The URL can be used to link to this page

13040034 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10209 BONNY DR' CONTRACTOR:BENJAMIN FRANKLIN PERMIT NO:13040034 PLUMBING OWNER'S NAME: CHANG WANG-YANG'AND CHIANG JAN PO BOX 1072 DATE ISSUED:04/04/2013 OWNER'S PHONE: 4083910605 CAMPBELL,CA 95009 PHONE NO:(408)298-1776 LICENSSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIALS License Class 3 Jo Lica# S73 sc'" REPLACE(E)WATER HEATER&INSTALL NEW 50 GAL Contractor,� n}.7A+*tQ - -Date.. T p— , L �T cL �3 WATER HEATER IN THE SAME LOCATION /RhnJK��W ' ' 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: 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:$2219 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:35912032.00 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 countyordinances;and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives,of this city to enter upon the above mentioned.property for inspection purposes. (We)agree to save 180 DAYS FRO AST CALLED INSPECTION. indemnify and keep harmless the Cityof Cupertino-against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the L13 granting of this permit. Additionally,the applicant understands and will comply Issued b r Date: with all non-point source regulations per the Cupertino Municipal Code;Section 9.18. y RE-ROOFS: Signqture Date �/ 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. ❑ -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the,Contractor's License Law for one of 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) 1,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(x)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I 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 thi''s permit is issued. will maintain compliance with the Cupertino Municipal Cod!,C11apter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 53d. Section 3700 of the Labor Code,for the performance of the work for which this c4l,l l J permit is issued. Owner or authorized agent Date: 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction 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 Cig0e41-06 ik GENERAL PERMIT APPLICATION P COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION . 10300 TORRE AVENUE•CUPERTINO,CA 950143255 CUPERTINO (408)777-3228• FAX(408)777-3333•building(a)cupertino.org MISC PLUMBING ❑MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESSI O 0[1 3Q A) D APN# 3 C1 Jy13 a OWNER NAME ,1W ET C 442 PHO I,O�©� E MAILp STREET ADDRESS CITY, STATE,ZIP FAX 020 9 �Aj'j z c z'7 we GA %S 6/ CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑OWNER AGENT XCONTRAcTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# !(!G_AO C ANY NAME E-MAIL FAX �o J E-MAIL v w 3�.✓ y Oy q I S� So 6.0q�D STREET 22 /� . CITY.STATE,ZIP �7D / / ,/ PHONE L1 61"-z_ '��7-3Z46 ARCHITECT/ENGINEER NAME LICENSE NUMBER `� BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF WISFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES BUILDING: q COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF WORK L + ��-/' �� /�I A _L'Z ta-'L- TOTAL VALUATION: 2 , D BY: By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I 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 building constructio nze r resentatives of cu er the above-identified prope for inspection pudposes. Signature of Applicant/Agent: Date: Z4 SUPPLEMENTAL ON REQUIRED OFFICE USE ONLY ❑ OVER-THE-COUNTER E ❑ EXPRESS U ca ❑ STANDARD U ❑ LARGE G ❑ MAJOR MEPA&cApp_2011.doc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10209 BONNY DR DATE: 04/04/2013 REVIEWED BY: SUEW APN: 35912 032 BP#: 13040034 "VALUATION: 1$2,219 *PERMIT TYPE: Plumbing Permit PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY SFD or Duplex PENTAMATION PRWHEAT USE: PERMIT TYPE: WORK REMOVE E WATER HEATER & REPLACE WITH NEW 50 GAL WATER HEATER IN THE SAME SCOPE LOCATION APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Water Heater 1 PRWHEATR 1 # $27 TOTALS: $27.00 r t Plumb.Plan Check 0.0 hrs $0.00 - g �olfi7 Fere: - Plumb.Permit Fee: IPPERMIT . c?t/rt t?e<h. tras . Other Plumb Insp. 0.0 hrs $45.00 t,,;,t.r r ,r,=t,- Ll L-1 NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . Theseees are based on the reliminar information available and are only an estimate. Contact the Det or addn'l in o. FEE ITEMS(Fee Resolution 11-053 E,ff. 7111121 FEE QTY/FEE MISC ITEMS Plan Check Fcc: PME Plan Check: $0.00 f %f 7tt < It7.dj1 t'Cc PME Unit Fee: $27.00 PME Permit Fee: $45.00 Administrative Fee: IADMIN $42.00 Work Without Permit? 0 Yes Q) No $0.00 .<1tf-urtcec/I'Irtnnifr.F:; Fees: Travel Documentation Fee: ITRAVDOC $45.00 A Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldp-Stds Commission Fee: IBCBSC $1.00 $160.50 $0.00 TOTAL FEE: $160.50 ae.;. Revised: 04/01/2013 X Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: 408-777-3228 L U P E RT I N O Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: OZ O p PERMIT# . P c13 OWNER'S NAME: J Aj E T PHONE# 44til',., �` ' 0.6 O GENERAL CONTRACTOR: e.�J3 Z �u�1 BUSINESS-LICENSE.# ADDRESS: 22- D/6/TA—r_ 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 SUBCONTRACTORS HAVE OBTAINED.,,A',CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: — 3 ignat Date Please check applicable subcontractor n p ete the following information: V' 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 Owner/Contractor Signature Date