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BLD-2023-2513_ApplicationCONSTRUCTION PERNIITAPPLICATION COMMUNI"IN I)EVEiLOPM.EN'I' I:)I:I.:PARTME:NI' • BUILI)ING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408)777-3228• I)erni.itcenter'Grupertino.org PERMIT #B- CUPERTINO REVR DEF1 ❑ NEW CONSTRUc7ION ❑ ADDITION ❑ ALTERATION ❑ T.I_ ❑ MFP rl RE -ROOF ❑ SWIMMING POOL/SPA PROJECT ADDRESS 10364A Vista Dr. Cupertino, CA 95014 APNI 316-33-127-00 OWNER NAME Zeljko ADDRESS 840 Croman Pt. CITY, STATE, ZIP Aubum, CA 95603 © CONTRACTOR NAME ❑ OWNER -BUILDER COMPANY NAME LICENSE NUMBEA LICENSE TYPE Tony Vladislavich I A.V. Construction CA#882408 I STREET ADDRESS 1145 West Iowa Ave CITY, STATE, ZIP Sunnyvale, CA 94086 E-MAIL PIIOIVE 408-507-1848 BUS. llC 1av_construction@yahoo.com ❑ ARCFRT ©OWNER I oO . AGENT ❑ cONrFtACTOR AcE O ENGINEER O oEVELOPER ❑ TENANT CONTACT NAME Zeljko Pavic E-MAIL zeljko.pavic@gmail.com STREET ADDRESS 840 Croman Pt. CRY, STATE, 71P Auburn, Ca 95603 PHONE. 530-392-2466 DESCRIFTON Basic remodeling of two Bathrooms and a Kitchen Bathroom #1 Bathroom #2 Kitchen TOTAL VALUATION: 52,365.00 ®SINGLE-FAIVIILY/DUPLEX ❑MULTI-FATIILY" ❑ INDUSTRIAL ❑ COMMERCIAL USE TYPE OCC SQ.FI. VALUATION($) EXISnNG USE I EXISTING SF NEW FLOOR 5F PORCH 5F DECK SF DEMOSF STORIE5I TOTAL NET SF REMODEL BATHROOM SF RE-MODELXI`TCHEN SF y y EMODEL^OTHR GARAGE 5F l p,( SF ATTACHED ❑ DETACHED 5 ORl' ADDn10N HKE SFRNKL.ERS ❑ Np EICHLER O `O O ONO DWELLING tOO\DDwEUJN\ YES [3ATTACHEDQDETACIffD OTHER LNITSu L'NIT ADDTroN. ❑NO 5F POOLS ❑ FRIERGLASS 0 VM 1-LINED ❑ GUN— ❑ PREFAeRICAT'ED POOL -SF 5PA-SF I SPA ATTACHED 0 — 0 NO I TOTAL -SF RECEIVED BY: Canntn-aal m Multi-Fmnl Bnddin with f'uWic S in Pods rc uva mtmmt Enairoxn¢ntd Hcath a nwW LIE -ROOF I EXISTING ROOF TYPE ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ TILE OTHER (SPECIFY) REMOVE /REPLACE❑NO IF NO PLYWOOD ❑�'" ❑3/8" PLYWOODT1PE PITCH: ROOF CLASS ❑YES a OF LAYERS-__--- THICKNESS ❑ 518" OTHER I ❑OSB ❑ COX OTT -Ex :12 A PROPOSED ROOF TYPE CIBUILT-UP ROOF 13ASPHALT SHINGLES ❑ WOOD SHAKES OWOOD SHINGLES DOTHER *Provide a signed copy of the Cupertino's Tear -Off Policy SF #ef SQUARES 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. 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. 1 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. I owledge and authorize all infomtation contained on this application form to be made available for public record. O- signature 1, 2023 SUPPLEMENTAL INFORMATION REQUIRED *New SFD/Sewnd Dwelling Units/Multifamily Dwellings: A Demolition permit is required prior to issuance of a building permit for all new constru lion. *Commercial Buildings: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. -copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. *HOA-Provide a letter of approval from the Home Owner's Association BldgApp_ 2017doe revised 0101,21