11100054 (2)CITY OF'CUPERTINO BUILDING PERMIT_
BUILDING ADDRESS: 10325 FARALLONE DR
NAME: UNDERWOOD PHILIP G AND MARCIA
£R'S PHONE: 4082575181
License Class '
Contractor Date.
1 hereby affirm that 1 pm licensed under the provisions of Chapter!)
(commencing with Section 7000) of Division 3 of The Business & Professions
Code and that my license is In full force and eRcel.
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.
1 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
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
cored. 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,
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 ail non -point source regulations per the Cupertino Municipal Code, Section
9.18.,
Date
OWN R-BUI D R DECLARATION
hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
I, as owner of the property, or; my employees with wages ss their sole compensation,
will do the work, and the structure is not intended or offered for sale (Sce.7044,.
Business & Professions Code)
1, es owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
i
I hereby alflrm 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
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
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, I
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisiore or this permit shall be deemed revoked.
APPI trANT CERTIFICATION
1 certify that 1 have read this application end state that the aboveinformation 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
ipa-mni fy and keep harmless the City of Cupertino against liabilities, judgments,
and expenses which may accrue against said City in consequence of the
g. -..,mg of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Scotion
•9.18. t ' ,.,
Sivnature 1 Daft) 71-Vj
CONTRACTOR: UNDERWOOD PHILIP G
PERMITNO: 11100054
AND MARCIA
10325 FARALLONE DR
DATE ISSUED:10/072011.
CUPERTINO CA, 95014-3105
PHONE NO:
r
r
BUILDING PERMIT INFO: BLDG
ELECT'r PLUMB
MECH r RESIDENTIAL
r COMMERCIAL!—
OMMERCIAL!—JOB
JOBDESCRIPTION: REP1. LACE EXISTING TUB & VANITY ONLY, NO '
ELECTRICAL
LIGHTING OR NEW OUTLETS
Sq. Ft Fluor Ara: - _ I Valuation: $5000
APN Number: 36931013.00 I Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
rued by:f::27—'ice—�-30 Date:��/..��Y.
Y ' RE -ROOFS: r
All roofs shall be inspected prior many roofing materiel berg installed. If a roof is
installed without first obtaining an inspection,) agree to remove all new materiels for
inspection.
Signature of Applicant: Dare:'
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
I F.VA" 'Aall 113U.111n e
1 have rad the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(m) should I store or handle bazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District 1 will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Date-
CONSTRUCTION
ate:
CONSTRUC ION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.) '
Leader's Name
Lender's Address
I understand my plans shall be used as public records.
• ITEM 1 OF 1
•
•
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Elk: Lot:
APN ........: 36931013.00
DATE ISSUED.......: 11/17/2011
RECEIPT #.........: BS0000IS343
REFERENCE ID # ...: 11100054
SITE ADDRESS .....: 10325 FARALLONE DR
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
OWNER ............: UNDERWOOD PHILIP G AND MARCIA
ADDRESS ..........: 10325 FARALLONE DR
CITY/STATE/ZIP ...: CUPERTINO CA, 95014-3102
RECEIVED FROM ....: PHILIP G UNDERWOOD
CONTRACTOR .......2 LIC # *OWNER*
COMPANY ..........: UNDERWOOD PHILIP G AND MARCIA
ADDRESS ..........: 10325 FARALLONE DR
CITY/STATE/ZIP ...: CUPERTINO CA, 95014-3102
TELEPHONE ........:
FEE ID UNIT
QUANTITY
AMOUNT PD -TO -DT
THIS REC
NEW BAL
----------
-----------------------
-ADMIN HOURS
----------
1.00
--------------------
41.00
41.00
----------
0.00
0.00
1BCBSC VALUATION
5,000.00
1.00
1.00
0.00
0.00
1BSEISMICR VALUATION
5,000.00
0.50
0.50
0.00
0.00
ISTINSP UNITS
4.00
520.00
390.00
130.00
0.00
----------
TOTAL PERMIT
---------- ----------
562.50
432.50
----------
130.00
0.00
METHOD OF PAYMENT
AMOUNT
REFERENCE
NUMBER
--------------------------------
CHECK
130.00
--------------------
#567
---------------
TOTAL RECEIPT
130.00
0
4 ITEMS OF 4
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Elk: Lot:
APN 36931013.00
DATE ISSUED.......: 10/07/2011
RECEIPT #.........: BS000014985
REFERENCE ID # ...: 11100054
SITE ADDRESS ......
