Loading...
11040112 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22951 LONGDOWN RD CONTRACTOR:THD AT-HOME SERVICES, PERMIT NO: 11040112 INC. OWNER'S NAME: WEIYING LI 2690 CUMBERLAND PKWY STE 300 DATE ISSUED:04/18/2011 !ER'S PHONE: 4082169062 ATLANTA,GA 30339-3913 PHONE NO:(510)731-1004 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# 360 2 + MECH f- � RESIDENTIAL COMMERCIAL Contractor Date qltqj )) I hereby affirm that I a nsed under the provisions of Chapter 9 JOB DESCRIPTION:INSTALL THREE(3)RETROFIT WINDOWS AT BEDROOM (commencing with ction 7000)of Division 3 of the Business&Professions LOCATIONS,NON-STRUCTURAL 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:$2975 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:34240013.00 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. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Issued byr Date: Signature Date ) L OWNER-BUILDER DECLARATION RE-ROOFS: 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. 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 construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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. 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(x)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 the Bay Area Air Quality Management District I will permit is issued. maintain compliance 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&Safety 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 or authoriz 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 hereby 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 i-' mnify and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION greening of this permit.Additionally,the applicant understands and will comply with 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 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 34240013 .00 DATE ISSUED. . . . . . . : 04/18/2011 RECEIPT #. . . . . . . . . BS000013208 REFERENCE ID # . . . : 11040112 SITE ADDRESS . . . . . : 22951 LONGDOWN RD SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER WEIYING LI ADDRESS 22951 LONGDOWN RD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : JEFF RAINEY CONTRACTOR FRANCES BLAKE LIC # 29818 COMPANY . . . . . . . . . . : THD AT-HOME SERVICES, INC. ADDRESS 2690 CUMBERLAND PKWY STE 300 CITY/STATE/ZIP . . . : ATLANTA, GA 30339-3913 TELEPHONE . . . . . . . . : (510) 731-1004 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 2, 975 .00 1. 00 0 . 00 1.00 0.00 1BSEISMICR VALUATION 2, 975 . 00 0.50 0. 00 0.50 0. 00 1WINREP EACH 8 3 .00 380. 00 0. 00 380 .00 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT 381.50 0. 00 381.50 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 381.50 VISA --------------- TOTAL RECEIPT 381.50 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 22951 long down rd. DATE: 04/18/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: 1$2,975 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Repair PRIMARY SFD or Duplex PENTAMATION 1GENRES USE: PERMIT TYPE: WORK install three retrofit windows at bedroom locations non structural SCOPE _FT F-1 I D L NOTE: These ees are based on the prelindnary in ormation available and are only an estimate. Contact the Det or addn'1 info. FEE ITEMS (Fee Resolution 09-051 1?ff. ',110) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Window/Sliding Glass Door Suppl.PC Fee: E) Reg. 0 OT F571 hrs $0.00 $380.00 1WINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl.Insp.Fee4@ Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Acoustical Fee: 0 Yes 0 No $0.00 Work Without Permit? 0 Yes 0 No $0.00 Planning; Fee: $0.00 Select a Non-Residential 0 Building or Structure Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg;Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $380.00 TOTAL FEE: $381.50 Revised: 01/15/2011 1 z z �- ado e � r p C 3 O OZN � n A pi � zL U3 A zM v� r O I z Oi p zO z o G D • p O ZM rp 3 D N 1 m � Z 0 3 W O 0 > O1 S > p m O O _ N .� ocz t- �° 00 c qi w O UJo C0- wv > 0 -- ,, �z 000 0Q � � o � in o � > m mU� CO z 9 co om 'o w : �m 20 Q $ i pp _0 a 00) X0 0 i U ° ° o E:9 WEIYING LI THD - At Home Services (North) D W N 22951 LONGDOWN RD. ` nY, 2456 Verna Ct. CUPERTINO, CA 95014 San Leandro, CA 94577 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: 'ZZgS I Lvtj PERMIT# OWNER'S NAME: vJc 1 G L f PHONE# qoq. 2 O(, 2 GENERAL CONTRACTOR: THD C�mE BUSINESS LICENSE# ADDRESS:2-14 5E llj'?-/JA c-T CITY/ZIPCODE: Ant L-ElrnJ➢R.D `745 *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: Signat Date Please check applicable subcontractors and comp a 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 GUPSRT1NO (408)777-3228 • FAX(408)777-3333•buildinma.cupertino.org ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMITif # PROJECT ADDRESS q L / 2 J�>. APN � u / OWNER NAME W � N PHCr ry O ©`C tj'F0 /l6 E-MAIL STREET ADDRESS /�,' J/� 2 STALTE,ZIP ^.4^.4 CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LI SE NUMBER LICENSE TYPE BUS.LIC# 36oz1 e;3ci7 COMPANY NAME 1 /�'7 r7�,�� Jc�zJC S E-MAIL FAX STREET ADDRESS!I 0 A G C 5 Jq y J Lt /� ��r�C� �jt l,� �T7 T S(,v ARCHTTECT/ENGINEERNAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK S­Ft-t 1 7 7�2� I�t �!~CJI'17 v 7f j. �� I C7/ Z S ✓t pj:-S 5 f 1t ., wl��/-7 0 LZZli 1 f: C- C . . EXIST[NGUSE PROPOSED USE CONSTR.TYPE A STORIES . W .. g EXISTG NEW FLOOR DEMO TOTAL 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 M DWELLING UNITS: IS A SECOM UNIT ❑YES SECOND STORY ❑YES BEING ADDED? ❑NO ADDITION? ❑NO " PRE-APPLICATION ❑ YES IF YES.PRovIDE COPY OF PLANNER'S NAME: PLANNING APPL N ❑NO PLANNING APPROVAL LEITER 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 construction. I authorize representatives of Cupertino to enter the above-identified fiproperty for inspection purposes. Signature ofApplicandAgent: `'�— Date: SUPT INFO D New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building ' permit for new building. _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. _Copy of Planning Approval Letter or Meeting with Planning prior to x submittal of Building Permit application. © h B1dgApp_2011.doc revised 03/16/11