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13040072 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10220 BONNY DRCONTRACTOR:LP CONSTRUCTION CO PERMIT NO:13040072 OWNERS NAME: ZENG XIANFENG'AND WU PING 360 E EVELYN AVE STE 440 DATE ISSUED:04/08/2013 OWNER'S PHONE: 4082038210 SUNNYVALE,CA 94086 PHONE NO:(408)720-1111 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL Ll License ClassLic.# ev -Y FILL IN 600 SQ FT OF(E)SWIMMING POOL,HANDOUT 1q A �v't1e yy - PROVIDED Contractor er /d Date. ' I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division3 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. Sq.Ft Floor Area: Valuation:$8200 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 APN Number:35911044.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and nstate that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county.ordinances and state laws relating WITHIN 180 D RMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DA ALLED INSPECTIO indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the / granting of this permit. Additionally,the applicant understands and will comply I e Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date . L/� All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534.. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous" I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: �� Date permit is issued.. ! .---�T I certify that in the performance of the work.for which this permit is issued,I shall 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that.I have read this application and state that the above information is correctA 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, ARCHITECT'S DECLARATION costs,and expenses which may accrue;against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non=point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date Al/ SWIMMING POOL / SPA PERMIT APPLICATION b� COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION \b 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 S�J� (408)777-3228• FAX(408)777-3333•building aacupertino.orgCUPERTINO PROJECT ADDRESS �� a �O ^ ^ ✓I� APN# OWNvER NAME [Y�n J/UL�I < `nJf' PO d jd EMAn( STREET AD RESS K., CTT Y, STATE,ZIP / /��FAX a i d Aa 11 6p, Pr GGA ✓� �1 T C o� L CONTACT NAME �e_0l/� PH rO� >�L) y� >f E 20 �C�lla (o, Art,c STREET ADD% , J y�y A J,j�> O CITY STATE,ZIP L / <3 J/ FAX jj 6 �.tJ G a{�j ,S ' n e/0 ❑ OWNER ❑ OWNER-BUILDER ❑ OwNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME 6 �i�o Co LIC NiJ aRG�A ENSE`TYPE� BUS.LIC# COMPANpYD�AMg L. C�7S�JY�-LL✓ JO�7 E-MAIL ,( �O lCfSJ �lFAX / EE;L(� � J STRr L livY U4 TATE,ZAP ARCHITECTIENGINEER LICENSE NUMBER/„/ c�L BUS.LIC# -G COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK USE OF ❑ SFD or Duplex ❑ Multi-Family TYPE MATERIAL.TYPE(CODE) AREA (SQ.FT.) VALUATION(S) STRUCTURE: ❑ Commercial POOL Gt'n ! Q_ POOUSPA MATERIAL TYPE CODES: SPA V - VINYL-LINED F - FIBERGLASS DEMO G - GUNITE P - PREFABRICATED By my signature below,I certify to each of the following: I am the property owner ora nt to ac e property owner's behalf. I have read this application and the information I have pro 'ded is correct. I have read the Description of Work and vers rate. I agree to comply with all applicable local ordinances and state laws relating to b ' II construction. I orize re a es upertino to enter the ab�tifi yr rty for inspection purposes. Signature of ApplicanVAge Date: SUPPLEMENTAL INFORMATION REQUIRED � ocEusioN� 4 MW �u 1111 Y' A1CHECKYYP7a �� 3tOI7TIi"IGSL s Commercial or Multi-Family Buildings with Public Swimming Pools: Department of Environmental Health approval required, i vExfim'CG R« IRLDINGMEPT f ��, �E RESSLOW-1IG DEPT STAI�I7!�RD�� `�D�YUBLICV�4'�ORKS DEPT� � GE ' ❑ ENVIRONMENTATHEAL �x Q<Mi1y0�2.. ,»wf� a_�a� �.,�"SANITARY SEW,ERDISTRICT SwimPoolApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10220 BONNY DR DATE: 04/08/2013 REVIEWED BY: MELISSA APN: 359 11 .044 BP#: *VALUATION: 1$8,200 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY PENTAMATION SFD or Duplex 1SFP00LDEM .USE: PERMIT TYPE: � WORK FILL IN 600 SQ FT OF, E SWIMMING POOL HANDOUT PROVIDED SCOPE .L1ech.Plan Check Plumb.Plan Check Elec.Plan Check Fled, 11'ermit Fee: Plumb.Permit Fee: Elec. Permit Fee: Other Mech.lnspa Other Plumb Imp. Other Elec,Insp. Atech.Insp.Fee. Plumb. h7sp.Fee: 1 Elec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments('tie.Planning,Public Works,Fire,Sanitary Sewer District,School District etc.). Theseees are based on the prefinWha information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS,(Fee Resolution 11-053 E . 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Swimming Pool Suppl.PC Fee: 0 Reg. ® OT 0,0 hrs $0.00 $306.00 IDEMOPRES Demolition PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee Reg. 0QT0.0 hrs $0.00 PME Unit Fee: $0.00 PME.Permit Fee: $0.00 Construction Tax: Administrative.Fee: Work Without Permit? 0 Yes (2) No $0.00 .0 Advanced Planning Fee: $0.00 Select a Non-Residential 0 Travel Documentation Fees: Building or Structure i Strong Motion Fee: IBSEISMICR $0.82 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 $1.82 $306.00 �'� r $307.82 Revised: 04/01/2013 "Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 C O P E RT I N O Telephone: 408-777-3228 Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# OWNER'S NAME: ,e PHONE# d' GENERAL CONTRACTOR: L ^ BUSINESS LICENSE# "' ADDRESS: aCITY/ZIPCODE: *Our municipal code requires a 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 AlCITY 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 1 CUPSR Building 0,,,, Cam, j ent APR 0 __001 82013 Thi-F,,et,of r.!,!3,ls and NIUST be kr pt at VIEV IED FoFi CODE Co / �/ job 14L iS Unlaw,'01 L() M8kU af)y Re jewed f3y.. MPLIA chanC,,;e,,or or to thcrofrom, without appoval from the Building or,;cial, The stamping of this plan and,spEeific-'?tions SH/,"%[..L-t%;OT ba 1h,!!d to pern-iji:ol'to� ,c?an;?,P,A'0vaI of the vio;Lt;ic)jj 01 an.y pr R� nce or State Law. .......... Y PERMIT NO. 00 tjy PERMIT 10. 6 0 '44 Ere A 10 P/01- Tr�!P---r z PR 0 8 f