04100034 CITY OF CUPERTINO
BUILDING DIVISION PER COIi�TRAGTOR INF,ORMkf IDN
DING ADDRESS: CEVAN FORRISTT DESIG pERMlr ND04100034
PERMIT ISSUE DATE
OWNER'S NAME:
STEPHEN LI
PHONE: SANrTARY NO. CONTROL NO.
0s 7-
BUILDING PERMIT INFO
ARCHI=i ENGINEER: BLDG ELECT PLUMB MECH
0 0 0 0
op LICENSED CONTRACTOR'S DECLARATION Job Description
u C 1 hereby affirm Num lise
I an¢d under p rvisium of Chapter 9(commencing
w with Sccdon 70fN)of DivisionJof NC Businm and Prrfruinm Code.and mylicen¢iswan
{p�?.
s infull rorteemcffca {� [9( SQ. FT. )
License Class ty.S "NAE[+ate'
'� Ores
ARCHITECT-S DECLARATION
`l 1 undersand my plans.hall he used u public me-,& FEB 9$ 2005
6V
ut; Li<cnse0 Professional
01 OWNER-BUILDER DECLARATION
I hemhy aRnm Nat 1 am eacrept from W Conlnnofs License law for the
0 O following mason.(Section 7031.Business and profam..Code:Any city ns'countyBUILD t!
m which mquims a permit m construct.alter,improve,dcmnlish,or Mpair any staclurt eA
zi pnmmits insumme.also requirrcNeapphwnlfor such permilw0leisignedsaament [. oorArea Valuation
< Wt he k licensed patentor to W provisions M im Co...,'s!dare Law(Chapter 9 q�
�0 (commencing with Section 70(lim of Division 3 of NC Business and Professions Crude)or
52 that he is eseinpt therefrom and W bask for W alleged esemption.Any violation of
Section 7031.5 by any applicant for a permit subjects W applicant to a civil pmulty of 3 55TNfl &8beT0 0 Occupancy Type
not mom Wan ase hundred dollen(gT00z
❑L u own¢of the pmpmy,or my emplay m with vngen n Neirmec coepcnution,
will do the work.and d¢swcam is nor intended or offered for sale(Sec.7061,Business Required Inspections
and Pmfessiam Codc The Coe
mmmrs Lt..law docs not apply to an owor Of 9 P
property who builds or(¢prows thcmon,and who does uch work himself ar N,vuth his
own employees,provided that such improvement are not intended or offered for made.If.
however,the Wilding or improvement is sold within one year of completion,the owner
Wilder will have W burden of proving that he did but Wild or improve for putpu s of
nit.)..
❑1.as owner of W property,am inclusively comae ing with licensed eanuacmrs to
construct the project(Sec.7014,Business and Pfofessions Cade:)The Contractor's Li.
nse taw docs not apply m an owner of property who Wilds as'improves demon,and
eonmtts for such projems with a commensals)licensed ponson,m W Convectors
sslaw.
tun p, der gee B&P Cfar
,,Nrl(i�Datem(.'...
Owner Da
cm WORK RS COMPENSATION DECLARATION
I hereby affirm under pcnahy of perjury one of the following declarations:
I have and will maintain aCerdricam of Consent to uef-insum for Winner's Compen-
mial as provided for by Section 3700 of W Labor Code,for the pcdomunce of W
work for which this permit is evaed.
I have and will maintain Workers Compensation Issuance,m required by Section
37W of the Labor Code.for the performance of the work firs'which this permit is issued.
My Wed,ce,Crmpemerion hs mince amu and policy numbs,am: .
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu seed.aced not be caoplced If the Iermit is nronch ouni cd dollars(5100)
or co.)
1 certify that in the performance of the work for which this permit is issued,I shall or
employ any person in any summer an a m heemen subject to W WOrtme Coepcnseuon
Laws of CaRrom e-Dam
Applicant
NOTICE TO APPLICANT:If,after making this Certificate Of Eacmp,ion,you should
become subject to Ne Wrrims-,Compensation pmvuions of the Labor Wr Code.you must
�Z. ronawits comply with such provisions or this fermi[small be deemed remand.
