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10070007 CITY OF CUPERTIPIO BUILDING PERMIT BUILDING ADDRESS: 1640 POPPY WAY CONTRACTOR:PAICHENG CHUANG PERMIT NO: 10070007 OWNER'S NAME: PAICHENG CHUANG 1640 POPPY WAY DATE ISSUED:07/01/2010 1ER'S PHONE: 4084166693 CUPERTINO,CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB License Class Lic.# MECH RESIDENTIAL COMMERCIAL Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:WINDOW REPLACEMENT (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:$10000 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. APN Number:36610103.00 Occupancy Type: APPLICANT CERTIFICATION 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 PERMIT EXPIRES IF WORK IS NOT STARTED to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION. costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Issued by• !-�� Date: 9.18. Signature Date RE-ROOFS: OWNER-BUILDER DECLARATION 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 I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: I,as owner of the property,or my employees with wages as their sole compensation. Signature of Applicant: Date: 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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). A ;-7 I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the permit is issued. Health&Safety Code,Sections 25505,25533,and 25534. 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 ? Owner or authorized agent: Compensation laws of California. If,after making this certificate of exemption,I .--� �'Date: 7 become subject to the Worker's Compensation provisions of the Labor Code,I muse forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.) I certify that I have read this application and state that the above information is Lender's Name correct.I agree to comply with all city and county ordinances and state laws relatinl to building construction,and hereby authorize representatives of this city to enter Lender's Address upon the above mentioned property for inspection purposes.(We)agree to save unify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Licensed Professional r Signature Date - CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: I DATE: REVIEWED BY: APN: I BP#: *VALUATION: $0 *PERMIT TYPE: Building Permit PL AN CHECK TYPE: Alteration /Addition/ Repair PRIMARY SFD or Du lex „_ APPLICATION USE. P 0 ;;?/: �. TYPE: MECHANICAL Q Yes (E) No PLUMBING 0 Yes Q No ELECTRICAL Q Yes Q No xw � a OO 3U OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. ;; .ft. R-3 (Custom) II-B,111-B,IV,V-B 0 $0.00 $0.00 TOTALS: 0 $0.00 $0.00 NOTE: These fees are based on the preliminary in ormatior available and are only an estimate. Contact the Dept for addh 7 info. FEE ITEMS (Fee Resolution 09-051 Eff.' 7%7/09) FEE QTY/FEE MISC ITEMS Plan Check Fee: :;0.00 15 # Window/Sliding Glass Door Suppl. PC Fee: (E) Reg. 0 OT0.0 hrs :;0.00 $760.00 1WINREP Replacement PME Plan Check: 50.00 Permit Fee: 50.00 Suppl. Insp. Feer Reg. 0 OT 0.0 hrs :>0.00 PME Unit Fee: 30.00 PME Permit Fee: 50.00 r. Acoustical Fee: 0 Yes Q No $0.00 Work Without Permit? Q Yes (E) No 60.00 E) Planning Fee: 60.00 Select a Non-Residential 0 Building or Structure o Strom Motion l=ee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $760.00 TOTAL FEE: 1 $760.00 Revised: 5/27/2010 CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 3E610103 .00 DATE ISSUED. . . . . . . : 0; /01/2010 RECEIPT #. . . . . . . . . : BE000010752 REFERENCE ID # . . . : 1( 070007 SITE ADDRESS . . . . . : 1F40 POPPY WAY SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : PlICHENG CHUANG ADDRESS . . . . . . . . . . : 16140 POPPY WAY CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : PlJ CHENG CHUANG CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : PRICHENG CHUANG ADDRESS . . . . . . . . . . : 1640 POPPY WAY CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE . . . . . . . . . FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----------- ---------- ---------- ---------- 1BCBSC VALUATION 10, 000. 