SUBDIVISION .......
CITY ........
IMPACT AREA .......
10325 FARALLONE DR
CUPERTINO
OPERATOR: patg
COPY # : 1
OWNER ............: UNDERWOOD PHILIP G AND MARCIA
ADDRESS .. ... ...: 10325 FARALLONE DR
CITY/STATE/ZIP ...: CUPERTINO CA, 95014-3102
RECEIVED FROM ....: PHILIP G UNDERWOOD
CONTRACTOR LIC # *OWNER*
COMPANY ..........: UNDERWOOD PHILIP G AND MARCIA
ADDRESS .. ... ..: 10325 FARALLONE DR
CITY/STATE/ZIP ...: CUPERTINO CA, 95014-3102
TELEPHONE ........:
• --FEE- D _- UNIT----- QUANTITY
-- - ---------
1ADMIN HOURS 1.00
1BCSSC VALUATION 5,000.00
1BSEISMICR VALUATION 5,000.00
1STINSP UNITS 3.00
TOTAL PERMIT :
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT :
0
AMOUNT
---------------
432.50
---------------
432.50
AMOUNT
PD -TO -DT
THIS REC
NEW BAL
----------
----------
41.00
----------
0.00
----------
41.00
0.00
1.00
0.00
1.00
0.00
0.50
0.00
0.50
0.00
390.00
0.00
390.00
0.00
----------
----------
432.50
----------
0.00
----------
432.50
0.00
REFERENCE NUMBER
--------------------
#563
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
• 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) T77-3228 • FAX (408) 777-3333 • buldirm(atcullong.ortl
CUPERTINO
0
11
B
FaorsaArmat�s to3'x5
owtamNAaa { i�1; l i
lil dd+weo�
57- 1b
;l aN l� mlo lcual.1.1
sM=AnvR={ 17� 2 5
Fa t ..11 o.,._ _'brow
Q
LM.AMo-�` H 0, 9, P,
9 jab{
FAX
FAX
❑ owaaa %mm4mLog,Q aw=Aowr D cm, u=ca D cmrrRAc=AaaNr d] A&c== 13 2aaaasa D nEvalm Ht ❑ 7wwa
COMIRACPOSNAMS . Licww ta1aE8 Lit.'@MrPPa t7oa. LSCS
COMPAMNAMS B -MAB. FAX .
St'MAmXWW% C111'Y.SrA71.M PROM
ARCMTS= WNEERNAM3 1JcM 8NOMB1R %a LIC.
coeemYNAMa &MAS. FAX
SlRMAMXW CUY.SGr$irP FROM
e'SM�ba�.. I �p'e.ly�.��.+ I +�+'••� •,•y`., USB TYPB OCG BQFI'. YALUAIION (Sl
lis )t
1 2.0XWFUM AREA___ AM r..ZW" tmrAREA �%" VvSt---
PLOaaNOAPPLa HNO W.AQQQ tOAFPa0VALL8T= I WC01=1 00an EJm I /�L:/ ! l w.• PJ' 000. v0
By asyalgaemrebetow, Irereft'ym aech of the fo0owin� Lam the prcputyownaaramharFudagmtmact an rhepgrpaty owae�s behalf: Ihave rmddda
RT&Sttmandd,ic{'olmedrmIhayspmvidadia mcxac4 Ifiave lead dm Desaiptlo¢oFWatk mdvaifyftis eecwste. [egimmoomFlYw&h aIl appllceble laael
ordimneev and amm lswareladngmbaildiag mneoaedaa Ienthadm[epresaamUPra aPCvpati¢erowtar die abovaddentiilad pcapmtF fm'lmpeadaa PeP�
Signato:e ofA.ppikmVAgmt I.O._ �l•"�--"^�}. Date, -7, 2. V11
New SFD or Multifam0y dwellings: APPLY ft demolition Permit for
;mating baild'mg(s). Demolition pwmit is required ]mm to issuance ofbm7dmg Q ant
permit for now buUd'mg•
Commercial Bldgs: Provide a completed Hazardous Materials Discloam Q srnrmAan
fwm if any Huard= Materials are being used as part of this project ❑ LAaot
_ Copy of planning Approval Letter or Meeting with Planning prior to Q Awoa
submittal of Buildatg Permit application.
