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13020066 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 8139 HYANNISPORT DR CONTRACTOR:KUANG'S PERMIT NO: 13020066 CONSTRUCTION CO OWNER'S NAME: LUH LUH TING ' PO BOX 4802 DATE ISSUED:02/13/2013 nOWNER'S PHONE: 4085688169 ELDORADO HILLS,CA 95762 PHONE NO:(916)941-2378 4O LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL U COMMERCIAL License Class Lic. 2ND FLR HALL BATHROOM REMODEL,NO STRUCTURAL Contractor r Date 2��3 CHANGES**BATHROOM REMODEL HANDOUT I hereby affirm that 1 licensed under the provisions of Chapter 9 PROVIDED** (commencing with Se n 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. Sq.Ft Floor Area: Valuation:$4000 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 APN Number:35611018.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAY F RMIT ISSUANCE OR. to building concoction,and hereby authorize representatives of this city to enter A/ upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS ST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Z ` j granting of this permit: Additionally,the applicant understands and will comply Issued b Date: with all non-point source regu ons per the Cupertino Municipal Code,Section RE-ROOFS: Signature DateAll roofs shall be inspected prior to any roofing material being installed.If a roof is / installed without first obtaining an inspection,1 agree to remove all new materials for inspection. 13 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one o[ Signature of Applicant: Date: the following two reasons: - ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this pernitis issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,2553 ,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: 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,[ CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a concoction lending agency for the performance of forthwith comply with such provisions.or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name .APPLICANT CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this,permit.Additionally;the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18: Signature Date �O CONSTRUCTION PERMIT APPLICATION O� COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O� 10300 TORRE AVENUE•CUPERTINO.CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildingC&cuoertino.org \ ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECTADDRESS g-(3 1 1 T•LV i S. ap-r D a-. APN# 35-6 i U OWNERNAME L pl �j �T/"1' 4 71w* 1 r 1 PHONE - ?1/ E-MAIL STREET ADDRESS V\ 1-\ `"` CITY,STATE,ZIP D b FAX CONTACT NAMEAyt fJ PHONE �j f" T-Q�F �. E-MAH. STREET ADDRESS �& v Z CITY,STATE,ZIP (37 H n FAX ❑OWNER ❑ OWNER-BUILDER O OWNERAGENT CONTRACTOR OCONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME WALN6 LICENSE NUMBER.7�6J Z LICENSETYPE BUS.LIC# COMPANYNAME • EMAIL FAX 1 60 w� STREET ADD Z� 7/� CITY,STATE,Z �fU` ��( PHONE T ARCHTTECVENAFER NAME llCENSE NUMBER *SN BUS.LIC#•"`OIC^ f( COMPANY NAME E-MAIL FAX STREET ADDRESS CrrY,STATE,ZIP PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTRTYPE I #STORffS USE TYPE OCC. SQ.Ff. VALUATION(S) E)USTG NEW FLOOR DEMO TOTAL AREA AREA AREA NETARPA i BATHROOM KITCHEN OTHER REMODELAREA RENIODELAREA REMODEL AREA PORCHAREA DECKAREA TOTALDECKIFORCH ARFA GARAGEAREADETACH ATTACH #DWELLINGUNITS: ISASECONDUNTr ❑YES SECONDSTORY OYES BEING ADDED? ONO ADDITION? ONO PRE-APPLICATION []YES IFYES,PROVmECOPYOF ISTHEBLDGAN OYES TOTALVALLUATI PLANNINGAPPL# ONO PLANNmp APPROVAL LEI'1'Elt EICHLER HOME? ONO 0 ((�f By my signature below,I certify to each ofthe following: I am the property owner or au ' agenh to act o e property owner's behalf. I have read this application and the information 1 have provided is 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 buil ' conslmcti I a thorize representatives of Cupertino to enter the above-idea' d property for inspection purposes. Signal=of Applicant/Agent: Date: irr SUPPLEMENTAL INFORMfflDN OQUIRED PLANCHECKTYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for existingPLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBUC WORKS Tom if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEFT _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_201 1.doc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 8139 HYANNISPORT DR DATE: 02/13/2013 REVIEWED BY: MELISSA APN: 35611018 BP#: *VALUATION: $4,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Repair PRIMARY SFD or Duplex PENTAMATION 1R3SFDREM USE: PERMIT TYPE: WORK ND FLR HALL BATHROOM REMODEL NO STRUCTURAL CHANGES SCOPE tt� s Frcv r �wj'. Mech. Plan Check Plumb.Plan Check F.lec. Plat?Check blech. Permit Fee: Plumb. Permit Fee: Elec. Permit Fee: Otho Afech.hasp. Other Plumb 7n.rp. Li Other Elec. Insp. A loch.Insp. Fee.' : Plumb. hisp. Fee: Elec.Insp. Fec: NOTE:This estimate does not include fees due to other Departments(de.Planning,Public Works,Fire,Sanitary Sewer District,School District etc). These fees are based on the p relludna information available and are only an estimate. Contact the Det Am addn't info. FEE ITEMS (Fee Resolution 11-053 E . 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F-457 s.f. Remodel,Bath(<=300 sf) Suppl. PC Fee: 0 Reg. O OT 0.0 1 hrs $0.00 $600.00 IREMRESBAT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Feer Reg. OOT T0,0Thrs $0.00 PME Unit Fee: 1$00,0000 PME Permit Fee: Construction I'tn: Administrative Fee: O Work Without Permit? O Yes 0 No 0 Advanced Planning Fee:. $0,00 Select a Non-Residential 0 Travel Documentation Fees: Building or Structure O 14 Strong Motion Fee: 1BSE7SM7CR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 $1.50 $600.00 �z� TOwT� EE $601.50 N Revised: 01/01/2013 G_ �_ _ 2 -r b r_ _-L L. L LI-- --I= - - - - — - �-- I- I - JI- -L !. 17 AL 3 J_ 4--l-T-1 1 L 1-.L I ce, 04 —FI- ----- ----————--i At ---EL Lj �+ _-_- _- - _ _I -_ - TF - -�- _-_ - I k�g_e4 � 5 12 JV I- - �- ! �( 8 X581 - —i J i I _ A-A J-1 I. � � _ _ I � _J_ - I- ._ - - -- _ � - I I---- ! -I—L � I_! Fie h � j__ 1`� r--- - op , 13'7 A-- 1- I l� _j ___L I A. I j 1 --i- i I I L 1 L 1LJ IL Building Department City Of Cupertino 16166 Torre Avenue GUpercmo,C;A YJ014-3Z33 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: N 1 u PERMIT# Q O U OWNER'S NAME: PHONE# GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONT CTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. a r I am not using any subcontractors: S nature D. e Please check applicable subcontractors and complete the following information: SUBCONTRACTOR ' BUSINESS NAME BUSINESS LICENSE# Cabinets & Millwork' Cement Finishing Electrical Excavation Fencing Flooring/Carpeting- Linoleum/Wood Glass/Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Date Owner/:Contractor Signature