Z O CONSTRUCTION LENDING AGENCY
I thereby afire dust them is a conswctinn lending agency for Nc performance of
ya �I W work for which this permit as issued(Sec.304f.CO.C.)
s3 L endeh Name
1 Lender's Addm_ss
jz I certify that I have mad this application and sae that the above information is
Z f" comm.I agree to comply with all city and county ordinances and sus laws mladng to
7 V Wilding(eonsweti to andhereeY mthond mpm4cnmasstof Nuc fCoemQupnnde /
aWve-mentioned property for inspection purpo s
(We)agree m cove.indemnify and keep hay in an the y se of against .gains
t. fry liabilitiu.judgmcna.scam!¢and eapensu which may in any way accmc.Sante soil City
JZ in consequence of Me Standing of this permit. to
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:
SOU RCE RECPUtakTION
Re-roofs
galurc aupplionvcon m Dam a of Roof
V HAZARDOUS MATERIALS DISCLOSURE Type
Will On applicant or future building Occupant mom or handle hanrdous material
as defined by Ne Camilla.Municipal Code.Chapter 9.12 and the Hea1N and Safety
Code.Secdan 85R(a)? All roofs shall be inspected prior to any roofing material being installed.
�Yv
/fat If a roof is installed without first obtaining an inspection,I agree to remove
Will Nc applicant m fauns building occupant use equipment or dMana which
emit hanrdrns air conmminsna u JcdncJ by Nc Bay Area Air Quality Management all new materials for inspection.
DisUicl? r
0YCm
I have mad W hvSeetio materials requimecns ander Cmenced 95 if the Wilding
nu Hcemth&Safny haveaSeetiomhat it i My repounia.l WMindy t WlirW Wilding
docs not currently have a stool that it k mY msponsithility m rodly de v¢apmt Of W
mqulm town; mam,hen ' r imuanapncemramarocram, Signature of Applicant Date
F _�i All roof coverings to be Class "B" or better
r awmmca agent Date
CITY OF CUPERTINO
Item 1 of 1 PERMIT RECEIPT OPERATOR: conniew
COPY # 3
Sec : Twp: Rng : Sub: Blk: Lot :
APN . . . . . . . . : 35918019 . 00
DATE ISSUED. . . . . . . : 10/06/2004
RECEIPT 4 . . . . . . . . . : 27333
REFERENCE ID # . . . : 04100034
SITE ADDRESS . . . . . : 10645 FELTON WY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER STEPHEN LING & APRIL HEVNG
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4305
RECEIVED FROM . . . . : JACKI YAHN
CONTRACTOR . . . . . . . : CEVAN FORRISTT LIC # 25986
COMPANY . . . . . . . . . . : CEVAN FORRISTT DESIGN
• ADDRESS . . . . . . . . . . 345 S 19TH ST
CITY/STATE/ZIP . . . : SAN JOSE, CA 95116
TELEPHONE . . . . . . . . : (408) 297-8538
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -- --- - - -- -- ---------- ---- - ----- ---------- ------- ---
BENERGY PERMIT FEE 299 . 16 143 . 60 0 . 00 143 . 60 0 . 00
BPERMFEE VALUATION 8 , 000 . 00 147 . 96 0 . 00 147 . 96 0 . 00
BSEISMICRE VALUATION 8 , 000 . 00 0 . 80 0 . 00 0 . 80 0 . 00
BPLANCHK PERMIT FEE 147 . 96 197 . 45 0 . 00 197 . 45 0 . 00
---- - ---- --- ----- ------
TOTAL PERMIT 489 . 81 0 . 00 489 . 81 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- - ----------- ---- --------- - ----
OTHER 489 . 81 VISA
TOTAL RECEIPT 489 . 81
•
� - OCITY OF CUPERTINO* va�3
CITA PERMIT APPLICATION FORM
CUPERTINO
APN# � �j� Date:
Building Address: Mailing Address (if different from building address):
Owner's Name: Phone #:
Contractor: License #:
vAr/ eOW srtr
Contact: Phone: 2 J7 Cupertino Business License#:
_Emi: a� X13•
Building Permit Info:
Bld Elect Plumb ❑ Mech ❑
Job Descri�ti n: y
Residential 7�] NZ-�, (07� mmerci
Sq.Ft. Floor Area: $/Sq.Ft.:
ostofProject: ` Occupant r
