11060152I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 22121 LINDY LN
CONTRACTOR: I PERMIT NO: 11060152
OWNER'S NAME:
1 , I PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION
License Class _ Lic.N Vol, �J O
Contractor Gc,) t 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:
1 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.
I have and will maintain Worker's Compensation Insurance, as provF
Section 3700 of the Labor Code, for the performance of the work fos
permit is issued.
APPLICANT CERTIFICATION
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point so __regulations per the Cupertino Municipal Code, Section
9.18.
Signature Date
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
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.
1 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
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
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
r- r r
BUILDING PERMIT INFO: BLDG ELECT PLUMB
MECH r RESIDENTIAL r COMMERCIAL r
JOB DESCRIPTION: REMODEL 400 SF KITCHEN, 600 SF BATHROOM, REPLACE
37 WINDOWS LIKE FOR LIKE, NO STRUCTURAL, 3 SETS OF
PATIO DOORS
Sq. Ft Floor Area: I Valuation: $191000
APN Number: 35627016.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Date:
RE -ROOFS:
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.
Signature of Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the upertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Secti925505, 25533, and 25534.
Owner or authorized age,, Date: (_ZZ a (
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Ad
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professi
Signature
Date
CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 22121 LINDY LN I CONSTRUCTIONCONTRACTOR:CRITCHFIELD I PERMIT NO: 11060152 I
OWNER'S NAME:
1 CAMPBELL, CA 95008 1 PHONE NO: (408) 371-3777 1
LICENSED CONTRACTOR'S DE LARATI N
r
License Class Lic. # j1
Contractor T �p " 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:
1 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.
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
permit is issued.
APPLICANT CERTIFICATION
1 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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source11ations per the Cupertino Municipal Code, Section
9.18. ff
Signature Date
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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 .
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
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.
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
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
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
MECH r RESIDENTIAL r, COMMERCIAL r
JOB DESCRIPTION: REMODEL 400 SF KITCHEN, 600 SF BATHROOM, REPLACE
37 WINDOWS LIKE FOR LIKE, NO STRUCTURAL, 3 SETS OF
PATIO DOORS
Sq. Ft Floor Area: I Valuation: $185000
APN Number: 35627016.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 D OM LAST CALLED INSPECTION.
Issued by: Date:
RE -ROOFS:
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.
Signature of Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous 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 the
Health & Safely Code, Sections 25505, 25533, and 25534.
agent: r_ _) q- ( %
Date: �p I I
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Date
Licensed Professional
I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 22121 LINDY LN I CONTRACTOR: CRITCHFIELD I PERMIT NO:.
OWNER'S NAME:
❑ LICENSED CONTRACTOR'S DECLARATION
License ClassLic.N B'
Contractor 4t , tL Date
I hereby affirm that I am licensed under the provision of Ch pte'r 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
1 hereby affirm under penalty of perjury one of the following two declarations:
1. 1 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.
2. 1 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
permit is issued.
APPLICANT CERTIFICATION
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this per mi Additionally the applicant understands and will comply with
all non -point sou egulation the Cupertino Municipal Code, ection .18.
Signature mate ff
❑ OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
t 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)
2 I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
1 hereby affirm under penalty of perjury one of the following three declarations:
t 1 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.
2. 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
permit is issued.
3. 1 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
become subject to the Worker's Compensation provisions of the Labor Code, 1
must forthwith comply with such provisions or this permit shall be deemed
revoked.
APPLICANT CERTIFICATION
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence ofthe
granting of this permit. Additionally, the applicant understands and will comply with
all non -point source regulations per the Cupertino Municipal Code, Section 9.18.
LOS GATOS, CA 95030
PHONE NO: (408) 395-0200
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
REVISE GREAT ROOM @ CEILING JOIST TO MAKE VAULTED
CEILING.
Sq. Ft Floor Area: I Valuation: $2000
APN Number: 35627016.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued byz /i _ _ Date: 7- Z ( -/"
RE -ROOFS:
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.
