed under the provisions of Chapter 9 RM & ADD A 2 X 10 OVER MASTER BDRM &INCREASE (commencing with Section 7000)of Division 3 of the Business&Professions MASTER BDRM WINDOW HEADER TO 4 X 12-ISSUED Code and that my license is in full force and effect. 6/9/15 I hereby affirm under penalty of perjury one of the following two declarations: 1 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. Sq.Ft Floor Area: Valuation:$150000 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 APN Number:36925001.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION ! I certify that I have read this application and state that the above information is PERMIT EXPIRES IF W OT STARTED correct.]agree to comply with all city and county ordinances and state laws relating WITHIN 180 D IT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DA CALLED INSPECTION. 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 ate: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature ate / All roofs shall be inspected prior to any roofing material being installed.If a roof is I installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ ER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 oft he 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 and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for theerformance of the work for which this p Owner or authorized agent: t �� W�� 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 any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,1 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,1 must I hereby affirm that there is a construction lending agency for the performance of j forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is,issued(Sec.3097,Civ C.) Lender's Name I APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct.1 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. SrantinS of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•building(Dcupertino.org ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI RBVISI DEFERRED ORIGINAL PERMIT n /J 03 )189. PROIECf ADDRESS APN R 6 2 00/ Q ✓ i/fi �Y :n n OWNER NAME e—sh ��� PHO S/a3 6 /83� E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX CONTACT NAME PE-MAIL / Ile-1 cJ C417 HONE ssv — 70 U LQii�P/�GsKslr w Msr.(,Cos*'! STREET ADDRESS CITY,STATE,ZIP , FAX OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ,tet CONTRACTOR ❑CONTRACTOR.AGENT ❑ ARCHrrECf ❑ENGINEER ❑ DEVELOPER ❑TENANT CONIRACTORNAME ) LICENSENUMBER LICENSETYPE BUS.LIC A[ ' %• �N � ODI COMPANY NAME E-MAIL FAX STU ADDRESS / / CITY,STATE,ZIP PHONE T 2 C 17 0 41 Z1, Cl Y I (//4li v h C ARCHITECT/ENGINEFR NAME LICENSE NUMBER I BUS.LTC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTIONOFWORK(;E e I -` l " 1_ -o l•�b �j2�Ht OVQJ, 6L �7 ." AMY r y�► � Z x O V� a stkW b B,c YOV VV\l I A C-1 4t (f X o u 4- Z {Z EXISTING USE PROPOSED USE CONSTR TYPE STORIES USE TYPE OCC. , SQ.FT. VALUATION(S) F7.7STG NEW FLOOR" DEMO TOTAL AREA AREA AREA NET AREA BATHROOM. KITCHEN, OTHER, REMODEL AREA REMODEL AREA REMODEL AREA I PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: El DETACH ❑ATTACH R DWELLING UNrrS: IS A SECOND UNrr ❑YES SECOND STORY ❑YES BEINGADDED? ❑NO ADDITION? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDC AN YES ' ""' ❑ - DAY ��fl �� -- �s TOTAL VALUATION: PLANNING APPL-, ❑NO PLANND4G APPROVAL LETTER EICHLER HOME? ❑NO ,�, .. I,,;r -. � -- - �ri _ By my signature below,I certify to each of the following: I am the property owner or autho ' act on the property ow'ner's behalf. I have read this application and the information I have provided is correc 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 co t I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: — Date: SUPPLEMENTZ,11i 4ATION REQUIRED �` '`�� � = I Y �' �� '�,.iC2�•CKT�I�.F��_'�'�4.,:s ; SFD or Multifamily ngs: Apply for demolition permit for s ` ROOM— New 04ER fHECOURTER � BUIIDINCPL4iRETTIEIST" S existing building(s). Demolition permit is required prior to issuance of building `�11, permit new ung Q� _ M-M FEIN, p it fbuilding. 