roup: 12
Type of Consttion Please chec a project is a
second-story addition: ❑ '
Project Size: Stan ❑ Laze ❑ Major ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> 100K to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to IM Btu MECHANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
BBOILER5 Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/Quasi BUILDING
BCONSTAXBQ Con. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax—Resi/Mobile BUILDING
BELEC1000 Elec 600V <= 1000A ELECTRICAL
BELEC1001 Elec 600V> 1000A ELECTRICAL
BELEC200 Elec Svcs 600V <= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
'l I
1 of 3 r
40
OCITY OF CUPERTIN(S
CITY OF PERMIT APPLICATION FORM
CUPERTINO
Quantity Fee ID Fee Description Fee Group
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
BNUCOND413 New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BOVERTIME Inspection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE Pblg Fixture PLUMBING
BPGAS Gas Piping System Fee PLUMBING
BPINIERCEP Ind Waste Interceptor PLUMBING
BPLANCHK Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plan Check Repeat Fee BUILDING
BPREPIPE Re i e Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn S rinkler/Backflo PLUMBING
BPSTORM Storm/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain &Vent PLUMBING
BPWATER Instalt/Alter Water Pie PLUMBING
BPWHEATER Water HeaterNent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BRENLkHU-AN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFD{T Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Fumace > I OK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power Device/Apparatus ELECTRICAL
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP I Remodel Res Appliance ELECTRICAL
2of3
*ITX OF CUPERTINO* S
CITY OF PERMIT APPLICATION FORM
CUPEkTINO
Quantity Fee ID Fee Description Fee Group
BREMSIGNAD Rmdl Sips Add Branch ELECTRICAL
BREMSIGNS Remodel Sips, Marquee ELECTRICAL
BREMTHEATR Theatrical Lighting Fix ELECTRICAL
BREMVENFAN Vent Fan Single Duct MECHANICAL
BREMVENSYS Ventilation Systems MECHANICAL
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Inspection BUILDING
BSVJTM Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Temporary Bldg Permit BUILDING
BTEMPSVCS Temp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicals . foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL AIL
PPERMITFEE _ Plumbing Permit Issue PLUMBING
PPLBG
Plumbing Fee sq foot PLUMBING
ZADDCHG Address Chane BUILDING
3of3
19'-O"
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-----------------------
- ----------- I - Jacqueline Yah n
JJNCE�Q—
78' 0" ---------- -- 6 x 6E) 6„ 75'-6" I I I 1 cedar post I IPROPERTY LINE IF IGHR I I
oll oll I
O I I I Xil XII 11 I Architect
O FENC _—_ I I l 0 1 1 I I o l 1 I 644 Tom sveec
a I I
(N) DECOMPOSED I I I I I I I I Redwood City, CA 94061
I j GRANITE AND i I IIx I I -------- I I — CFil addyaa: 650.6.7842
1 1 FLAGSTONE o I I I tO _6x10 -- I _ 4�c$_——— I— 1 ie Jdrahn�yahco.com
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II 11---- ----�11 6X10 ---- I 1 9T RENEWA N) FENCE & GATE oI ---_----- ---- I OFO(N)TRELLIS I ----------------�---
(APPROVED ON 9/24/04)- N ----------------------
CE N WORK: NEW PATIO COVER FLAN CEDAR SHINGLES ON OWNERS:
CEL NO: 35918019 I 2 Stephen ling &April Heung
CK: 717/LOT 43 COPPER DRIP 30#ROOFING FELT
ING: R-1 SCale: 1/4° = 1 -0° FLASHING 3 OVER 1/2" CDX PLYWD 10645 Felton Way
SIZE: 78'X 125' � r� Cupertino,CA 95014