Signature of Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should 1 store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous 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 the
Health & Safety Code, Sections 25505, 25533, and 25534.
Ownuth ized a f .
ate:
LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Add
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Profession
Signature
Date
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 22121 LINDY LN CONTRACTOR: PERMIT NO: 11060152
OWNER'S NAME:
PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION
License Class A Lic. # q U
Contractor Date
1 hereby affirm that 1 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.
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
permit is issued.
APPLICANT CERTIFICATION
1 certify that I have read this application and state that the above information is
correct. 1 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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature.
BUILDING PERMIT INFO: BLDG F ELECT r PLUMB r
MECH r RESIDENTIAL r COMMERCIAL r-
JOB DESCRIPTION: REMODEL 400 SF KITCHEN, 600 SF BATHROOM, REPLACE
37 WINDOWS LIKE FOR LIKE, NO STRUCTURAL, 3 SETS OF
PATIO DOORS
11/28/201 l -REV#2 REVISE WINDOW LOCATION, ADD RETAINING WALL-
01/04/2012 REV#2 ISS'D
Sq. Ft Floor Area: I Valuation: $197000
APN Number: 35627016.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Date I Issued by:
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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
construct the project (Sec.7044, Business & Professions Code).
1 hereby affirm under penalty of perjury one of the following three
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.
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
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, 1
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
I certify that 1 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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non-po' ource regulations per the Cupertino Municipal Code, Section
9.18.
Date:
RE -ROOFS:
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.
Signature of Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(s) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous 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 the
Health & Safe Code, Sections 25505, 25533, and 25534.
Owner or o ' agent:
Date:f/ Z
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of mrk's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
Signature! - Date
I understand my plans shall be used as public records.
Licensed
CITY OF CUPERTINO BUILDING PERMIT DATE -1--1
BUILDING ADDRESS: 22121 LINDY LN
CONTRACTOR: G W KARIS
PERMIT NO: 11060152
OWNER'S NAME:
REDWOOD CITY, CA 94063
PHONE NO: (650) 216-6900
❑ LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
r r
BLDG ELECT PLUMB
License Class Lic. it � � `�
COMMERCIAL
r� -- 2V-1 2
MECH
RESIDENTIAL
Contractor 1.�k,k-� Date
I hereby affirm that 1 am licensed under the provisions of Chapter 9
JOB DESCRIPTION: REMODEL 400 SF KITCHEN, 600 SF BATHROOM, REPLACE
(commencing with Section 7000) of Division 3 of the Business & Professions
37 WINDOWS LIKE FOR LIKE, NO
STRUCTURAL, 3 SETS OF
Code and that my license is in full force and effect.
PATIO DOORS
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.
1 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 is
permit is issued. I ��
APPLICANT CERTIFICATION
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 propertyforinspection purposes. (We) agree to save
indemnity and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point urce regulations per the Cupertino Municipal Code, Section
9.18.
Signature Date
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
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.
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
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
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
1 certify that 1 have read this application and state that the above information is
correct. 1 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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -pooh so ce regulations per the Cupertino Municipal Code, Section
9.18.
Signature Date3, v � f 2
3/7/2012-REVil3 - ADD FURRING WALL @FIREPLACE. ADD NEW RETAINING
WALL AT FRONT OF RESIDENCE(50LF}3/20/2012 REVit3 ISS'D
Sq. Ft Floor Area: I Valuation: $201300
APN Number: 35627016.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAY F M LAST CALLED INSPECTION.
Issue by: Z Date:
o-10
RE -ROOFS:
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.
Signature of Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous 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 the
Health & S fety Code, Sections 25505, 25533, and 25534.