'ESS e RyF.L�REVIE ry� ': _Commercial Bld s: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. � y � Sm F�� rr _Copy of Planning Approval Letter or Meeting with Planning prior to p R s rTts>Sr�x �� submittal of Building Permit application. . B1dgApp_2011.doc revised 06/21/11 i CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10640 GLEANVIEW AVE DATE: 06/09/2015 REVIEWED BY: MELISSA APN: 369 25 001 BP#: 15030189 *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1 GENRES USE: PERMIT TYPE: A WORK REV#2- ELIMINATE 2 CEILING BEAMS OVER FAMILY RM &ADD A 2 X 10 OVER MASTER SCOPE BDRM & INCREASE MASTER BDRM WINDOW HEADER TO 4 X 12 - ISSUED 6/9/15 '��'���ti•,�R1+fY�rs'.�1� .�i�': �G7�1�?�F1d� 'c3f�{k��l� �.�;':;tw . s'�':'a �.-,�.,` �"+t.:::ky;' 4d£` rtiidP+iZ .e�:.;�+�r ��':`.. X34..�.a:»ua n'y^`,.:.f., ",i1 M41u ywv. ,., i,,;E.� i. i.•�� w,..: .w r:.x,��r .s -..x„*�r �,9...tiYe"�a.>Jir H.7',�e.�.�}��.a�s�tk� �. :r�t a- IF'4:. "�^`ri�—�'* �,��Y.. .�� z•4a^�,+�Te,�"v9. r�r,.. �°F .qx.� i,t ,� �:`1”, s:;! � +�".a�a pix .,.,r t,� B.q ,,gyp•s ,.0 r:ii 4Ty4'Si�"r'. } �'r�i 1�� .�"Cs 3'•'3..� ,i"� t^ Sr:A i��. u.1;.r'`sSt ��•s^�,�:r.,��w.1.47`��' �R r -� M,.:.-Lh ,,,Ett �,�Px$h H�•n 4�.!;�'iu"s�::Vii: 6r�n.il3:e 'tk �.�r, a:.t�,.,.. :.�w ..:r.�:r,... :.�, y��,...,a c�.m•.„�✓,,,.�.��i.. I 1 'Lied. Plan(.'heck /'11110. Plan("heck L'lecr. !Tarr Cherk J4eah. Permril Fre: Plumb. Permit Fee: lilec. Permit Fee: 01011 A'lec'h. Insp. 0(her Phrrrlh Insp. Other 61ec. /rul:r. 1•/�clr. Iavj. }''e . Phmrrh. h)sp. /••rc•: Llew. hair.Fe.: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Thesefees are based on the prelitiniina information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS(Fee Resolution 11-053 f f 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes Q No $0.00 1 hours Plan Check,Hourly Suppl. PC Fee: Q Reg. 0 OT0.0 hrs $0.00 $143.00 ISTPLNCK PME Plan Check: $0.00 Permit Fee: Hourly Only? 0 Yes Q No $0.00 Suppl. Insp.Fee:Q Reg. 0 OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C:cntsrructkni Tax: r1fbninisl'rafive Fee: Work Without Permit? 0 Yes 0 No $0.00 E) Advanced PlanninL Fee: $0.00 Select a Non-Residential E) Building or Structure 0 71crvc I U(rC'lc1Y(ict7.luhorr F'c'(.'.i': A Strong Motion Fee: $0.00 1.0 hrs Inspections Bldg Stds Commission Fee: $0.00 $143.00 ISTINSP Inspection,Hourly hApm;4�s 2H}..-7i ti t�,',+ - k i '✓5..io i ,k � u��d 7 R ntx •'k i t r"I }yariy, sY7BTO,TA $0.00 $286.00 ` x ,xsToTE $286.00 sdaC4F'-x' a uAa Revised: 05/07/2015 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300TORRE AVENUE• CUPERTINO, CA 95014-3255 CUPERTINQ (408)777-3228• FAX(408)777-3333•building(LDcupertino.org ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI REVISION/DEFERRED ORIGINAL PERMIT PROJECT DRESS APN R e%r✓i'e'k✓ 14Ve OWNERNAMEYO PHONEPE-MAIL STREET ADDRESS �i CITY, STATE,ZIP L FAX CONTACT NAME -el )eN PHONE 40 �0717pV E-MAIL, 6V 7'V STREET ADDRESS CITY,STATE,ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTORAGENT . ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENS TYPE BUS.LIC# Ze.r 11t1 S da/j- 15 COMPANY NAME E-MAIL FAX LOl1 GCC �o�f L'I ✓LS/s' o �1 ` C�° STRE DRESS // C CITY,STATE,ZIP /_� ip PHONE v D L662 Y(.( Ci LZ ��y Cl.J! '`7�i ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORKon 1 �. . �0 12, " 12U4r­ EXISTING USE PROPOSED USE CONSTR.TYPE 4 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 DECKIPORCH AREA GARAGE AREA: LJDETACH ❑ATrACH 9 D WELLING 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 ❑YESVins - .�-r: vZ_.;--"-* _ _ -OTAL VALUATION: PLANNING APPL 9 ❑NO' PLANNING APPROVAL LETTER EICHLER HOME? - By my signature below,I certify to each of the following: I am the property owner or auth o act o owner's be have read this application and the information I have provided is correct. I have rea Description ork an Fri it is accurate. I agree to comply with a icable local ordinances and state laws relating to building construction. I &0'r;e representatives of Cupertino to enter the above-identified property for inspection p ses. Signature of Applicant/Agent: Date: !,((A SUPPLEME 'T INFO REQUIRED - �, New SFD or Multifamily dvvellings: Apply for demolition permit for ovs T�coiJhTER s � 'S ❑�BUII,DING PLAN J2EVIEFi' existing