14070130CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 23500 CRISTO REY DR UNIT 114C CONTRACTOR: CLINE CONSTRUCTION PERMIT NO: 14070130
OWNER'S NAME: ERLER THEODORE G JR TRUSTEE & ET 1 330 B LINCOLN AVE I DATE ISSUED: 07/30/2014 '
OWNER'S PHONE: 6509440100 1 SAN JOSE, CA 95126 1PHONE NO: (408) 924-0204
4j' LICENSED CONTRACTOR'S DECLARATION
License Classy t3 Lic. # O p (.2 2 7^57 c'Zt �y
Contractor C 1� ►� r �^ 5 '� 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
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 co
with all non -point source regulations per the Cupertino Municipal Code, Section
9 18.
Signature Date 7-30-0-1
❑ 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
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL
UNIT 114C - ADD 2 (N) CEILING LIGHTIFANS, 1
RECESSED LIGHT, 2 OUTLETS & 3 SWITCHES
Sq. Ft Floor Area: I Valuation: $450
APN Number: 34253021 00 I Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 RMIT ISSUANCE OR
180J3AT9_FRALLED INSPECTION.
Date: PV
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or authorized agent: Imo- Date: -� 3 6-V
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of
work's for which this permit is issued (Sec. 3097, Civ C )
Lender's Name
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
eU�'��TCl�O
GENERAL PERMIT APPLICATION\.10MEP
COMMUNITY DEVELOPMENT DEPART DENT • BUILDING DIVISION 0
10300 TORRE AVENUE - CUPERTINO, CA 55014-3253 \'\
(408) 777-3228 - FAX (403) 777-3333 - building.0cuge tino.ora m I
(�
I In T71/mn,Trz I IT,=(-=AW.TrAT�I1.1SCF_TT_ANBOUS
PRGi ADDP�SS �i 2 5 OQ Cr I,f I- d Ilei () IL
'l4edAet �C—K/er
I o qw�l prob I
STI Erl P DDP,. SS
I CrY, STA; n, ZIP. IFAX
COI�iACr Ii � �/�. r •
� o vt C �/ i��
P �0?�T'" N ��•
I O � ill U O$F! � Jd►T`�.�coHS�'r�ci�'o a,r'�'Z�12
r / I
c-�_.i cDDn^cg t/ 1 (U G
T � t�✓ 1 yt
1 p 7
CaSi�l `�✓O
„
F.L�,
❑ Ovl t ❑ 0�? e-B�_ )T ^Li ❑ 0'v.,k,--Z.4L-m r ❑ COTm4CTOR ❑commSCTORAO=T'r❑ fs?C :aCT ❑ G- R ❑ ❑
CGA hCTORI AI✓�/r /1rS.
�� ��c t
I uc:5s� g6Z 3Sy I Cr NSE �7{N 5
LIC
I B ---
STFbcT ADDP,ESS� 5 � �r �1 Q Y I $ 1 vJ
�, STATF� Z J a :4 J,05 C C'A 9 5/2 3
P s /Vto 0591
A �C�T r.GAJT'�P I�h1J
I LIc TSEINTMSER.
I BUS. LjC
CON3A?4Y N.4I�
E-MAIL
I FAX
STR U ADDRESS
CITY, STATE, ZIP
I PHONE
USE OF ❑ SFD or DUPLEX ❑ MaTI-FAMI YI ?ROJECT IN WZDATII'D ❑ YES IPROM= W ❑ YES
BUIIA-TK-G: ❑ cobe.CLAL IMBAN 11\-1 ACE AREA ❑ NO FLOOD Z0217- 131,10
I IS = BLDG AN ❑ 1 FS
MCE=-I.r.-.'? E3HO2ho
DESCRIPTION OF WORK
/
74J 2 eel�
6,J CGH /�' A► 2 eu41eJ5
y mo _V.A
TGTAT V;LTUrTION:
.xe � ..
By ny siatre Belo;,, I ce iiy to e�^h of the follotiviTl,� I a a the p rope, -y o:;�er or autho iz�d agent to act on grope: ;awe' _ ,al` I have read thus
application and the ir�o . ,eioa I have provided is cor-ect I have read tie Desc; ipdon of Work and ; e iry it is ac ra.e. I z�Tee to co , ly "I th all applicable local
ordinances and state lz;,,s relative to buil^%`ng cons action I authori-� ; epresen gives of Cupe; ino to enter the above- n ,e o,ope, for saection pn poses.
