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09100004 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS'10445 Sr1N FERNANDO AVE CONTRACTOR:TBD-TO BE DETERMINED PERMIT NO:09100004 OWNER'S NAME: YUEQUIN t&SOPHIE LIN DATE ISSUED: 10/01/2009 NER'S PHONE: 4086671776 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# S?7 t �- r- F_ F J J �f MECH RESIDENTIAL COMMERCIAL Contractor(-Al: P H!U e # " ale I hereby affir that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REMODEL KITCHEN&4& 1/2 BATHROOMS;NO (commencing with Section 7000)of Division 3 of the Business&Professions STRUCTURAL Code and that my license is in full force and effect. &NO RE-ROOF;CONTRACTOR(CALIFORNIA HOME BUILDERS& DESIGN INC.)PD FOR BUS LIC 10/01/09 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 Sq.Ft Floor Area: Valuation:$50000 permit is issued. APPLICANT CERTIFICATION APN Number:35712050.00 Occupancy Type: 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 to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Signature Date I DL� Issued 1s OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 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. I 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 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 maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. 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 must Owner or Adporized agent: /] forthwith comply with such provisions or this permit shall be deemed revoked. Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save -iify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address nd expenses which may accrue against said City in consequence of the grai.,mg 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. I understand my plans shall be used as public records. Signature Date Licensed Professional V CITY OF CUPERTINO 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35712050 .00 DATE ISSUED. . . . . . . : 10/01/2009 RECEIPT #. . . . . . . . . : BS000008807 REFERENCE ID # . . . : 09100004 SITE ADDRESS . . . . . : 10445 SAN FERNANDO AVE SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : YUEQUIN & SOPHIE LIN ADDRESS . . . . . . . . . . : 10445 SAN FERNANDO CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2834 RECEIVED FROM . . . . : CALIF.HOMES&KITCHEN 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 ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 50, 000 . 00 2 . 00 0. 00 2 . 00 0 .00 1BSEISMICR VALUATION 50, 000. 00 5 . 00 0 . 00 5. 00 0 . 00 1BUSLIC FLAT RATE 1. 00 114 . 00 0 . 00 114 . 00 0 . 00 1REMRESBAT SQ FEET 330. 00 633 . 00 0 . 00 633 . 00 0 . 00 1REMRESKIT SQ FEET 250 . 00 570 .00 0 . 00 570. 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 1324 .00 0 .00 1324 . 00 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 1, 324 . 00 #3984 --------------- TOTAL RECEIPT 1, 324 .00 CITY OF CUPERTINO ADDITION/REMODEL OF CUPERTINO PERMIT APPLICATION FORM APN # Date: Is a 2°d unit being added? Yes ❑ No If yes, please fill out the permit application for 2" unit. Building Address: 1 p 4 L SU X Fev ►n c�l� o Ali Q_ C. P-e r 1-i v,,9,co 9 �_o 14 Mailing Address (if different from building address): Owner's Name: Phone# :(4-09) W1 1 Contractor: h (�oM e ��.�d1p v,S. 17 e ��+ lr Phone#: C�/o�� 9 - 37 99 Fax #: Contractor License#: 8g Z i T c.,o tx u>--P W`164-4 -0 Cupertino Business License#: 91 Contact: I/ Phone#: (q S)-7- Fax#: Z a Building Permit Info: Bldg. ❑ Elect. 91- Plumb. [J/ Mech. Hillside ❑ Job Description: Addition-What is being added?(Be Specific): 9 n/ What is being remodeled (not including addition)? f 440"Ve V�j Remodel Includes Re-Roof. Yes ❑ No yes list number of squares Remodel Includes Structural: Yes ❑ No ❑ Do you have the pre-application planning approval? Yes ❑ No E] If yes, please provide a copy of your planning approval letter. Planners name: Square Footage: Addition: Porch: Deck: Garage: Detached Attached Remodel: Kitchen '' Bath '3 ZT Other Type of Construction (Usage Class): Occupancy Type: I-A, I-B [-] II/III/V-A ❑ II/Ill B, IV-HT, V-B E3 -�+ � _'3 Valuation: S-,o ooc,' � Please check this box if the project is a second-story addition ❑ Project Size: Express M Standard ❑ Large ❑ Major❑ 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. 