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11050185CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11897 WOODHILL CT CONTRACTOR: A-1 ELECTRICAL PERMIT NO: 11050185 CONTRACTING, INC OWNER'S NAME: VINCENT FUNG 1819 POLK ST STE 236 DATE ISSUED: 05/23/2011 'ER'S PHONE: 4084290315 SAN FRANCISCO, CA 94109 PHONE NO: (415) 573-5522 ❑ CONTRACTOR'S DECLARATION /LICErNSED �/ a T 3 -f q 6 � BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class v Lic. # �'l,� f f Z 1 Contractor Q W�^ Date MECH RESIDENTIAL COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: INSTALL EVC CHARGING STATION INCLUDE NEW (commencing with Section 7000) of Division 3 of the Business & Professions BREAKER BREAKER 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: $1200 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 36604069.00 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 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 / 7 Issued by: Date: L 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 I, 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: 1, 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 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 1 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 contaminants as defined by the Bay Area Air Quality Management District I will [ certify that in the performance of the work for which this permit is issued, I shall 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 Othorized nt: Date: e- J forthwith comply with such provisions or this permit shall be deemed revoked. J 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 wrk'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.) ;o building construction, and hereby authorize representatives of this city to enter Lender's Name ipon the above mentioned property for inspection purposes. (We) agree to save 0-innify and keep harmless the City of Cupertino against liabilities, judgments, Lender's Address and expenses which may accrue against said City in consequence of the . _...ging 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 ).18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 5 ITEMS OF 10 PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36604069.00 DATE ISSUED.......: 05/23/2011 RECEIPT #.........: BS000013537 REFERENCE ID # ...: 11050185 SITE ADDRESS .....: 11897 WOODHILL CT SUBDIVISION ...... CITY .............. CUPERTINO IMPACT AREA ...... OWNER ............: VINCENT FUNG ADDRESS ..........: 11897 WOODHILL CT CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: patg COPY # : 1 RECEIVED FROM ....: ROBERT F WHITEAKER CONTRACTOR .......: ROBERT WHITEAKER LIC # 32218 COMPANY ..........: A-1 ELECTRICAL CONTRACTING, IN ADDRESS ..........: 1819 POLK ST STE 236 CITY/STATE/ZIP ...: SAN FRANCISCO, CA 94109 TELEPHONE ........: (415) 573-5522 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ---------- 1BCBSC ------------- VALUATION ---------- 1,200.00 -------------------- 1.00 0.00 -------------------- 1.00 0.00 1BREMMISC EACH 1.00 126.00 0.00 126.00 0.00 1BSEISMICR VALUATION 1,200.00 0.50 0.00 0.50 0.00 1EPERMITFE FLAT RATE 1.00 42.00 0.00 42.00 0.00 1TRAVDOC FLAT RATE 1.00 42.00 0.00 42.00 0.00 TOTAL PERMIT ---------- ----------- 211.50 0.00 ---------- ---------- 211.50 0.00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- 304 ROUGH ELECTRICAL -------- 505 ---------------------------- FINAL ELECTRICAL ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(cDcugertino.org CUPERTINO PROJECT ADDRESS (APN # OWNER NAME �v/t PHO r /') (/I 1` 7y _ ��) )-TE IL �— �� PU STREET ADDRESS t CITY, STA ZIP FAX V�/U 1 �/ 1/YJ CONTACT NAME �2' I'_ ^ / PHO ` - E-MAIL STREET ADDRESS, ry . x �- !, CITY, STATE, ZIP _ FAX ❑ OWNER ❑ OWNER -BUILDER % OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR N p / jar LICEN NUMBER SFWE TYBUS. LIC # LISPE J � COMPANY NAME(� �'! E-MAIL (J FAX v STREET ADDRESS ,,n J J- CITY, STATE ZIP , PHONE ARCHITECT/ENGINEER NAME �L / F LICENSE NUMBER BUS. LIC # J COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or Duplex ❑ Multi -Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD ZONE ❑ Yes ❑ No ❑ SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION j ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: KILOWATTS (COMMERCIAL ONLY): TOTAL VALUATION: DESCRIPTION OF WORK ! 