Loading...
09070106 CITY OF CUPERTINO �!'t c -p BUILDING DIVISION PERMIT � 7 � ?R � � ' —y BUILDING ADDRESS: PERMIT NO. 10139 CASS PL BLACK DIAM '1WNER'S NAME: PERMIT ISSUE DATE PHON SA A CONTROL NO. ARCHTTECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH REMODEL KITCHEN, INSTAL NEW yoo LICENSED CONTRACTOR'S DECLARATION CABINETS, GRANITE, Job Description mC�, I hereby affirm that I am licensed under provisions of Chapter 9(commencing Z c3 with Section 7000)of Division 3 of the Business and Professions Code,and my license is e<% in full force and effec i n Z License Cl Lk•# /Trr1 T—r t Date7-0 Contractor �h ARCHITECTS DECLARATION s U 1 understand my plans shall be used as public records y o y Licensed Professional n 0 OWNER-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the E00 O following reason.(Section 7031.5,Business and Professions Code:Any city or county e$ which requires a permit to construct.alter•improve,demolish,or repair any structure Z y prior m its issuance,also requires ire applicant for such permit to file a signed statement E_`e that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation yF- (commencing with Section 7000)of Division 3 ofLk Business and Professions Code)or y 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 mote than five hundred dollars($500). ❑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 Required fired Ins ectlons and Professions Code:The Contractores s License Law donot apply to an owner of q P property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements arc 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.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business and Professions Code:)The Contractors Li- cense Law does not apply to an owner of property who builds or improves thereon,and• who contracts for such projects with a contractors)licensed pursuant to the Contractors License Law. ❑1 am exempt under Sea B&P C for this reason vner Date WORKER'S COMPENSA71ON DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑1 have and will maintain a Certificate of Consent to self-insure for Worker's Compen- sation,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 required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Workers Compensation Insurance carrier and Policy number am: Cartier. 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 as to become subject to the Workers'Compensation Laws of Califomis Applicant NOTICE TD APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must ,J O forthwith comply with such provisions or this permit shall be dremed revoked. Z CONSTRUCTION LENDING AGENCY [~i Cn 1 hereby affirm that there is a construction lending agency for the performance of pC,> the work for which this permit is issued(Sec.3097,Civ.C.) Wn.Q Lender's Name Z Lenders Address U C) I certify that I have read this application and state that the above information is t7,h"4 conea l agree to comply with all city and county ordinances and state laws relating to Vbuilding construction,and hereby authorise representatives of this city to enter upon the W above-mentioned property for inspection purposes. a (We)agree to save,indemnify and keep harmless the City of Cupertino against iE tt to) liabilities,judgments.toss and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. Date `�' D h"h APPLICANT UN ERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOURCERE' TIONS. ol roofs Si of Applicant/Contractor ale HAZARDOUS MATERIALS DISCLOSURE Type of R)of 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 +e,Section 25532(a)? All roofs,hall be inspected prior to any roofing material being installed. Cl Yes Will the applicant o alum building occupant use equipment or devices which If a roof i, installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as dctincd by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes ❑No 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Codc,Sections 75505,25533 and 25534.1 understand that if the building does not currently a tenant,that it is my responsibility to notify the occupant of the reyuircmcnts must be met prior to issuance of a ertifeate or ancy - Signature A Applicant Date crorauthorized agcnt Da All roof coverings to be Class'tW'or better CITY OF CUPERTINO 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk.: Lot : APN . . . . . . . . : 35-, 01037 . 00 DATE ISSUED. . . . . . . : 07/13/2009 RECEIPT #. . . . . . . . . : BSC00008178 REFERENCE ID # . . . 