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Home My WebLink AboutB-2017-1570CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1570 22345 CARTA BLANCA ST CUPERTINO, CA 95014-1008 (326 13 057) REMODO KITCHENS & BATHS CONCORD, CA 94520 OWNER'S NAME: CUTLER GREGORY M AND MAI,H DATE ISSUED: 09/13/2017 OWNER'S PHONE: 408-425-1236 PHONE NO: (408) 914-8666 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. #955200 Contractor REMODO KITCHENS & BATHS Date 05/31/2018 X BLDG _ELECT —PLUMB MECH X RESIDENTIAL COMMERCIAL 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. JOB DESCRIPTION: KITCHEN REMODEL - (127 SF) I hereby affirm under penalty of perjury one of the following two declarations: 1. 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 Sq. Ft Floor Area: Valuation: $16000.00 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 APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 326 13 057 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signaty�;�,. Date 09-13-2017 Issued by: Kim Dunbar Date: 09/13/2017 OWNE-B i I I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS: following two reasons: ; ' All roofs shall be inspected prior to any roofing material being installed. If a roof is 1. I, as owner of thepproperty, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sec.7044, Business I& Professions Code) z. I, as owner of, the property, am exclusively contracting with licensed Signature ofApplicant: contractors to;construct the project;(Sec.7044, Business & Professions Code). Date: 09-13-2017 1 hereby affirm under penalty of perjury one of the following three declarations: "A" 1. I have' and will maintaina! Certificate of Consent to self -insure for Worker's ALL ROOF COVERINGS TO BE CLASS OR BETTER Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which'this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6'.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued, I Health & Safety. Code, Section 25532(a) should I store or handle hazardous shall not employ any person in any;manner so as to become subject to the material. Additionally, should I use equipment or devices'which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and exemption, I becoime subject to the Worker's Compensation provisions of the the Health & Safety Code, Sections 25505, 25533, and 25534. Labor'Code, 1, must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agen ' APPLICANT CERTIFICATION Date: 09-13-2017 I certify that I have read this application and state that the above information is L D E correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that ther ' construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's. Name to save indemnify and keep harmless the City of Cupertino against liabilities; judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section 9.118. 1 understand my plans shall be used as public records. Signature Date 09-13-2017 Licensed professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • building@cuPertino.or ; PEMIT #B -Mlt- �b CUPERTINO I REV # DEF # I -I NEW CONSTRUCTION ❑ ADDITION 'WALTERATION ❑ T.I. ❑ MEP ❑ RE -ROOF . ❑ SWIMMING POOL/SPA ' t. . PROJECT ' 1 S �GLC� +Cl & ( G� J APN # c/� OWNER NAMEPHONE . WZ _ 12 - E-MAIL STREET STREET ADDRESS�� % C °� CITY, STATE, ZIP Gi V (� C. GL fir Gt J / CONTRACTOR NAME ❑ OWNER -BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE 1i , 2vt 0 J gss��() R STREET ADDRESS 7- CITY, STATE, ZIP �' 599-2-0 z( 0114 1/7 , G E-MAIL /n // PHONE BUS. LIC # 0S0 flt i et,� 14A b Z 7 ❑ ARCHITECT 191 OWNER ❑OWNER AGENT. MONTRAcToR AGENT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTACT NAME / E-MAIL c /eL�c c d�Gi` O• �fA/� STREET ADDRESS 7 CITY, STATE, ZIP PHONE (fDLt G SY Z2f GCS DECRIPTON Itc e -P SINGLE-FAMILY/DUPLEX ❑ MULTI -FAMILY ❑ INDUSTRIAL ❑ COMMERCIAL USE TYPE OCC SQ.FT. VALUATION ($) EXISTING USE I EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES # TOTAL