The URL can be used to link to this page

11070083 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10970 LUCKY OAK CT CONTRACTOR:SANDIUM PERMIT NO: 11070083 OWNER'S NAME: KUO PONAN AND CHOU LIANG-YUAN 4223 VERDIGRIS CIR DATE ISSUED:07/13/2011 OWNER'S PHONE: 4153282195 SAN JOSE,CA 95134 PHONE NO:(408)894-9072 t LICENSED CONTRACTOR'S DEC(L�ARATION BUILDING PERMIT INFO: BLDG F ELECT F PLUMB N License Class C— [—y Lic.# e a TJ cc // 91 MECH RESIDENTIAL COMMERCIAL� Contractor Com[/L �/()1M Date 0 JOB DESCRIPTION:REMOVE EXISTING&INSTALL NEW FRONACE AND AIR I hereby affirm that I am licensed under the provisions of Chapter 9 CONDITIONING (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:$6821 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:32657008.00 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 City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. granting of this permit. dditionally,the applicant understands and will comply with all non-point sou c regulation p the Cu ertino Municipal Code,Section _�/ 9.18. l z / Issued - �- Date: %O F_� Signature Date 0/1 RE-ROOFS: OW ER-BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am 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 reasons: inspection. 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, 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: I 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. I 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. Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this contamina s as defined by the Bay Area Air Quality Management District I will permit is issued. maintain o pliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health S ety Code,Sections 25505,25533,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 r t e p�.//�/�/ 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. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereb affirm that there is a construction 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, r—ts,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION ing of this permit.Additionally,the applicant understands and will comply 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 V� CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION \ tADDRESS: 10970 Lucky Oak Ct. DATE: 07/13/2011 REVIEWED BY: gs C�� (�Q� BP#: 'VALUATION: $6,821 RIPETYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY PENTAMATION FURN/AC USE: SFD or Duplex PERMIT TYPE: WORK SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Furnace, Forced-Air 1MFR=<100 1 # $130 A/C Units (<=10K cfm) 1BREMAiR 1 # $65 TOTALS: $195.00 Mech.Plan Check 0.0 hrs $0.00 Mech.Permit Fee: IMPERMIT Other Mech.Insp. 0.0 �hrs $44.00 NOTE. These fees are based on the preliminary in ormation available and are only an estimate. Contact the De t or addn'l info, FEE ITEMS ,Resolution 11-053 f.?ff—Z"1.-11) FEE QTY/FEE MISC ITEMS F= PME Plan Check: $0.00 PME Unit Fee: $195.00 PME Permit Fee: $44.00 Work Without Permit? 0 Yes No $0.00 Travel Documentation Fee: 1 TRA vDOC $44.00 Strom Motion Fee: IBSEISMICR $0.68lect an Administrative Item Bld&Y Stds Commission Fee: IBCBSC $1.001 t". SUBTOTALS: $284.681 $0.00 TOTAL FEE: 68 Revised: 07/04/2011 I �r Building Department City Of Cupertino [us 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: QR=to LU b L PERMIT# / �G OWNER'S NAME: �V Q O N PHONE# 9V - GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: .�K *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: 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 Heating Insulation Landscaping Lathing Masonry Painting /Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date CITY OF CUPERTINO 7 ITEMS OF 7 PERMIT RECEIPT OPERATOR: TraciC COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 32657008 . 00 DATE ISSUED. . . . . . . : 07/13/2011 RECEIPT #. . . . . . . . . BS000014030 REFERENCE ID # 11070083 SITE ADDRESS 10970 LUCKY OAK CT SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : KUO PONAN AND CHOU LIANG-YUAN ADDRESS . . . . . . . . . . : 10970 LUCKY OAK CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : MARTIN CORREA CONTRACTOR . . . . . . . : MICHAEL LEE LIC # 28867 COMPANY SANDIUM ADDRESS 4223 VERDIGRIS CIR CITY/STATE/ZIP . . . : SAN JOSE, CA 95134 TELEPHONE (408) 894-9072 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- lADMIN HOURS 1. 00 41 . 00 0 . 00 41. 00 0 .00 1BCBSC VALUATION 6, 821 . 00 1 . 00 0 .00 1 . 00 0 . 00 1BREMAIRHA NO.UNITS 1. 00 65 . 00 0 .00 65. 00 0 . 00 1BSEISMICR VALUATION 6, 821. 00 0 .68 0 . 00 0 . 68 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 1TRAVDOC FLAT RATE 1 . 00 44 . 00 0 . 00 -----44_00 ------0_00 ---------- ---------- TOTAL PERMIT 325 .68 0 .00 325 . 68 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- --- CREDIT CARD 325 .68 01361B --------------- TOTAL RECEIPT 325 .68 VOICE ID DESCRIPTION VOICE ID DESCRIPTION __ _ -------- ---------------------------- -- ----------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL GENERAL PERMIT APPLICATION o MEP COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 \O 408 777-3228• FAX(408)777-3333• building(aDcupertino.org ` MISC CUPERTINO ( ) PLUMBING UgMECHANICAL ❑ELECTRICAL []MISCELLANEOUS PROJECT ADDRESS APN# -7 O� n - Ov ' S+- a OWNER NAME E-MAIL P4NE -��g� STREET ADDRESS tt CITY FAX TATE,ZIP LJ "t _ h0 _ QSOI CONTACT NAME PHONE E-MAIL __ - STREET ADDRESS CITY,STATE, ZIP F ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR 11CONTRACTOR AGENT ❑ ARCHITECT 11ENGINEER ❑ DEVELOPER 1:1TENANT CONTRACTOR NAME , LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL vVV� s 11f�"Sa 1 c,ov, STREET ADDRESS CITY,STATE,ZIP 0\1\x. -_jC0' . fog q%_to$s PHONE- ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME' E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF FD or DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES EI THE BLDG E El YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO CHLER HOME? [3 NO DESCRIPTION OF WORK TOTAL VALUATION: . V RECEIVED BY: f By my signature below,I certify to each of the followi I am the property owner or authorized agent to act on the prop owner's behalf. I have read this application and the information I have provided is torr ct. have re d t e Desc' tion of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construc'on u tives of Cupertino to enter the above-identified property for inspection pulposes. Signature of Applicant/Agent: Date: SUPPLEMENTAItj N REQUIRED OFFICE USE ONLY OVER-THE-COUNTER ❑ EXPRESS Y U w ❑ STANDARD U < ❑ LARGE ❑ MAJOR MEPMiscApp_2011.doc revised 06121111