Si�ztse oi."-.palic ,t'.�.gwt: 6-" z—,— Date:
S LEA/FNTAJ1 L'v�tOR-NfLkTION REQUIR D
�RE�FtGMEN=-
.k,E?MRsr-1pp_,20JJ. d
NC+-
?✓F?MRsc1pp_2011.doc revised 06/21/11
.j
CITY OF CUPERTINO
-VVU i', C9PT1%4 A 9PnI2 — III TTI .TIINC IIIVICInN
APPLIANCE / EQUIP TYPE
ADDRESS: 23500 CRISTO REY DR # 114C
DATE: 07/30/2014
REVIEWED BY: MELISSA
10
APN: 342 53 021
BP#:
*VALUATION: $450
*PERMIT TYPE: Electrical Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY
USE: Multi -Family Dwelling
Buildino is
>3 Stories 0 Yes (!!) No
PENTAMATION 1 REAP11
PERMIT TYPE:
WORK
ADD 2 N CEILING LIGHT/FANS 1 RECESSED LIGHT 2 OUTLETS & 3 SWITCHES
SCOPE
A'S los f }f,
APPLIANCE / EQUIP TYPE
FEE ID
------ -
QTY/FEE
QTY
UNITS
BP FEES
Fixtures, Lighting
1BREMFIXT
3
#
$72
Recep/Switch/Outlets
1 BREMRECEP
A'S los f }f,
5
#
47
PME Unit Fee:
$119.00
PME Permit Fee:
$48.00
Administrative Fee: IADMIN
$45.00
Work Without Permit? ® Yes 0 No
$0.00
TOTALS:
Travel Documentation Fee: ITRA VDOC
1 $119.00
Strong Motion Fee: 1BSEISMICR
1
I- P.'f' rt lee:
Phunh. I'lon Chc,,-A;
Plumb P rmr7zz::
Code• Pharrib Insn
Pliant:). Insp. Fee�
Elec. Plan Check 10.0 hrs $0.00
Elec. Permit Fee: IEPERMIT I
Other Elec. Insp. 0.0 hrs $48.00
NOTE: This estimate does not ineludefees due to other uepartments (Le. rianning, ruuttc rrartta, rttu, ..'. uiy �••�
C..mrt iho Dont for addn'l info.
"tStrtct, etc. wear cru uic uuucw v. •.•� ..............
FEE ITEM//S (Fee Resolution 11-053 Efj: 7/1/13)
... ... ...�"_-_ --' ---------
FEE
------ -
QTY/FEE
MISC ITEMS
jr
Si'lppi. .fit.., F_ f,,
PME Plan Check:
$0.00
A'S los f }f,
PME Unit Fee:
$119.00
PME Permit Fee:
$48.00
Administrative Fee: IADMIN
$45.00
Work Without Permit? ® Yes 0 No
$0.00
A:: °}'r.rl1.
Travel Documentation Fee: ITRA VDOC
$48.00
Strong Motion Fee: 1BSEISMICR
$0.50
Select an Administrative Item
Bldy, Stds Commission Fee: IBCBSC
$1.00
r
$261.50
$0.00 TOTAL FEE.
$261.50
Revised: 07/10/2014
2 6 2. !�_O
i
-Z3500 C r;5+v Reg Q2
J
G0 1 " `.'!";"`r DEVELOPMENT DEPARTMENT
( 'CJ'L' : 1NG DIVISION - CUPERTINO
t LA C
G Up
4
PPROV fl
and specifications MUST be kept at the
.s
o struction. It is unlawful to make any
rlbaraJons on same, or to deviate
»;thodt approval from the Building Official.
r`
,. .toca,aitante
n "'his plan and specifications SHALL NOT
''�
AMiNp Comer Units
• t or, to be an a,. proval of the violation
C
y�
Law.
Bedroom
I VO' a 12'9'
0
` �h
\:
Closet ,y�l
3'9'x 65"
Bath
8'4" x 8'9' by
6y. BBa��ony
6 Top Floor
Living Room
14'0" x 11'0" Bedroom
11'5" x 12'5"
A
Dining -
14'0.'.x 8'3'
o � 6'7 x 3�6'
H gn Ceiling....
3i Top Y7CGt
0. s
Kitchen
001.
Closet ..i
,4!,5'x 8'8" i
'''Entry
Bath
6'S' x 5'4'
Z �«h 5 f3ed�-oo� 5
AOQ Z & f'le�S sw 46)\S