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10090141 CITY OF CUPERTINO BUILDING PERMIT CONTRACTOR:GREENERBLU IDHM,INC PERMIT NO: 10090141 BUILDING ADDRESS: 20719 GARDEN MANOR CT OWNER'S NAME: SHI YU SUN&QING ZHU SONG PO BOX 612048 DATE ISSUED:09/16/2010 IER'S PHONE: 4088952010 SAN JOSE,CA 95161 PHONE NO:(408)418-2000 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F ELECT r PLUMB r License Class \ Li,# h /y MECH r RESIDENTIAL COMMERCIAL Contractor(q! 1 J Date U JOB DESCRIPTION: SIDING&STUCCO REMOVAL&REPLACEMENT,STUCCO I hereby affirm that I am licensed under the provisions of Chapter 9 REPAY STUCCO 24,SIDING 46 (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. I have and will maintain Worker's Compensation Insurance,as provided for by Valuation:$1585 Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: permit is issued. APPLICANT CERTIFICATION APN Number:36230074.00 Occupancy Type: 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 constriction,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, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 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. �..--- _ Date: f Issued by:.� Signatur e l CJIb V OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one or 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 the following two reasons: I,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the stricture 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 declarations: HAZARDOUS MATERIALS DISCLOSURE ' I have and will maintain a Certificate of Consent to self-insure for Workers 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. I 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(a)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 permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I 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 er or author' d ag //-/- /Z become subject to the Worker's Compensation provisions of the Labor Code,I mt st Date: / Z 51l U forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION 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 won s sued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relati ig for which this permit is is 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 Lender's Address -mify and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Signature Date Licensed Professional CITY OF CITY OF CUPERTINO is GENERAL BUILDING APPLICATION FEE SCHEDULE CUPERTINO Fee Permit Type Fee Desci-iption Group 1GENRES or Quantity/Sf Fee ID 1GENCOM PARTITION WALLS B 1PARTICOMM 1PpRTICOMM Partition Interior Commercial Partition I nterior Residential B 1PARTIlZ<=30 1PARTIR RETAINING wlw�WAI,L(CONCItETE OR So RY Standard(up to 50 ft) B IRETSTNg IRETSP310 Special Design,3-10' high(up to 50 ') B 1RETSP10 Special Design,over 10' high(up to B 50' B Gravity/-rib Wall,0-10'high(up to 1RETCRB< 50 ft Gravity/Crib Wall over 10' high(up to B 1RETCRB> 50 ft SIDING 1 SIDESTBK Siding, Stone&Brick Veneer B L{ interio r/exterior) B 1 SIDEOTHER Siding Al other SKYLIGHTS is <10 SF Skylig it less than 10 sf B 1SKYL>10SF Skylight greater than 10 sf or B structs xal B 1STAIRS Stairs•first flight/ea addt'l STORAGE R ACKS 1 SRACKS<=8 Stora,,, Racks 0-8'high(up to 100 sf) B Stora;e Racks over 8' high(up to 100 B 1 SRACKS>8 st 4of5 CITY OF CITY OF CiJ PERTINO N GENERAL BUILD '[G APPLICATIO FEE SCHEDULE CUPERTINO Fee Permit Type Fee Description Group 1GENRES or Quantity/Sf Fee ID 1GENCOM Stucco App l ications(up to 400 sf) B 2 y 1STUCOAP additional stucco a lication B Replacement window /sliding glass l WINREP door ea 8 windows B 1WINMEWSTR New Window-structural shear wall/mason includes Ian ck fee IEPERMITFEE Electrical Permit Fee E IMPEItMITFEE Mechanic-I Permit Fee M 1PPERMITFEE Plumbing Permit Fee P IELCPLNCK Stand one Electric Pin Ck(hourl Y) E Stand Ali)ne Mechanical Pin Ck(hrly) M IMECPLNCK P 1PLMBLNCK Stand Al one Plumbing Ph'Ck(hrlY) Standard 1 Plan Check(when no E/M/P) B 1STPLNCK-(3 Hr Min hourl -:,tand alone when not over counter B ALL PERMIT Cal Blc g Standards Commission Fee TYPES 1BCBSC 1BSEISMICR Seismil;Residential B IBSEISMICO Seismic Commercial B 1TRAVDOC Trave�&Documentation B B IBUSLIC Business License 5 of 5 TINO CITY OF CU PER C.IV of GENERAL I lwILDIN G 01 PERMIT APPLICATION FORM Date: 9 loll () APN# 3� �.. 3 � �� Building Addresnv C49�oly deo manor Cf: , &,oe�� /A �� — p address): c J v CA Mailing Address (if differe l �� ing 2,10 S• GIS ? ❑ N0 � Are Hazardous Materials being used as part of this l roject. Yes A _ �No ❑ 1f E s, rovide letter from HOA 9 xterior work onl ) Yes Phone#: HOA: �• 1..�-�� yU`�.. Owner's Name: 5h l y U /7 "C`` 2 Phone: �� Contractor: Fax: ►u. nc- Contractor License Cupertino Business License#: Phone: aS "ontact: Fax: �3- Residentia Commercial ❑ 1 Job -Description: �j Building Pe- it Info: Mech❑ ❑ Bldg Elect. ❑ Plumb Occupancy Type: Type of Construction s�� (Usage Class): 3 f2 3 Re �� f .� II/VI B,N-HT,V-B 1-A, 1-B ❑ II/III/V-A ❑ Square Footage: Valuation: o'ect Size: Express Standard ❑ Larg,1:1. Major ❑ Pr J i EED Checklist& attach it Please complete relevant portio n of the Green Bu ding/L Green Building applicable,include in plan set&the sheet index. to the application or if pP oints Achieved: buildit reen.or For help, contact Build it Green at www• Revised 07/14/09