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13090065CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20085 CEDAR TREE LN CONTRACTOR: AC CONSTRUCTION PERMIT NO: 13090065 OWNER'S NAME: GARRETT WADE PO BOX 51302 DATE ISSUED: 09/10/2013 OWNER'S PHONE: 4086912427 SAN JOSE, CA 95151 PHONE NO: (408) 422-4260 ❑ LICENSED CONTRACTOR'S DECLARATIION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class Li,. # 402(041-9GG UPGRADE (E) 100AMP ELECTRICAL PANEL TO 200AMP, INSTALL (N) DESIGNATED GAS LINE FROM METER TO Contractor Date fU (2i KITCHEN STOVE/OVEN 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: $3000 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: 31634004.00 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 WITHIN 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 ST 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 Date 13 G granting of this permit. Additionally, the applicant understands and will comply d by: with all non -point source r lations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signature Date l0 r '2> All roofs shall be inspected prior to roofing material being installed. If a roof is installed without first obta' ing . ' rs to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION e of Appli Date: I hereby affirm that I am exempt from the Contractor's License Law fo the following two reasons: ALL R F 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 25505,2 3, a 25534. Section 3700 of the Labor Code, for the performance of the work for which thisOwner or authorized agent: Date: c-_760 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If, 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 �J CONSTRUCTION PERMIT APPLICATION DO COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 0 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • building4cupertino.org [:]NEW CONSTRUCTION ❑ ADDITION�ALTERATION / TI ❑ REVISION / DEFERRED \ ORIGINAL PERMIT # PROJECT ADDRESS 2-(/ 9.f— / v -)AX iIz-� APN # -316 - 3 q 6— /S y OWNERNAME - /, V.. -I PHONE O� `/� f� Z E -MA I, (J STREET ADDRESS ��/�vs"i' ✓✓✓�� f / CITY, STATE, ZIP /n ZL ` /V v FAX CONTACT NAME �( �� 1(� t' �J � PHONE V q ' Y` -2 r 72- E-MAIL ADDRESS �© hex - STREET f JJOI� CITY, STATE, Z`IP") Jr�I �( �R��i F Q� 067 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME i^ / _ _ / n „� LICENSE NUMBER�V� / �iG`TLIECENSE7iTYPE BUS. LIC # COMPANY NAME fa- /(_�.�fy/!> ,��/ L--[ E-MAIL FAX STREET ADDRESS / i� 4 /p„ 2 CITY, STATE, ZIP kz---,f r� �(, M PHONE ARCHITECT/ENGINEER`FNAME J/ LICENSE NUMBER NI v J BUS. LIC# COMPANY NAME I E-MAIL I FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK t" p� D :r v C/ EXISTING USE PROPOSED USE CONSTR. TYPE I # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA I AREA I NET AREA REMODEL AREA I REMODEL AREA DECK REMODELAREA ATTACH # DWELLING UNITS: IS A SECOND UNrr VYL's SECVIVL5IVKT U. - BEING ADDED? ONO ADDITION? ONO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YESOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO 006 By my signature below, I certify to each of the foyoff�gct the property owner or authorized agent t act a property owner's behalf. have read this application and the information I have provided ead the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building coorize representatives of Cupertino to enter the above -Id ntifie roperty for inspection purposes. Signature of Applicant/Agent: Date: _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. _ Commercial Bldgs: 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. BldgApp_2011.doc revised 06/21/11 _1 CITY OF CUPERTINO Fe-mMnIM�+ L0crir7AR A Tl1D __ 121TH "TIVC_ 11IVIQInN ;1,fech. Plan Cheek Plumb. Plan Check 0.0 1 hrs $0.00 Elec. Plan Check 10.0 1 hrs $0.00 -Wec-h. Permit Fee: Plumb. Permit Fee: IPPERMIT Elec. Permit Fee: IEPERMIT Oche r Nlerch. Insp. Other Plumb Insp. 1-2-01 hrs $47.00 Other Elec. Insp. 0.0 hrs $47.00 ,tech. Insp. lee: Plumb. Insp. Fea; Elec. Insp. Fee: NOTE: This estimate does not mclude,jees aue to orner ueparwwnts ti -r- X-LLLrL.LL/Lg, •.•.«. ., ....._,.. __ ___, ____ _ __ - ,... ,. r:..,oro /'n mri tho Dont fnr addn'l info. uisJrJCy eLG . l LLeJ I: GCJ lL/G UuuGu V/s wsc . mow..».a... FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/12) ADDRESS: 20085 CEDAR TREE LN DATE: 09/10/2013 REVIEWED BY: MELISSA APN: 316 34 004 BP#: "VALUATION: $3,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Du lex p PENTAMATION 1 REAP2 PERMIT TYPE: USE: PME Plan Check: WORK REGRADE E 100AMP ELECTRICAL PANEL TO 200AMP INSTALL N DESIGNATED GAS LINE SCOPE FROM METER TO KITCHEN STOVE/OVEN ;1,fech. Plan Cheek Plumb. Plan Check 0.0 1 hrs $0.00 Elec. Plan Check 10.0 1 hrs $0.00 -Wec-h. Permit Fee: Plumb. Permit Fee: IPPERMIT Elec. Permit Fee: IEPERMIT Oche r Nlerch. Insp. Other Plumb Insp. 1-2-01 hrs $47.00 Other Elec. Insp. 0.0 hrs $47.00 ,tech. Insp. lee: Plumb. Insp. Fea; Elec. Insp. Fee: NOTE: This estimate does not mclude,jees aue to orner ueparwwnts ti -r- X-LLLrL.LL/Lg, •.•.«. ., ....._,.. __ ___, ____ _ __ - ,... ,. r:..,oro /'n mri tho Dont fnr addn'l info. uisJrJCy eLG . l LLeJ I: GCJ lL/G UuuGu V/s wsc . mow..».a... FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/12) .•. ... ....-_...._ .-•--__^--- FEE ------ --- QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Laiamps $47.001 Electrical IBELEC200 Services Suppl. PC Fee: Q Reg. OOTM hrs $0.00 PME Plan Check: $0.00 F 1 # $70.00 Plumbing 1PGASRES Piping, Gas <=4 Outlets Permit Fee: $0.00 Suppl. Insp. Fee -.0 Reg. ® OT 0,0 I hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $94.00 Construction Tax: Administrative Fee: IADMIN $44.00 G) Work Without Permit? ® Yes (2) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure ®� Travel Documentation Fee: ITRA VDOC $47.00 StrongMotion Fee: IBSEISMICR $0.50 $117.00 Select an Administrative Item �-�$303.50 Blda Stds Commission Fee: IBCBSC $1.00 $186.50 \N Revised: 07/01/2013 JOB ADDRESS: aofS ! 2EE 1.n1 PERMIT # D OD OWNER'S NAME:f�' PHONE # GENERAL CONTRACTOR: A -C ( w /l% BUSINESS LICENSE # ` cCF o C,-' ADDRESS: [ AyF, CITY/ZIPCODE: A-jJ dS7E S *Our municipal code requires all businesses working in the city to have.a City: of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCO TORS HAVE OBTAINED A CITY O CUPERTINO BUSINESS LICENSE. / /D f I am not using any subcontractors. (��' Signature Date Please check applicable subcontractors 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 G Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner-/ Contractor Signature OF