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07050008 777777-7777777777 CITY OF CUPERTINO BUILDING DIVISION PERMITIa TR�CCiR IN +O►IKMTI01�1 BUILDING ADDRESS: PERMIT NO. 1632 �TAMES TOWN DR OWNER'S NAME: — PER I N r LE SAN CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 i 7p LICENSED CONTRACTOR'S DECLARATION Job Description I hereby affirm that I am licensed under provisions of Chapter 9(commencing NON-STRUCTURAL P with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. t Z License las Lie.fl p Date—j" Contractor rt7 AR HiTECTS DECLA TION --� I understand my plans shall he used as public records Licensed Professional OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the )c following reason.(Section 7031.5,Business and Professions Code:Any city or county li which requires a permit to construct,alter,improve,demolish,or repair any structure y prior to its issuance,also requires the applicant for such permit to file a signed statement a that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft. Floor Area Valuation $ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not more than five hundred dollars($500). 0 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 and Professions Code:The Contractor's License Law docs not apply to an owner of Required Inspections property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). 0 1,as owner of the property,am exclusively contracting with licensed contractors tm construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. 0 I am exempt under Sec. B&P C for this reason Owner Dale WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: have and will maintain a Certificate of Consent to self-insure for Worker's Compen- --on,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 0 1 have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Worker's Compensation Insurance carrier and Policy number arc: Carrier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (this section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued,1 shall not employ any person in any manner so a;�p be bjcc o the Wo�kgLro on " Laws of California.Date—�_ C��_ Applicant - r NOTICE TO APPLICANT:If,aftEr making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must ,z forthwith comply with such provisions or this permit shall be deemed revoked. 0 ' CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of > the work for which this permit is issued(Sec.3097,Civ.C.) Q Lender's Name z Lender's Address 0 1 certify that I have read this application and state that the above information is r" correct.I agree to comply with all city and county ordinances and state laws relating to Vbuilding construction,and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. W (We)agree to save,indemnify and keep harmless the City of Cupertino against v) liabilities,judgments,costs and expenses which may in any way accrue against said City Z in consequence of the granting of this permit. r APPLICANT UNDER fro WILL COMPLY WITH ALL NON-POINT Issued by Date SOURCE REG OV. JQt---pJ_df2Re-roofs Signature ApplicanUContractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Cede,Section 25532(a)? All roofs ;hall be inspected prior to any roofing material being installed. DYcs ANo If a roof i.;installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. strict? 0 Yes rYNo I have read the hazardous matcrialsrequirements under Chapter 6.95 of the Califor- nia Health&Safciy Codc,Sections 25505,25533 and 25534.I understand that if the building does not currently have a tenant:that it is my responsibility to notify the occupant of the requirements which must be me issuance mfaCertificate ofoeNpancy Signature of Applicant Date A _ All roof coverings to be Class"B" or better Owner or auth r d agent D - CITY OF CU?ERTINO 8 ITEMS OF 8 PERMIT RECEIPT OPERATOR: bethe COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36610066 . 00 DATE ISSUED. . . . . . . : 05/01/20.07 RECEIPT #. . . . . . • • • : BS000001168 REFERENCE ID # . . . : 07050008 SITE ADDRESS . . . . . : 1632 JAMES TOWN DR SUBDIVISION . . . . . . . CITY CUPEF.TINO IMPACT AREA . . . . . . OWNER CHOI, DO CHAN ADDRESS CITY/STATE/ZIP CUPEPTINO CA, 95014-5315 RECEIVED FROM - • ' pETE]ZpWANGTERLICE# 25511 CONTRACTOR . . . . . . COMPANY . . . . . . . . . . : PETER'S CONSTRUCTION ADDRESS : 100 CONCORD CIRCLE CITY/STATE/ZIP . . . : MOUNTAIN VIEW, CA 94040 TELEPHONE . . . . . . . . : (650 , 906-8788 FEE ID UNIT QUANTITY AM-)UNT PD-TO-DT THIS REC --NEW-BAL- ---------- _ ___ ---------- -- BENERGY PERMIT FEE 1.00 34 . 86 0 .00 34 . 86 0. 00 BPERMFEE VALUATION 15, 000 .00 223 .56 0 .00 223 .56 0. 00 BPFIXTURE UNITS 4 .00 36 . 00 0 .00 36 . 00 0 . 00 BREMFIXT NO. FIXTURES 5.00 6. 00 0 .00 6 .00 0. 00 BREMRECEPT NO. OUTLETS 2 .00 2 .40 0 . 00 2 .40 0 .00 BSEISMICRE VALUATION 15, 000 .00 1.50 0 . 00 1.50 0 . 00 EPERMITFEE FLAT RATE 1 .00 38 .37 0 .00 38 .37 0 . 00 1.00 38 .37 ---- 38 .37 ------0. 00 PPERMITFEE FLAT RATE ---------- ---------- ---------- TOTAL PERMIT : 381. 06 0 .00 381. 