STRUCTION: TYPE V T 6" �;. tel:(408)973-8639
RIES: 2.UPANCY: R-3, SINGLE FAMILY 20'-7" obi
TE:ALL WORK SHALL BE IN I NORDANCE WITH THE 2001 UBC, UMC
AS AMMENDED BY THE STATE OF
CALIFORNIA AND THE CITY OF d
CUPERTINO. Ivl OFFICE GOP
(N) 5' FELEIW pM
TO SCREEN ICM KED IBfi '
CHILLER — — I n O CC
(E) A/C CHILLER i D'� O 0)
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(E) 2 STORY HOUSE AND GARAGE DU Scale: 1/4" = 1 '-O"
Z LU11 SEE A2.0 FOR FRAMING Ca
LL DEP1: 12
to
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40' CORNER i• 'I
TRIANGLE SETBACK
(E)HYDRANT — — 10/6108
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(E) CONC. DRIVEWAY b
SITE PLAN &
FELTON WAY SEE A2.0FOR FPA MING PATIO I COVER
ti
1 EXISTING & PROPOSED SITE PLAN
Scale: 1/16" = 1 '-0" 4 NORTH & SOUTH ELEV
Scale: 1/4"! = V-0"
Jacqueline Yahn
V
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ASfi a2h'b.r.. XG? e2c}i'G.t� �v6T t iP.
644 Topaz Sveet
Ofal� `Y f1' Fsdwaod City, CA 44061
TWX I J .�. v L' iJ tel Max 6Soa06.7e42
Or~I �1 04 Vadclyahn@yahoo.com
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111111 MINERS:
s�t. Stephen Ling &April Heurg
^ / Xto 3� iG _ �, . 10645 Felton Way
l �S Cupertino,CA 95014
tel: (408)973-8639
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CITY OF CUPERTINOr I =x .Amac o� ti,.
BUILDING DIVISION PERMIT 7rCONTRACTOR�INFORMATION =$.
RE
BUILDING ADDRESS: CEVAN FORRISTT DESIGN PERMITNOh4100034
OWNER'S NAME: PERMITISSUUEDATE
STEPHEN L
E:
SANITARY NO. CONTROL NO.
4 8 2
ARC ITTECUENGINEEA: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 l�
uoo LICENSED CONTRACTOR'S DECLARATION Job DeSC tlpn
F I thereby affirm that I am li¢nad under previsions of Chapter 9(commencing - a''❑u ggr,,,��� II /�
`i in full to=
ndafai Division 3orlM Businev arW Pro(essiuna Code.end.1 license is _ I' �� /nY _��
n_oa'+ mmue Chdodercen. PATIO COVER (190
SQ.. T. 'ugh u e(`/'��
i Licen.CI¢v Lie.• ®-----
n f,0 Dam rr—
ARCHITECTS DECLARATION
Iandennndmyplans shall heused aspublic records FEB 2 2005 _—_—
�yU
t e l; Licensed Professional - -
+05 OWNER-BUILDER DECLARATION _ sI
'<P I Wrathy affirm Net I ore cacmpt from Nc Camnn.h Liccnu Ito for the -
OO following.urn.(Section 703LS,Business and Profeuiurn Code:Any city or county
=6' which.claims a permit ha conmm�,.Rea improve,demolish,or.,air any structure
._ IL
Z< prior In am issuance,also acclaims the applicant for such permit to file a signed statement
that he is licensed pursuant ha the provisions of the Contractor's License Law(CWPW 9 Sq.Ft. Floor Area Valuation
iHO (commencing with S.tion 7006)of Division 3 of the Business and Professions Code)or
y Nat be,is axdnpt therefrom and the baso far Ne alleged exemption.Any violation of
Section 7031.5 by a"applicant for•permit subjects the applicant to a civil penalty of 3 5'ffV91I"er0 0 Occupancy Type
not moa Nan five hundred dollen($500A
❑I,as owner of the pm,eny,in my employees with wages as their sole compensation,
will do the work,and the structure,is not intended or offc.d for sale(Sec.7014.Business
and Profession Cade:The contractor's Lion.Law does not apply In an owner or - - Required Inspections _
property who Wilda o6roproves cor......4 wbodasmichwork himself.,Nmugh his
own employars,provided contain improvements aremm intended diapered forme.If. .- ..
however,ote Wilding or impravement is sold within ane year of completion.IW owner-
builder will have the burden of proving Nat he did not Wild or improve for purpose of
sale.).
