14040063 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10479 BONNY DR CONTRACTOR:CALIFORNIA SUPERIOR PERMIT NO: 14040063
CONTRACTOR INC
OWNER'S NAME: SAFARI VENTURES LLC 2625 MIDDLEFIELD RD STE 350 DATE ISSUED:04/11/2014
OWNER'S-PHONE: 6509960635 PALO ALTO,CA 94306 PHONE NO:(650)787-8486
bt LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑
p REMODEL HALL&MASTER BATH(94 S.F.),REMODEL
License Class_ Lic.# 63 7p 0 1p KITCHEN(86 S.F.),UPGRADE 100AMP PANEL TO 200AMP,
Contractor
UIF. SuPe(LcolfA0` DO e W 1t SAMESAN PE E
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:$25000
N 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 APN Number:35913017 00 Occupancy Type:
permit is issued.
ITj Ry
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 WITHIN 180 DAYS OF PERMIT 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 1:bv
0 DAYS FROM ALLED 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 Issued Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9 18.
RE-ROOFS:
Signature Date 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
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
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
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 25505,25533,and 25534. / (j
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent:Date: /11
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 CONSTRUCTION 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 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.
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
918.
Signature Date
b
CONSTRUCTION PERMIT APPLICATION O
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 ��
CUPERTINO (408)777-3228•FAX(408)777-3333•building(ftupertino.ora
❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS I o1 0 P my w uPl `V,e APN# 35
OWNER NAM11f 11E � 11 PHONE 65,0
_%-(DbJ35 E
STREET ADDRESS 2 r IC M,dale h
dA Kct 330 CITYTATE
' ZiP W O CA
^ 9 q 3O FAX
CONTACT NAME SC_ I RV Q PHO O.(o - 1 -635
1 E-MAIL
STREET ADDRESS Am C CITY,STATE,ZIP 1� FAX
❑OwNER ❑ OWNER-BUILDER ❑ owNERAGENT CONTRACTOR ❑CONTRA�CTTOrRT AGENT ❑ ARCBTTECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONT�C,;T�( R N i A c7 V 1 G KIS
LICENSE NUMBER y� y O LIC Ura' C, BUS.LIC# 6 i
CO AN�Y{NAME ," E-MAII a "� FAX b
A t�FoR,V)A S ?e 1,oK (,odTfIALWR nelSo�l�o(e�n�� rmOU ,(Am {j
STREET ADDRESS
5 SS�4jadI a� 390 CrrY T;Iw,4�-N CA gg3o� P)i(VE
0 -'7V V {{JC
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC if
COMPANY NAME - E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK MO(a(,{J� i lc�fil r m O e I e'dV i c old
Slr+�
ew r I h�1e c��0u� Q ,Cr�r
EXISTING USE PROPOSED USE CONSTR ES
TYPE #STORIES
s .5 11 USE TYPE OCC. SQ.FT. VALUATION($)
EXISTG1137- 1
A NEW FLOOR DEMO TOTAL
AREA 37- AREA AREA NET AREA
BATHROOM )))��' KITCHEN OTHER
REMODEL AREA 93,q REMODEL AREA $5 REMODEL AREA
PORCH AREA DECK (AREA TOTAL DECIMRCH AREA GARAGE AREA: DETACH
ATTACH
#DWELLING UNITS: I IS A SECOND UNrr OYES SECOND STORY YES
BEING ADDED? RIO ADDITION? RIO
PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES ` { -' TOTAL VALUATION:
PLANNINGAPPL# ❑NO PLANNING APPROVAL LETTER EICHLERHOME?
G.
SOO
By my signature below,I certify to each of the following: I am the property owner o.;wxCormn ager o act o5Kerty 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' urate. I agree to comply with all applicable local
ordinances and state laws relating to building ction. I authorize representatives of Cupertino to enter the above-identified ropeerty for inspection purposes.
Signature of Applicant/Agent: Date: 7! 11 j /
SUPPLEMENTAL INFO TI
ON-REQUIRED RUUTflVGSZIP-
New SFD or Multifamily dwellings: Apply for demolition permit foratkt7 zy ❑ >srLDnvo rralwRl vrw "
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. RI ss" ❑ riAANNnvG.rLAI�IREv>Ew
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure � TANUARIS � ❑ prs>IcvvoieRs
form if any Hazardous Materials are being used as part of this project.
❑r LARGE ❑ FIRE DIRT
_Copy of Planning Approval Letter or Meeting with Planning prior to
submittal of Building Permit application itbR ' ❑ sNrxaacysvvER DrsTRicr
,r �: ..�_t. - ❑.E1 'iRONME1VTe1L HEALTH,
BldgApp 201 Ldoe revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10479 BONNY DR DATE: 04/11/2014 REVIEWED BY: MELISSA
APN: 359 13 017 BP#: *VALUATION: $25,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex PENTAMATION 1 R3SFDREM
USE: p PERMIT TYPE:
WORK REMODEL HALL & MASTER BATH 94 S.F. REMODEL KITCHEN 86 S.F. UPGRADE 100AMP
SCOPE PANEL TO 200AMP, SAME LOCATION & INSTALL (N) PROPERTY LINE CLEANOUT.
