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11080014 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10108 S TANTAU AVE CONTRACTOR:ALPS CONSTRUCTION& PERMIT NO: 11080014 REMODELING OWNER'S NAME: STEPHEN WU 681 E BROKAW RD DATE ISSUED:08/01/2011 ER'S PHONE: 4088872399 SAN JOSE,CA 95112 PHONE NO:(408)898-6474 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# .. t MECH RESIDENTIAL COMMERCIAL Contractor ate 1 I hereby affirm that I am licensed under the provisio f Chapter 9 JOB DESCRIPTION:REMODEL TWO(2)BATHROOMS(90SQFT),NEW (commencing with Section 7000)of Division 3 of the Business&Professions PLUMBING MECHANICAL&ELECTRIC,FOOTPRINT TO REAMIN THE Code and that my license is in full force and effect. SAME 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 A 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 Sq.Ft Floor Area: Valuation:$8000 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:37507040.00 Occupancy Type: 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, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. Signature Date t' Issued by: Date: L OWPi -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS: the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date: construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain [have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. permit is issued. Additionally,should I use equipment or devices which emit hazardous air I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534. 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. Own rr o —7,.4 agent: Date: C7 a IQ Of APPLICANT CERTIFICATION CONSTRUCTION LEG AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of work's to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.) upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name i •nify and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the Lender's Address grwiting of this permit. dditionally,the applicant understands and will comply with all non-point s u -regulations per the Cupertino Municipal Co e,Section ARCHITECT'S DECLARATION 9.18. .- 1 I understand my plans shall be used as public records. Signature Date/I u 0 Licensed Professional CITY OF CUPERTINO 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 37507040 . 00 DATE ISSUED. . . . . . . : 08/01/2011 RECEIPT #. . . . . . . . . BS000014272 REFERENCE ID # . . . : 11080014 SITE ADDRESS 10108 S TANTAU AVE SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER STEPHEN WU ADDRESS 10108 S TANTAU CITY/STATE/ZIP CUPERTINO, CA 95014 RECEIVED FROM MEHRDAD A ZAMANI CONTRACTOR ALI ZAMANI LIC # 28677 COMPANY ALI'S CONSTRUCTION & REMODELIN ADDRESS 681 E BROKAW RD CITY/STATE/ZIP . . . : SAN JOSE, CA 95112 TELEPHONE (408) 898-6474 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ------ 1BCBSC VALUATION 8, 000 .00 1. 00 0 . 00 1.00 0. 00 1BSEISMICR VALUATION 8, 000 . 00 0 .80 0. 00 0 .80 0. 00 1EPERMITFE FLAT RATE 1 .00 44 . 00 0 . 00 44 . 00 0 . 00 1ERT<200 UNITS 1. 00 44 . 00 0 . 00 44 .00 0. 00 1REMRESBAT SQ FEET 90 .00 588.00 0. 00 588 .00 0. 00 1TRAVDOC FLAT RATE 1 .00 44 . 00 0 . 00 44 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 721. 80 0. 00 721.80 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 721.80 VISA --------------- TOTAL RECEIPT 721. 80 I I () � C-D I CONSTRUCTION PERMIT APPLICATION 12 COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 GUPERTINO (408)777-3228 • FAX(408)777-3333 - buildingCcDcupertino.org ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS _Ct nr OWNER NAME V) I u, PHO Y97-2 3111 1/y E-MAIL STREET ADDRESS �� �� � ► ���, CITY, STATE,ZIP CONTACT NAME f �L r PHONE © T l- /y E-MAII.4/ f S C0441RCh011 n CdNOV STREET ADDRESS 4/ /I © CITY,STATE. ZIP - 157 11 El OWNER El OWNER-BUILDER -BUILDER ❑vOWNER ASG(ENT Pk CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENNANNT CONTRACTOR NAME '' LICENSE NUMBERgc LICENS E BUS.LIC#L )s Cn 51M Ir COMPANY NAME V ~ E-MAIL FAX AU STREET ADDRESS r�!� CITY,STATE,ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ')ESCRIPTION OF WORK r 12 EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXLSTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKNORCH AREA GARAGE AREA 0 DETACH []ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES 0-t c/ BEING ADDED? []NO ADDITION? []NO PRE-APPLICATION [I YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY: TOTAL VALUATION: PLANNING APPL# []NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the prr>perty owner's behalf. I have read this application and the information I have provide r correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildin struction. I authorize represgptatives of Cupertino to enter the above-ideytif3ed p perry for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENT tt71red QUIR FD PLAN CBE E ROUTING SLIP _New SFD or Multifamily dwellings: Aolition permit for OVER-THE COUNTER ❑ BUILDING PLAN REVIEW existing building(s). Demolition permit is yto issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW —Commercial Bldgs: Provide a completed Hazardous Materials Disclosure C] STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FME 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 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10108 s tantau ave DATE: 08/01/2011 REVIEWED BY: larry s APN: BP#: "'VALUATION: 1$8,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex 2nd Unit? 0 Yes No PENTAMATION 1 R3SFDADD USE: I OTC. 0 Yes (F)No PERMIT TYPE: WORK remodel two bathrooms new plumbing mech and elec footprint to remain the same. SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,111-B,IV,V-B 0 $0.00 $0.00 TOTALS: 0 $0.00 1 $0.00 MECH,HOURLY 0 Yes 0 No PLUMB,HOURLY 0 Yes 0 No ELEC,HOURLY 0 Yes Q No Elec.Plan Check 0.0 1 hrs $0.00 117 Elec.Permit Fee: IEPERMIT LiOther Elec.Insp. El hrs $44.00 NOTE. Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addh 7 info, FEE ITEMS (Pee Resolution 11-053£jf 7;1,11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. Remodel,Bath(<=300 sf) Suppl.PC Fee: G Reg. 0 OT F75 1 hrs $0.00 $588.00 T] A PME Plan Check: $0.00 200 amps Electrical Permit Fee: $0.00 $44.00 IERT<200 Services Suppl. Insp. Feer', Reg. 0 OT0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $44.00 Acoustical Fee: 0 Yes 0 No $0.00 0 Work Without Permit? 0 Yes 0 No $0.00 0 Planning Fee: $0.00 Select a Non-Residential 0 Travel Documentation Fee: ITRA VDOC $44.00 Building or Structure 0 i Strong Motion Fee: IBSEISMICR $0.80 Select an Administrative Item Bid,Stds Commission Fee: IBCBSC j $1.00 SUBTOTALS: $89.80 $632.00 TOTAL FEE.T $721.80 Revised: 07/04/2011 • Ci-iiA-CHEr46r LPi • 45741 CHABLIS COURT FREMONT,CA 94539 • '1'EL:5105868:180 s C1 E. ' 1 LIN, r August 20,2011 00 1 c 0 Building Division L 10300 Torre Avenue car (�M, a U Cupertino, CA 95014 -.�...�... Dear Sir or Madam: This letter mainly is to notify you that I, Chia-Ching Lin, P.E., have visited the job site and inspected the recessed ceiling at the locations of(E) living room and(E)master bedroom for the single family house located at 10108 S. Tantau Avenue, Cupertino, California. The recessed ceiling framing for above locations installed are installed conforming current code and in general practice and acceptable. If you have any question regarding this, please let me know. Sincerely, 4p� q, Ca O C hia.-Chino Lin, P.E. 45741 Chablis Court Fremont,CA 94539 ♦ ! • • 1 • 0 0 0 • 0 0 0 0 0 0 • 0 0 0 0 0 • • 0 • • •