00 1. 00 0 .00 1. 00 0 . 00 1WINREP EACH 8 15. 00 506 . 00 0 . 00 506 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 507 . 00 0 . 00 507 . 00 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 507 . 00 VISA --------------- TOTAL RECEIPT 507 . 00 fTY OF CITY OF CUPERTINO ADDITION/REMODEL CUPERTINO PERMIT APPLICATION FORM APN# _� L6; —(C)_ I p 3 Date: Is a 2" unit being added? Yes No N If yes,please fill out the permit application for 2° unit. Building Address: I 6-q D POPPY Gt,V , (,tcr er0h 0 , CA q,�0 Mailing Address (if different from building address): Owner's Name:-pa # : �aIr_ ►eu- C A a a n Llde- z�16693 Contractor: Phone#: 4-o8 - j/ 8 —4 Y 8 ��1�b�>' Cv��, Fax#: _ Contractor License#: Cupertino Business License#: Contact: Phone#: llo -4l6— 6 E`l3 Pa i C7 e C ��( n Fax#: t-�v - 5/c7 - k' Building Permit Info: Bldg. � Elect. ❑ Plumb. [] Mech. ❑ Hillside ❑ Job Description: Addition-What is being added?(Be Specific): What is being remodeled (not including addition)? W111dew rep lace ww -f- Remodel Includes Re-Roof: Yes ❑ No If yes list number of squares Remodel Includes Structural: Yes ❑ No �1 Do you have the pre-application planning ap oroval? Yes ❑ No ( ] If yes,please provide a copy of your planninA,,approval letter. Planners name: Square Footage: Addition: Porch: Deck: Garage: Detached Attached Remodel: Kitchen Bath Other Type of Construction(Usage Class): Occupancy Type: I-A, 1-B ❑ IUIII/V-A ❑ II/VI B,IV-HT, NY-B CWNer UCS Valuation: ��,a v; Please check this box if the project is a second-story addition ❑ Project Size: Ex ress ❑ Standard❑ Lar e ❑ Major❑ 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. (2�7 ***For Office Use Only*** ElRevised 07/06/09 Over-the-Counter CfTY Of CITY OF CUPERTINO 19 ADDITOPUREMODEL CUPERTIV40 FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft 1REMRES2 Remodel Resic.ential B Greater than 1000 sq ft 1REMRES3 Remodel Residential B Greater than 2'+00 sq ft. 1REROOFRES Residential Re-roof Each B 100 SF REMODEL PLNCK ISTPLNCK(1-3 for Standard Pl<m Check B NOT FOR OVER THE remodel) COUNTER PLAN CKS. WINDOW/SLIDING 1R3SFDREM GLASS DOOR 1 WINREP Replacement windows B ea 8 windows) f I WINNEWNSTR New Window (non- B structural 1 WINMEWSTR New Window (Structural B Shear Wall/Masonry) 1 WINBAYSTR Bay Window(Structural) B SKYLIGHTS 1R3SFDREM 1 SKYL<10 SF Skylight less t ian 10 sf B 1SKYL>10SF Skylight great;rthan 10 B sf or structura 1STAIRS Stairs-first flight/ea addt'1 B IEPERMITFEE Electrical Pennit Fee E IMPERMTTFEE Mechanical P,;rmit Fee M 1 PPERMITFEE Plumbing Per nit Fee P IELCPLNCK Stand Alone Electric Pln E Ck(hourly) CITY of CITY OF CUPERTINO ADDITOPUREMODEL CUPERTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft 1MECPLNCK Stand Alone Vechanical M Pln Ck(hourly 1 PLMPLNCK Stand Alone P umbing P Pln Ck hourly) I BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Resid,;ntial B 1 TRAVDOC Travel & Documentation B 1BUSLIC Business License B - ream Z �- rn C3> ° Z m Z Z o5.,) u I i CZ> � az r �, i I v- C N : 0CP 3j � � �. � � O to m �i yl 03 a � XO 0 - - - -- - v x ( - {` ml b Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST v v JOB ADDRESS: D�P v PERMIT# _ OWNER'S NAMPHONE G EN ERAL CONTRACTOR: 12 -A)q �,i -A)r ti. BUSINESS LICENSE# ADDRESS: -� 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 SUBCONTEACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Date Sinnature Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINE SS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/ Carpeting Linoleum/Wood Glass / Glazing >6s�r-s Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile --7 Date O/Contractor Signature