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14100148 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10281 LOCKWOOD DR CO TRACTOR PERMIT NO: 14100148 OWNER'S NAME: PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL E] RECONFIGURE&REMODEL MASTER&HALL BATHS. License Class _ Lic.# e REMOVE �� 6*Sw,f, �U 1 t NON LOAD BEARING WALL IN MASTER(TOTAL 130 S.F.) Contractor �/ti V t ate `'( I hereby affirm that I am licensed under the provisions of Cha ter 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:$40000 I-Ifave 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:34230002.00 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 O IT 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 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 D te:�v granting of this permit. Additionally,the applicant understands and will comply s with all non-point source regulations per the Cupertino Municipal Code,Sect aow- 9 18. RE-ROOFS: Signature DateA44 Qt L( 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. ❑ OWNER-BUILDER 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 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) 1,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 255059 25533 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized ag Date: I 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 CONSTRUCTION PERMIT APPLICATION �\ COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION \� 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•building(d),cupertino.org ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 10281 Lockwood Dr. APN# , gy 1/ ?C) 2 OWNERNAME STREET ADDRESS 10281 Lockwood Dr. CITY,STATE,ZIP Cupertino,CA,95014 FAX CONTACT NAME Danny Borges PHONE(408)640-8233 E-MAIL Borgesbuilt@gmail.com STREET ADDRESS 6120 Montoro Ct. CITY,STATE,ZIP San Jose,CA,95120 FAX (408)622-5964 ❑OWNER ❑ OWNER BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME Gordon Patton LICENSE NUMBER 665050 LICENSE TYPE B BUS.LIC# COMPANYNAME Primus Construction Inc. E-MAIL Primus30@msn.com FAX (408)2683992 sTREET ADDREss 2064 Folle Blanche cny,STATE,zip San Jose,CA,95135 PHO (408)288-4848 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK Interior remodeling to two existing bathroom. Removal of a non load bearing partition wall(no structural changes). Relocation of existing plumbing fixtures and new led lighting. Replace existing exhaust fans with new whisper quiet panasonic fans. EXISTING USE PROPOSED USE CONSTR.TYPE I #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHRREMODELL AREA 130 sgft RE OOM DEL AREA OTHER AREA PORCH AREA I DECK AREA TOTAL DECKIPORCH AREA I GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT S SECOND STORY S BEING ADDED? O ADDITIONY7 vio PRE-APPLICATION [I YES IF YES,PROVIDE COPY OF IS THE BLDG AN 13 A TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME! By my signature below,I certify to each of the following: I am the property owner or orize nt to ac the rty owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of W and veri urate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to Ver the above-identified p perty for inspection purposes. Signature of Applicant/Agent .� --.•_ '�"F Date: �,c SUPPLEMENTAL INFORMATION REQUIItEDr3c o f 7 XP .. '.R00MG SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for , er O'vCRe ttNT>ttR ❑ H DINGPLANREVIEW existing building(s). Demolition permit is required prior to issuance of building p ` permit for new building. EyggESg ❑ p G PLAN REVIEW Wi as ,a k t" _Commercial Bldgs: Provide a completed Hazardous Materials DisclosureIrmA C Ic woxlcs form if any Hazardous Materials are being used as part of this project. g 1e� LCE sal ❑ PIEDEPT:" Copy of Planning Approval Letter or Meeting with Planning prior to 71s 3 aR�r sEWER-DISTRICT su_bmittal of Building Permit application. BldgApp 2011.doc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10281 LOCKWOOD DR DATE: 10/24/2014 REVIEWED BY: MELISSA *VALUATION: APN: 342 30 002 BP#: $40,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY PENTAMATION 1 R3SFDREM USE: SFD or Duplex PERMIT TYPE: i WORK RECONFIGURE & REMODEL MASTER & HALL BATHS. REMOVE NON LOAD BEARING WALL IN SCOPE MASTER (TOTAL 130 S.F.) ............. . ......... Tech Plan(.'- retch 11hoirh. Pl(,nr('hcck 1''an Chcck Wecft. 11crrtril Fiee.. Plumb.Irermil hee �)tirr;r ,l9tc h. Irt�,T3- (O7her 1�'itrrrb Jra.��P. (�Plt��r 1,1�'c.lips}). 1�;%' Plunth b?sl;. F �•: f iec.&V) r>:e: NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These fees are based on the prelimina information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff: 7/1/13) FEE QTY/FEE I MISC ITEMS Plan Check Fee: $0.00 = s.£ Remodel,Bath(<=300 sf) Suppl.PC Fee: Q Reg. ® OT 0.0 hrs $0.00 $645.00 IREMRESBAT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee: Reg. ® OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 T= (`O sir uc°rit r, Tax: : 0 Work Without Permit? 0 Yes (j) No $0.00 G Advanced Planninjz Fee: $0.00 Select a Non-Residential E) Building or Structure 0 t;ftrirrfCalic>r71=cies: Stromz Motion Fee: IBSEISMICR $5.20 Select an Administrative Item Bldg Stds Commission.Fee: IBCBSC $2.00 $7.20 $645.00 TOTAL FEE: $652.20 Revised: 07/10/2014 c li 1 i Is Nv - E i xis A 1 A�H N Rui�d; RT/ BEV ;e R Af I_ 5MA � is 32.'' j I 7E G` rt"dsL -D I I Ito" Cr► �' l 3 L C UPERT t �ain.9 DP f No cn pa>�irtenj �r REVIEWED R C.7D Reviewea E Co&,P(IANC,iz css-tet