Q rLAmmvo PLANBEYIaw
Q rmaxwomm
Q Fmccarr
Q BAxarAaxacw=ws=cr
BldgAw d011.dacrevised06ai1u
OWNER -BUILDER DISCLOSURE FORM
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
• 10300 TORRE AVENUE • CUPERTINO, CA 850143255
CUPERTINO (408) 777-3228 - FAX (408) 777.3333 • buildinaCcuoertino.orn
Dear Property Owner(s):
An application for a building permit has been submitted in your name listing yourself as the builder of the property
Improvements specified at:
SITE ADDRESS
OWNER
APN
We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of
your responsibilities and possible risk you may Incur by having this permit Issued in your name as the Owner -Builder. We
will not Issue a building permit until you have read, Initialed your understanding of each provision, signed, and
returned this form to us at our official address Indicated. An agent of the owner cannot execute this notice unless
you, the property owner, obtain the prior approval of the permitting authority.
you understand or verify this information.)
X1.1 understand a frequent practice of unlicensed persons la to have the property owner obtain an "Owner -
Builder' building permit that erroneously Implies that the property owner Is providing his or her own labor and material
personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any Injuries sustained by
. an unlicensed person and his or her employees while working on my property. My homeowners Insurance may not
provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my
Insurance coverage for Injuries to workers on my property.
'L+,2.1 understand building permits are not required to be signed by property owners unless they are responsible for
the construction and are not hiring a licensed Contractor to assume this responsibility.
_?14 3.1 understand as an "Owner -Builder I am the responsible party of record on the parnlL I understand that I may
protect myself from potential financial risk by hiring a licensed Contractor and having the permit flied In his or her
name instead of my own.
1A,4.1 understand Contractors are required by law to be licensed and bonded in California and to list their license
numbers on permits and contracts.
Yu 5.1 understand If I employ or otherwise engage any persons, other then California licensed Contractors, and the
total value of my construction is at least five hundred dollars ($500), Including labor and materials, I may be
considered an `employer under state and federal law.
.Py 6. 1 understand If I am considered an 'employer under state and federal law, I must register with the state and
federal government, withhold payroll taxes, provide workers compensation disabliity Insurance, and contribute to
unemployment compensation for each "employee.m I also understand my failure to abide by these laws may subject
me to serious financial risk.
X7.1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family
residential structures cannot legally build them with the Intent to offer them for sale, unless all work is performed by
licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work
Is performed under contract with a licensed general building Contractor.
Amt 8.1 understand as an Owner-BuIlder if I sail the property for which this permit is issued, l may be held liable for
any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction
defects in the workmanship or materials.
0wnerBuUderForm_2010.dnc revised 04/14110
ornuropaewfwP•oraz UU0.vWvnE�Um0
:8180
:wnUwBIS s teump AUGdad
•am;gu6ls
sAumo AUadaid ey;)Wm o; pens; sl iluuad ay; us" pe;uesaid eq of pagnbei eq Aaw A;p aw W algaldame uopeayueA