MOW
Plumb.Plan Check 0.0 hrs $0.00 Elec.Plan Check 0.0 hrs $0.00
f� :Or. Tc>rrult 'ne; Plumb.Permit Feer IPPERMIT Elec.Permit Fee: IEPERMIT
Other Plumb Insp. 0.0 hrs $47.00 Other Elec.Insp. 0.0 hrs $47.00
Plumb. hiSp. Fee: Lr'ec.Ins" Fie:
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 relimina information available and are onlyan estimate. Contact the Det or addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/131 FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 = s.f. Remodel,Bath(<=300 sf)
Suppl. PC Fee: Reg. 0 OT 0.0 hrs $0.00 $626.00 1REMRESBAT
PME Plan Check: $0.00 86 s.£ Remodel,Kitchen(<=300 sf)
Permit Fee: $0.00 $626.00 1 IREMRESLT
Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 200 amps Electrical
PME Unit Fee: $0.00 $47.00 IBELEC200 Services
PME Permit Fee: $94.00 I J # Plumbing
f�`c, , t�,rction r7l $24.00 IPRSEWER Sewer, Sanitary
Administrative Fee: IADMIN $44.00 0
Work Without Permit? 0 Yes (F) No $0.00 G
Advanced Planning Fee. $0.00 Select a Non-Residential
Travel Documentation Fee: 1TRAVDOC $47.00 Building or Structure
Strong Motion Fee: IBSEISMICR $2.50 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $1.00
54
O ALS, $188.50 $1,323.00 TOTAL FEE:-mme WE
$1,511.50
Revised: 04/01/2014
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: 0479 BONNY DR PERMIT# C 0 00
OWNER'S NAME: S/k FA Ri VE(l7iM(&Y Ll-C_ PHONE#((.-5-0-) 6 -06
GENERAL CONTRACTOR: ('AUFOCQA- SUfFW0P- 60 BUSINESS LICENSE#
ADDRESS: 2625 H)4LtLeU RJ -570 QR-40 14t1C'0 CAj. I CITY/ZIPCODE:
*Our municipal code requires all businesses working in the city to have a City of Cupertino business 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 subcontractors and 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
Owner/ContractyCEEnature Date
'PROTECT INFO COVER SKEET
SiN UE FAMii.Y - 1 sTOR`(
ADDRESS .. . 1047�Q SONNY DR. � CWER1 )NO CA g50Iq
APAI
SCOPE OF iIJORy
2 Br i RENOVR nOU (00 LAYv+t C#A-P6'6)
ki TCRetj REMO DEL ( X O Wt V7 C#kA16E)
UP VhDE ELFCTK)C, PANEL (zoo AHP
(3vt�c� Sewer C�e.a
at per Say Nrn D15Trid- SPECS
�1►V NSR = SAFfrRl UeNTUR�S� L� C - Phone (G510) 1% -0G3-r,
2625 Mi �d1e tld Pad # 350 Palo hrFo CA 9430 6
C001-R Et mA . CA Ci FOR N)A S)WKWAITY&4TA4l PgPTMEW C
BUILDING DIVISION-CUPE TIDO
2 i�2s M. d1e i�d NO, #?FR�qR&kDh1F0 CA &1x{30 6
D C 5-0) �et olytspecifications MUST be kept at the
t �0 Y1Q �O J in" oPtruction. it is unlawful to mane any
char es o Iterations on same,or to devia,
r+q Qt*approval from the Building O`ficial.
1
1 The stamping of this plan and specifications SHALL NOT N lX be held to permit or proval of the vioiaticn
J�- tDA13
n r State Law.
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Building Department
City Of Cupertino
10300 Torre Avenue
„ ,.CupertitQ, CA 95014-3255
Te'lehoie: 408-777-3228
D U P E RT I N O Fax:408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: 0 q 7? 8O N y DR PERNI'IT# ' U 0o
OWNER'S NAME: SA FA Qi VEWUk E LL.G PHONE G �;U '96 - C)6 3S
GENERAL CONTRACTOR: CACI Fo{ZiP Sv f E IPA J Q- OP111A 1k BUSINESS LICENSE#
ADDRESS:2 0� Mid d(c JA k 3;V R-L`0 ALV CITY/ZIPCODE: PALO A L1D q4t 30
*Our municipal code requires all businesses working in t e city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONT CTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE. 5
I am not using any subcontractors:
Si ure Date
Please check applicable subcontractors and 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
Owner 7 ontract i nature Date