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12100171
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1320 PRIMROSE WAY CONTRACTOR: ERSOY LEVENT AND PF,RMIT NO: 12100171 ANITA E OWNER'S ERSOY LEVENT AND ANITA E 1320 PRIMROSE WAY DATE ISSUED: 10232012 OWNER'S PHONE: CUPERTINO, CA 95014 -5228 Pl IONE NO: ❑ LICENSED CON T'RACTOR'S DECLARATION .10B DESCRIPTION: RESIDE\ 11AL 11 COMMERCIAL License Class Lic. Contractor 1 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. hereby affirm under penalty of perjury one of the following No 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 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. APPLICANT CERTIFICATION 1 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 Imes 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 all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Date r' ❑ - OW'NF-R- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Lao for one of the following two reasons- 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 construct the project (Sec.7044, Business & Professions Code). 1 hereby affirm 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. 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. 1 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 provisions or this permit shall be deemed revoked APPLICANI- 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 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 all non -point source regulations per the Cupertino Municipal Code, Section 9.18. /) Signatur /in z - tpl LU Date 10b3A�-- REMODEL 2 BATHS 90 SQ FT, REMOVE WATER HEATER AND INSTALL TANKLESS WATER HEATER IN GARAGE, AND UTILITY SINK Sq. FI Floor Area: I Valuation: $38190 APN Number: 36618011.00 Occupancy-fype: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN DAYS OF PERMIT ISSUANCE OR 180 DA F OM LAST CALLED INSPECTION. Issued by: � L Date. /U RE- ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, 1 agree to remove all new materials for inspection. Signature of Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health S Safety Code, Sections 25505, 25533, and 25534. 1 will ' maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use eynipment or devices which emit hazardous air contaminants as defined by the Bav Area Air Quality Management District 1 will maintain compliance with the Cupertino Junicipal Code. Chapter 9.122 and the Health & Safeh Code, Secti is 25 11. 2 5 d 25534. '� ,� /���11 .�,,� Owner or authorized agent Date: 1(2 / O!- "l' CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Cie C.) Lender's Name Lender's ARCHI'I'EM"S DECLARA'T'ION I understand my plans shall be used as public records. Licensed Professional CUPERTINO OWNER- BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777.3228 • FAX (408) 777 -3333 • buildinora)cuoenino.ora Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SITE ADDRESS I2 20 of ro$ �Q •J 1 APN BP# OWNERNAME o OWNER ADD SS r a DESCRIPTION OF WORK: �AU_V`0bYY\. r4,11614_10 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 apliroval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS: Please read and initial each statement below to signify you understand or verify this information.) 1'. 1 understand a frequent practice of unlicensed persons is 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 homeowner's insurance may not provide coverage for those injuries. 1 am willfully acting as an Owner - Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. A-2. I 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. k3. 1 understand as an "Owner - Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name' instead of my own. &1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the (/�(YJ 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. A6. I understand if I am considered an "employer" under state and federal law, I must register with the state and fe aral government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to.serious financial risk. &7. 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. —AA I understand as an Owner - Builder if I sell the property for which this permit is issued, I may beheld 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. OirnerBuilderFonn 2010.doc revised 04114110 P ev9I understand I may obtain more information regarding my obligations as an "employer" from the Internal enue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' Stale License Board (CSLB) at 1 -800- 321 -CSLB (2752) or www.csib.ra.gov for more information about licensed contractors. A10. 