NET SF REMODEL REMODEL KITCHEN, REMODEL OTHR GARAGE ❑ ATTACHED BATHROOM SF SF 2 SF SF ❑ DETACHED EXISING ❑ YES EICHLER ❑ YES ', SECOND STORY ADDITION O YES FIRE SPRINKLERS ❑ NO ❑ NO NO DWELLING SECOND DWELLING ❑ yES ❑ ATTACHED ❑ DETACHED OTHER UNITS # UNIT ADDITION: ,• ❑,'Jo S F I POOLS ❑ FIBERGLASS ❑ VINYL -LINED ❑ GUNITE ❑ PREFABRICATED .. POOL - SF SPA - SF 11 SPA ATTACHED ❑ YES ❑ NO TOTAL - SF RECE D B TOT L/ VALUATION: Commercial or Multi -Family Buildings with Public Swimminft Pools requires Department. of Environmental Heath approval( �tb 0_0 RE -ROOF EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ TTLE OTHER (SPECIFY) REMOVE /REPLACE ❑ NO IF NO IPLYWOOD ❑'h" [13/8" PLYWOOD TYPE: PITCH: ROOF CLASS YES I #OF LAYERS THICKNESS ❑ 5/8" OTHER ❑OSB ❑ CDX OTHER 12 A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER *Provide a signed copy of the Cupertino's Tear -Off Policy SF #of SQUARES 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 have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. I acknowledge and authorize all information contained on this application form` to be made available for public record. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION R ED *New SFD/Second Dwelling Units tifamily e lings: A Demolition permit is required prior to issuance of a building permit for all new construction. *Commercial Buildings: Provide'a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. *Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. *HOA -Provide a letter of approval from.the Home Owner's Association BldgApp_2017.doe revised 08101117 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1570 22345 CARTA BLANCA ST CUPERTINO, CA 95014-1008 (326 l3 057) REMODO KITCHENS & BATHS CONCORD, CA 94520 OWNER'S NAME: CUTLER GREGORY M AND MAI H DATE ISSUED: 09/13/2017 OWNER'S PHONE: PHONE NO: (408) 914-8666 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO. License Class GENERAL BUILDING CONTRACTOR Lic. #955200 Contractor REMODO KITCHENS & BATHS Date 05/31/2018 X BLDG X ELECT —PLUMB MECH X RESIDENTIAL COMMERCIAL 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, JOB DESCRIPTION: KITCHEN REMODEL - (127 SF) I hereby affirm under penalty of perjury one of the following hvo declarations: REV# I - ADD SUB-PANEL (60 AMPS) (LAUNDRY ROOM) ISSUED I- 1. I have and will maintain a certificate of consent to self-insmro for Worker's 22-2018 Compensation, as provided for by Section 3700 of the Labor Code, for the I— performance of the work for which this permit is issued, 2, f 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. Sq. Ft Floor At eft: Valuation: $16000.00 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 AIN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 326 13 057 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 PERMIT EXPIRES IF WORI{ IS NOT STARTED may accrue against said City In consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature - Date Issued by: Kim Durbinr Date: 09/13/2017 O R-BUILDERCLXf ATION 1 hereby affirm that 1 am exempt from the Contractor's License Low fur one of the RE-ROOFS following two reasons: All roofs shall be inspected prior to any rooting material being installed. if a roof is t. I, as owner critic property, or my employees with wages as their sole installed without fist obtaining an inspection, 1 agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sce.7044, Business & Professions Code) z. has owner of the property, am exclusively contracting with licensed Signature of Applicant - contractors to construct the project (Sce.7044,.Business & Professions Code). Date: ------ - 1 hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CL?AOREI ER I 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, HAZARDOUS MATERIALS DISCLOSURE 2. 