11090201 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20556 SUNRISE DR CONTRACTOF /, 'MIT NO: 11090201
OWNER'S NAME: SITYR YOUYUH AND SHUTZU 7 h I 'lT DATE ISSUED:09/28/2011
OWNER'S PHONE: 9258380174 PHONE NO:
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB F
License Class C Z L Li !# �, G� MECH RESIDENTIAL COMMERCIAL
Contractor (5cv �'��,,de,
Date
I hereby affirm that I a liceprovisions of Chapter 9 JOB DESCRIPTION:HEATING EQUIPMENT INSTALLATION&DUCT WORK
(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.
I have and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$4000
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued.
APN Number:35910043.00 Occupancy Type:
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 relating
to building construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep harmless the ity of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may ccruIb against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION.
granting of this permit. Addif nally the ap �bant understands and will comply
with all non-point source r tions'per t _Cupertino Municipal Code,Section �f
-t'�''r3__--�---- C '24-
9.18. Issued by.��
Date:
Signature Date Z dl /-//
OWNS -BUILDER DECLARATION RE-ROOFS:
All roofs shall be inspected prior to any roofing material beng installed.If a roof is
1 hereby affirm that I m exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for
the following two re ons: inspection.
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, Signature of Applicant: Date:
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to
ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE
declarations:
1 have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air
contaminants as defined by Bay Area Air Quality Management District I will
permit is issued. maintain compliance with e ;uperf Municipal Code,Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued,l shall Health&Safety Code,Se ions 255 ,25533,and 25534.
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 Owner or authorize%rcis
: --� �
become subject to the Worker's Compensation provisions of the Labor Code,I must Date:
forthwith comply with such provisions or this permit shall be deemed revoked.
S RUCTION LENDING AGENCY
APPLICANT CERTIFICATION I hereby affirm that tconstruction lending agency for the performance of work's
I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.)
correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
c--'-.and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION
og of this permit.Additionally,the applicant understands and will comply
H.>..all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.18.
Licensed Professional
Signature Date
CITY OF CUPERTINO
7 ITEMS OF 8 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 35910043 . 00
DATE ISSUED. . . . . . . : 09/28/2011
RECEIPT #. . . . . . . . . BS000014888
REFERENCE ID # . . . : 11090201
SITE ADDRESS . . . . . : 20556 SUNRISE DR
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER SITYR YOUYUH AND SHUTZU
ADDRESS . . . . . . . . . . : 20556 SUNRISE DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : ECO SYSTEMS HEATING
CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096
COMPANY TBD - TO BE DETERMINED
ADDRESS . . . . . . . . . .
CITY/STATE/ZIP . . . : ,
TELEPHONE . . . . . . . .
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
-ADMIN HOURS 1 .00 41. 00 0 . 00 41.00 0. 00
1BCBSC VALUATION 4, 000 .00 1. 00 0. 00 1. 00 0 .00
1BSEISMICR VALUATION 4, 000 . 00 0 .50 0. 00 0 .50 0. 00
1MFR=<100 UNITS 1.00 130. 00 0 . 00 130 . 00 0. 00
1MPERMITFE FLAT RATE 1 .00 44 . 00 0. 00 44 .00 0. 00
1MRRAA UNITS 1 .00 65.00 0. 00 65 .00 0. 00
1TRAVDOC FLAT RATE 1. 00 44 . 00 0 . 00 44 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 325. 50 0. 00 325 .50 0. 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
GENERAL PERMIT APPLICATION MEP
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE-CUPERTINO, CA 95014-3255
CUPER TINO (408)777-3228 • FAX(408)777-3333• building(a�cupertino.org MISIC
❑PLUMBING R1 MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS
PROTECT ADDRESS /�^' G� �- ,` �� APN#
OWNER NAME 12 r PHONE
- � S
STREET ADDRESS , ^} �� CITY, STATE,ZIP s ? '�• FAX
CONTACT NAME PHONE E-MAIL
STREETADDRESS CITY,STATE,ZIP FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME r �� A_ LICENSENUMBER ;
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ILI ADDRESS: 20556 sunrise dr. DATE: 09/28/2011 REVIEWED BY: bobs.