1 am aware of and consent to an Owner - Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the site address listed above. A 11. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide y a I applicable laws and requirements that govern Owner - Builders as well as employers. a 12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the mfo ation I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner - Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS: Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verifv the orooerty owner's signature: n I Property Owner's Signature: jad E LM 7-,tl7 Rt t Date: 10 /.:)3 I11 - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - -- -- --- - - - - - - - - - - - - - - - - - - - - - -- --- - - - - - - - - - - --- ------ --- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - --- The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner - Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner - Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: Owne,-BuilderFornr 1010.doc revised 04114110 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION JAEADDRESS: 1320 Primrose Way DA'Z'E: 10/23/2012 REVIEYVED BY: SEAN Meth. Penuit Fee: APN: 13P#: 'VALUATION: $38,190 *PERMIT TYPE: Building Permit PLAN CIIECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: Lice. Insp. Fee: PEN "1'A1IATION 1R3SFDREM PERI111T TYPE: WORK REMODEL 2 BATHROOMS 90 SQ FT); REMOVE WATER HEATER AND INSTALL NEW SCOPE TANKLESS WATER HEATER IN GARAGE, AND INSTALL UTILITY SINK. NOTE: This estimate does not include fees clue to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These ees are based on the prelintinan information mailable and are on/w, nn estimate. Contact the Delujor aeldn'1 info. FEE ITEMS LFee Resolution 11 -053 E/f 7111121 Meth. Plan Check Plumb. Plan Check 0.0 1 hrs $0.00 Dec. Plan Check Meth. Penuit Fee: Plumb. Permit Fee: IPPERMIT fact•. Permit Fee: Otherdlech. lasp. Other Plumb Insp. 0.0 hrs L$45.00 Other rice. Ia.sp. Hech, Insp. Fee: Plumb. h),Yp. Fee: Lice. Insp. Fee: NOTE: This estimate does not include fees clue to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These ees are based on the prelintinan information mailable and are on/w, nn estimate. Contact the Delujor aeldn'1 info. FEE ITEMS LFee Resolution 11 -053 E/f 7111121 FEE QTY /FEE MISC ITEMS Plan Check Fee: $0.00 90 s. f. $600.00 Remodel, IREaIRESBAT Bath (< =300 sQ Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 1 # $27.00 Plumbing 1 IPRI191EATR I Water Heater Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 1O # Plumbing $10.00 /BPFaTURE Fixture or Trap PME Unit Fee: $0.00 PME Permit Fee: $45.00 Construction Tux: Administrative Fee: IADMIN $42.00 Q E) Work Without Permit? O Yes Q No $0.00 Advanced Planninst Fee: $0.00 Select a Non - Residential Building or Structure Q C) i Travel Documentation Fee: ITRAVDOC $45.00 Strong Motion Fee: IBSEISMICR $3.82 Select an Administrative Item ' B1de Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: $137.82 $637.001 TOTAL FEE: F $774.82 Revised: 1 0/0 112 01 2 r N U~ U O X s. M 9• m is CL M ♦p m v 10 n 0 1 m 0 0 r D n m i� m 0 a� to n 'ON IIINH3d As ele1S Jo soueulPJO G!O Rue ;o i' ,lslf .id Rue ;o UOI1e101A 81110 lenoJdd - wie 01 PI04 eq ION TIVHS suogeol ;load ; pue veld slyl ;o 6uldwels 9y1 IePWO 6ulpllo8 a41 wog leA J e In 11 'wa ;sJa41 a1el^aP 01 Jo 'ewes u ` suoll ile io se5uey � of Alle a)lew o1 In ;meld suo 1eo11!oaa,lsuo sued 080•,3 SMI ayt-1- 1de){ aq Is(1W m fo a o N N d 6 � 4 N U) F cb 0 n f-' ra L Mine f) !'.;i \00 x l FIF N. m 01 S 0 3 r ry O fll f0 ?."omm 7 =. N m ° 3 0 no o n� o� p� R1 i O C N a m l� n w y Qt • W Qt fJ R1 i 0 r m rn m w 0 �c k \ u y S a n 2 m d m w N v m ° n r- �w�m ry O N U o � o M.- 03wom ° 3 0 0 d N � � N ft� O � A � O 0 O N lU n 's m m m v s 0 0 3 3 0 o. rn I 0 s m r c � � �. -0 m� M 0 3 o N (�0�0 <0 0 o� A `C m x m m m 0 0 c SCOPE OF WORK: Bathroom Remodel(s). Project shall comply with the 2010 California Building (Base code 2009 IBC), 2010 Residential (2009 IRC), Plumbing (2009 UPC), Mechanical (2009 UMC), Electrical (2008 NEC), Fire (2009 IFC) and Energy Codes (2008 Building Energy Efficiency Standards) Energy code mandatory lighting measures: 1. All permanently installed high efficacy luminaires shall be switched separately from low efficacy luminaires. (150(k)(7)) 2. Permanently installed luminaires in bathrooms, garages, laundry rooms and utility rooms shall be high efficacy luminaires OR are controlled by an occupant sensor(s) certified to comply with Section 119 that does not turn on automatically or have an always