The URL can be used to link to this page

13090115-expiredCITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10259 AINSWORTH DR CONTRACTOR: MAURICE A AGRILLO PERMIT NO: 13090115 OWNER'S NAME: HERSCHER BRET A AND PENELOPE A 651 FENLEY AVE DATE ISSUED: 09/27/2013 OWNER'S PHONE: 6505952955 SAN JOSE, CA 95117 PHONE NO: (408) 910-4266 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIALE] LICENSED CONTRACTOR'S DECLARATION Lic. # 479290 ENCLOSE BACK PORCH AREA (77S.F.) TO ENLARGE (E) License Class KITCHEN. REMODEL (E) KICHEN & BATHROOM & Contractor _ Date 9-o?7 Z6i3 CREATE I hereby affirm that I am licen ed under the provisions of Chapter 9 (N) LAUNDRY AREA (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 rformance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $90000 A, ave 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: 32613130.00 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 180 DAYS F T C D INSPECTION. upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the by: Date:granting of this permit. Additionally, the applicant understands and will complywith all non -point source regulations per the Cupertino Municipal Code, Section rs'sued 9.18.RE-ROOFS: Date �� roofs shall be inspected prior to any roofing inbeing installed. If a roof is SignatureOL Tz::= 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 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) 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 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and performance of the work for which this permit is issued. 1 have and will maintain Worker's Compensation Insurance, as provided for by the Health &Safety Code, Sec ' s 25505, 25533, a 534. 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I I I hereby affirm that there is a construction lending agency for the performance of become subject to the Worker's Compensation provisions of the Labor Code, must work's for which this permit is issued (Sec. 3097, Civ C.) forthwith comply with such provisions or this permit shall be deemed revoked. 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 21 CCUPERTINO F-1 NTFW (Y)NTSTRT T`TInN CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinq(d_)cupertino.org AT)I)ITIC)NT F-1 AITFRATTON/TI F-1 RFVICI0M/T)FFFRRFI) Cr^ 0\ v\ �O ORIGINAI. PERMIT # PROJECT ADDRESS /oZS /ieswar�h D�' /I a CA- APN # 211-1 - I3o OWNER NAME PHONE E-MAIL _ terry s� So S9S-'LgSS .rJ r Car STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAME PHONE I '/ 1 , L E MA �� 9A4620/l/ ` ��Q� C J -I ✓,Q fT! �!'G�i7«T3 C STREET A DRESS ` �o CITY, STATE, ZIP FAX So vlAso "I ❑ OWNER 13 OWNER -BUILDER 11 OWNER AGENT 1:1 CONTRACTOR 11 CONTRACTOR AGENT SCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME / E-MAIL _ FAX < 7�s� �Y7 ILLIi�/�iC, rcl o/0 /vtILG�CdT✓1 STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # /a COMPANII;N ME �c E-MAIL i�✓ie>�i�c,�o�. FAX -W ISo o v,o cvh.G (k 515- STREET CITY, PHONE/&670 6<e S DESCRIPTION OF O �l�l L,L,4 o EXISTING USE PROPOSID USE CONSTR TYPE #STORIES V-15 USE TYPE OCC SQ FT. VALUATION (S) EXISTG AREA 3�`�� NEW FLOOR AREA DEMO AREA TOTAL 7 NET AREA 35 88 BATHROOMKITCHEN �p REMODEL AREA e l $f OTHER REMODEL AREA REMODEL AREA 100 sF PORCH AREA DECK AREA TOTAL DEC R H AREA GARAGE AREA: UDETACH I ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES BEING ADDED? SECOND STORY []YES ADDITION? Ofi0 ffRO PRE -APPLICATION []:YES IF YES, PROVIDE COPY OF PLANNING APPL # ffNO PLANNING APPROVAL LETTER IS THE BLDG AN YES EICHLER HOME? ffNO REC TOTAL VALUATION. ev0 By my signature below, I certify to each of the following: I am the property owner or au ed agent to act e p/op96y 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 ' acur)V I agree to comply with all applicable local ordinances and state laws relating 'di co truction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED PLAN CHE K TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW 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. EXPREss ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 1:1STANDARD ❑ PUBLIC WORKS fo_rm if any Hazardous Materials are being used as part of this project. ❑ ❑ 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 /0-1 ��,,�� CITY OF CUPERTINO 7 1�►V" IPV1 . F.QTIMATOR — R1TILDING DIVISION LAADDRESS: 10259 AINSWORTH DR DATE: 09/16/2013 REVIEWED BY: MELISSA PC FEE ID APN: 326 13 130 BP#: `VALUATION: 1$90,000 %PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY USE: SFD or Duplex 2nd Unit? -' Yes • No OTC? 0 Yes (OF)No PENTAMATION 1 R3SFDADD PERMIT TYPE: WORK ENCLOSE BACK PORCH AREA 77S.F. TO ENLARGE E KITCHEN. REMODEL E KICHEN & SCOPE I BATHROOM & CREATE (N) LAUNDRY AREA OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,III-B,IV,V-B 77 $1,059.00 IADDPLCK $1,026.00 IADDINSP leer. Insp. Pae, $0.00 Permit Fee: $1,026.00 Suppl. Insp. Fee -0 Reg. Q OT 0,0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 77 $1,059.00 $1,026.00 MECH, HOURLY 0 Yes (F) No PLUMB, HOURLY ® Yes E No ELEC, HOURLY 0 Yes Q No iviech. flan Check P(nurb, Plan C'hec'A Plan (:;heck Mech. Permit Fee: Plumb. Permit Fee: Elec 1' Other Rye;1, In;°h Other Plumb Insp,E17-- Either Elec. Insp. hrs r,t im leer. Insp. Pae, NOTE: This estimate does not include fees due to other Departments (i.e. Ptammng, Pubuc works, rare, Sumiury Sewer u,sh ILL, ocrrour Contact the Dent for addn'1 info. U,sirta, etc. . iueor juva- FEE ITEMS (Fee Resolution 11-053 E ' 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,059.00 F-3767 s.£ $488.00 Remodel, Other 1REMRESOTx Suppl. PC Fee: Q Reg. Q OT T 0.07 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,026.00 Suppl. Insp. Fee -0 Reg. Q OT 0,0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: __F_T Adrninistrative.F'ee: E) Work Without Permit? Yes (F) No $0.00 Advanced Plannin& Fee: 1PLLONGR $10.78 Select a Non -Residential Building or Structure 0 T�rrs cel L?�ctrn�rtttr;irrrt fens: Strong Motion Fee: IBSEISMICR $9.00 Select an Administrative Item Bldg_Stds Commission Fee: IBCBSC $4.00 SUBTOTALS: $2,108.78 $488.00 TOTAL FEE: I $2,596.78 Revised: 08/01/2013 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: /0-2G5; 'PERMIT # 1 OWNER'S NAME: 61-e-11 * ee.V PHONE # o •-g/v— 2G�G• GENERAL CONTRACTOR: /?1a BUSINESS LICENSE # ADDRESS: 65/ oCEjVLee , S , �, CITY/ZIPCODE: *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 SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date V 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 Ow '-/ Contractor Signature Date