APN: BP#: 'EVALUATION: 1$4,000
°PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition/ Repair
PRIMARY SFD or Duplex PENTAMATION FURN/AC
USE: PERMIT TYPE:
WORK
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
Furnace, Forced-Air 1 MFR=<100 1 # $130
Heating System 1MRRM 1 # $65
TOTALS: $195.00
Mech.Plan Check 0.0 1 hrs $0.00
Mech.Permit Fee: IMPERMIT
Other Mech.Insp. 0.0 hrs $44.00 LJ F1 L
NOTE. This estimate does not include fees due to other Depts(i.e.Public Works,Sanitary Sewer District,School District,etc.).
Thesefees are based on the preliminary in ormat'on available and are only an estimate. Contact the De t or addn'1 info,
FEE ITEMS (Lee Resolution 11-053 L;lf 71/11) FEE QTY/FEE MISC ITEMS
PME Plan Check: $0.00
PME Unit Fee: $195.00
PME Permit Fee: $44.00
Administrative Fee: IADMIN $41.00
Work Without Permit? Q Yes (D No $0.00
Travel Documentation Fee: ITRA VDOC $44.00
Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $325.50 $0.00 TOTAL FEE: $325.50
Revised: 09/02/2011
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: `' X24 N 'V PERMIT# i L Z-
OWNER'S NAME: ------ PHONE#
GENERAL CONTRACTOR: +r-,- BUSINESS LICENSE# � � c
ADDRESS: ? E -• X-- -� 04 CITY/ZIPCODE:
*Our municipal code requires all businesses work' 4t /'a4 1;`a.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.
1 am not using any subcontractors:
Signature Date
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
a
Heating L - ' - C Z-ex
Insulation
Landscaping
Lathing
Masonry
Painting /Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile -
uy ,
Owner/ tractor Signa ure Date
i
CITY OF CUPERTINO BUILDING PERWS'O
BUILDING ADDRESS: 10108 S TANTAU AVE CONTRACTOR:STEPHEN 090095
OWNER'S NAME: STEPHEN WU 10108 S TANTAU DATE ISSUED:02/16/2011
._ IF,R'S PHONE: 4088872399 CUPERTINO,CA 95014 PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT F PLUMB
License Class Lie.# C0 0�lck: _)� Date {M
�' 1 � MECH RESIDENTIAL COMMERCIAL
Contractor J s C�1� tit? f�
,
1 hereby affirm that I am licensed under the provisions of Cha ter I JOB DESCRIPTION: ADD 912SQ FT ADDITION TO LEFT REAR OF FXIS"I ING
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect. MASTER BATH&REPLACE WATER HEATER;NO RE- ROOF&
FT INCLUDING NEW FAMILY,KITCHEN DINING&
9/21/2011-REV42-ADD SKYLITE IN KITCHEN&MODIFY ON SHEAR WALL IN
1 hereby affirm under penalty of perjury one of the following two declarations: GARAGE TO 8'LENGTH-REV#2 ISS'D 9/21/2011
1 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. Sq.Ft Floor Area: Valuation:$200000
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:37507040.00 Occupancy Type:
correct.1 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
indemnify and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non- oint source gulati s r tate Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
{{
Signature Date C� Zk Issued bye/ � -�- 1 Date:,/",
OWNER-BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant:_ Date:
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the
I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued.
California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by
compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this
Safety Code,Section 25532(a)should I store or handle hazardous material.
permit is issued. Additionally,should 1 use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code Se 'ons 25505,25533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,1 must
forthwith comply with such provisions or this permit shall be deemed revoked. O r r auth ized I
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I 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 relating I hereby affirm that there is a construction lending agency for the performance of work's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
c- and expenses which may accrue against said City in consequence of the Lender's Address
ng of this permit.Additionally,the applicant understands and will comply
all non-point sourcc rcgulaticim per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
9.18.
1 understand my plans shall be used as public records.
Signature Date
Licensed Professional