on option. (150(k)(10)) Plumbing plan notes: 3. Water closets shall have an average water consumption of not more than 1.28 gallons per flush. (CPC 402.2) 4. Shower heads shall have a water flow not to exceed 2.5 gallons per minute. (CPC 402.1.1) 5. Faucets in kitchens, wet bars, lavatories, laundry sinks, etc shall have a water flow not to exceed 2.2 gallons per minute. (CPC 402.1.2) 6. Shower stalls shall have a clear interior finish area of 7.1 sq. ft. and be able to accommodate a minimum 30 inch circle at the threshold level. These clearances shall be maintained up to a height of 70 inches above shower drain. (CPC 411.7) 7. Shower compartments and walls above bathtubs with installed shower heads shall be finished with a smooth, nonabsorbent surface to a height not less than 72 inches (6 ft). (CRC R307.2) 8. The maximum hot water temperature discharging from the bathtub, shower and whirlpool bathtub filler shall be limited to 120 degrees Fahrenheit. The water heater thermostat shall not be considered a control for meeting this provision. (CPC 414.5 & 418.0) 9. A 30 -inch clear width for water closet compartment and 24 inch clearance in front of water closet. (CPC 407.5) 10. Control valves and showerheads shall be located on the sidewall of shower compartments or be otherwise arranged so that the showerhead does not discharge directly at the entrance to the compartment and the bather can adjust the valves prior to stepping into the shower spray. (CPC 411.10) 11. Electrical Plan Notes: 12. The installation of smoke alarms in all of the following areas shall be provided: (R314.3) a. On the ceiling or wall outside of each separate sleeping area in the immediate vicinity of bedrooms. b. In each room used for sleeping purposes. 13. The installation of carbon monoxide alarms in the following areas shall be provided: (R315.1) a. Approved carbon monoxide alarms shall be installed outside of each separate sleeping area in the immediate vicinity of the bedrooms and on every level including basements in dwelling units that have fuel -fired appliances or attached garages. 14. At least one 20 amp branch circuit shall be provided to supply bathroom receptacle outlets. Such circuits shall have no other outlets. (CEC 210.11(C)(3)) 15. All receptacles in bathrooms, garages, accessory buildings, outdoors, crawl spaces, unfinished basements, kitchens (where receptacles serve counter top surfaces), laundry, utility, wet bar sinks (within 6 feet of the edge of the sink), shall have ground -fault circuit interrupter (GFCI) protection. (CEC 210.8) 16. In all areas specified in 210.52, all 125 -volt, 15- and 20- ampere receptacles shall be listed tamper- resistant receptacles. (CEC 406.11) 17. At least one 20 amp branch circuit shall be provided to supply laundry receptacle outlets. Such circuits shall have no other outlets. (CEC 210.11(C)(2)) 18. At least one receptacle shall be installed for the laundry area. (CEC 210.52(F) x x CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • buildino6cuoertino.ora "` t4 i ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT k PROJECT ADDRESS 13a 0 i—'c me ose I AI N k 3 W lf/ 0 O I 1 I OWNER NAME 1 P PHOhE - I E -MAIL O n I Idm STREET ADDRESS G n ^ n .. IU b CI , $TA7'E,e f '' a F b J a : l CONTACT NAME J -1 1 P PH E E E -MkIL STREET ADDRESS �n C CITY, STATE, ZIP �^M^ A FAX :OW'NER ❑ OwhTA- BUILDER ❑ OWNTR AGENT ❑ CONTRACTOR 13 CONTRACTOR AGENT V CONT RO NAME C LICETSEN}R•1@ES a UCENSETYPE B BUS. LIC0 C L a U CO ` `ANY ANTE E EI STREETADD l CtI�s�TE, ZIR G PHONE _ G _ i�IJ3 ARCHITECT/LNGMEER NAME L I P LIG k COMPANY NAME E E -A1AFL I FAX STREET ADDRESS C CITY, STATE, ZIP P PHONE DESCRIPTION OF WORD: 12, loD o' a o o I' K; a,� F e- a &A e alp. e e EXISTIliG USE P PROPOSED USE q CONSTR. TE k kSTO USE T TYPE O OCC. Q Q.FT. V VALUATION (5) E.MTG L h•EW FLOOR D DEMO T TOTAL 9 ✓13 3 3 9 BATHROOM KrrCTfl:N OTF¢R RFJ.MODELAREA D REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK ORCH AREA GARAGE AREA: LJDETACH ❑ATTACH I DWELLING UNITS: I IS A SECOND UNIT ❑YES I I SECOND STORY ❑YES BEING ADDED! ONO A ADDITION! El NO PRE- APPLICATION ❑1F5 IF YES. PROVIDE COPY OF I IS THE BLDG AN (D YES R RECEIVED'H ''^/- R R "'},.,q T TO � P� C �fVALUATION: 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 h ve rca this application and the information I have provided is correct. 1 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 (ding cqnstru io . th nze representatives of Cupertino to enter the abovI-id,miif ed pr perty for inspection purposes. Signature of Applicam/Agent: t _ Date: �U C.