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10080029 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10438 VISTA DR CONTRACTOR: Y PERMIT NO: 10080029 OWNER'S NAME: CECELIA MALONEY _ Yvm - S J ,il (an DATE ISSUED:08/03/2010 PHONE NO: iNER'S PHONE: 4083909766 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT r— PLUMB License Class Lic.# ��/� MECH RESIDENTIAL COMMERCIAL Contractor COAL //JrhG Jo"TiD Date &- //0 JOB DESCRIPTION:REMODEL KITCHEN(132SQ),NEW CABINETS/SAME I hereby affirm that I am licensed under the provisions of Chapter 9 LOCA rION,UPDATING ELECTRICAL TO MEET (commencing with Section 7000)of Division 3 of the Business&Professions CODE APPLIANCES&PLUMBING STAYING IN SAME LOC BUT 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 Sq.D Floor Area: Valuation:$35000 permit is issued. APPLICANT CERTIFICATION APN 4umber:31633073.00 Occupancy 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 to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save ]PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply 80 DAYS FROM LAST CALLED INSPECTION. with all non-poi t source.regulations per the Cupertino Municipal Code,Section 9.18. Issue d Date:cP�G-'1 �C byr=`'" Signature Date ❑ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All n ofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspe;tion. will do the work,and the stricture is not intended or offered for sale(Sec.7044, Business&Professions Code) Signs ture of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three — declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I hai'e read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. Calif ornia Health&Safety Code,Sections 25505,25533,and 25534. I will maintain 1 have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Safe y Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Add tionally,should I use equipment or devices which emit hazardous air permit is issued. cont iminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall mail lain 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 Worker's Health&Shlety Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption, become subject to the Worker's Compensation provisions of the Labor Code,I must Owl r or an o Date: PY forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I het eby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for vrhich this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Len ler's Name n-on the above mentioned property for inspection purposes.(We)agree to save nnify and keep harmless the City of Cupertino against liabilities,judgments, Len ler's Address -s,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I un.ierstand my plans shall be used as public records. Signature Date Lic(nsed Professional CITY OF CUEERTINO 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Blk: I,ot: APN . . . . . . . . : 31633073 .00 DATE ISSUED. . . . . . . : 08/03,'2010 RECEIPT #. . . . . . . • • : BS000o11076 REFERENCE ID # . . . : 10080029 SITE ADDRESS . . . . . : 10438 VISTA DR SUBDIVISION . . . . . . . CITY CUPERrINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : CECELIA MALONEY ADDRESS : 10438 VISTA DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : MICAPEL R ARO CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096 COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED ADDRESS . . . . . . . . . . . CITY/STATE/ZIP . . . : TELEPHONE . . . . . . . . . FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC --NEW-BAL- ---------- ------------- ---------- --- 1BCBSC VALUATION 35, 000. 00 2 .00 0 . 00 2 . 00 0 . 0 1BSEISMICR VALUATION 35, 000. 00 3 .50 0.00 3 . 50 0 .00 1REMRESBAT SQ FEET 87 .00 570 .00 0. 00 570. 00 0 .00 1REMRESKIT SQ FEET 132 .00 570 .00 0. 00 570. 00 ------0_00 --- ------- ---------- ---------- TOTAL PERMIT L145.50 0 . 00 1145. 50 0 .00 METHOD OF PAYMENT AMOUNT----- REFERENCE NUMBER ----------------- ---------- CREDIT CARD 1, 145 .50 JISA --------------- TOTAL RECEIPT 1, 145.50 CITY OF CUIPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: I h ATE: REVIEWED BY: APN: BP#: *VALUATION: 1$35,000 9��PERMITTYPE: Building Permit PLAN CI[ECK TYPE: Alteration/Addition / Repair PRIMARY SFD or Duplex OVER THE APPLICATION , S USE: p COUNTER. 