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10070047
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10281 WESTACRES DR CONTRACTOR:TRI ELECTRIC PERMIT NO: 10070047 OWNER'S NAME: CHAROEN AND WINNIE KOSOLCHAROEN 1606 100TH AVE DATE ISSUED:07/06/2010 .BER'S PHONE: 4082578954 OAKLAND,CA 94603 PHONE NO:(408)394-8972 ❑ LICENSED CONTRACTOR'S DECLARATIONr r� BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class C^#'O Lie.# r Z13 MECH r— RESIDENTIAL I— COMMERCIAL r Contractor4��cLJ Date(l 7 Z' I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:KITCHEN LIGHTS,OUTLETS,SWITCHES&200 AMP SVC (commencing with Section 7000)of Division 3 of the Business&Professions UPGRADE 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 Sq.Ft Floor Area: Valuation:$6000 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:35911035.00 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 to building construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save 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 180 DAYS FROM LAST CALLED INSPECTION. granting of this permit. Additionally,the ap lifrtino t understands and will comply with all non-point source regulation per th Municipal Code,Section 9.18. / Issued b ^l _� -Z Date: Signature ' Dates° T r� u OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. 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, Signature of Applicant: Date: Business&Professions Code) 1,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 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 contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. 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 Owne or autho ' ed agent: become subject to the Worker's Compensation provisions of the Labor Code,I in t t4„ Date: forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address unify and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date CITY OF CUPERTINO ADDITIOw/REMODEL CUPERTINO FEE SCHEDULE APN# ;, _ Date: Is a 2nd unit being added? Yes ❑ No es, lease fill out the permit application for 2nd unit. Building Address: Mailing Address (if different from building address): Ownis Name: Phone# : .. Contractor: Phone#: wee, Fax Fax#: Cupertino Business License: 2)2212 1 State Contractor Licen 4// ?12 ' Contact, Phone#: ao-Fz_ r Fax#: Landscape Ordinance Compliance: Landscape area in sq. ft. (includes all irrigated ar 3as): - 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 F roject Submittal is required. Compliance Method: ❑ Plant Type ] Water Budget Building P�erm Info: Bldg. L�? Elect. Plumb. [ Mech. ❑ Hillside ❑ Job Description: Addition-What is being added?(Be Specific): What is being remodeled(not including,addition)? /2,OV (2#,.Q Remodel Includes Re-Roof: Yes ❑ No If yes list number of squares Remodel Includes Structural: Yes ❑ No �r Do you have the pre-application planning approval? Yes ❑ No i,T If yes, please provide a copy of your planning approval letter. Planners name: Square Footage: Addition: Porch: Deck: _ � Garage: DetachedAttached_ Remodel: Kitchen eO Bath Other >'F ' Type of Construction(Usage Class): Occupancy Type: 1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B Valuation: 6. eno .*'`' Please check t1is box if the project is a Project Size: Express bard ❑ Large ❑ Major ❑ second-story addition ❑ Please complete relevant portion of the Green Building Checklist& attach it to the application or if applicable, Green Building Points Ached: include in plan set& the sheet index. Revised 05/18/10 M.Indoor Air Quality and Finishes 1.Use Low/No-VOC Paint 1 IAQ/Health pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 3.Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes 0 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y--yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Health pts y=yes 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0 7.Seal all Exposed Particleboard or MDF 4 IAQ/Health. pts y=yes 0 8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0 10.Install Whole House Vacuum System 3 IAQ/Health pts y--yes 0 N.Flooring 1.Select FSC Certified Wood Flooring B Resource pts y--yes 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pts y--yes 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 'total Points Available:1 1 1401 130 57 Total Points Project Received: 01 01 0 a/progs/grc anbuildingguidelines/remodelers/greenpointsfinat2.12.o4protected.xls CITY OF CUPERTINO 5 ITEMS OF 6 PERMIT' RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Bl{: Lot : APN 35911035. 