11070007 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11620 WILDFLOWER CT CONTRACTOR:BAY CITY WINDOWS PERMIT NO: 11070007
OWNER'S NAME: MAO YALAN AND CAO RANDONG 3030 OSGOOD CT DATE ISSUED:07/01/2011
OWNER'S PHONE: 4084801118 FREMONT,CA 94539 PHONE NO:(510)353-1600
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG f— ELECT f— PLUMB
License Class L J, Lic.# ?Z
/ D MECH r— RESIDENTIAL F COMMERCIAL
-,y' 4f/Contractor d �fNL�i✓; Date 2 /
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: SFD,6 WINDOW&DORR REPLACEMENTS,NON-
(commencing with Section 7000)of Division 3 of the Business&Professions STRUCTURAL,
Code and that my license is in full force and effect. BEDROOMS TO MEET EMERGENCY RESCUE REQUIREMENTS PER
2010 CBC
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
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$6900
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:36619060.00 Occupancy Type:
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
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-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature � Date ---
g � Issued by;.. �—� Date ��
C OWNER-BUILDER DECLARATION
I hereby affirm that I 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
performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
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 I 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,Sections 25505,25533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I must
Owner or autho �a , /
forthwith comply with such provisions or this permit shall be deemed revoked. �C Date:
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
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 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,
cc id expenses which may accrue against said City in consequence of the Lender's Address
91. a of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations 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
Ia. 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: 1 I Z , ( { o �, PERMIT#
OWNER'S NAME: PHONE# S►o ') 3 s 3- ( (,Y P c>
GENERAL CONTRACTOR: w; wr BUSINESS LICENSE#
ADDRESS: 3 0 , C_? ere"O/A Ca CL 4 5 3 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: -
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
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CITY OF CUPERTINO
4 ITEMS OF 8 PERMIT RECEIPT OPERATOR: TraciC
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36619060 .00
DATE ISSUED. . . . . . . : 07/01/2011
RECEIPT #. . . . . . . . . : BS000013951
REFERENCE ID # . • • 11070007
SITE ADDRESS . . . . . : 11620 WILDFLOWER CT
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER MAO YALAN AND CAO JIANDONG
ADDRESS 2800 MCANDREW CT
CITY/STATE/ZIP . . . : SAN JOSE, CA 95121-1100
RECEIVED FROM . . . . : DAVID MORKIN
CONTRACTOR . . . . . . . : ROBERT BENTLEY LIC # 27371
COMPANY BAY CITY WINDOWS
ADDRESS 3030 OSGOOD CT
CITY/STATE/ZIP . . . : FREMONT, CA 94539
TELEPHONE . . . . . . . . : (510) 353-1600
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 6, 900 . 00 1 .00 0 . 00 1. 00 0 . 00
1BSEISMICR VALUATION 6, 900. 00 0 .69 0 . 00 0 .69 0 .00
1WINREP EACH 8 6 . 00 392 . 00 0 . 00 392 . 00 0 .00
---------- ---------- ---------- ----------
TOTAL PERMIT 434 .69 0 . 00 434 .69 0 . 00
1 -,)
CONSTRUCTION PERMIT APPLICATION
Lis COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 �J r
(408)777-3228• FAX(408)777-3333• build inq(a)cupertino.org
CUPERTINO
❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS I 1 + , 1 I I O �1 APN# Q/
OWNER NAME �J (Y ` PHONE
STREET ADDRESS1 ' 2-L,0
L,(' \^ ' 0 � `� CITYCSTATE,ZIP Z r y 1 v�CJ � I S �I FAX
CONTACT NAME v\1 PHONE '[ E-MAIL
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STREET ADDRESS U S C�Q C1 1 CITY,ST Ae YY1IP FAX
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❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC#
nc4vtvS 2322��Co Ll1
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
Swl � S3 lc�06
ARCHITECT/ENGINEER NAME 11 � LICENSE NUMBER BUS.LIC#
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COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK 11
r'2 e rnelnA VU , �'lrlUwi �' Jtl�lrl�
11 S, z2 n , rdrd 4
EXISTING USi: PROPOS -% CONSTR.TYPE #STORIES
S I i lam( USE TYPE OCC. SQ.FT. VALUATION(S)
AREA NEW FLOOR DEMO 1/ TOTAL t3 V
AREA AREA AREA NET AREA
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH
ATTACH
#DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES
BEING ADDED? []NO ADDITION? []NO
PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑Y RECEIVED BY- TOTAL VALUATION:
PLANNING APPL# []NO PLANNING APPROVAL LETTER EICHLER HOME? PA4 O
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the pr_cperty owner's behalf. I have r ad this
application and the information I have provided is rrect. 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 c ction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: Date: -7_ I— N
SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP
_New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER ❑ BUELDING PLAN 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 ❑ PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT
_Copy of Planning Approval Letter or Meeting with Planning prior to p MAJOR ❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
BldgApp_201 1.doc revised 06/21/11