09C70106 SITE ADDRESS . . . . . : 10139 CASS PL SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER SHUOSEA LIU ADDRESS 10139 CASS PL CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-2751 RECEIVED FROM . . . . : BR-',DFORD MUELLER CONTRACTOR . . . . . . . : MUELLER, CRAIG D LIC # 18104 COMPANY . . . . . . . . . . : BLI,CK DIAMOND DESIGNS ADDRESS . . . . . . . . . . : 34E1 DEL NORTE DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95132 TELEPHONE . . . . . . . . : (4(,8) 272-5959 FEE ID UNIT QUANTITY 1,MOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- -- -------- ---------- ---------- ---------- 1BCBSC VALUATION 200 . 00 1 . 00 0. 00 1. 00 0 .00 1BSEISMICR VALUATION 200 . 00 0 .50 0. 00 0 . 50 0 . 00 1PPERMITFE FLAT RATE 1. 00 42 .00 0. 00 42 . 00 0 . 00 1TRAVDOC FLAT RATE 1. 00 42 .00 0 . 00 42 . 00 0 . 00 -- -------- ---------- ---------- ---------- TOTAL PERMIT 85.50 0 . 00 85.50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 85 .50 1520 --------------- TOTAL RECEIPT 85 .50 Community Development -„ 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 CUPEkTINO Building Department JOB ADDRESS: PERMIT OWNER'S NAME:.S v Z-,( J PHONE # dg GENERAL CONTRACTOR ` FAX # I am not using any subcontractors• Si mature Date Please check applicable subcontractors and complete the following information: 60 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 Owner/Contractor Signature Date CITY OF ..UPERTINO CITY OF CUPEkTINO GENERAI_j BUILDING PERMIT APPLICATION FORM APN # Date: S D 1 037. -711310 Building Address: !a/ CC-,--S's F1 Mailing Address (if different from building address). Owner's Name: Sic �pc�� L.t c� Phone#: 1,� y3/- G/Gf HOA: (Exterior work only) Yes ❑ No If yes, provide letter from HOA Contractor: k �icP �!j�-t Phone: c fc-*) g Z 3r� 7©p 7 Fax: Contractor License#: �l Cupertino Business License#: Contact: cA-o`,,c) M v e l L c.r` Phone: qr)5 2--541 -7007 Fax: Resid tial ® Commercial ❑ Job Description: /l,1Cc� Com►�;,,,G�f-s� �j_y.�,�� 1 !�h k- v _ Building Permit Info: Bldg nJ Elect ❑ Plumb Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ II/III/V-A ❑ IUIII B, IV-HT, V-13 ©_ 12- -'-7 Valuation: Square Footage: Project Size: Express �andard ❑ Large [] Major ❑ Green Building: Please complete relevant portion A the Green Building/LEED Checklist& attach it to the application or if applicablf, include in plan set& the sheet index. Points Achieved: For help, contact Build it Green at www.buildit rE en.or Revised 02/05/09 am CITY OF CUPERTINO CITY OF GENERAL BUILDING APPLICATION CUPEI�TINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1 GENCOM 1STUCOAP Stucco Applications (up to 400 sf) B additional stucco application 1 WINREP Replacers,ent windows/sliding glass B door (ea 3 windows) l WINMEWSTR New Window-structural shear B wall/masonry (includes plan ck fee) 1 EPERMITFEE Electrical Permit Fee E 1 MPERMITFEE Mechanical Permit Fee M 1 PPERMITFEE Plumbing Permit Fee P 1 ELCPLNCK Stand Alone Electric Pln Ck (hourly) E 1 MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M 1 PLMBLNCK Stand Alone Plumbing Pln Ck (hrly) P 1 STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B when not over counter) hourly-st<<nd alone 1 BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1 BSEISMICR Seismic F.esidential B 1 BSEISMICO Seismic Commercial B i 1 TRAVDOC Travel & Documentation B 1BUSLIC Business License B 5 of 5 INPUT Resourres Energy .D M.1ndODr Air Quality and Finishes 1.Use LowNo-VOC Paint 1 IAQ/Health pts y=yes p 2.Use Low VOC,(Nater-Based Wood Finishes 2 IAQ/Health pts y=yes p 3.Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes p 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Health pts y=yes p 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes p 7.Seal all Exposed Particleboard or MDF 4 IAQ/Health. pts y=yes p B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0 10.Install Whole House Vacuum System 3 IAQ/Health pts y--yes p 1 1 1 N.Flooring 1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0 2.Use Rapidly.Renewable Flooring Materials 4 Resource pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes p 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 1 1 1 Total Points Available: 1401 1301 57 Total Points Project Received: 01 0 0 At 77/a y G:datalprogslgrei:nbuildingguidelines/remodelers/greenpointsfinal212.D4proteoted.xls