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13060195
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7548 WATERFORD DR CONTRACTOR:ALI'S CONSTRUCTION& PERMIT NO: 13060195 REMODELING OWNER'S NAME: DOHERTY JOSEPH W AND DOROTHY E 681 E BROKAW RD DATE ISSUED:06/25/2013 OWNER'S PHONE: 4086743587 SAN JOSE,CA 95112 PHONE NO:(408)898-6474 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIAL❑ License Class_ Lic.# REMODEL KITCHEN&REPLACE 1 WINDOW,REMODEL f� 2 Contractor ; � ate BATHRMS&REPLACE 2 WINDOWS.UPGRADE I hereby affirm that I am licensed under the provisions of Cha ter 9 ELECTRICAL (commencing with Section 7000)of Division 3 of the Business&Professions PANEL TO 200AMPS.REPLACE(E)BAY WINDOW 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:$80000 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:36616010.00 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 WITFIIN 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 D QOM LAST CALLED 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 6 Z granting of this permit. Additionally,the applicant understands and will comply Y Date: with all non-point sourc regulations per the Cupertino Municipal Code,Section 9.18. � 14'E-ROOFS: Signature Date /3 All roofs shall be inspected prior to any roofing material being installed.If a roof is 44- installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ O DERDECLARATION 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 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 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,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner Owner or authorized agent: 1 / �(A I►L a 4' Date: Xqw- 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 CONSTRUCTION LENDING AGENCY 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 CONSTRUCTION PERMIT APPLICATION �� COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•building a CUPERTINO I cupertino.org [:]NEW CONSTRUCTION ❑ JADDITION j ALTERATION/Ti ElREVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS ✓ 1�A�Q-j -b �' APN# c5(0 6 // O/ }1 OWNER NAME PH ` _35WFE-MAIL (o STREET ADDRESS CITY, STATE,ZIP FAX CONTACT NAME Lh Zamam ` -MA /,� dnvb STREET ADDRESS !� CITY,STATE,ZIP F C o �" N �' t ❑ OWNER ❑ OWNER BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACT/O�RAGENT 1111ARc=cT ENGINEER El DEVELOPER 11 TENANT CONTRACTOR NAME LICENSE NUMBER O L ,3 LICENSE TYPE BUS.LIC# COMPANY NAME b21 f E- co f q FAX � O a``�/7/VI 1 O � I STREET ADDRESSO t CITY,STATE,ZIP �� PHO 2T3- ARCMECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS n CITY,STATE,ZIP PHONE DESCRIPTION OF WORK f K r i nd lir { DIVRe;'l0J&Af .It1 GI` i Lj•f AA LjS n l' 200 6- EXISTING USE PROPOSE15 USE NS TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXLSTG NEW FLOOR DEMO TOTAL AREA AREA AREA NErAREA BATHROOMKrrCHEN OTHER REMODEL AREA19 0 REMODEL AREA REMODEL AREA PORCH AR_EA I DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA LIDETACH Ji ATTACH #DWELLINGUNTTS: IS A SECOND UNIT []YES SECOND STORY ❑YES BEING ADDED? ANO ADDITION? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES - IVED`B _ TAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? []NO 000By my signature below,I certify to each of the following: I am the property owner or au age e property owner's behalf.'I have read this application and the information I have provided is correct. I have read the Description of Work nfy it is accurate. I agree to comply with all applicable local ordinances and state laws relating to bui (, construction. I authorize representatives of Cupertino to enter the above-ident ed prope for inspection purposes., Signature of Applicant/Agent: iz Date: SUPPLEMENTAL INFO ION REQUIRED "t aFt r 'tLN'•G �:.`�YPE ,t _OUTJ71Cr,SL� _ New SFD or Multifamily dwell s Apply for demolition permit for r OVER THCOUh R BUILD]I1G PLAN existing building(s). Demolition permit is required prior to issuance of building permit for new building. � E P sS u� AaV iciw _; _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure r., DARD. 'r CrusrlCi�o7zIts - form if any Hazardous Materials are being used as part of this project. _Copy of Planning Approval Letter or Meeting with Planning prior to Y. JOR L3 Y ELY IS RI submittal of Building Permit application. AN SEFR BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 7548 WATERFORD DR DATE: 06/25/2013 REVIEWED BY: MELISSA APN: 366 16 010 BP#: `VALUATION: 1$80,000 %PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1 R3SFDRE WORK REMODEL KITCHEN & REPLACE 1 WINDOW REMODEL 2 BATHRMS & REPLACE 2 WINDOWS. SCOPE UPGRADE ELECTRICAL PANEL TO 200AMPS. REPLACE (E) BAY WINDOW 7; g� g 21 ou Llech. Plan Check Plumb. Plan Cheek Elec.Plan Check 0.0 hrs $0.00 F-1 lec,h.Permit Fee: Plumb.Permit Fee: Elec.Permit Fee: IEPERMIT Other Herch.Insp. Other Plumb Insp, 0 Other Elee.Insp. 0.0 hrs $45.00 Ilech.Ln.sp.Faze: Plumb. Insp.Fee: Lslec.Insp,Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Theseees are based on the prefinmina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS(Fee Resolution 11-053 Eff' 7/1112) FEE QTY/FEE I MISC ITEMS Plan Check Fee: $0.00 = s.£ Remodel,Kitchen(<=300 sf) Suppl. PC Fee: (E) Reg. ® OT0.0 hrs $0.00 $600.00 IREAfl?ESKIT PME Plan Check: $0.00 D2Ls.£ Remodel,Bath(<=300 sf) Permit Fee: $0.00 $600.00 1 1REMRESBAT Suppl. Insp.Fee-0 Reg. 0 OT 0.0 hrs $0.00 ® # Window/Sliding Glass Door PME Unit Feer $0.00 $400.00 1WINREP Replacement PME Permit Fee: $45.00 200 amps Electrical C onstruNion Tax: $45.00 IBELEC200 Services Administrative Fee: IADMIN $42.00 Work Without Permit? ® Yes (j) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential E) Travel Documentation Fee: 1TRAVDOC $45.00 Building or Structure 0 i Strong Motion Fee: IBSEISMICR $8.00 Select an Administrative Item Bldp-Stds Commission Fee: IBCBSC $4.00 s 9 $144.001$1,645.00111w ra 4 ° $1,789.00 I�A•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: PERMIT# OWNER'S NAME: e PHONE GENERAL CONTRACTOR: ('Q BUSINESS LICENSE s#' ADDRESS: NCITY/ZIPCODE 2 *Our municipal code requires all businesses working in the city.to:have a City of Cupe'rfiRo business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) 'WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SU ONTRACTORS HAVE OBTAIN;E-D A CITY O CUP RTINO BUSINESS LICENSE. ` I am not using any subcontractors: ignature Dat Please check applicablesubcontractors an c plete 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 core{�!I;.T I�UfLV G l T I^a i -_ r,e Thk s of p,'ars ami til t /� /� A'p nc i. a J ,l `�\�� IpU t V !T f N tliyzsiom,4 'tiro 1tThe an c lr'r '' J 1 l4! of an s Ordinance or to e Law. c // �lK��cJg, 4p l� D E - PERMIT NO. t/�om:06a I� w l �© o wt Zoe c II YiNo Y'LOT PLANS F�l Ly C�, I I cu event CHECKED BY aG,A— I .)ATE • 2� 2013 NING DEPT. DE COMPLIANCE P N �e l�� REVIE�NE� FOR C� OATE v� ; Reviewed BY' ger o . ovvi JfJid r , ��9