12060032 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11180 SANTA TERESA DR CONTRACTOR:130 WU PERMIT NO: 12060032
OWNER'S NAME.: MARINKOVICH CHRISTY I. 40087 AIISSION BLVD STE 382 DATE: ISSUED:06/05/2012
ON'N'ER'S PIIONF: 4088737015 FREMONT.C\ 94539 PHONE NO:(5h)93&9479
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License ClassLic.9
�? ) / ` MECH r RESIDENTIAL r COMMERCIAL r
Contractor Dale &' r
1 hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION:SINGLE FAMILY RCaROOF REPLACE WI'I'11 COMI'
(commencing with Section 7000)of Division 3 of the Business&Professions SHINGLES(30 SQ),KITCIIEN RHMODEL
es (150
Code and that my license is in full force and effect. SQFT)NON-STRUCTURAL AND ADD NEW GAS LINK FOR NEW
I hereby affirm under penally 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 ollhe Labor Code,for the performance of the work for which this Sq,Ft Fluor Area: Valuation:$25000
permit is issued.
APPLICANT CERTIFICATION APN Number:35617022.00 OceupaneN Type:
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
m building construction,and hereby authorize representatives of this city to enter
upon the above mentioned propert) for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indenm if) and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulaiinrs per the Cupertino Municipal Code,Section
9.18- / (�I� tI2
GS��—= k16 .� yrs y Issued b Date:
Signature Date
01 OWNER-BUILDER DECLARATION
RE-ROOFS:
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material beug installed.If a roof is
the following two reasons: installed wkithout first obtaining an inspection,I agree to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection.
%kill do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signature of Applicant: Date:
1,m owner of the property.am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code).
ALL ROOF COVERINGS TO RE CLASS".\"OR BETTER
I hereby uffirm under penally of perjury one of the following three
Ideclarations:
have and will
IIAZARDOUS MATERIALS DISCLOSURE:
I have and%kill maintain a Cclilicate of Consent tosell=insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the
perfommnce of the work for which this permit is issued. California llealth&Safely Code,Sections 25505,25533,and 25534. 1 will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the llealth&
Section 3700 of the Labor Code,for the performance of the work for which this Safely Code,Section 25532(a)should 1 store or handle hazardous material.
permit is issued Additionally.should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
I cerlify that in the performance of the work for which this permit is issued,l shall maintain compliance with the Cupertino Municipal Code.Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Workers Health&Safely Code,Sections 25505,25533,and 25534.
Compensm ion laws of Cali forma. If,alter making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Code,I must Owner or authorized agent: p./
fardi%%ith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGE:NCV
I eertity that I have read this application and stale that the above information is I hereby affirm that there is a construction lending agency fix the performance of work's
correct. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec 3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned properly for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
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 .\RCIII'1'F.f.T'S DECLARATION
9.18. 1 understand my plans shall he used as public records-
Signature Date Licensed Professional
RESIDENTIAL; PROJECT COVER SHEET
Assessor's Parcel Number:
Name of owner. 1 A- P. (A-41hVX) G( d
Projectaddress.11t .SQWtO, col
p/. r
Contact person. h C 4�1 L Phona i d 7 t� "
Fax. CX
Net square footage of lot.
Existing Proposed
Square footage: First floor:
Second floor:
Garage:
TOTAL. l
Are there at least two 10 foot by 20 foot clear spaces inside the garage?
CUPERTINO
Is privacy protection planting required,for the project? N Building Department
Build it Green Total Points_ JUN 0 5 2012
On what floor(s) is work being done? REVIEWED FOR CODE COMPLIANCE
Reviewed
Brief description of work(Z) I � /k I Yi"o—
ren\ae� -(lam r, 6 r
Code editions: 2010 CBC9-N)2010NEC
N)2010 CFC9-N)
- N)2010 CMC ON)
2010 CPC
California6�$t$ 6matr86d1€ X10
BUILDING DIVISION-CUPER '
APPROVED
Effective 1/01/11 This set of plans'and specifications MUST be kept at the
job site during construction. It is unlawful to make any
changes alt approval from the Buons on same,or ilding Official.
deviall
therefrom,without
app
out app
The stamping of this plan and specifications SHALL NOT
be held to permit or to be an approval
of the violation
ate Law.
nance
BY
of any provisions of any City
(3 S�
_
DATE 6
PERMIT
Plan Review Process Work Book Page-8- Revised 12/21/10
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JUN 0 5 2012
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REVIEWED ORCODECOMPI ,
Reviewed By:
p� 314N �( �E e�✓► MAI Pvt i v (CI i Cb+ �+�J
V G-N T C N) (9'R STOry E
CITY OF CUPERTINO
8 ITEMS OF 9 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35617022. 00
DATE ISSUED. . . . . . . : 06/05/2012
RECEIPT #. . . . . . . . . : BS000017008
REFERENCE' ID # . . . : 12060032
SITE ADDRESS . . . . . : 11180 SANTA TERESA DR
SUBDIVISION . . . . . . .
_ CITY . . . . . . . . . . . . . . CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : MARINKOVICH CHRISTY L
ADDRESS . . . . . . . . . . : 1433 N CROSSWATER WAY
CITY/STATE/ZIP . . . : EAGLE, ID 83616
RECEIVED FROM . . . . : TODAY'S BUILDER COR
CONTRACTOR . . . . . . . : BO WU LIC # 31343
COMPANY. . . . . . . . . . : BO WU
ADDRESS . . . . . . . . . . : 40087 MISSION BLVD STE 382
CITY/STATE/ZIP . . . : FREMONT, CA 94539
TELEPHONE . . . . . . . . : (510) 938-9479
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
- ------------ ---------- ---------- - - ---------- ----------
lADMIN HOURS 1.00 41. 00 0. 00 41 .00 0. 00
1BCBSC VALUATION 25, 000.00 1. 00 0 . 00 1 .00 0 .00
1BSEISMICR VALUATION 25, 000.00 2.50 0 .00 2 .50 0 .00
1PGASRES OUTLETS 1.00 65 .00 0 . 00 65. 00 0 .00
1PPERMITFE FLAT RATE 1 .00 44 . 00 0 . 00 44 . 00 0 . 00
1REMRESKIT SQ FEET 150 .00 588 . 00 0. 00 588 . 00 0. 00
1REROOFRES SQ FEET 30 .00 420. 00 0. 00 420 .00 0. 00
1TRAVDOC FLAT RATE 1 . 00 44 . 00 0. 00 44 .00 0 . 00
TOTAL PERMIT 1205.50 0 .00 1205 .50 0.. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 1, 324 . 50 VISA
---------------
TOTAL RECEIPT 1, 324.50
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
1:21 ADDRESS: 11180 Santa teresa dr. DATE: 06/05/2012 REVIEWED BY: bobs.
APN: I BP#: 'VALUATION: $25,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex PENTAMATION 1R3SFDREM
USE: PERMIT TYPE:
WORK Sfd roof replace with compshingles, kitchen remodel non structural add new as line for new
SCOPE kitchene-rstove top.
k /'G;n c'hrcd Plumb. Plan Check 0.0 hrs $0.00
;t":L /',-;nrir For: Plumb. Permit Fee: IPPERMIT P.lac I'rnrnr/;r:
01/,rr1h,h_ 6„1- Other Plumb Insp. 0.0 hrs $44.00 Urde, la r. lay. ED
.Ikrh. b"/, Fr,': P6mrh, bop. For: lila. b;q�. i”, __j
NOTE: This estimate does not include fees due to other Departments(i.e.Planning, Public Works, Fire,Sanitary Sewer District,School
District,etc. . Thesefees are based on the prelimina information available and are only an estimate. Contact life Dept for arltln'I info.
FEE ITEMS (Fee Resolulion 11-053 Lill: 711111) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 F-150-1 s.f. Remodel, Kitchen (<=300 sf)
Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $588.00 IREh1RESKIT
PME Plan Check: $0.00 3,000 s.E Re roof
Permit Fee: $0.00 $420.00 /REROOFREs
Suppl. Insp. Fee-.0 Reg. Q OT 0,0 hrs $0.0011 # Plumbing
PME Unit Fee: $0.00 $65.00 IPGISRES Piping,Gas<=4 Outlets
PME Permit Fee: $44.00
Administrative Fee: (ADMIN $41.00 O
Work Without Permit? O Yes (j) No $0.00 0
Advanced Plannine Fcc: $0.00 Select a Non-Residential t7
Travel Documentation Fee: ITRA VDOC $44.00 Building or Structure
Stroma Motion Fee: IBSEISMICR $2.50 Select an Administrative Item
Bide Sids Commission Fee: IBCBSC $1.00
SUBTOTALS: $132.50 $1,073.00 TOTALFEE $1,205.50
Revised: 05/01/2012
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE-CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228-FAX(408)777-3333-buildinaCdcuoertino.oro
PROIF.CT ADDRESS I n � APN u
C.
Y n
OWNER NAM&-? '1 1
v PIIONE C ��-� T[ �o�.ti��li•it � f%{ c�r�/Lni bt Ur'�
STREET ADDRESS .^ q CITY.STALE ZIP , FAX
CONTRACTOR NAME, ` V'\ LICENSE NO R LICENSE TYPE (l BUS.LIC.<
COMPANY NAME V E-MAIL FAX
STRF.E ,DORES, I �S1u.N 1S1 �A� CITY.STATE.zIP ry1� �/� ^ rC� PH S1`E_,�_���_�rV
I UNDERSTAND AND AGREE TO THE FOLLOWING: / r
1. The re-roof project shall comply with all applicable provisions of the 2010 California Codes.
2. An inspection request can be scheduled up to the day before the inspection date. Please call (408)777-
3228 from 7:30 - 3:30pm (Mon-Thurs) or 7:30 - 2:30pm (Friday) to schedule the next day inspection.