Owner a td d
Date: rl.v
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
- CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
r
ADDRESS: 22121 Lindy Lane
DATE: 03/07/2012
REVIEWED BY: Sean
APN:��
BP#: 11060152
"VALUATION: 1$4,300
°PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
PENTAMATION 1 RBCRW
PERMIT TYPE:
WORK
Revision #3: Add furring wall
a fireplace. Add new retaining wall at front of residence 50 LF
SCOPE
A'OTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc). These fees are based on the reliminar information av�rdlable and are only an estimate. Contact the De t or addn7 info.
FEE ITEMS (t et Be.solylion 11-053 U.. 7_ I�IIj
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
50 l.f.
$783.00
Retaining Wall
IRETSTN Standard Retaining Wall
Suppl. PC Fee: Q Reg. Q OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee:Q Reg. Q
OT
Q Q
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
0
E)
Work Without Pen -nit? O Yes O No
$0.00
A,_.,;ioed Planning lies :
$0.00
Select a Non -Residential
Building or Structure
Q
0
5tran Motion Fee:
IBSEISMICR
$0.
Select an Administrative Item
Bld Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$1.501
$783.00
TOTAL FEE:
$7
.50
Revised: 1 /19/2012
FM_7
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
19
ADDRESS: ��'� �'l (�l (,�
DATE: 06/17/2011
REVIEWED BY: gs
APN:
BP#:
"VALUATION:
1$185,000
%PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
PENTAMATION 1 R3SFDREM
PERMIT TYPE:
WORK
Remodel 400s ft kitchen 600s ft of bathroom Replace 37 windows like for like no structrual 3 sets of
SCOPE
patio doors.
ttech.
fe",C�
1'Ft. „ . , ,
t'
NOTE: These fees are based on the preliminary information available and are onlv an estimate. Contact the Dent for addn 7 info.
FEE ITEMS (Eee Resolution 09-051 [ff. 711110)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
300 s.f.
$570.00
Remodel, Bath (<=300 sf)
IREMUSBAT
Suppl. PC Fee: 0 Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
= s.f.
$570.00
Remodel, Kitchen (<=300 sf)
1REA9ZESKIT
Permit Fee:
$0.00
Suppl. Insp. Fee4O Reg. 0 OT
0.0
1 hrs
$0.00
= # Window / Sliding Glass Door
$884.00 1 wINREP Replacement
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
300 s.f.
$570.00
Remodel, Bath (<=300 sf)
IREAIRESBAT
i.ra�sCtit(`tllll7 T:r.1
Acoustical Fee: 0 Yes (D No
$0.00
200 s.f
$570.00
Remodel, Kitchen (<=300 sf)
IREA9ZESKIT
0
0
Work Without Permit? 0 Yes 0 No
$0.00
Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
E)
0
i�-,t �r r��c:�tn�:nr?tit3it Fces;
Strong Motion Fee: IBSEISACCR
$18.50
Select an Administrative Item
Bldg, Stds Commission Fee: 1BCBSC
$8.00
SUBTOTALS:
$26.50
$3,164.00
TOTAL FEE:
1 $3,190.50
Revised: 04/29/2011
FM_7
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 22121 lindy In.
DATE: 11/28/2011
REVIEWED BY: bobs.
APN:
BP#:
"VALUATION:
1$12,000
r,PERMIT TYPE: Building Permit
PLAN CHECK TYPE. Alteration / Repair
PRIMARY SFD or Duplex
USE:
PENTAMATION 1 GENRES
PERMIT TYPE:
WORK
revise window location add retaininq wall.
SCOPE
Li
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 Drelininary information available and are only an estimate. Contact the DeD1 for addn'1 info.
FEE ITEMS (1'ee Resolution 11-053 E . 7111,111)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: Q Reg. OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee-0 Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
V,
!O
0
Work Without Permit? 0 Yes 0 No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
E)
0
i
1,-;eve 4 Docirtnewtaiwi l•"ees
Strong Motion Fee: IBSEISMICR
$1.20
1 #
$652.00
Revision
IREVRESADD Addition u
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$2.20
$652.00
TOTAL FEE:
4.20
Revised: 401/2011