No preview available
13050100CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 23500 CRISTO REY DR UNIT 416F CONTRACTOR: BAY AREA ENTERPRISE PERMIT NO: 13050100 OWNER'S NAME: DOROTHY LASKOWSKY OWNER'S PHONE: 6505371523 ❑ LICENSED CONTRACTOR'S DECLARATION License Class_ Lie. # 117 Z(-7 `� Contractor 4te,_ Ch Date � %�7 I hereby affirn iat I am licensed under the provisions of C apter 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: T 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 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, applicant understands and will comply with all non -point source gulation er the Cupertino Municipal Code, Section 9.18. 2110 MANGIN WAY DATE ISSUED: 05/14/2013 SAN JOSE, CA 95148 PHONE NO: (408)238 -5043 JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIALE] UNIT 416F- REMOVE AND REPLACE 10 SWITCHES, 22 OUTLETS, REMOVE SHOWER TILE WALL AND INSTALL NEW SHOWER VALVE, REPLACE HEAT PUMP AND DUCTING- Sq. Ft Floor Area: I Valuation: $35000 APN Number: 34253180.00 1 Occupancy Type: PERMI EXPIRES IF WORK IS NOT STARTED WIT 180 DAYS OF PERMIT ISSUANCE OR 180 S ROM LAST CALLED INWEC ON . Issued by Date. z d � 3 RE- ROOFS: Dale 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 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). I 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. 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 provisions or this permit shall be deemed revoked. 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 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 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. I 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 Cuperti Municipal Code, Chapter 9.12 and the Health & Safety Code, Section).Ogr533, and 25534. Owner or authorized agent: Date: 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, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional s l� CONSTRUCTION PERMIT APPLICATION /0 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION t ^� 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 l� (4Q8j 7Z7 -3228 • FAX (408) 777 -3333. • buildingCEDcupertino.org NEW CONSTRUCT+I�ON . ❑ ADDITION ❑ ALTERATION / SION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 'l 7 ��%' 1 v C Lj ° PN R % , 1 ! y PHONE STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAME �^ 5 PHONE g ^ E-MAIL V =y�e lce.. STREET ADDRESS' CITY, STATE ZIP C� �` • FAX OWNER ❑OWNER- BUIIDER OWNERAGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME LICENSE NUMBER S1/7q/0 LICENSETYPE BUS. LIC# COMPANY N n �� , EMAIL ® /�i f • e-e� a c4 FAX Tt G` P STREET ADDRESS STATE, HONE �� T 2( (h Y ARCHITECT/ENGIN . EERNAMIr LICENSE NUMBER BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK A ft IV u ���'- Iv w�7G In %� ! c � �✓!ih lI/l�/'+� /^�' lc! `� i'cC�Q Gl. / {.' EXISTING USE PROPOSED USE CONSTR TYPE # STORIES USE TYPE 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: LJ DETACH ❑ ATTACH # DWELLING UNITS: ' IS A'SECOND UNrr []YES SECOND STORY OYES BEING ADDED? ❑ NO ADDITION? ❑ NO PRE- APPLICATION ❑ YES IF YES, PROVIDE COPY OF -. is THE ❑ YES ARE ^ I' -- - - _ - TOTAL VALUATION: PLANNING APPL #, ONO PLANNING APPROVAL LETTER EICH R G E? ❑ NO By my signature below, I certify to each of a Ilowing: I e o erty owner or authorize agen act on the property - owner's behalf. I have read this application and the information I have pro d s correc ve r d e Description of Work and venfy it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buil in co c 'on. I i representatives of Cupertino to enter the above - identified property for inspection purposes. Signature of Applicant/Agent: Date: O SUPPLEMENTAL INIF ON REQUIRED oui - New SFD or Multifamily dwellings: ly for demolition permit for existing building(s):. Demolition permit is required prior to issuance of buildin permit for new building. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure' z form if any Hazardous Materials are being used as part of this project. G D 3 _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. BldgApp_2011.doc revised 06/21/1-1 CITY OF CUPERTINO 1V1W1V FCTTMAWnD — RTTTT.TITN(i' TITVTCTnN LAADDRESS: 23500 Cristo Rey Dr DATE: 05/14/2013 REVIEWED BY: Mendez FEE APN: BP #: EVALUATION: 1$35,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex p 0.0 1 PENTAMATION AP10 PERMIT TYPE: USE: WORK -remove and replace 10 switches 22 outlets REMOVE SHOWER TILE WALL AND INSTAL NEW SCOPE I SHOWER VALVE, replace heat pump and ducting- maintenance upgrade in kitchen, remove and p Mech. Plan Check 0.0 hrs $0.00 Phoub. Plan Check Mech. Permit Fee: IMPERMIT Plumb. Permit Fee: Other Mech. Insp. 0.0 hrs $45.00 Other Plumb Insp. Alech. Insp. Fee: Plumb. hish. Fee: Elec. Plan Check 10.0 1 hrs $0.00 Elee. Permit Fee: IEPERMIT Other Elee. Insp. 0.0 1 hrs $45.00 Elec. Insp. Fee: NOTE. This estimate does not include fees due to other Departments ye. riannmg, ruolic rrOTKs, Lire, our[uury newer Ef 1, �a iwvc District, etc). These fees are based on the prefimina information available and are only an estimate Contact the Dept-for addn I info, FEE ITEMS (Fee Resolution 11 -053 E . 