00 DATE ISSUED. . . . . . . : 07/06/2010 RECEIPT #. . . . . . . . . : BSDO0010789 REFERENCE ID # . . . : 10)70047 SITE ADDRESS . . . . . : 10281 WESTACRES DR SUBDIVISION . . . . . . CITY CU?ERT INO IMPACT AREA . . . . . . OWNER CKkROEN AND WINNIE KOSOLCHAROE ADDRESS 20507 PARADISE DR CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4063 RECEIVED FROM . . . . : JOSE TRINIDAD CONTRACTOR . . . . . . . : JOSE TRIUIDAD LIC # 27277 COMPANY TR: ELECTRIC ADDRESS . . . . . . . . . . : 1606 100TH AVE CITY/STATE/ZIP . . . : OAK.LAND, CA 94603 TELEPHONE (408) 394-8972 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----------- ---------- ---------- ---------- 1BCBSC VALUATION 6, 000 . 00 1 .00 0. 00 1. 00 0 . 00 1EPERMITFE FLAT RATE 1. 00 42 . 00 0 . 00 42 . 00 0 . 00 1ERT<200 UNITS 1. 00 42 . 00 0 . 00 42 . 00 0 . 00 1REMRESKIT SQ FEET 1 . 00 570 . 00 0. 00 570. 00 0 . 00 1TRAVDOC FLAT RATE 1. 00 42 . 00 0 . 00 42 . 00 0 . 00 -- -------- ---------- ---------- ---------- TOTAL PERMIT 697 . 00 0. 00 697. 00 0 . 00 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: *VALUATION: Iso FPERMIT TYPE: Building Permit PLikN CHECK TYPE: Alteration /Addition / Repair PRIMARY SFD or Duplex OVER TF.E APPLICATION 1 R3SFDADD/REM USE: COUNTER Q Yes E) No TYPE: MECHANICAL Q Yes Q No PLUMBING 0 Yes (F) No TELECTRICAL 0 Yes (E)No as cc 3 � OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s. .ft. R-3 (Custom) II-B,111-B,IV,V-B 0 $0.00 $0.00 TOTALS: 0 $0.00 $0.00 NOTE: Thesefees are based on the preliminary information cvailable and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 29-051 E'ff 7,'1%09) FEE QTY/FEE MISC ITEMS Plan Check Fee: $C.00 F 180 1 s.f. Remodel, Kitchen(<=300 sf) Suppl. PC Fee: E) Reg. 0 OT 0.0 hrs $C.00 $570.00 IREMRESKIT PME Plan Check: $C.00 200 amps Electrical Permit Fee: $C.00 $42.00 IERT<200 Temporary Power Suppl. Insp. Feer Reg. 0 OT0.0 hrs $C.00 PME Unit Fee: $C.00 PME Permit Fee: $42.00 Acoustical Fee: Q Yes Q No $0.00 0 Work Without Permit? Q Yes (E) No $0.00 1 E) Plannin�e: $0.00 Select a Non-Residential Q Travel Documentation Fee: ITRA VDOC $42.00 Building or Structure 0 Strong, Motion Fee: $0.00 Select an Administrative Item Bldg= Stds Commission Fee: $0.00 SUBTOTALS: $84.00 $612.00 TOTAL FEE: $696.00 Revised: 6/30/2010 RESIDENTIAL PROTECT COVER SHEET Assessor's Parcel Number:/ Name of owner. O scq/G Lec-o� Project address. A2 vz� � w �(/��✓ � Contact person. fUS� _ _Phcne. D� Fax. Net square footage of lot. Existing Pro-posed Square footage: First floor: _ Second floor: �- Garage: TOTAL: Are there at least two 10 foot by 20 foot clear spaces ins:de the garage? Y�'I Is privacy protection planting required for the project? Y� 3uild it Green Total Points On what floor(s) is work being done? _ r w ter, Brief description of work. Code editions:2007 CBC (�JDN)2007 CFC -N)2007 CMC (Y-N) 2007 CPC (Y-N)2007 NEC >N) Effective 1/1/08 APPRWiTH�.HE CITY OF GODk`,AN[�7RDINANCES IN ACCORDAN�t CUPS RTINO DATE ) �— SI GN �t�cat�ons MUST P1 and 5pe mes and it is � - This set of P t>at al t �A. f be kept on the 10 es 0r alterations ul to make at`Y ',;h`s Termission trom1. unlawt t�ntte� P Rino. me Withou t ,�t Cupe on same �n yy ,hc,at�ons the ;en Building De „ The stamping 0�th5 N rmit or to t an NOT bt'herl to Pe ,vs0ns Sl TALL t it V10`c1t l( I )t a t ite�aY� 'w approval CRv i xdinu "' of anY Plan Review Process Work Book Page-8-Revised 8/05/08 m N L1. m3.r 311".. _.___.. __ 33" 33" 1 z rr <� 0 , - 21". _ . _..____. _ ---.—.—.117"_..------------------- -------- y i to cr o N• A 7 p, _ I.L F -- O 0t-fjq cp ' Teel- O W al Citi h W3 �r 0 W3340 ,. W362224 O W Cti Ca fl _. - N w ; M03194 B24 ' BBC42R m A -- CD 0 SoW _...... _ .a I W cr -j A N N ..... _._... N CA Wcm 71 w 0 0£eS _ OdZW9 fA CD -- -_ CL A' tv .� •� -� 0 _ f � 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: 10 .2,-g 0 We-3-7&r- C-c PERMIT# OWNER'S NAME: / PHONE # GENERAL CONTRACTOR: G�`� BUSINESS LICENSE# 2 Z7 ADDRESS: �jo� 0- ©Aec lti CITY/ZIPCODE: 9Y 6r>-;? *Our municipal code requires all businesses working ire 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 SUB ONTI:ACTO HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. 1 am not using any subcontractors: Si gnature 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 Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date