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10040081 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 5986 SUTTON PARK PL CONTRACTOR:TBD-TO BE DETERMINED PERMIT NO: 10040081 OWNER'S NAME: YUJUNG SHEN DATE ISSUED:04/13/2010 ER'S PHONE: 4085179875 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION f— �� - � BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# 6� `7 y�gh "aulo 4_"o MECH RESIDENTIAL COMMERCIAL Contractor � Date (//,t // D I hereby affirm that I am lic nsed under the provisions of Chapter 9 JOB DESCRIPTION:REMODEL ONE BATHROOM,FLOORING WITH (commencing with Section 7000)of Division 3 of the Business&Professions HARDWOOD,PAINTING 3 ROOMS&INSTALL Code and that my license is in full force and effect. LIGHTING(40SQ)NO RE-ROOF&NO STRUCTURAL 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 Sq.Ft Floor Area: Valuation:$8000 permit is issued. APPLICANT CERTIFICATION APN Number:37535027.00 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 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, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additi pally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source re ations pe the Cupertino Municipal Code,Section 9.18. > (� � j (J Issued by: '� Date: Signature Date G OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of 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, Business&Professions Code) Signature of Applicant: Date: 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 Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. 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 become subject to the Worker's Compensation provisions of the Labor Code,I must Owner or authori ed agent: forthwith comply with such provisions or this permit shall be deemed revoked. ��t ��, Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 1 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 work's correct. I agree to comply with all city and county ordinances and state laws relating 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 upon the above mentioned property for inspection purposes.(We)agree to save i, nify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address C and expenses which may accrue against said City in consequence of the granting of this permit.Addit5irially,the oplicant understands and will comply ARCHITECT'S DECLARATION with all nt source o p e upe unicipal Code,Section 9.18. I understand my plans shall be used as public records. Signature:; Date ( /?! lD Licensed Professional r CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 37535027. 00 DATE ISSUED. . . . . . . : 04/13/2010 RECEIPT # . . . . . . . . . BS000010169 REFERENCE ID # . . . : 10040081 SITE ADDRESS . . . . . : 5986 SUTTON PARK PL SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER YUJUNG SHEN ADDRESS 5986 SUTTON PARK PL CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-3531 RECEIVED FROM . . . . : ALLEN HAN CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096 COMPANY TBD - TO BE DETERMINED ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 8, 000 . 00 1 . 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 8, 000 . 00 0 . 80 0 .00 0 . 80 0 . 00 1REMRESBAT SQ FEET 40 . 00 570 . 00 0 . 00 570 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 571 . 80 0 . 00 571 . 80 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 571. 80 #1681 --------------- TOTAL RECEIPT 571 . 80 CITY OF CUPERTINO I--I-al�k__11 ADDITION/REMODEL CUPEkTINO PERMIT APPLICATION FORM _ _ Date: y/0 Is a 2"d unit being added? Yes ❑ No f yes,please fill out the permit application for 2" unit. Building Address: qf1612 4, a`jr it v C/" Mailing Address (if different from building address): [� Owner's Name: / Phone# (�I Contractor: Leh Qe n' ease C' Phone#: � c�. /�f�l�ii-► �� Fax#: Contractor License#: 3 G Cupertino Business License#: ->Y�k3� Contact: Phone#: �-- Fax #: Building Permit Info: Bldg. [�----" Elect. �-- Plumb. d Mech. F1 Hillside F-1 Job Description: Addition-What is being added?(Be Specific): What is being remodeled not including addition)? ,C 1'. 