10090116 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7596 NEWCASTLE DR CONTRACTOR: 153 CORNERSTONE PERMIT NO:10090116
CONSTRUCTION,INC.
OWNER'S NAME: SANG H LEE
1240 DALE AVE,STE 46 DATE ISSUED:09/15/2010
NER'S PHONE: 4087121038
MOUNTAIN VIEW,CA 94040 PHONE NO:(408)655-9020
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB
License Class Lic.# A -3 D MECH RESIDENTIAL r COMMERCIAL
Contractor ,( � 1 <Crl►pj Date `�J V
JOB DESCRIPTION:29 RECESSED CEILING LIGHT WIRING&2 FAN LIGHT
I hereby affirm that I am licensed under the provisions of C apter 9 INSTALLATION WIRING
(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:$1700
Section 3700 of the Labor Code,for the performance of the work for which thi Sq.Ft Floor Area:
permit is issued.
APPLICANT CERTIFICATION �j APN Number:36617010.00 Occupancy Type:
I certify that I have read this application and state that the above infor n on 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, 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:
Signature
'?
/ J Issued b<
Date � D
❑ OWNER-BUILDER DECLARATION RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one o 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, 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. 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 Owner or authoo gent: //
become subject to the Worker's Compensation provisions of the Labor Code,I mu st Date:
forthwith comply with such provisions or this permit shall be deemed revoked. —
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I hereby a
I certify that I have read this application and state that the above information is affirm that there is a construction lending agency for the performance of work's
correct.I agree to comply with all city and county ordinances and state laws relati rg for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
n—the above mentioned property for inspection purposes.(We)agree to save Lender's Address
inify and keep harmless the City of Cupertino against liabilities,judgments,
c 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 CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: DATE: REVIEWED BY:
APN: I BP#: *VALUATION: 1$1,700
PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration /Addition/ Repair
PRIMARY 1 C)T;7 L PENTAMATION 1 REAP 11
USE: SFD or Duplex V1,0OR Ai FA, PERMIT TYPE:
WORK
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
Fixtures, Lighting 1BREMFIXT 31 # $96
TOTALS: $96.00
-T-T
L1idr. I't;.rr,('I, ck PhflO, Moll l,l<< rElec.Plan Check 0.0 hrs $0.00
1,11"ch_ Peau"t F< I�r f:i,. F'_� ,t/<<.e; Elec.Permit Fee: IEPERMIT
F-1
Elec.Insp. 0.0 hrs $42.00
firs
NOTE: Theseees are based on the relimina in ormatior available and are onlyan estimate. Contact the De t or addn'1 in o.
FEE ITEMS (Fee Resolution 09-0.51 Eff 7,1/10) FFE QTY/FEE MISC ITEMS
Plus Check Four:
Srrp/� PC.'1"CC
F-1
PME Plan Check: 30.00
Pc�rrnit 1`c�c'
Sta/�ph Irrs°1�I'ce
PME Unit Fee: $96.00
PME Permit Fee: $42.00
C017SI171(t1 017 Tc'r:V
,-Icouslic al Rc vieii-P't,C:
Work Without Permit? 0 Yes (E) No 60.00
Travel Documentation Fee: 1 TRAVDOC $42.00
Strong Motion Fee: $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $131.501 $0.00 TOTAL FEE: $181.50
Revised: 9/14/2010
CITY OF CUPERTINO
6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # : 1
Sec: Twp: Rng: Sub: B].k: Lot:
APN 36617010 .00
DATE ISSUED. . . . . . . : 09/15/2010
RECEIPT #. . . . . . . . . BS000011470
REFERENCE ID # 10090116
SITE ADDRESS 7396 NEWCASTLE DR
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER SANG H LEE
ADDRESS . 7596 NEWCASTLE DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM SEUNG N KIM
CONTRACTOR IL LAE CHO LIC # 28762
COMPANY 153 CORNERSTONE CONSTRUCTION,
ADDRESS . 1240 DALE AVE, STE 46
CITY/STATE/ZIP . . . : FOUNTAIN VIEW, CA 94040
TELEPHONE . . . . . . . . : (408) 655-9020
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -------------
---------- ------ ---
---------- ----
1BCBSC VALUATION 1, 700 . 00 1 .00 0 .00 1. 00 0 .0
1BREMFIXT NO. FIXTURES 31. 00 96 . 00 0.00 96 . 00 0 .00
1BSEISMICR VALUATION 1, 700. 00 0 .50 0 .00 0 .50 0 .00
1BUSLIC FLAT RATE 1. 00 114 .00 0 . 00 114 .00 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 295.50 0 . 00 295.50 0 .00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- -------------- -
--
CREDIT CARD 295 .5 ) VISA
-------------- -
TOTAL RECEIPT 295 .5)
Kitchen
At least 50% of the total wattage is high efficacy:
Fixture Type High efficacy Relainping x Quantity = High-efficacy or Low-efficacy
(y/n) wastage wattage wattage
x — _ or
x — or
x — or
x — or
(Complies if 4,2: B) Total: A: B:
Compliant? YES ❑ NO ❑
Additional requirements YES N/A NO
Recessed fixtures installed in insulated ceilings are rated ICAT and certified ❑ ❑
ASTM E283 or equivalent. Installation is airtight(caulking, gaskets). ❑ ❑
High-efficacy and low-efficacy fixtures are switched separately. �
RJ Bathroom(s) YES N/A NO
All light fixtures are high efficacy. ❑ ❑
Incandescent fixtures are switched with marual-on/automatic-off occupancy ❑ ❑
sensors.