Jsy;o m 'uopezpe;ou uuol 'asueoll saeAup sjeumo AUedOid ay110 Adoo v.spN •Aaemata sll A;IUeo pus uoneuw4ul enoge
ma Ino pollB Allmostad I pus enoge polsli secuppe eta fol jeumo AUadad eta we 1;eta Atnped;o 4oued iepun atapap I
ON lel
:lUsav PozPOLRW la sswppv
:4ua6y pez1104111y 10 aweN
:sseippy m uopeaoi loa(ad
:0PoM 10 U01100900 ao) pa[opd uoaam4suo010 edOOS
•pe[ad Aw m; auued JePlln9 -J@wu0
us ulelgo o; Amsseoeu sluswnoop ota Big pus'uBls 'jo; Aldde of (sxiusBe Atu se pe of (s)ucwed Bulmonal eta ezlmtane
Ageis41 1411gisuodsw lauasted Aw sl puemepun I tpl4m 10 uonnoexe eyl'isumo Apedad OI BORON ogl Bulpnlx3
:11"38 S.M3NMO A LM3dOMd NO 13Y 011N30V d0 NOIIVMVOHlni
•Popling-jsumo ew lo{ 11uued uoponysuOO a iq Aldde o; jeumo AUedcud Big ,lo;ue6a
us Bupeu4eap usym Aluo leumo AUedad ayl Aq pe;eldwoo eq o; pa4nbep sl uuoj uopez/mtilny Bulmopo{ eta :31oN)
--------------------------------------------------------------------------------------------------------------------------------------------
1 to Z :elep :angauBIS s,teumO MOCICUd
wMgU IS saeumo Ayodojcf etp w
penesi sl;luued eq; usym pe;ussaid aq o; paalnbei eq Am AP ay; o; elqa;demo uopeWm jay;o ja 'uopgzpg;ou ruro;
'esuson sjenpp s,jeumo Alisdoid eq;,10 MOD y :e;oN •Buued stp Bulnesi uol elglsuodseu Anuebe sq; o; pawl
pus jeumo Apedcrd sg; Aq pauSis pus pe;oldwoo aq pnw uuol slg;'panssl eq tion >luued Bulpllnq a walog
:sseippy Japue-1 :etueN Jepus-1
(MO L60£ osS)
penal sl quoad slt0 gslym fol )pom eta 10 eoueuuoped eta fol Aouelle Bulpual uolpn4suco a sl sista ;eta uu1Ue Agetey I
(•u0pewl0{u1 AaUe6e Bulpual uopangsuoa 6ulmoln ay; e;eldwar eseeld :SN0LL33NIQ)
V (VA A0100V ONICINS-1OLL2;1SN00
-o5wonoo souamsul uonesuedwoa ,simpom ileLg p srgep eta pus pasueon Apedad eie siopaWOO asogl
jou jo jayletlm BulA oA jo; elglsuodsw eq nim noA 'sioptuluoo ejly a; qslm pug aapnnS isumo se Iluued a ulu;go noA
11 •seBawep io; elgg0 ploy eq Amu noA 'AUedoid moA uo 6uplrom ollgm painful sl will m Ignpvgpul;eta to eeAoldwe
jo iopetltioo pesusallun us A lata puslsrepun of noA joj lwgjodwl oslo sl it •Unoo IIAI* ul aq Aew smpo.4mo
pasueollun lsuleBe Apawei A1uo ino/, -luleldwoo a p iinsm a as ulalsrts Aaw noA ssol lelauoug Aug talm noA lalsse
of eigeun aq Aaw p goo esueorl em ,simawoo era 'asuean a envy IOU scop ogm euoewos tnlm pa4 ar nOA
ll 'ollgnd etU peiad of pouBlsep smal Aq pe elnBw eta sropailum pesueorl •two; s141 uo peplAoid eneq I uoneuuolul
ata 10 Aug of saBuetp io 'suonelap 'suoalppe Aue;o Alelelpatuwl tial aµn to ionssl ata A1nou of mBe I •Zl, M
meAoldwe so nem se siaplln8 ieump wenoB;ey; sluswaiinbei pus smel elgealldda ne Aq
eplqe Illm I 'Alinaos ualpngsuao pesodad slyp j01 o1cptiodsej AllsiouotiU Pus AlloBel AUad eql sa Tail! seJBe I.1, i PT
-oAoge polsll smppe ens egl is AilAnaa uolpnAsum pesodotd jot alcnsuodsw Allspueug pue AneBel Mod etll wo
1 Ima pualstepun pus'eweu Aw ul fol pepdde;luued BulPllnq isplln8 jeum0 us Ol;uesuoo pus 10 epeme we I.OiY1d
•
•siopa4uoo •
pesusoll poga uogeuuolul slow tot no8-m,giso mmm jo (ZSLZ) SISo-iZS-009-i Is (SnSO) ptaoS esuean
a;eig ,smpa quoo epuoAlso etll peluar Asw 1 puemepun Osie I slueppoV IePlsnpul to tiolem alwollleo ata Pug
'sluewAed a;euep;o luewliedea alwolAoo et4'uone4slulwpb ssoulen8 IlswS gems penuN eta'eovueS enumou
lawelul aql woo .ieAoldwe. us as suolle6pgo Aw Bupeft uoneuuo;ul ejow uMgo Asw 1 puelatepun 1.6"Fg
is
REPLACE (E) TILED
TUBISHOWER WALLS WITH
(N) WR GYPSUM BD AND
PRE -MANUFACTURED \
CULTURED MARBLE TUB & \
SURROUND FULL -HEIGHT.