0 Yes 0 No TYPE: MECHANICAL ® Yes 0No PLUMBING 0 Yes () No ELECTRICAL Q Yes 0 No x 9 a CO 3 � OCCUPANCY TYPE: TYPE OF FLR ARE A PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s .ft. TOTALS: 0 $0.00 $0.00 P/c h7' NOTE. These fees are based on the preliminairTy in ormation avails ble and are only an estimate. Contact the Dept for addn 7 info. FEE ITEMS (F'ee Resolution 09-051 Lff.' '/1i0.9j FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 132 s.f. Remodel,Kitchen(<=300 sf) Suppl. PC Fee: (F) Reg. 0 OT 0.0 hrs $0.00 $570.00 IREMRESKIT PME Plan Check: $0.00 = s.f. Remodel,Bath(<=300 sf) Permit Fee: $0.00 $570.00 IREMRESBAT Suppl. Insp. Feer Reg. OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Acoustical Fee: Yes No $0.00 Work Without Permit? Q Yes 0 No $0.00 Planninhee: $0.00 Select a Non-Residential 0 Building or Structure i Strong Motion Fee: 1BSEISMICR $3.50 Select an Administrative Item Bldc= Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: $5.50 $1,140.00 TOTAL FEE: $1,145.50 Revised: 7/27/2010 CITY OF CUPERTINO ADDITIONAZEMODEL CUPERTINO FEE SCHEDULE APN# Date: Is a 2°d unit being added? Yes E] No [:1If yes, ple :se fill out the permit application for 2"d unit. Building Address: _ Lu Prac 7) Mailing Address (if different from building address): Owner's Name: Phone# r C/-) l--2( Contractor: Phone#: Fax#: Cupertino Business License: State Contractor License#: ; ;< G-l Contact: / � ,` > Phone#: DTZ-2 Fax#: Landscape Ordinance Compliance: Landscape area in sq. ft. (includes all irrigated areas): If 2,500 sq. ft. or less, compliance with the Landscape Water-Efficiency Checklist is required. If more than 2,500 sq. ft., a complete Landscape ProjeA Submittal is required. Compliance Method: ❑ Plant Type ❑ eater Budget Building Permit Info: Bldg. ❑ Elect. IN Plumb. Mech. ❑ Hillside ❑ �iTCf. /C� ��2,'7s�dJc Z-: l�, -'i. cti';ti'c-Tc SNr; G C rG'�iTla Job Description: Addition-What is being added?(Be Specific): ,c L�/t�i-'+►1i3 I N k1 Tti►.Lh3v�] '�:�'T� t�'�� //1.—NrG,.'Gtt_ i�c12.;1%c t � r_'c_��. ''�'d��-` T�� :ri r,:5 '5,(e nr' 5A6 LiL --L_ C'i� .._,�� .5 L"yLG,—a �C�<i. l.;r='�jr 'r7�tt� To PC },C1,�c= What is beim remodeled (not including addition). -� s;�oU;E r -�r 'h a� -� ✓,i V; 3 j </-l�C' C•'i�Tlr u�C�'tiS T,t;;/�G� ter✓/�- .T� �C �t`,l_ � c:7 Remodel Includes Re-Roof: Yes ❑ No ❑ If yes list number of squares Remodel Includes Structural: Yes ❑ No ®T Do you have the pre-application planning approval? Yes ❑ No If yes, please provide a copy of your planning appi oval letter. Planners name: Square Footage: Addition: Porch: Deck: Garage: Detached Attached Remodel: Kitchen IR-2-- _ Bath i; Other Type of Construction (Usage Class): Occupancy Tyype: 1-A, 1-B Q II/III/V-A ❑ II/III-B, IV-HT, V-BVI Valuation: Please check this box if the project is a Project Size: Ex rens ❑ Standard 0 Lar e ❑ Major ❑ second-story addition ❑ Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable. Green Building Points Achieved: include in plan set& the sheet index. Revised 05/18,10 RESIDENTIAL PROJECT COVER SHEET Assessor's Parcel Number: Name of owner. Li ,�z ti Project address. I Q u j ; 617-A Contact person. Phone Fax. Net square footage of lot. _<� Existing Proposed Square footage: First floor: Second floor: Garage: ---— TOTAL: Are there at least two 10 foot by 20 foot clear spaces inside the garage? Y Is privacy protection planting required for the project?/Y N Build it Green Total Points L Y� p,�1G On what floor(s) is work being done? Brief description of work. 61,10 ,-cc�� /`-7� �s�PL�t?il.' � -Sr9/79E" C '�G�lTi dN 2Fi� �Q �b'T/�/js�7 t�-i 5 U I� �-"G �J�C [„-Z-LZ"TYL/C✓�Z a��i //J W i %7 Code editions: 2007 CBC -N)2007 CFC N) ?007 CMC N) 2007 CPC -N)2007 NEC -N) Effective 1/1/08 �h-,� '� r�� ,•�- �,��„AN�',t rlrF�THE clrr of iN A �%' �4+�� i ti! K r l�lt�N CUt'Et�INt�LC)C7t_,AND ORDINANCE L!rt DATE Sil 6 (L—,At�,--kt Cr> This et of plans and sF)ec tj.ations MUST to Kept on the if)t,at all Un�es and it is unlaw'ul to make any -hanges or alterations on ame witDheuari eet,City of Cupert v. the E wilding f this plan and specifications The<tamping oit or to be an SH;ALL NOT be hel�tin perm any pro ons apt<<wal of the ,t any State�W. Plan Review Process Work Book Page-8-Revised 8/05/08 1M�J f '•`1 L j yl N 3 N s Sy ti 3 Joa _�Y s XX J ` F s s -7749-11PYI wol Cz, 49 - I u I #oil A-Z