6 ***For Office Use Only*** Over-the-Counter ❑ Revised 07/06/09 CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft DECKS 1R3SFDADD OR 1R3SFDREM 1 DECKWOOD Deck (Wood)-Each B (Each) 1 DECKRAIL Deck Railing-Each B (Each) GARAGES 1R3SFDADD OR DETACHED 1R3SFDREM 1 GARDTW<=1 K 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 detachedgarage) PATIO'S OPEN 1R3SFDADD OR 1R3SFDREM 1PATIOWOOD Wood Frame up to 300 B SF 1 PATIOMETAL Metal Frame up to 300 B SF 1PATIOOTHER Other Frame up to 300 SF B PATIO'S CLOSED 1R3SFDADD OR & SUN ROOMS 1R3SFDREM 1PATIOENCLW Enclosed Wood up to 300 B SF 1 PATIOENCLM Enclosed Metal up to 300 B SF 1PATIOENCLO Other Enclosed Patio up B to 300 SF 1 COVPORCH Porch Covered-Each B (Each) REMODELS 1R3SFDREM 1 REMRESKIT Kitchen Remodel up to B (Deduct "$"for ea plan ,2�v 300 SF check 1 REMRESBAT Bath Remodel up to 300 B " 3 d SF 1REMREOTH Other Remodel up to 300 B " SF CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft 1 MECPLNCK Stand Alone Mechanical M Pln Ck(hourly 1 PLMPLNCK Stand Alone Plumbing P Pln Ck(hourly) IBCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B ITRAVDOC Travel &Documentation B % 1BUSLIC Business License B . n oor it ualrty an 1 mtshes 1.Use LOWNo-VOC Paint 1 IAQ/Health pts y=yes 0 2.Use Low VOID,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 3.Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes 0 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Health pts y=yes 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0 X11 Ple$�gar�l:rx 4 IAQ/Health. pts y=yes 0 8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0 10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0 1 1 1 N.Flooring 1.Select FSC Certified Wood Flooring B Resource pts y=yes 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 1 1 1 Total Points Available: L 1401 130 57 Total Points Project Received: 01 0 0 G:data/progs/greenbuildingguidelines/remodelers/greenpointsfinal2.12.D4proteoted.xls RESIDENTIAL PROJECT COVER SHEET Assessor's Parcel Number: S 7— Sn U Name of owner. L Project address. T o �{4 ��c I'o t n V n�. t�Pr �fl C' j� 1 9 y Contact person. s- I' w,.a v� Kre- K Phone. T�7�— Fax. o O Net square footage of lot. Existing Proposed Square footage: First floor: Second floor: Garage: TOTAL: ---_- -e there at least two 10 foot by 20 foot clear spaces insidearage the ? Is privacy protection planting required for the project? N '°--- ------ _On what floor(s) is work being done? Brief description of work. e LA Code editions: 2008 CBC N)2008 CFC N)2008 CMC Y N) 2008 CPC -N)2008 NEC N) Effective 1/1/08 A IN ACCOR NC IT E 1 CUPERTI R ES ` DATE 13N, SIGNED _ This set of plans and specifications MUST be kept on the job at all times and it is unlawful to make any changes or alterations on same without written permission from the Building DepaFtment,City of Cu ino. The stamping of this plan an .nations SHALL NOT be held to permit or to be an approval of the violation of any provisions of any City Ordinance or State Law. Plan Review Process Work Book Page-8-Revised 1/1/08 Z b wa OC = Z3 4 \,,dac � rl� S (Z C 9-5rcA I M1 z r � �MItS DC C'DvvAte69� i Cn J-l c J S '5 59 -5� :% -69 ., - - -69 17 al/32 ' V t��r(10 Ale �� t�FP/ �� ;9� 37 v h s� 24 - -$6 15/16 AC Nb 24 N N 3 OD'"7 C C 2 �(� CPC LMO CO - 1 ►. 16 CO (DD(DD —� Ic O CO CI) V v -- -------- 18 1� N 15 6 N NTOA. J lb� LO LO C G, >----- �� 19 a NN V o ' o ' 7 CI) ch LO \� io 27 -: ---40 _-- _ 45 1/2 __ --- 37 1/2 ;- I--,' - 40 - - 45 1/2 - 371/2 ?D _ _ - ---- - 125 - -- --- 3 1/2 California Kitchen Bath & Tile Sophie Lin Floorplan IM i racoon Ave Ph".4 CA 9X112 Kitchen Room 1 Current Date:Sep 24,2009 Scale NTS Phame:406-�92-8200 Fax:408-392-8201 4,r` Master B ro rn ��'� �� c --- - -- - - - - 361 ------ -_ - >,_ ---------------- - - 199 /2 �� 47 114 1/2 -- -- .6 94 - -- - 45 -- 36 - - - 125 - - 36 - -19 - S - 94 -- - - -45 - - 36 --- 29 ---16 - 29 --- 47 - 36 -- 19 -------------------------------------------- N y- 2 \__j : ----1 36 Closet NM �� Closet N 0 ��` Loft _f �:3 �S �A^`� 6 60 o -- - ' -54 -L v V�i aCVCC1 - -77 - - - - --- -----120 ----- �0 L �p a 58 60 cc,r QI_.14_r Aa4/ 13a c oafd fa N r1 py 2 Kk tin, California Kitchen Bath & Tile Sophie Lin Floorplan 1775.Nncim Am e PhonerOF' 412 Master Bathroom Room 4 Current Date:Sep 24,2009 Sca'- NTS • Pnw�e:��.axoo�jos-M-s2o1 1/8 -------------- 114 - - ---------- 251/2 --251/2 — ------ 88 1/2 -------- 12 —12 --- 24 - - 12 - --- --657/8 ----- - 3 1 �el A A4 v � - 4 6 y C_ 00 / CO M J 1 37 - - -- ter, LO M pv. — - 31 — -� - " -35 2 2 Califomia Kitchen Bath & Tile Sophie Lin Floorplan 1775 duncim Ave Son.lasejCA 96112 Phone,468-M43200 Fax:408-392-8201UP stairs Bathroom Room 5 Current Date:Sep 24,2009 Scale: NTS' a- F a Down stairs bathroo 72 90 ``r i ��4• 36 36 49 30 32 M M -------------------------------N M i ------ -- X00 N 7 N ------------------- ,� 72 Powder Room N s N - 12 32 46 — 90 lv Califomia Kitchen Bath & Tile Sophie Lin Floorplan 1775 Jur4 im Ave San Jose•oA 95112 Down stairs Bathroom/ Room 8 Current Date:Sep 30,Zoos Scale: NTS Plane:408-392-8200 Fax:408-3.92-8201 µF Community Development 10300 Torre Avenue - Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 _UPEkTINO Buildijag Department JOB ADDRESS: S SU.,,. ev tAo PERMIT # Cv •e� o L-k 0 OWNER'S NAME: S Li v-, PHONE # CD2 ?-F 7 3 78 GENERAL CONTRACTOR-Ca1.'FPrvt i ,,A (4pMe FAX # _ Q 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 Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile IN .o Owner/Contractor Signature Date