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09070163CITY OF CUPERTI BUILDING ADDRESS: 818 HOOSHANG CT )WNER'S NAME: MEI CHENG .OWNER'S PHONE: 4082554983 ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. # Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 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 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. I 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 permit is issued. NO BUILDING PERMIT APPLICANT CERTIFICATION 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 relatin ; 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, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. gnature Date 0 OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one c f the following two reasons: 1, as owner of the property, or my employees with wages as their sole compensatiol1, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 1 hereby affirm under penalty of perjury one of the following three 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. I 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 pen-nit 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, I become subject to the Worker's Compensation provisions of the Labor Code, I mu: t forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 1 certify that 1 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 relatin; building construction, and hereby authorize representatives of this city to enter ,n the above mentioned property for inspection purposes. (We) agree to save ..emnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signatu Date 2 CONTRACTOR: WANG'S I PERMIT NO: 09070163 MAINTENANCE 495 FIRLOCH AVE DATE ISSUED: 07/24/2009 SUNNYVALE, CA 94086 PHONE NO: (408)828 -8537 r_.� BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH RESIDENTIAL COMMERCIAL JOB DESCRIPTION: REMODEL 45 SQ FT TO BATHROOM Sq. Ft Floor Area: I Valuation: $1800 APN Number: 35902010.00 1 Occupancy PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by. '/ Date: v RE- ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should 1 use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF -,UPEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777 -3228 Fax (408) 777 -3333 Building Department JOB AD R S: PERMIT # OWNER'S NAME: wt_ PHONE # sS Ll GENERAL CONTRACTOR: (,, >c;,nm►^ FAX # I am not using any subcontractors: Sim ature Date Please check applicable subcontractors and complete the following information: Owner /Contractor Signature Date 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 F--]Tile Owner /Contractor Signature Date Assessor's Parcel Number: Name of owner. - CL A Project address. c c T Contact person. Pb one. L Fax. Net square footage of lot. Existing Square footage: First floor: Second floor: Garage: TOTAL: 'ire there at least two 10 foot by 20 foot clear spaces in: ide the Proposed AWL .L6 privacy protection planting required for the project? N On what floor(s) is work being done? 2 Li A -Ar-V r BMP HEET Brief description of work. F h M V Vrz- � JZ 6 r4ALa � d Zit -Cog , TOM L &T , 4 ( N OVA T le� c.rYt� % vv�vl'�cvt ,2c,✓t Y�c� S''Irr �ct�o�� .� Code editions: 2008 CBC ( - N)2008 CFC ('- N)2008 CMC N) 2008 CPC N)2008 NEC N) Uk Effective 1/1/08 iN ACCORDANCE WITH THE C� CUPERTINO CODES AND ORDINANCES SATE SIGN _ ations MUS This set �' sand it is un k)e kept on o; alteration: lawful to ma ; mission iron )n some W;., ;,;; tino. �. he building 'pecrfication - the stamping' i' to be >` LL NOT be h: rovis� ;HA an p rr._`,a:��n of Y nr04 of the ' r .rata I ow ,;}.,. n ri r —K, Plan Review Process Work Book Page -B- Revised 1/1/08 ,, ue F iz FLuS+ — i. .,5uQ02�- 1 z7 " X W �IA c C —t' I `t 0 ZGz A CA V 4 P, r>l g 4 c-0 St 1 i, L w u c 0 eW') ] A Kx" . ` VI � 3 ITEMS OF 3 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: BlY: Lot: APN ........: 358,02010.00 DATE ISSUED.......: 07/24/2009 RECEIPT #.........: BS(,00008263 REFERENCE ID # ...: 09(70163 SITE ADDRESS .....: 81E. HOOSHANG CT SUBDIVISION ...... CITY CUPERTINO IMPACT AREA ...... OPERATOR: SylviaM COPY # : 1 OWNER MEN CHENG ADDRESS 81E; HOOSHANG CT CITY /STATE /ZIP ...: CUPERTINO, CA 95014 -4218 RECEIVED FROM CONTRACTOR ... COMPANY ...... ADDRESS ...... CITY /STATE /ZIP TELEPHONE .... ME- EUGENE WANG LIC # 22343 WAPIG' S MAINTENANCE 49E) FIRLOCH AVE SUTINYVALE, CA 94086 (408)828 -8537 FEE ID UNIT QUANTITY INOUNT PD -TO -DT THIS REC - - - - -- NEW BAL ---- - - - - -- ---- - - - - -- ------- - - - - -- 1BCBSC VALUATION ---- - - - - -- 1,800.00 - •-- - - - - -- ---- 2.00 - - - - -- 0.00 ---- 2.00 0.00 1BSEISMICR VALUATION 1,800.00 1.00 0.00 1.00 0.00 1REMRESBAT SQ FEET 45.00 1140.00 0.00 - - - - -- 1140.00 ---- - - - - -- 0.00 ---- - - - - -- TOTAL PERMIT -- --- - - - - -- ---- 1143.00 0.00 1143.00 0.00 METHOD OF PAYMENT AMOUNT REFERENCE --------------- NUMBER - - - -- ----------- - - - - -- --------- CASH - - - - -- 1,143.00 MEI CHENG --------------- TOTAL RECEIPT 1,143.00 CITY OF CUPERTINO 4 "DITIOly /REMODEL CITY OF .