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Electrical Suppl. PC Fee: Q Reg. ® OT 0.0 1 hrs $0.00 $93.00 IBREMRECEP I Recep /Switch/Outlets PME Plan Check: $0.00 = # Mechanical Permit Fee: Hourly Only? ® Yes Q No $0.00 $67.00 iBREmAiR7 Heat Pump ( < =10K cfm) Suppl. Insp. Fee-.(E) Reg. ® OT 0,0 hrs $0.00 PME Unit Fee:. $0.00 PME Permit Fee: $90.00 fl Mech. Plan Check 0.0 hrs $0.00 Phoub. Plan Check Mech. Permit Fee: IMPERMIT Plumb. Permit Fee: Other Mech. Insp. 0.0 hrs $45.00 Other Plumb Insp. Alech. Insp. Fee: Plumb. hish. Fee: Elec. Plan Check 10.0 1 hrs $0.00 Elee. Permit Fee: IEPERMIT Other Elee. Insp. 0.0 1 hrs $45.00 Elec. Insp. Fee: NOTE. This estimate does not include fees due to other Departments ye. riannmg, ruolic rrOTKs, Lire, our[uury newer Ef 1, �a iwvc District, etc). These fees are based on the prefimina information available and are only an estimate Contact the Dept-for addn I info, FEE ITEMS (Fee Resolution 11 -053 E . 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Electrical Suppl. PC Fee: Q Reg. ® OT 0.0 1 hrs $0.00 $93.00 IBREMRECEP I Recep /Switch/Outlets PME Plan Check: $0.00 = # Mechanical Permit Fee: Hourly Only? ® Yes Q No $0.00 $67.00 iBREmAiR7 Heat Pump ( < =10K cfm) Suppl. Insp. Fee-.(E) Reg. ® OT 0,0 hrs $0.00 PME Unit Fee:. $0.00 PME Permit Fee: $90.00 (Amslruction Tax Administrative Fee: IADMIN $42.00 0 0 Work Without Permit? ® Yes (E) No $0.00 Advanced Planning Fee: $0.00 F-7--] hours Inspections 0 $133.00 1STINSP Inspection, Hourly 0 Travel Documentation Fee: ITRAVDOC $45.00 Strong Motion Fee: 1BSEISMICR $3.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $2.00 _ ,mow„ $182.50 $293.00 _ »� $475.50 . , r Revised: 04/2912013 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014 -3255 Telephone: 408- 777 -3228 C U P E RT I N O Fax: 408 - 777 -3333 CONTRACTOR / SUBCONTRACTOR- LIST JOB ADDRESS: 235-Ob v'i V�6 AO-` r- PERMIT # BUSINESS LICENSE # OWNER'S NAME: PHONE #;>_: •� 2 GENERAL CONTRACTOR: a BUSINESS LICENSE # ` Cement Finishing ADDRESS:-z j/ jq CITY /ZIPCODE: 1W ek *Our municipal code requires all beidesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTI N(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTOR 7 OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: l / Signature Date Please check applicable subcontractors and complete the following information G/ 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 Owner / Contractor Signature Date the Fer&-fn a-f rZarCGI� s'cr� y -4 AO C- 114 r��, � rack Far bC.fy, aoK& 1� t (0 mew b OP9ram K'+CVo K d be4k r^clan,. -i-,� r.� c1� cx ►`���`rr c:5 �f ra cue s � vC.1Ve � . dam' w, C%4 �' ht e � �•`lli gh �`��s � Mt�c<<`n P �.`r► f-- �'�- c�� � � E� ,� C-1 Storage CL Balcony an Comer Unrts 7'S' x Balcony Q Living Room Q © 150'x 15'0' LU RMONUM Q Bedroom Ij 1911• x 13.7 M p © Dining Room ° a _ Cu Z Q p 12'6' x 8'9' F— cu cs O © Q ? O ID E s cn> > CA ea I 0 -0 s., C N O CO CL Closet Nan Ceding al top Roor ❑ CL � ai � w 2 c 68'x4'2* w r rj O G c N O LL +�_ oy , © L.1 CL N .0 @ Bath Entry z w 0 0 r �f 5'0'x9'' 7'a Cz 5'11'x811` , p s .I en LZ o 0 0 o a :� ' o -� z W/D Closet © " - 5 2 x 27" rn c+ @ _ m 0 a N evi' t Puv° a_1 013 tNBULATION tNC Aallation Certificate x Address: 23500 CRISTO REY DRIVE,. UNITS 416E & 416F CUPERTINO Permit Number wnty Subd'v.sron IL at Number SDI INSULAT� N%%��°°C -370 LANG RD, BURLINGAME, CA 94010 !EWVlF�1QLAIRK, CFO omenss4�•� GREG / Vj WALL EXTERIOR CHASE (416E) 36 KNAUF R -19 KRAFT FACED BATT INSULATION @ 6.25" WALL 2X6 PARTITION (#416E) 360 KNAUF R -19 UNFACED BATT INSULATION @ 6.25" WALL 2X4 PARTITION (#416E) 556 KNAUF R -13 UNFACED BAIT INSULATION @ 3.5" FLOOR BETWEEN (#416E) 559 KNAUF R-19 UNFACED BATT INSULATION @ 6.25" wg WWI Mr WALL EXTERIOR CHASE (416F) 36 KNAUF iM R -19 KRAFT FACED BATT INSULATION @ 6.25" WALL 2X6 PARTITION ( #416F) 360 KNAUF R -19 UNFACED BATT INSULATION @ 6.25' WALL 2X4 PARTITION ( #416F) 556 KNAUF R -13 UNFACED BATT INSULATION @ 3.5" FLOOR BETWEEN (#416F) 559 KNAUF R -19 UNFACED BATT INSULATION @ 6.25" SDI INSULAT� N%%��°°C -370 LANG RD, BURLINGAME, CA 94010 !EWVlF�1QLAIRK, CFO omenss4�•� GREG / Vj