�3 1) SUPPLEMENTAL INFORMATION REQUIRED' � �— W W" � �,�'a New SFD or Multifamily dwellings: Apply for demolition pe for � �' ' wwly +•r f ftU3'% existing building(s). Demolition permit is required prior to issuance of buildlno h D��ESS x'ae _ ❑ ❑D 7 LANn7NCl c.Ah REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ; ;� •sTANDDAR CITY OF CUPERTINO BUILDING PERMIT Rtvlatvr. n Z BUILDING ADDRESS: 1320 PRIMROSE WAY I CONTRACTOR: ERSOY LEVENT AND ERmTrK2100171 OWNER'S NAME: ERSOY LEVENT AND ANITA E 1 1320 PRIMROSE WAY I DATE ISSUED: 10/23/2012 I OWNER'S PHONE: I CUPERTINO, CA 95014 -5228 I PHONE NO: I ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. # Contractor Date 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. 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. APPLICANT CERTIFICATION 1 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, 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 all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date ❑ OWNER - BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 1 hereby affirm 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. 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. 1 certify that in the performance of the work for which this permit is issued, l 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 provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 1 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, 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 all non -pgirq`o r re Iglio�Stper the Cupertino Municipal Code, Section 9.18. �� BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r MECH r RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: REMODEL 2 BATHS 90 SQ FT, REMOVE WATER HEATER AND INSTALL TANKLESS WATER HEATER IN GARAGE 12/17/12- REV #1 REMOVE & REPLACE SHOWER TILE AND VALVE IN HALL BATHROOM -REV #I ISS'D 12/17/12 Sq. Ft Floor Area: j Valuation: 540190 APN Number: 36618011.00 j Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: �EAn/ Date: RE- ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read 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(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Date: a Of D-, 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.) ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERTINO CONSTRUCTION PERMIT APPLICATION ppi�ppg�� % COMMUNITY DEVELOPMENT DEPARTMENT • BUILDINCA iWA 111 __L� 10300 TORRE AVENUE • CUPERTINO, CA 95014 - 3255 96 �6 (408) 777 - 3228• FAX (408) 777 -3333 • buildinoi ffi�m CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments ae. Planning, Public Works, Fire, Sanitary Sewer Disl niabint e" 1 Thaeo !ee a hnmA nn the nroliminnnr inlnrmnrinn nvnilnhlo and pro nnly an octimato_ Cantart the Dent for addn'l inlo. FEE ITEMS (Fee Resolution 11 -053 Eff 711112) ADDRESS: 1320 Primrose way DATE: 12117/2012 REVIEWED BY: Sean APN: BP #: 12100171 'VALUATION: $2,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: Plumb. PENTAMATION 1RPFIX PERMIT TYPE: WORK Revision #1: Remove and replace shower tile and valve in hall bathroom. SCOPE Other Plumb Insp. NOTE: This estimate does not include fees due to other Departments ae. Planning, Public Works, Fire, Sanitary Sewer Disl niabint e" 1 Thaeo !ee a hnmA nn the nroliminnnr inlnrmnrinn nvnilnhlo and pro nnly an octimato_ Cantart the Dent for addn'l inlo. FEE ITEMS (Fee Resolution 11 -053 Eff 711112) FEE QTY/FEE MISC ITEMS tfM,. Flan Check Plumb. Plan Checkj 0.0 hrs $0.00 Dec. Plan Check LlTech. Pernril Fee: Plumb. Permit Fee: 1PPERMIT Dec, permit Fee: O,ho Alech. Imp. Other Plumb Insp. 1.0 hrs $45.00 Other Vcc. Insp. Ale(11. Invp. /. ex, Plumb. Insp. Fee: IPLMBINSP $133.00 Elec. Insp. Fee: NOTE: This estimate does not include fees due to other Departments ae. Planning, Public Works, Fire, Sanitary Sewer Disl niabint e" 1 Thaeo !ee a hnmA nn the nroliminnnr inlnrmnrinn nvnilnhlo and pro nnly an octimato_ Cantart the Dent for addn'l inlo. FEE ITEMS (Fee Resolution 11 -053 Eff 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F-1-1 # $10.00 Plumbing IBPFIXTURE Fixture or Trap Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-.0 Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $178.00 Consiniction Tar: Administrative Fee: 1ADMIN $42.00 0 Work Without Permit? © Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure Q Travel Documentation Fee: ITRAVDOC $45.00 Strong Motion Fee: 1BSEIS1vffCR $0.50 Select an Administrative Item � / j( � f2 Bldg Stds Commission Fee: IBCBSC $ .00 1 $266.50 $10.00 ` ' TOTAL FEET: $ 50 VA Revised: 10/01/2012 ,