-. "Irim 1n 1DDDA4TT A DDT T!'l A 9rlr"XT T'.� "lDVT %_UrCi`1 11N%J 1 X•.iuvii i L-11 1 l /1vA 1 1V1 \ i' Vi\lVi 09M01 L ] APN # 359 02 O r O 4 C) Date: —?— 2-LI 1 Is a 2" unit being added? Yes ❑ No E] If yes, please fill out the permit application for 2a Building Address: S� a- A (? Mailing Address (if different from building address): Owner's Name: Phone # Contractor: , / i Phone #: Ct�t�3 Fax #: Contractor License #: Cupertino Business License #: Contact: Phone #: Fax #: Building Permit Info: Bldg. Elect. [-- Plumb. Mech. ❑ Hillside ❑ Job Description: Addition -What is being added ?(Be Specific): What is being remodeled (not including addition;? 6a#L,-y,-00,),n . Remodel Includes Re -Roof: Yes ❑ No [r, If yes list number of squares Remodel Includes Structural: Yes F-1 No [I/ Do you have the pre - application planning approval? Yes ❑ No ❑ If yes, please provide a copy of your planning approval letter. Planners name: Square Footage: Addition: Porch: Deck: Garage: Detached Attached Remodel: Kitchen Baths Other Type of Construction (Usage Class): Occupancy Type: I -A, 1 -B ❑ IUIII /V -A ❑ IUIII B, IV -HT, V -B Valuation: �� - Please check this box if the project is a second -story addition ❑ Project Size: Express ❑ Standard ❑ Large ❑ Pda'or ❑ Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, Green Building Points Achieved: include in plan set & the sheet index. ** *For Office Use Only * ** Over - the - Counter ❑ Revised 07/06/09 CITY OF C_.UPERTINO ADDITOPUREMODEL FEE SCREDULE Quantity Fee ID Fee Descripl:ion Fee Group Permit Type Sq Ft DECKS 1R3SFDADD OR 1R3SFDREM 1 DECKWOOD Deck (Wood) -Each B (Each) 1 DECKRAIL Deck Railing -Lach B (Each) GARAGES 1R3SFDADD OR DETACHED 1R3SFDREM 1GARDTW < =1K Wood Frame up to B 1,000 SF (each) 1 GARDTM < =1 K Masonry up to 1,000 SF B (each) 1BCONSTAXR Construction Tax Res (new detached garage) PATIO'S OPEN 1R3SFDADD OR 1R3SFDREM 1PATIOWOOD Wood Frame up to 300 B SF 1 PATIOMETAL Metal Frame u j to 300 B SF 1PATIOOTHER Other Frame u) to 300 SF B PATIO'S CLOSED 1R3SFDADD OR & SUN ROOMS 1R3SFDREM 1PATIOENCLW Enclosed Wood up to 300 B SF IPATIOENCLM Enclosed Metal up to 300 B SF 1PATIOENCLO Other Enclosed Patio up B to 300 SF ICOVPORCH Porch Covered -Each B (Each) REMODELS 1R3SFDREM 1REMRESKIT Kitchen Remodel up to B (Deduct "$"for ea plan 300 SF check y 1REMRESBAT Bath Remodel up to 300 SF B " 1REMREOTH Other Remodel up to 300 B " SF CITY OF C.UPERTINO ADDITOrUREMODEL FEE SCHEDULE Quantity Sq Ft Fee ID Fee Descripl ion Fee Group Permit Type 1 MECPLNCK Stand Alone Mechanical Pln Ck (hourly M 1PLMPLNCK Stand Alone Plambing Pln Ck (hourly;, P / 1BCBSC Cal Bldg Standards Commission Foe B ALL PERMIT TYPES 1BSEISMICRE Seismic Residential B 1TRAVDOC Travel & Documentation B 1BUSLIC Business License B 1. use Loan No --VOC Paint 2. Use Low VOC, Water -Based Wood Finishes 3. Use LowlNo VOC Adhesives 4, Use Salvaged Materials for Interior Finishes 5. Use Engineered Sheet Goods with no added Urea Formaldehyde 6. Use Exterior Grade Plywood for Interior Uses 7. Seal all Exposed Perddeboard or MDF 8. Use FSC Certified Materials for Interior Finish 9. Use Finger- Jointed or Recycled- Content Trim 10. Install Whole House Vacuum System N. Flooring 1. Select FSC Certified Wood Flooring 2- Use Rapidly Renewable Flooring Materials 3. Use Recycled Content Ceramic Tiles 4. Install Natural Linoleum in Place of Vinyl 5. Use Exposed Concrete as Finished Floor 6. Install Recycled Content Carpet with Low VOCs Total Points Available: Total Points Project Received: 1 IAQ/Health pts y =yes 21AQ/Health pts y =yes 31AQ/Health pts y =yes 3 Resource pts y =yes 61AQ/Health pts y =yes 1 IAQ/Health pts y =yes 41AQ/Health. pts y =yes 4 Resource pts y =yes 1 Resource pts y =yes 3 IAQ/Health pts y =yes 8 Resource pts y =yes 4 Resource pts y =yes 4 Resource pts y =yes 5 IAQ/Health pts y =yes 4 Resource pts y =yes 4 Resource pts y =yes 1401 130 57 01 01 0 710 � G:data/progslgre - nbuildinoguidelineslre modelers/ greenpointsfinal2 .12.G4proteoted.xls