1 have and will maintain Worker's Compensation Insurance, as provided of by I have rend the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will permit is issued, maintain compliance with the Cupertino Municipal Code, Chapter 9,12 and the a. 1 certify that in die performance of the work far which this permit is issued, 1 Health & Safety Code, Section 25532(a) should 1 store or handle hazardous shall not employ any person in any manner so as to became subject to tine material. Additionally, should I use equipment or devices which emit hazardous tilt contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 said exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Sections 25505, 25533, and 25534. Labor Code, 1 must forthwith comply with such provisions or this permit shalt be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date: I certify that I have read this application and state that the above information Is CONSTRUCTION LENDING AGENCY correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for Inspection purposes. (We) agree Lender's Name to save Indemnify and keep harmless the City of Cupertino agalnst liabilities, judgments, costs, and expenses which may accrue against said City In Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARXHON Code, Section 9.18. 1 understand my plans shall be used as public records. Licensed SignatureDate Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION Nome 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 EDIs _ (408) 777-3228 • building@cupertino.org PEMITXB- _ ISS CUPERTINO REV DEF DEF k_ F-1 NEW CONSTRUCTION I (ADDITION n AT TR.RATInN n T i',I.7I'ARFP IRF.Rnni; I7.SWTMMING Pnni./SPA PROJECTADDRESS APNq Z OWNER NAME PHONEE C v 215-(2 - ATL STREET ADDRESS CITY, STATE, ZIP CONTRACTORNAME ❑OWNER -BUILDER COMPANYNAME LICENSE NUMBER LICENSE TYPE R CL" ygswo R . ETADDRESS �_ 2Zi CITY, STATE, ZIP " � ��p.� C C/ `/ E-MAIL PHONE Q / BUS. LIC 9 agg!'fit . O. C t7l LI LI ❑ARCHITECT WWNER El OWNER AGENT ❑ CONTRACTOR AGENT ❑ ENGINEER ❑DEVELOPER El TENANT CONTACT NAME E-NIAIL STREET ADDRESS CTIY, STATE, ZIP PHONE DESCRIPTON GI vl e1A 1/ >" r ❑SINGLE-FAMILY/DUPLEX ❑MULTI -FAMILY ❑INDUSTRIAL ❑COMMERCIAL USE TYPE OCC 'SQ.FT. VALUATION ($) EXISPINGUSE EXISTINGSF NEWFLOORSF PORCHSF DECK IF DEMOSF STORIESk TOTAL NET SF REMODEL REMODEL KHCHEN REMODELOTHR GARAGE ATTACHED BATHROOM IF IF SF IF ❑ DETACHED EXISING ❑ YES EICHLER ❑ YES SECOND STORY .ADDITION NO [:]FIRESPRINKLERS NO ONO DWELLING SECONDDWELLING ❑YES ❑ATTACHED❑DETACHED OTHER UNITS UNITADDITUN: El NO SF POOLS ❑ FIBERGLASS ❑ VINYL -LINED ❑ GUNITE ❑ PREFABRICATED POOL -SF SPA-SFSPAATTACHED ❑YES ❑ NO TOTAL -SF Cornme nu! o � MuRi-Po rilv.Bwildines with Public Smm''r r Poois 'en r' es Drnn 4 nrf of Enr''m ver Fnl H ntl ...... - 7 RECEl Y: / /� TOTAL VALUATION: RE -ROOT EXISTING POOP TYPE: [:1 BUILT-UP ROOF EJ ASPHALT SHINGLES❑WOOD SHAKES❑WOOD EHINGLES❑TILE 'OTHER (SPECIFY) REMOVE/REPLACE❑NO FEND PLYWOOD [:]'A;' ❑3/B" PLYWOOD TYPE: PTTCH: ROOF CLASS [-]YES POFLAYERS THICKNESS❑5/S" OTHER_ ❑OSB ❑CDX OTHER —.12 A PROPOSED ROOF TYPE:❑BTIILT-UP ROOF DASPHALT SHINGLES El WOOD SHAKES []WOOD SHINGLES ❑OTHER *Provide a signed copy of the Cupertino's Tear -Off Policy SF :d SQUARES 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 have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply With all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. I acknowledge and authorize all information contained on this application form to be made available for pub ' Signature of Applicant/Agen : - Date: e9`"- 2 SUPPLEMENTAL INFOR N REQUIRED *News SFD/Second Dw e Units/Multifam' flings;-A.Demolition permit is required prior to issuance of a building permit for all new construction. *Commercial Buildings: Provide a co ed Hazardous Materials Disclosure farm if any Hazardous Materials are being used as part of this project. `Copy of Planning Approval Letter or Meeting With Planning prior to submittal of Building Permit application. *HOA -Provide a letter of approval from the Home Owner's Association BldgApp_2017.doc revised 08101117