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10070039 CITY OF CUPERTIP40 BUILDING PERMIT BUILDING ADDRESS: 10641 CASTINE AVE CONTRACTOR: r„S.T:n uF nFTERMINED PERMIT NO: 10070039 OWNER'S NAME: JOHN&KAREN CHENGL. 0i J,� DATE ISSUED:07/06/2010 JER'S PHONE: 4084604476 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# CJ � " ��d�� rCL� MECH RESIDENTIAL COMMERCIAL Contractor o �' (�7-i4bate — I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: REMOVE PLYWOOD SIDING&ADD FACIA,STUCCO (commencing with Section 7000)of Division 3 of the Business&Professions FRONT Code and that my license is in full force and effect. HOME,450SQ 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 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. K—Y Sq.Ft Floor Area: Valuation:$3500 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:32643026.00 Occupancy Type: 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the granting ofthis permit dditionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non point ur a regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. / Signature Date ! Issued bDate: C OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS: the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date: construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& 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 I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534. become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner au or' d a en _ Date: U APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of work's to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.) upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name _nnify and keep harmless the City of Cupertino against liabilities,judgments, ,and expenses which may accrue against said City in consequence of the Lender's Address granting 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 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO FEE ESTIMATOR-- BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: *VALUATION: Iso PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Restucco PRIMARY RESTUCC'O APPLICATION USE: SFD or Duplex WALL AF:EA: =S.f. TYPE: 1 R3SFDADD/REM as O 0 3 � FEE ID 1STU,:OAPP F-1 I T7 I T-1 _ 77 7, 7;- NOTE: Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'1 info, FEE ITEMS (Fee Resolution 09-051 Ff1' "1/09) FEE QTY/FEE MISC ITEMS Permit Fee: $475.00 Work Without Permit? Q Yes 0 No $0.00 Strom Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $475.00 $0.00J TOTAL FEE: $475.00 Revised: 6/30/2010 CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Bl:c: Lot: APN . . . . . . . . : 32343026 . 00 DATE ISSUED. . . . . . . : 07 /06/2010 RECEIPT #. . . . . . . . . : BS )00010780 REFERENCE ID # . . . : 10 )70039 SITE ADDRESS . . . . . : 10,541 CASTINE AVE SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : JOHN & KAREN CHENG ADDRESS . . . . . . . . . . : 10,5341 CASTINE AVE CITY/STATE/ZIP . . . : CUERTINO, CA 95014 RECEIVED FROM . . . . : RICHARD P CADET CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096 COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . FEE ID UNIT QUANTITYAMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- - --------- ---------- ---------- ---------- 1BCBSC VALUATION 3, 500. 00 1 .00 0 . 00 1 . 00 0 . 00 1STUCOAPP SQ FEET 450 . 00 475 .00 0 . 00 475. 00 0 . 00 - --------- ---------- ---------- ---------- TOTAL PERMIT 476 .00 0. 00 476 . 00 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 476 . 00 VISA --------------- TOTAL RECEIPT 476 . 00 CITY OF ('UPERTINO CITY OF CUPEkTINO GENERAL BUILDING PERMIT APPLICATION FORM APN # Date: ;��6 4 (� , -i C) Building Address: Mailing Address (if different from building address): Are Hazardous Materials being used as part of thi,; project? Yes No 91 HOA: (Exterior work only) Yes ❑ No If;yes, provide letter from HOA Owner's Name: //�� Phone#: tt)t ,3v l��Y.yJ &r-k- 41- C7 O iq'7& Contractor: Phone: da tlr Fax: S3/ Contractor License#: Cupertino Business License#: �J Contact: Phone: Fax: Residential Commercial ❑ Job Description: gen'--ova mat,,. 400,4P Building Permit Info: Bldg �- Elect ❑ Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ I1/111 V-A ❑ IUIII B, IV-HT, V-13 12 ''3 Valuation: Square Footage: Project Size: Express Ej---Sfandard ❑ Large [] Major ❑ Green Building: Please complete relevant portion of the Green Building/LEED Checklist& attach it to the application or if applicable, include in plan set& the sheet index. Points Achieved: For help, contact Build it Green at en.orst Revised 07/14/09 CITY OF CUPERTINO C U CITY OF O GENERAL BUILDING APPLICATION FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM 1STUCOAP Stucco Applications (up to 400 sf) B Cf v additional stucco application 1 WINREP Replacement windows/sliding glass B door (ea ,3 windows) 1 WINMEWSTR New Window-structural shear B wall/mast nry (includes plan ck fee) 1 EPERMITFEE Electrical Permit Fee E IMPERMITFEE Mechanical Permit Fee M 1PPERMITFEE Plumbing Permit Fee P 1 ELCPLNCK Stand Alone Electric Pln Ck(hourly) E 1 MECPLNCK Stand Alone Mechanical Pln Ck(hrly) M 1PLMBLNCK Stand Alone Plumbing Pln Ck(hrly) P 1 STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B when not over counter) hourly-stand alone / 1BCBSC Cal Bldg ;standards Commission Fee B ALL PERMIT TYPES 1BSEISMICR Seismic Residential B 1BSEISMICO Seismic Commercial B 1 TR.AVDOC Travel & Documentation B 1BUSLIC Business :.icense B of 5 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: 5 i�`w 1�5�� PERMIT# OWNER'S NAME: -Y0htJ Cj ljp.,� PHONE# GENERAL CONTRACTOR: 6ae- Caj r-r rc r' BUSINESS LICENSE # ADDRESS: I CITY/ZIPCODE: *Our municipal code requires all businesses working it 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 SUBCONTVACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/Glazing Heating Insulation Landscaping Lathing V E-I Ee�,d "c60) Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contracto Signature Date