building(s). Demolition permit is required prior to issuance of building permit for new building. �xPEss ern meinTlRr ulEw -� _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ©�rAlvnAxD ❑ PUBLTwoTzxs x form if any Hazardous Materials are being used as part of this project. x s = LARGE LDIIt!DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to _ © MA70RSA1�TfAIYSEwER>)ISTRICT submittal of Building Permit application. B1dgApp_2011.doc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10640 GLENVIEW AVE DATE: 06/01/2015 REVIEWED BY: MELISSA APN: 369 25 001 BP#: 15030189 *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1GENRE WORK REV# 1 - REVISE SLAB/FOUNDATION TO ACCOMODATE ROOF LOAD- ISSUED 6/1/15 SCOPE ;blech. Plan(.'heck Plumb.Plan Check Flee.Plan Cheek .hlcclr. Permit Fee: Plumb.Permit Fee: Rex. Permit Pie: Other;llech..lnsp. Other Plumb Insp. Other Elec.Insp. Mech,Ins)).Fee: Phrnib.Irup. Fee: Elec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). Theseees are based on the prelimina information available and are only an estimate Contact the De t or addn'1 info. FEE ITEMS (Fee Resolution 11-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes (j) No $0.000 hours Plan Check,Hourly Suppl.PC Fee: (j) Reg. 0 OT 0.0 hrs $0.00 $143.00 1STPLNCK PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee-.0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Acdministrative Fee: Work Without Permit? 0 Yes (2) No $0.00 o Advanced Planning Fee: $0.00 Select a Non-Residential Travel Documentation Fees: I Building or Structure 0 i Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 N'q b ffi SUBTOTALS:fi $0.00 $143.00 n TOTAL FEE $143.00 M� ,o o . Revised: 05/07/2015 I . CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O I� 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 5b� CUPERTINO LJ(408)777-3228•FAX(408)777-3333•building(a cupertino.org ` ❑NEW CONSTRUCTION eADDITION ALTERATION/Ti ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 7AP # t7 2AW 6 - yS - OWNER NAME Q C �.\_ PHONE EMAIL 1, Y� IVC 'SIP -366 -0$3 Y \0 wast con, STREET ADDRESSk a ! 4.- O �`euU;�' ' CITY,STATE,Z[� � CNA- J FAX G CONTACT NAME PHONE E-MAIL ' PW" V' C,ngs.. 4ls- Z-�S3� Q.y+kan Get . H,4 Go1�. STREET ADDRESS CITY,STATE, FAX 1k-t-��f!_ r, m d,• -tti1-e 4 ❑OWNER ❑ OWNER.BUILDER ❑OwNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT u ARCHITECT EYENGiNEPR ❑ DEVELOPER ❑TENANT i CONTRACTOR NAME J LICENSE NUMBERLICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCMTECT/ENGINEER NAME w 1 LICENSE NUMBER 0 BUS.LTC# COMPANY NAME E-MAIL y FAX STREET ADDRESS 6S, mor"2 CITY,STATEL P y CA ctA-r¢ PHONE S -;- ' r 3 DESCRIPTION OF WORK T'J o yve _ t 9-d �tZa " {v ¢ e�dr=) Mc"S te,r cg EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES Sy v USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO` TOTAL AREA , AREA a 1 AREA O NET AREA-Zi' BATHROOM KITCHEN OTHER REMODEL AREA Z REMODELAREA Q c REMODEL AREA 60. I ,2 t7 r PORCH AREA DECK A,REElA TOTAL DECKIPORCH AREA ,GrA�R�fA�GEE ARREA: � DETACH 15 1 1.6 r ACIT #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY YES I BEING ADDED? PI ADDITION? PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑ RECEIVED BY`, - - 1 ° PLANNING APPL# aWO PLANNING APPROVAL LETTER EICHLER HOME? - -.7t10 By my signature below,I certify to each of the following: I am the property owner or authorized agent to property owner's behalf. I have 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 buil g construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: �` ' ' Date: SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑'.OVER-THE-COUNTER ING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. EXPRESS, IRIPLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD El PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. Ip LARGE ❑ FIRE DEPT- _Copy of Planning Approval Letter or Meeting with Planning prior to p MAJOR SANITARY SEWER DISTRICT submittal of Building Permit application. " ❑ ENVIRONMENTAL HEALTH i B1dgApp_2011.doc revised 06121111 i i r i I 1 I I CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10640 Glenview Ave DATE: 04/16/2015 REVIEWED BY: Sean APN: BP#: 0 0 "VALUATION: 1$150,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY 2nd Unit? ` Yes No PENTAMATION USE: SFD or Duplex OTC? 0 Yes E)No PERMIT TYPE: 1 R3SFDADD WORK Construct one storV additions 317 sq ft • Bathroom remodel 60 sq ft); Other remodel 338 sq ft • Elec SCOPE panel upgrade (200 amp). OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3(Custom) II-B,III-B,IV,V-B 317 $1,626.00 IADDPLCK $1,323.00 1ADDINSP TOTALS: 317 $1,626.00 . $1,323.00 °' MECH,HOURLY `. 