Recessed fixtures installed in insulated ceilings are rated ICAT and certified ❑ ❑
ASTM E283 or equivalent. Installation is airtight(caulking, gaskets). �.�/
High-efficacy and low-efficacy fixtures are snitched separately. >Dd ❑ ❑
Ed Laund Room / Utility Room YES _N/A NO
19
All light fixtures are high efficacy. ❑ 13
A
Incandescent fixtures are switched with maiwal-on/automatic-off occupancy ❑ �,/ ❑
sensors.
o, Recessed fixtures installed in insulated ceilir gs are rated ICAT and certified ❑ ❑
ASTM E283 or equivalent. Installation is airt ght(caulking, gaskets).
a, High-efficacy and low-efficacy fixtures are switched separately.
❑ " a
Garage
YES N/A NO
GrJ
N All light fixtures are high efficacy. n 1:1
a�
Incandescent fixtures are switched with manual-on/automatic-off occupancy ❑ ❑
~ sensors.
Recessed fixtures installed in insulated ceilings are rated ICAT and certified 13 ef 0
N ASTM E283 or equivalent. Installation is air:ight(caulking, gaskets).
High-efficacy and low-efficacy fixtures are switched separately.
[3 13
1
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CE)�N
L E G F— N { nFt rvc[
IN Rii C7tt[)� .y. Caa i HE � N t�i
CUf,t fi1lNt�t ;pi 9A�L) NC:E'>
n ql M�12 sw ITc�P
DATE_ �bL
SIGNEE
SIS chis set of plr ns and s ficatr kn MUS'
k>e kept or),he,lob at all tames nd't
Sw ITCR,nlawtul to ma,0 any<:han(Ies or Iterations
on same will out .ti^�ttE'n perrT2is ion froll)
t the building C ej)artnref" Crt of 'upertin�;
�O 1 c C The stamping at Ih,',p!�+r ar" sp rfacaUonr
r= L -,HRt 1 NO i)01,1 ar taermit to be an
J
Y ' 3
fdl.Indoor QirQuairty anFinishes ';• _
I.Use LovvifJo-VbC Paint
2.Use Low VOC,Neater-.Based Wood Finishes 1 IAQ/Health Pts Y--yes
D
3.Use Low/No V2IAQJHealth is as
Adhesives P Y=Y D
4.Use Salvaged Materiais for Interior Finishes 3 IAQ/Health pts y--yes
es p
5.Use Engineered Sheet Goods with no added Urea 3 Resource pts Y-Y D
Formaldehyde
6.Use Exterior Grade PlytaoDd for Interior Uses 1 IAQ/Hea6 IAQ/Health Pts y=yes
lthis Y=Yes D
ETP.a
Dsed rtioleboard Dr MDF P Y_y
7.Seal all p
B.Use FSC Certified Materials for Interior Finish 4 IAQ/Health Dts = as
4 Resource pts y=yes p
9.Use Finger Jointed orRecycled-Content Trim p
ID.Install Whole House Vacuum System 1 Resource pts y=yes p
3 IAQ/Health pts y=yes
D
N.Flooring 'N 1 1 1
1.Select FSC Certified Wood Flooring
2,Use Rapidly Renewable Flooring Materials B Resource pts y=yes p
3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes p
4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=4 Resource pts y=yes p
5.Use Exposed Concrete as Finished Floor s
4 Resource is D
6.Install Recycled Content Carpet with Low VOCs P Y-yes p
4 Resource pts y=yes D
Total Points Available:
140f- 130 57
Total Points Pro'ect Received:
�f
G:data/progs/gree ibulldngguidelinesJramodslers/greenpointAna121204prdeetedAs
CITY OF (XPERTINO
..si
CITE of BUILDIN G
�?
cu�� INO GENERAL
PEPMT APPLICATION FORM
Date: a
APN #
Building A dress: ') � -
�.
Mailing Address (if different from building address):
Are Hazardous Materials being used as part of this project? Yes No
BOA: xterior work only) Yes ❑ No I:' es, rovide letter from BOA
Phone#:
Owner's Name:
Phone: r u J s
Contractor: - Fax: �t
i
Contractor License
Cu ertino Business License#:
Phone: ✓ f'�' ,`- t
Contact: Fax:
Residential Commercial
Job Description:
EBI
ding Permit Info:
❑ ElectPlumb ❑ MechOccupancy Type:
e of Construction (Usage Class):II/IIW-A , ,, 1-B ❑ Square Footage:
uation: �{�
Project Size: Express [��
��L�arge ❑ Major ❑ :�T. L
Building: Please complete relevant porton of the Green Building/LEED Checklist & attach it
Green B b
to the application or if applicable, include in plan set & the sheet index.
Points Achieved: .
For hel , contact Build it Green at www.buildit2reen.or
iz
Revised 07/14/09
3