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10120025 CITY OF CUPERTINO BUILDING PERMIT - r BUILDING ADDRESS: 20607 PARADISE DR CONTRACTOR:KENNETH TAN PERMIT NO: 10120025 OWNER'S NAME: KENNETH TAN 20607 PARADISE DR DATE ISSUED: 12/06/2010 OWNER'S PHONE: 4085077233 CUPERTINO,CA 95014 PHONE NO: LICENSED CONTRACTOR'S DECLARATIONr BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# r MECH RESIDENTIAL COMMERCIAL Contractor Date JOB DESCRIPTION: REMODEL KITCHEN 150 SQ,2 BATHROOMS 105 SQ FT I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 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:$5000 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:35915011.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state 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 DAYS OF PERMIT 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 DAYS FROM LAST CALLED INSPECTION. 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 Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date 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). All.( 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 permit is issued. Owner or authorized agent: Date: ZAI 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 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, As,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. sting 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 v G `G `7 Date CITY OF CUPERTINO 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN 35915011 . 00 DATE ISSUED. . . . . . . : 12/06/2010 RECEIPT # . . . . . . . . . BS000012146 REFERENCE ID # . . . : 10120025 SITE ADDRESS 20607 PARADISE DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER KENNETH TAN ADDRESS 20607 PARADISE DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : MABEL CHANG CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : KENNETH TAN ADDRESS . . . . . . . . . . : 20607 PARADISE DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE . . . . . . . . . FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ------ 1BCBSC VALUATION 5, 000 .00 1 . 00 0 .00 1 .00 0 . 00 1BSEISMICR VALUATION 5, 000 . 00 0 .50 0 . 00 0 .50 0 .00 1REMRESBAT SQ FEET 105 .00 570 . 00 0 .00 570 .00 0 . 00 1REMRESKIT SQ FEET 150 . 00 570 . 00 0 .00 570 . 00 0 .00 ---------- ---------- ---------- ---------- TOTAL PERMIT 1141 .50 0 . 00 1141 .50 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 1, 141.50 visa --------------- TOTAL RECEIPT 1, 141.50 RESIDENTIAL PROJECT COVER SHEET Assessor's Parcel Number: j S2 -I S- Name of owner. Ke A-, k cz-n Project address. Contact person. Fax. Net square footage of lot. ■Coo> Existing Proposed ■ ■ Square footage: First floor: Second floor: ..�� Garage: TOTAL: Are there at least two 10 foot by 20 foot clear spaces inside the garage? �N Is privacy protection planting required for the project? X,---_N Co Build it Green Total Points ...� On what floor(s) is work being done? Brief description of work. avx �4-c �^ I ^^�- `` �.� eL9L r Code editions: 2007 CBC N)2007 CFC N)2007 CMC N) 2007 CPC -N$ 9,971�4EC -N) IN AG(ORDAM i I it Gl U CUP FRTuNIJ e,k)t1E`, .Ili t.)FdDiNANt c . Effective 1/1/08 DATE This set of plans and speaf�czhoRs MUSS t+,kept on the fob at all tides and it is , ,.mtaw tui to make any changes or alterations -_ �• �._ on same without written permission from the Building De artment,City of Cupertino. The stamping d rfications o this plan an spec ` ©j� ;,HALL NOT be.held to permit or to be an approval of the vjaiaeion of ar•v provisions, ,,f,;,y Cr?j,-Ordf ince Plan Review Process Work Book Page-8-Revised 8/05/08 v ri CO ew Kitchen Layout OP Y , i2P 4r Wkdaw G z� 3r 2"x34' 24'z17x NMI Doubt.Dom r 3 N"44V Sink B.. Wall OhN Gan.l i Dkgmrl Zy j', •'•., GDIrM 38'x3rx34.P Lary 6—5.N 24y�4Xd4.5'D,W'.'"r i• 0 o r N FZr. ' L�� D. WON Dmf wX24•X34.s epi.r.ck GurNhop + 125Q4S34.8' �• —dSkVN amp oor Dw 12, IrgDH 39''x17%37 ablrM j IA�`� C:.I'tr�+`� R'ro'h00d B...C.W rl �1 d.- -n .—m o _3 3 19r 3 Ca r (�4 S k.wcc Sir. 185Q4'x34.s Draws B.N C.bkW b ................................. Id Ceiling height: 90" 2r W.IIP.n±Door All countertop switches are 8.5" 2r a9■e4 3sX,7Xie" high from countertop Wou R.9q.r■tor 17 DNp Garage Downstairs bath Hallway Bathroom Master Bathroom �'D ,fp Adjacent to 10( hallway bath Stairway landing 84.5 44" 5"1 35" i " 84.5" �" 5.5 �G1 T' 60" , �l N O M Linen Cabinet CD 3 14 6 § E W o � M o CD CO- 23" door 9"_ p N r\�e ar 6 LS" �V'� M 3 CU �` ` �µ _ o Linen Closet O S} U) "" o = - �� LO 50" M (�Cn N 0 e— N o _ Master bedroom 32" N + + �;� closet space 1" 15/16" 4" 5 35.5" Adjacent to Master Bath Ceiling ieight = 8" Hall Bathroom: Replace the and bath tub Master Bathroom: Replace tile on shower wall Change light Wur, i both bathrooms OWNER-BUILDER DISCLOSURE FORM 13 COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333-building(aD-cupertino.org Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SITE ADDRESS MN OWNER NAME enti e f dt Tait OWNER ADDRESS )r DL0 7 P,0%od'Se pfi✓e, �N�i'�/i.9v (A CSOI/{ DESCRIPTION OF WORK: / l C dl E'iY► C(rt 16� u�� i'"' / C v<�E We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read,initialed your understanding of each provision,signed,and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you,the property owner,obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS:Please read and initial each statement below to signify you understand or verify this information.) It 7 1. 