(E) ENTRY
1 1
Zoe
mmO
�om
x
2q
vlmin
r
m 0
0p0
DETECTOR.
010
3
BATHROOM FLOOR PLAN
SCALE: 1/4"=1'-0" 11/17/11
T-0'
(E) 2630 C
REPLACE (E) VANITY &
LAV WITH (N) VANITY
& MANUFACTURED
MARBLE TOP
(E)RECEPACLE-(N)
WCANDESENT OR HALOGEN
DECORATIVE LIGHT
REPLACE (E) TILE
FLOOR WITH (N)
/(WTOILET 1.6 GPF
ITH IN) WAX RINGRESET
—11
K 3'-2" -4\REMOVE & REPLACE WITH
(N) SOLID CORE FLUSH
PAINT -GRADE DOOR
(E) HALL
1 1
R
U
HAVE SMOKE DETECTORS. HALL
HAS (E) CARBON MONOXIDE
DETECTOR.
010
3
_m
>
Sv E
a -o a N
m
c
® a co =
s C
La
IE -6
RECESSED R.OURESCENT
28W -120V
m
—11
K 3'-2" -4\REMOVE & REPLACE WITH
(N) SOLID CORE FLUSH
PAINT -GRADE DOOR
(E) HALL
GR EXISTING RECEPTACLE - GFCI 1500 W-120 V
IUI "" TOTAL 1866W -120V
CIRCUIT REQUIREMENT: 18661120 V =15.5 AMP (20 AMP) DEDICATED
'011 CIRCUIT ALLOWS SUPPLY TO OTHER EQUIPMENT WITHIN THE SAME
BATHROOM WHERE IT SUPPLIES ONE BATHROOM ONLY.
(E) BATHROOM REMODEL
PHIL AND MARCIA UNDERWOOD
. 10325 FARALLONE DRIVE
CUPERTINO, CA 95014
408-257-5181
ARCHITECT
MORELAN ASSOCIATES, INC
1101 S. WINCHESTER BLVD. STE G-181
SAN JOSE, CA 95128-3917
CALIFORNIASBLICENSE NO. C-5471
NOTE: ALL (E) BEDROOMS & HALL
HAVE SMOKE DETECTORS. HALL
HAS (E) CARBON MONOXIDE
DETECTOR.
ELECTRICAL LOADS
FIXTURE / RECEP
WATTS
�A!
RECESSED R.OURESCENT
28W -120V
"JUNO" 5" RETROFIT IC RATED
WITH SHOWER TRIM AIR -TIGHT
(BI
INCANDESCENT OR HALOGEN
300 W_120
DECORATIVE FIXTURE TO BE
SELECTED BY OWNER WITH
OCCUPANCY SENSOR SWITCH
J
PANASONIC FANILIGHT, 110 CFM, (2)18
40 W_120 V
W FLOURESCENT, (1 ) 4 W NIGHT
LIGHT, BACKDRAFT DAMPER, 1.5
SONES.
GR EXISTING RECEPTACLE - GFCI 1500 W-120 V
IUI "" TOTAL 1866W -120V
CIRCUIT REQUIREMENT: 18661120 V =15.5 AMP (20 AMP) DEDICATED
'011 CIRCUIT ALLOWS SUPPLY TO OTHER EQUIPMENT WITHIN THE SAME
BATHROOM WHERE IT SUPPLIES ONE BATHROOM ONLY.
(E) BATHROOM REMODEL
PHIL AND MARCIA UNDERWOOD
. 10325 FARALLONE DRIVE
CUPERTINO, CA 95014
408-257-5181
ARCHITECT
MORELAN ASSOCIATES, INC
1101 S. WINCHESTER BLVD. STE G-181
SAN JOSE, CA 95128-3917
CALIFORNIASBLICENSE NO. C-5471