The URL can be used to link to this page

13060043 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7752 ROBINDELL WAY CONTRACTOR:GREEN WORKS US PERMIT NO:13060043 OWNER'S NAME: CARROLL JOHN JR AND EDITH M 2500 OLD CROW CANYON RD DATE ISSUED:06/06/2013 OWNER'S PHONE: 4082536488 SAN RAMON,CA 94583 PHONE NO:(925)272-4590 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIAL❑ License Class C 3 Lie.# 66 // — REPLACE(E)BATHTUB WITH(1)WALK-IN TUB.ADD(1) Gi�e'Fn)G.I�-�S VS 116113fDEDICATED CIRCUIT(GFCn Contractor 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. Sq.Ft Floor Area: Valuation:$5000 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:36223010.00 Occupancy Type: permit is issued. 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 WITIIIN 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 180 DAYS F LLED 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 Is Date: granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Mu ' ' al Code,Section 9.18. 6 RE-ROOFS: Signature Date—0 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. ❑ OWN LDER 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 1,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,a 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date 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 CONS CTION LENDING AGENCY Compensation laws of California. It after making this certificate of exemption,I 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 9.18. Signature Date v` CONSTRUCTION PERMIT APPLICATION �O COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION �b 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 UP RT[Nt� (408)777-3228•FAX(408)777-3333•building@cuoertino.org El NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED \ORIGINAL PERMIT# PROJECT ADDRESS '7q �5 2_ 5 W D� 0 'r APN# / Z_— t� + O O OWNER NAME 4f�-2� � � J PHONE � (O E-MAIL STREET ADDRESS �//]�� C/ CITY,STATE,'7--7 t O O/ FAX CONTACT NAME (gG(- /-�,.w 'n�l��® r p Cl 7-5 �/V��, //�� E-MAIL STREET ADDRESS �'3 O' / `V/�/'1� /� /•'+�1 /� CIT I,SCT`ATE,ZIPWIOA)i) �`1'}� p �//1'/�� FAX ❑ OWNER ❑ OWNER-BUILDER1:1('❑ OWNER AGENTC h+ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# GREENWORKS US 668492 B,C33 COMPANY NAME GREENWORKS US E-MAIL FAX 925-265-4590 STREET ADDRESS CITY,STATE,ZIP PHONE 4301 LAKESIDE DR. RICHMOND CA 94806 925-272-4590 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK REPLACE EXISTING TUB WITH NEW WALK-IN TUB - SAME LOCATION. ADD DEDICATED GFCI CIRCUIT. EXISTING USE PROPOSED USE CONSTR.TYPE I #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODELAREA REMODELAREA REMODELAREA PORCH AREA I DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH []ATTACH #DWELLING UMTS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? ❑NO ADDITION? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES C ,, TOTAL VALUATION: PLANNINGAPPL# ❑NO PLANNING APPROVALLETTER EICHLERHOME? 0 N 5'000,00 By my signature below,I certify to each of the following: I am the property owner or authorized agent to 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 representative ertino to enter the abgv Iden�ed roperty for inspection purposes. Signature of Applicant/Agent: Date: (/J SUPPLEMENTAL INFO UIRED r.LAN C ECX TYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for YER THE-coUNTER ❑ BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. �E) E WREss ❑' PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD [] PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. Q LARGE ❑ FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH _ BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 7752 ROBINDELL WAY DATE: 06/06/20137 REVIEWED BY: MELISSA APN: 362 23 010 BP#: *VALUATION: 1$5,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Duplex PENTAMATION 1 RPFIX USE: p PERMIT TYPE: i WORK REPLACE E BATHTUB WITH N WALK-IN TUB. ADD N DEDICATED CIRCUIT GFCI SCOPE -m Awl WIN Xlech.Plan Check Plumb.Plan Check 0.0 hrs $0.00 Elec.Plan Check 0.0 hrs $0.00 Llech.Permit Fee: Plumb.Permit Fee: IPPERMIT Elec.Permit Fee: IEPERMIT [Ah"',h. Alech.Imp. Other Plumb Insp. 0.0 hrs $45.00 Other Elea 0.0 Insp. hrs $45.00 Insp.Fee: Plumb. Insp.Fee: Elec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,eta). These fees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 E . 7f� /1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Plumbing Suppl.PC Fee: Q Reg. ® OT 0,0 hrs $0.00 $10.00 IBPFIXTURE Fixture set on One Trap PME Plan Check: $0.00 F-1-1 Electrical Permit Fee: $0.00 $133.001 IBREMMISC Special Circuits Suppl. Insp.Fee-0 Reg. ®OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $90.00 Consiruction Tax: Administrative Fee: 1AVMIN $42.00 Work Without Permit? ® Yes ONO $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential Travel Documentation Fee: 1TRAVDOC $45.00 Building or Structure ®, Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 $178.50 $143.00 . $321.50 _ . � Revised: 04/29/2013 Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: 7 s Z o i3 j)C-Z c.. tJ PERMIT# o6 p o OWNER'S NAME: e--A ©�„L PHONE# Z5 3 6 GENERAL CONTRACTOR: 6XE-" Ci -K-5 U S BUSINESS LICENSE# ADDRESS: t4 301 e- j IZ CITY/ZIPCODE.-,jzI�..'04O 4 D `� O *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WILL BE"SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OB - -D A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractor • 6 3 Si ature Date Please check applicable subcontrac s and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood "- Glass/Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date MAIN CONTROL BOX(WORKING CONDITION AND FEATURES) SCOPE OF WORK: RATEDVOLTAGE 110V INSULATED RESISTANCE >50M n REPLACE EXISTING TUB WITH NEW WALK IN TUB. NEW TUB WILL SLIDE INTO EXISTING TUB LOCATION. RATED POWER 282OW PRESSURE RESISTANCE 125V/0.5mA/1MIN. N 4kALL EXISTING PLUMBING WILL BE USED. RATED FREQUENCY 60Hz WATERPROFF GRADE IPX4 ADD A DEDICATED GFCI CIRCUIT FOR THE TWO MOTORS IN THE TUB. LOADING PARAMETER U) ¢m BONDING:CONTINUOUS RUN,CLIP ATTACHMENTS. N o ELECTRICAL PANEL LOCATED ON THE EXTERIOR OF THE HOME. LOADING ITEM RATED LOADING RATED LOADING RATED LOADING �M z 4 VOLTAGE FREQUENCY POWER Y cc)p HEATER 110V 60Hz 1500W �Q0 za z WATER PUMP 110V 60Hz 900W j�: �* C-. o WIND PUMP itOV 60Hz 400W LZ m p-< BEDROOM LIGHT AC12V low LLJ U � BEDROOM OZONE AC12V 10W ATERC.4 o N 0 N BEDROOM n$ BATHROOM DINING ROOM AyRyORKF CUPERTINO drug C7eFarbnent ry g LIVING ROOM Q�' JUN u 6 2®13 KITCHEN REyiEWED FOR R CODE COMpLlANCE x z Reviewed ey. (E)FRONT DOOR $ (N) EL (N)TUB 30"(w)x so"(L) ROBINDELL WAY }., FRONT YARD CD J O FLOOR PLAN 0 J � COMMUNITY DEV (d DEVELOPMENT DEPART '-IvT �w ¢ o BUILDING DiViSiON-CUPRTI+NO o E V Z C:) APPROVED CD F— This set of plans and specifications MUST be kept as e cm N w job site during construction. It is unlawful to s: _I<: a .y w tiCl- changes or alterations on same,or to cls- ti U therefrom,without approval fronn the Suiilc i r The r` nping of this plan and VED b,c hodd ILO I::ermlt o w .--roval Of GATE S ' '+ 05.31.13 of s y City �Oln:nce o �.�.�� L. uv. 9-5'_ '� _. 1.� SCALE NTS DKW BY:8177 DATI ES l au._ PERMIT NO. O 00 / 3 BATHROOM DETAIL SHEET HA-1 � .'.. A-1