For Tear-Off and Nailing Inspections, you must also call on the day of the inspection only after that
phase of the work is completed. The building inspector will be available within one hour. Progress
and Final Inspections will be given a two hour window.
3. Tear-Off Inspection is required. Any and all dry-rotted wood shall be replaced prior to this inspection.
Unless new plywood roof sheathing is proposed throughout, all the nails/fasteners shall be either
completely knocked-down or removed prior to this inspection.
4. If plywood is installed, a plywood Nailing Inspection is required.
5. Roofing shall not be applied without first obtaining all prior inspection and written approvals from the
building inspector. Any roofing which is applied without first obtaining an approved inspection will
require the removal of all new material down to the sheathing so a proper inspection can be performed.
6. Progress Inspection is required when approximately 50% of roof covering is installed.
7. A Final Inspection and approval shall be obtained from the building inspector when the re-roofing is
completed. To receive a final sign-off, the following items will be verified:
a. Flat roofs shall have a minimum of per foot of slope and demonstrate there is no ponding.
b. Listings from approved testing agencies for all pre-manufactured products used shall be
available on-site to review at the time of the inspection.
c. Proper spark arrestor installation, vents painted, gutter/downspouts installed, debris removed.
8. NOTE: If you call for a tear-off or plywood nailing inspection and the work is not complete, you will be
charged a re-inspection fee of$126.00. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the
property owner's behalf. 1 understand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential C e.
Signature of ApplicanUAgent: Date: C •rI �� L
Rernn/Puhn 201 Ldoc Tensed 02116//l
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228• FAX(408) 777-3333• buildinD(dicupertino.orD
❑NEW CONSTRUCTION ❑ ADE)MON ❑ ALTERATION/T1 ❑ REVISION/DEEFERRED ORIGINAL PERmrr
PROIECT.ADDRFSs !1 I n,O ` tl I�-�QL
(� APNt Z ��� L�`/ '\r' d 1�
OWNER NAME'I `I ��C��YC� k PHO - )5EM7�C•{.\ C�ItJC%1 �_l�C:,C\�C•�� �t '�1%
STREET ADDRESS . 1. STA ZIP F
QAM-�A �i r ( (L"4 r n , nC' �.n �l�h 111
CONTACT NAME PHONE _ 'E-MA 9
STREET ADDRF•$SI ) ; ,I �. r CITY,STATE IIP , FAY
❑ OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTORAGENT ❑ ARcIrEcr ❑ENGINEER ❑ DEVELOPER ❑ ISAY
CONTRACTOR NAME O �1 LICENSE NUMBER r. Q LICENSE TYPE BUS.LIC N21 5q
COMPANY MME �t ^,t / p ,n E-MALL �j FAX /�✓ I
STREET ADDRESS r 64 Fl Pr I 1 S-?"0 01S/40651 STATE ZIP R` P_w')0� } PHONE ,`I U —,/3o* Q
ARCHITECrENGINEERNAME 1 'I LICENSENUMBER rt' I BUS.LIC79
COMPANY NAIvM E-MAIL FAX
STREET ADDRESS /) CITY,STATE ZIP PHONE
/t
DESCRIPTION OF WORYO(,! r 12-
2
IY J r T�t%V T
D and
EXISTING USE PROPOSED USE CONSTR TYPE 1STORIES
USE TYPE OCC. EQ.FT. VALUATION(S)
EXISTG NEW FLOOR DEMO TOTAL s �,
u'^ ,rI
AREA :FA AREA NEr.MEA `/\ J( rJ([
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL '(✓'/I REMODELAF-EA
PORCHAREA DECKAREA TOTALDECWORCHARFA GARAGE ARF.vDETACH
ATTACH
4 DWELLDIG UNITS: ISASECONDUNTT OYES SECONMSTORY YES
BEINGADDED' ONO ADDTITONP ONO
PREAPPLIGDON OYES IF YES.PROVIOECOPYOF I LS THE BLDG AN ❑YES RECEIVED BY: TOTALVALUATION:
LANNLN
PGAPPL9 ONO PLANNING APPROVAL LETTER EICHLER HOME' 0N
By my signature below,I certify to each of the following: 1 am the property owner or authorized agent to act on the prpperty owner's'oehalf. 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 emer the above-identified property for inspection/purposes.
Signer=of ApplicandAgent Date: /e:d
SUPPLEMENTAL MFORMATION REQUIRED P IT�CIC TYPE ROUTING SLIP
New SFD or Multifamily dwellings: Apply for demolition permit for OVER-THELOUNTER BUD.DLNG PLAN REVIEW
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. ❑ EXPRESS ❑ PLANNINGPLAHREVTEW
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORHS
Tom if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT
Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MANOR ❑ SANITARYSEWER DLSTRICT
submittal of Building Permit application.
❑ ENvmONMENTAL.HEALTH
Blde ipp_1011.dot revised 06121111