7 _ 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 buil * construction. I authorize representatives of Cupertino to enter the above -identified propefor inspection purposes. Signature of Applicant/Agent: ` �� Date: I Z -7 7 /,( TION REQUIRED PVApp_2011.doc revised 03/16/11 i CITY OF CUPERTINO I�AI FEE ESTIMATOR -BUILDING DIVISION imADDRESS: 11897 woodhill ct. DATE: 05/23/2011 REVIEWED BY: bobs. UNITS APN: BP#: "VALUATION: 1$1,200 PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: # PENTAMATION 1 REAP? PERMIT TYPE: WORK install evc charging station include new 30 amp breaker SCOPE APPLIANCE / EQUIP TYPE FEE ID QTY/FEE QTY UNITS BP FEES Apparatus 1 BREMMISC 1 # $126 PME Unit Fee: $126.00 PME Permit Fee: $42.00 Work Without Permit? 0 Yes E) No $0.00 TOTALS: Travel Documentation Fee: ITRA VDOC 1 $126.00 Stronp_ Motion Fee: IBSEISMICR NOTE. These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'1 info_ FEE ITEMS (Pee Resolution 09-05.1 Il.. ' 1.-10 FEE QTY/FEE MISC ITEMS PME Plan Check: $0.00 PME Unit Fee: $126.00 PME Permit Fee: $42.00 Work Without Permit? 0 Yes E) No $0.00 Travel Documentation Fee: ITRA VDOC $42.00 Stronp_ Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg, Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $211.50 $0.00 TOTAL FEES $211.50 Revised: 04/29/2011 CUPERTINO COMMUNITY BUILdINGDIVIS ONE RT44LNr PROJECT DATA -RESIDENTIAL NTpEpA CUPERDNO COMMUNITY DEVELOPMENT DEPARTM T •BUILDING DIVf�I�FjOVCD 10300 TORRE AVENUE • CUPERTINO, CARVIA plans and speC' tor�V' rficationS MUST (408) 777-3228 •FAX (408) 777-3333 • buildinct� C�&onstruc±ion. be k 'mss o� alter I t `s Unlawful to kept at The there€turn, without a atr�ns on make an �A� or to deviate Y ThA ,.+ _ . PProva/ from the QTTrc la l. at i 8t1c.1 cry; . -„r PROJECT ADDRESS ' . eAP' "i � ",rlt `� C YP �, t of A t, G w i!a� G8 _IOf S pool OWNER NAME f /� ( PHC*��2 ' _aJ( 7o vio;.a±jcn J� j J utile STREET ADDRESS LT, CITY, ZIP F 11 L -,-X APPLICANT N 6r_ ' / , i l/rye /�' P N� E- k STREET ADDRESSf� f / CITY, ST- TE, ZIP f G ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGWEER ❑ DEVELOPER ❑ TENANT CRi'LE3N0sow- f. w law apfy ,. S -¢H3' i 4gb Y-.y$&�' `h9^�g -- Y4c��y -wN3. ,q cM1-' W fY�'>r.r"`�” '� i,'� kv"tT' F- 6 .3.' ix T .ray �` 'c ._ wry Y £`�+.. _ _ s. k. ^�." >` zs, ffi` ^°£4,#s' �Y€..'.4a 6.;,.. .. T .i�: :,>„fin ., .... �,,,. �'sr.,F „v.x..iy�,n, �x� wt%�za...: EXISTING USE(S): y/ PROPOSED USE(S): (� J OCCUPANCY(S): _ rJ JJ TYPE OF/ LJ PARCEL CONSTRUCTION: AREA: FIRE Y N WUI AREA: Y N FLOOD AREA: Y N I SIESNUC AREA: Y N i SPRINKLERS: Existing Proposed Floor Area: First Floor: s.f. s.f. Second Floor: s.f. Garage s.f -s.f TOTAL: S. s.f. Are there at least two 10 feet by 20 feet clear spaces inside the garage? Y N Is privacy protection planting required for the project? Y N Governing Codes: 2010 California Building Code (based on the 2009 International Building Code) 2010 California Residential Code (based on the 2009 International Residential Code) 2010 California Plumbing Code (based on the 2009 Uniform Plumbing Code) 2010 California Mechanical Code (based on the 2009 Uniform Mechanical Code) 2010 California Electrical Code (based on the 2009 International Electrical Code) 2010 California Energy Code 2010 California Green Building Standards Code Cupertino Municipal Code ProjectData-Residential.doc revised 03/09/11 Main 200 amp ► U -, -, Vv(--�o(/'-v\)JJ (-.1.. cc-4�- t\t�o ) L I-