1 understand a frequent practice of unlicensed persons is to have the property owner obtain an"Owner- Builder"building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. X' 2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. _LJ 3. 1 understand as an"Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. k1 4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. �5. I understand if I employ or otherwise engage any persons,other than California licensed Contractors,and the total value of my construction is at least five hundred dollars($500), including labor and materials, I may be considered an"employer"under state and federal law. xl 6. 1 understand if I am considered an"employer"under state and federal law, I must register with the state and federal government,withhold payroll taxes, provide workers'compensation disability insurance, and contribute to unemployment compensation for each"employee."I also understand my failure to abide by these laws may subject me to serious financial risk. x 7 7. 1 understand under California Contractors'State License Law,an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year,or all of the work is performed under contract with a licensed general building Contractor. 1�1 8. 1 understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s)that result from any latent construction defects in the workmanship or materials. OwnerBuilderForm 2010.doc revised 04/14/10 9. I understand I may obtain more information regarding my obligations as an"employer"from the Internal Revenue Service,the United States Small Business Administration,the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors'State License Board (CSLB)at 1-800-321-CSLB(2752)or www.cslb.ca.gov for more information about licensed contractors. ,Y1 10. 1 am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the site address listed above. xl 11. 1 agree that,as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. P 12. 1 agree to notify the issuer of this form immediately of any additions,deletions,or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license,the Contractors'State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint.Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property,you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors,you will be responsible for verifying whether or not those Contractors are property licensed and the status of their workers'compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS:Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued,this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit Note:A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: ---------------------------------------------------------------------- ---------------------------------------------------------------------- (NOTE: The following Authorization Form is required to be completed by the propertyowner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner,the execution of which I understand is my personal responsibility, I hereby authorize the following person(s)to act as my agent(s)to apply for,sign,and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project(or Description of Work): k l he r 4od re.?°111e l Project Location or Address: �h�� l�Ge�u�l�s e /�� v f� �u� ��°'� l �l 9 So f l, Name of Authorized Agent: /•lu he Tel No 40Y- 33 y-eV 9 Address of Authorized Agent: )-0607 PA,-A,rg e 1);I-le CLI pe- /117d I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note:A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. 7 (— Property Owner's Signature: &Lmd–� - Date: I�S�1 ac, OwnerBuilderFormn 2010.doc revised 04/14/10 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: p b o ?crstj i Ci s-t PERMIT# OWNER'S NAME: ,,, T�,,� PHONE# ;cl--'3 2' 33 GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: 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: T SJ) 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 CITY OF CUPERTINO ADDITION/REMODEL CUPERTINO FEE SCHEDULE d z 602-S APN# Date: I `Dec:, (o Zciu Is a 2°d unit being added? Yes❑ No If yes,please fill out the permit application for 2° unit. Building Address: c (.C Mailing Address(if different from building address): Owner's Name: Phone# is c` Contractor: Q Phone#: Fax#: Cupertino Business License: State Contractor License#: Contact: Phone#: Fax#: Landscape Ordinance Compliance: Landscape area in sq.ft.(includes all irrigated areas): O/A . If 2,500 sq. ft.or less,compliance with the Landscape Water-Efficiency Checklist is required. If more than 2,500 sq.ft.,a complete Landscape Project Submittal is required. Compliance Method: ❑ Plantlype ❑ Water Budget Building Permit Info: Bldg. ❑ Elect. ® Plumb. Mech. Hillside ❑ Job Description: Addition-What is being added?(Be Specific): N� What is being remodeled(not including addition)? Oso se 3 ) 2- Remodel Remodel Includes Re-Roof: Yes ❑ No 0 If yes list number of squares Remodel Includes Structural: Yes ❑ No R Do you have the pre-application planning approval? Yes ❑ No X% If yes,please provide a copy of your planning approval letter. Planners name: Square Footage: Addition: Porch: Deck: Garage: Detached Attached Remodel: Kitchen /S>c Bath IeS Other Type of Construction(Usage Class): Occupancy Type: i e- TFcl VV.� 'y I-A, 1-B ❑ II/III/V-A ❑ I1/III B,IV-HT,V-B Valuation: $S z��c. Please check this box if the project is a Project Size: Express® Standard❑ Lar e ❑ Ma'or second-sto addition —1 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. Revised 05/18/10