0 I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7(114,Business and Professions Cade:)The Cdnuacmr's Li.
tae Law does not apply to m comer of prapany who Wilds.,imPmves Ne...and,
who contncu for such projects with a concomitants)li¢vcd pursuant o the Conwnofs
License Taw.
O1mr emp, oder Scc. B&PC far this naso
Owner Dau a
d bf
WORT R'S COMPENSATION DECLARATION
I hereby.Rite under penalty of perjury one of IW following d.lanlions:
have and will maintain a Certificate ofC..at,.self-insure for Wollner;Campen-
ration,as provided for by Section 37W of the Inbar Code,for the performance of the
ork far which this permit is issued.
1 have and will maintain Worker's Compensation Iesonnce,as mr,amd by Secum,
37W of the Labor Code,for Ne perf.rmanc,of the work for which this permit is issued.
My Wo,keri Compensation Insunrta.,rite and Polity number an,:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE I
(Thu section need not W comple.d if the,permit is for one hundred dollars(SIM)
or lcss) —
I a,dfy Not in the pe,farmance of the.,it for which this permit is issued.I shall nm
employ any person in any manner m as to become subject o the Worteri Compewtion
Laws.f California.Data
Applicant ..
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject no the Worker's Campm
cation provisions of Jac Labor Chile.you most
M
O Z f. wilh comply with such provisions or this permiuMll be doomed revoked.
Z O^ CONSTRUCTION LENDING AGENCY
[-.� Ihe.hy affirm that Nem is a construction lending agency fm Ne perfurmanee of
�( > Nm work(a,which this permit is issued(Sec.3067.Civ.CJ
!y Lender's Namc
6. lender's Address
U C) I certify than 1 have read Nis application and sue Nal IW above information is
If. P emmcL I agree to comply with all city and county on inumacs and sats laws.lating to
C U building construction,and hereby maori emprrsenutivas of this city In enter upon the
move-mentioned(Weagree
toescoy savc for emnif an keep hs.
(We)agree m save,indemnify and hick hay in an they of Cupertino against
UZ inco1JG,jddg,of the
raring ex this crk. may in any way aCCNe against said City
C.) Z A APPLICANT
of Ne UNDERSTANDS
of this per mit
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:9
to -
SOURCEREf'I.pT10NF.-rr) n 13a 6 .y J'{ Re-roofs
Sig [are of ApplicanUCov raclor Data
V HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant a,far.Wilding.,.Paul than,or handle hmallous mamual
as defined by the Cu.nino Municipal Code.Gaper 9.11.and the Health and Safety
cWe.Saturn 25531(.)+ All roofs shall be inspected prior to any roofing material being installed.
0Yea o
Wm the applicant or future building Occupant use eclumment or demices.nim If a roof is installed without first obtaining an inspection,I agree to remove - ..
Ail hazardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection.
Uismin7
p Yes
In avereed Neh.Scdnus 25505ls.cluimmemtsdnJcr Chapter6. Lifn Wilding
Iia Health&Safety Cade,Secuuns alio. my snJ15bil,ty nJemland Nmifu, ,.Fi c
Js not curtently have a tenons Nal it is my spansihilily m netily the occupant of Ne _
.claire c tswhi must be ct ' r uisuanoc Ccnifca ora,up.ney. Signature of Applicant Date
'� �B-� -D'Y -
r amhorivcd
at Dam All roof coverings ro be Class "B" or better