06 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- ---------- -- CHECK 381.06 1333 --------------- TOTAL RECEIPT 381.06 CITY OF CUPERTINO alo PERMIT APPLICATION FORM CUPEkTINO _CPN# Dat ✓��,.4/�:' ���'�' e: Building Address: Mailing ddress (if different fro building address): ' 3 2 s TqW AR C&trte, o tt Owner's Name: Phone#: Do Cho^ (- Contractor- _ License Canst�-t�o� Contact: ��av�� 0/7 Fax: ��C�—�;�/2 Cupertino Business License#: Fax: Building Permit Info: o 7 r �tru ci. ac m /xZthhoem Bldg Elect Plumb Mech El Job Description: rMg5~ eK "r,M yam;– -- Residential �-Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: Occupancy Grou Type of Constructio : Please check this box if the project is a second-story addition: ❑ eroject Size: Standard ❑ Large ❑ Maj)r ❑ Quantity Fee ID Tee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boi er<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Bc iler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind,'Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH 17otel and Motel BUILDING BCONSTAXR Con.;tax–Resi/Mobile BUILDING BELEC 1000 Ele(; 600V<= l OOOA ELECTRICAL BELEC1001 Elf c 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Er.ergy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 o'3 CITY OF t'UPERTINO CITYOF OF. CUP O PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Conan. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTIME Ir.spection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Incl Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plal Check Repeat Fee BUILDING BPREPIPE R,! i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK LaAn S rinklerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT A]t of Drain &Vent PLUMBING BPWATER Instt.lUAlter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Jnits <= 10,000 cfm MECHANICAL BREMAPPLI j�ppliance Install MECHANICAL BREMBUS WAY Remodel Busways ELECTRICAL BREMFIXT bighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relc Furnace> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC 10isc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pol,-/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rept[, Switch & Outlets ELECTRICAL BREMRELOCA Rc location of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Rem,-del Res Appliance ELECTRICAL 2 c,f3 aWO CITY OF C UPERTINO PERMIT APPLICATION FORM CUPERTINO Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rm& Signs Add Branch ELECTRICAL BREMSIGNS Remc del Signs, Marquee ELECTRICAL BREMTHEATR Thearical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD S,-,b Specific Plan BUILDING BSEISMICOM Seip mic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIMswimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS r,emp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elea: Permit Issuance ELECTRICAL MPERMFEE M,,chanical sq. foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING PLLONGRNGR Planning Long Ran a Residential PLANNING ZADDCHG Address Change BUILDING 3 of 3 ih V, qq r 181 � ��/ moi- w c:i •� �w '� - � y 'O "� � tai U � cn ' •� � ✓ G s _ r .r c' o? - H c p i 2.6 68 AD CIArte+ -� - op • r w u m r � (E) 3o3c� 771 tv IN Un r JA C> k -gyp tom- tj r- o �� Caoa' �rTi ® �' � c� s CA 2p, Th tA 01 tA 70 o O t 1 t- 19; ia, Ch Os- to rill s MIN, � i- (wZ4-�� (r=)2.6,68 dE � r c OY 0 � F ,ice__ vt 1% -� c9 ���)� �•-6tt � '� tit! it1 -t c ,OD 070 a ' � a An TO d ire 20 .a-in � � a �pomw Community Development 10300 Torre Avenue In Cupertino CA 95014OF Telephone(408)777-3228 Fax(408)777-3333 "UPEkTINO Building Department All Cupertino building permits must meet certain conditions related to maintaining environmental quality and public peace and safety. The two most common conditions are described below. STORMWATER POLLUTION CONTROL State law requires that Cupertino, 12 other Silicon Valley cities, Santa Clara County and the Santa Clara Valley Water District control stormwater pollution. Educating local residents and businesses and enforcing stormwater pollution control laws are key parts of the City's compliance efforts. Stormwater pollution prevention: It's up to us In northern Santa Clara Valley, storm drains flow directly to local creeks and San Francisco Bay, with no treatment. Stormwater pollution is a serious problem for wildlife dependent on our waterways, for people living near streams and baylands, and for the local water supply. Common sources of stormwater pollution include: • Dripped oil, fuel, and antifreeze from vehicles and heavy equipment; • Construction debris, including dirt, concrete and paint; • Landscaping runoff containing pesi:icides or weed killers; and Any material dumped or spilled into streets or storm drains The property owner and the contractor share ultimate responsibility for activities occurring at a construction site and will be held responsible for any environmental damage caused by subcontractors or employees. For more information on construction-related stormwater requirements, see the Stormwater Quality Regulations section o- the City of Cupertino web site at: http://www.cupertino.orq/city government/departments and offices/ environmental services COMMUNITY NOISE CONTROL The basic noise control requirements for construction sites are as follows: • Typical construction work hours are: - Weekdays - 7 a.m. to 8 p.m. - Weekends - 9 a.m. to 6 p.m. • Construction other than street con:;truction is prohibited on holidays. • Residential daytime noise levels from complaint site - 60 dBA • Nonresidential daytime noise level:; from complaint site - 65 dBA For more information on noise con:rol, please see Chapter 10.48 of the Cupertino Municipal Code, which can be accessed at .http://www.amlegal.com/cupertino ca/ C Greg Casteel Building Official 1 _- 1 n rT% ---70 3 .4 � :, vo (N T i r ta "'� nub ® � � +� � @� ..A .. S� �°► _;. , 3i 73 • n i� �, �► - CIM o4)2A-i�& 771 M 70 oil IL IA -Ii Lpn7� � r v ©vv0 70 r r r Community Development 10300 Torre Avenue a Cupertino CA 95014 s' Telephone(408)777-3228 Fax(408)777-3333 CITY OF -UPEkTINO Buildirt De artment JOB ADDRESS: PERMIT # OWNER'S NAME: o �J PHONE # GENERAL CONTRACTOR: �� i �w r FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and com :.ete the followin information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Date er/Contractor Signature