0 Yes 0 No. PLUMB;HOURLY Q Yes Q No ELEC,HOURLY 0. Yes Q No. Mech. Plan Check Plumb, Plan Check Elec.Pian Check 0.0 1 hrs $0.00 i alae&Permit Fee: Plrnnb. Permit Fee: Elec.Permit Fee: IEPERMIT Other Aiech.Insp. Other Plumb Insp. Li Other Elea Insp. Lojhrs $48.00 Xlech.Insp. Fee: Plumb.Insp. Fee: F'lec.Insp.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 fees are based on the prelinddna information available and are only an estimate. Contact the De tor addn't in o. FEE ITEMS (Fee Resolution 11-053E . 7111131 FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,626.00 60 s.f. Remodel,Bath(<=300 sf) Suppl.PC Fee: Q) Reg. Q OT 0.0 1 hrs $0.00 $645.00 IREMRESBAT PME Plan Check: $0.00 = s.f. Remodel,Other Permit Fee: $1,323.00 $503.00 IREMRESOTH Suppl. Insp.Fee:Q Reg. Q OT 0.0 hrs $0.00 = amps Electrical PME Unit Fee: $0.00 $48.00 IBELEC200 Services PME Permit Fee: $48.00 Construction Tax: Administrative Fee: 0 Work Without Permit? 0 Yes No $0.00 G Advanced Planning Fee: IPLLONGR $44.38 Select a Non-Residential Q Travel Documentation Fee: ITRAVDOC $48.00 Building or Structure r Strong Motion Fee: IBSEISMICR $19.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $6.00 .SUBTOTALS: $3,114.88 $1,196.00 kr ��;ToT�L�EE=�A $4,310.88 Revised: 04/01/2015 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10640 glenview ave DATE: 03/31/2015 REVIEWED BY: Mendgz APN: BP#: *VALUATION: $150,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addit'on PRIMARY 2nd Unit? Yes No PENTAD' TION USE: SFD or Duplex OTC? 0 Yes (F)No PERMIT TYPE: 1R3SFDADD WORK 317 s ft addition to expand master suite; family rm Guest rm; remodel throw h out 397 sq ft SCOPE TYPE OF FLR AREA OCCUPANCY TYPE: CONSTR. J. PC FEEY PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,111-B,IV,V-B 317 vn6, 1 IADDPLCK $1,323.00 IADDINSP t / TOTAL N. 317 $1,626.00 $1,323.00 MECH,HOURLY" 0..Yes' HfOURLI'' ,"`Yes Q No; r ELEC;`HOURLY:`,. Mech. Plan Check Plat Check Elec.Plan Check 0.0 hrs $0.00 :Vech. Petnnil Fee: r Plumb.Permil Fee: Elec.Permit Fee: IEPERMIT J Orher Meeh. Insp• l)rlte Plumb Insp. Other Elea Insp. 0.0 hrs $48.00 AJech.Insp.Pee: P trnb. Insp. Fee: Elec.Insp.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 ees are based on the RLelimina information available and are only an estimate. Contact t1:e De t or addn'l info, FEE ITEMS (Fee Resolution 11-053 11f. 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,626.00 = s.f. Remodel,Other Suppl. PC Fee: ) Reg. 0 OT, 0.0 1 hrs $0.00 $503.00 /REMRESOTH PME Plan Check: $0.00F-2007 amps Electrical Permit Fee: $1,323.00 $48.00 IBELEC200 Services f� Suppl. Insp. Fee-.(D Reg. )(DOTFO.07 hrs $0.00 PME Unit Fee: $0.00 I PME Permit Fee: $48.00 Construction Tax: Adininistrative Fe : Work Without P60 0 Yes (j) No $0.00 Advanced Plan in Fee: IPLLONGR $44.38 Select a Non-Residential G Travel Docu ntation Fee: ITRAVDOC $48.00 Building or Structure 0 i Strong Motio .Fee: IBSEISMICR $19.50 Select an Administrative Item .Bldg Stds Commission Fee: IBCBSC $6.00 SUBTOTALS: $3,114.88 $551.00 ,¢TOTAL FEE: $3 ISS Revised: 02/14/2015 1 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I IN O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# OWNER'S NAME: PHONE# GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: "�-Y2 p Lu f CITY/ZIPCODE: Uoz.3 h *Our municipal code requires all businesses working in fhe city to have a City of Cupertino busines license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontrac nd 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 Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank, Sheet Metal Sheet Rock Tile Ow e• or S' aturej� ate