3 Remodel Includes Re-Roof. Yes ❑ No If yes list numblf squares Remodel Includes Structural: Yes ❑ No Do you have the pre-application planning approval? Yes ❑ No ❑ If yes, please provide a copy of your planning approval letter. Planners name: Square Footage: Addition: Porch: Deck: Garage: Detached Attached Remodel: Kitchen Bath (V=10 s`��Other Type of Construction (Usage Class): Occupancy Type: 1-A, I-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B 3 Valuationz ' pc o d ,--- Please check this box if the project is a second-story addition ❑ Project Size: Express [ tandard ❑ Large ❑ 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. ***For Office Use Only*** ElRevised 07.06/09 Over-the-Counter CITY OF CUPERTINO ADDITION/REMODEL CUPEfZTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft ADDITIONS 1R3SFDADD 1 PLLONGRNGR Long Range PL Planning/Residential 1R31NSP Dwellings Inspections B 1 R3PLNCK Dwellings plan check B 1R3REPINSP Dwellings Repeat B Inspection 1 R3REPPLNC Dwellings Repeat Plan B Check 1 R3HINSP Dwellings Hillside B inspect on 1R3HPLNCK Dwellings Hillside plan B check 1R3HREINSP Dwellings Hillside B Repeat Inspection 1R3HREPLNC Dwellings Hillside B Repeat Plan Check I R3ALTINSP Dwellings Alternate B Materials Inspection 1R3ALTPLNC Dwellings Alternate B Materials Plan Check 1 PCESS Cesspool P 1PPRSEWG Ea. Private Sewage P Disposal System 1 PRSEWER Sewers P 1 BPSPRINK Lawn Sprinkler/Backflow P 1 BPWSVCS Main Water Service P 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee I 1 BSEISMICRE SeismicResidential B 1REROOFRES Residential Re-roof Each B 100 SF CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft DECKS 1R3SFDADD OR 1R3SFDREM 1 DECKWOOD Deck (Wood)-Each B (Each) 1DECKRAIL Deck Railing-Each B (Each) GARAGES 1R3SFDADD OR DETACHED 1R3SFDREM 1 GARDTW<=1 K Wood Frame up to B 1,000 SF (each) I GARDTM<=I K Masonry up to 1,000 SF B (each) 1 BCONSTAXR Construction Tax Res (new detached garage) PATIO'S OPEN 1R3SFDADD OR 1R3SFDREM 1PATIOWOOD Wood Frame up to 300 B SF 1PATIOMETAL Metal Frame up to 300 B SF 1PATIOOTHER Other Frame up to 300 SF B PATIO'S CLOSED 1R3SFDADD OR & SUN ROOMS 1R3SFDREM 1 PATIOENCLW Enclosed Wood up to 300 B SF IPATIOENCLM Enclosed Metal up to 300 B SF 1PATIOENCLO Other Enclosed Patio up B to 300 SF I COVPORCH Porch Covered-Each B (Each) REMODELS 1R3SFDRE I 1 REMRESKIT Kitchen Remodel up to B (Deduct "$"for ea plan 300 SF check) 1 REMRESBAT Bath Remodel up to 300 B " �D SF IREMREOTH Other Remodel up to 300 B " SF M.Indoor Air Quality and Finishes 1.U96 i o NNO-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/b VOGAdhasww 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 0 0i1e ", 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 LO 0 1 1 1 N.Flooring 1.Select FSC Certified Wood Flooring 8 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 1 1 t Total Points Available: 1 1401 130 57 Total Points Project Received: v 1 01 0 0 G:data/pings/greenbuildngguidelines/remodelers/greenpointsfinal2.12.D4protected.xls IN AC:C()It1,A14, I RE CITY OF CUPERTINO 0,001 ANIS ORDINANCES DATE-- l b SIGNED X. This set of plans and specifications MUST be kept on the lob at all times and it is unlawful to make any changes or alterations on same without written permission from CL the Building Department, City of Cupertino. f The stamping of this plan and lDecifications SNALI NOT be held ro permit or to be an approval of the violation of any provisions Of any City Ordinance or State Law C) _ n TT N O W N cn SU Q COOD n5 � M � a o c cn 3 (D ,... Q0 O o v m O '0 CL s CD W n v CD o co' Cn D o � v SCC co CD X� C O 9 O Q o = C J •F T o C (D O n (, o CCD o CD ;v D SN \V n S A TO S N n ;v f N °w _ n� N 3 m m m o mho $ s0 v ;:W a - c o° � N_= 3 Q <D 0 Q Cr F fg i N O N .N. 90 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: PERMIT# 6e�L OWNER'S NAME: PHONE# ST' GENERAL CONTRAC R: P,ok ,ws v_ BUSINESS LICENSE# ADDRESS: U9 CITY/ZIPCODE: *Our municipal code requires all businesses working in 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 SUBCON TORS AVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: ' Signature Date Please check applicable subcontractors and complete the following information: &/ 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