09070173CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1151 SSTELLING RD
E,R'S NAME: JOANNE PARK
OWNER'S PHONE: 4088737019
❑ LICENSED CONTRACTOR'S
/DECLARATION
S License Class Lic. # T
Contractor AA 6zn 0hU C,_ Date�Z 7
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
1 hereby affirm under penalty of perjury one of the following two declarations:
1 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.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. 1 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,
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
9.18. /1 ._
❑ OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for one of
the following two reasons:
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,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
1 hereby affirm under penalty of perjury one of the following three
declarations:
1 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.
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
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
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
1 certify that 1 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 ' ;ng construction, and hereby authorize representatives of this city to enter
ul_ : above mentioned property for inspection purposes. (We) agree to save
inacnmify and keep harmless the City of Cupertino against liabilities, judgments,
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
9.18.
Signature Date
CONTRACTOR: BB CONSTRUCTION PERMIT NO: 09070173
1535 ROSS AVE #105B DATE ISSUED: 07/27/2009
iAN JOSE, CA 95124 PHONE NO: (408)266-6266
BUILDING PERMIT INFO: BLDG ELECT I— PLUMB
MECH r— RESIDENTIAL r COMMERCIAL I-
1OB DESCRIPTION: REVISION, REVISE ENG. DETAIL 10/S2-I,ADD
DETAIL
l/S2-1 & 2/S2.2 & RE -SIZE LIVING ROOM WINDOW
iq. Ft Floor Area: Valuation: $0
kPN Number: 36222016.00 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM L CALLED INSPECTION.
Issued by: C Date:
loor
RE -ROOFS:
%II roofs shall be inspected prior to any roofing material being installed. If a roof is
nstalled without first obtaining an inspection, I agree to remove all new materials for
nspection.
signature of Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
iafety Code, Section 25532(a) should I store or handle hazardous material.
%dditionally, should I use equipment or devices which emit hazardous air
:ontaminants as defined by the Bay Area Air Quality Management District I will
naintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Iealth & Safety Code, Sections 25505, 25533, and 25534.
Jwner or a&I or' g n0.
Date:
1 /09
CONSTRUCTION LENDING AGENCY
hereby affirm that there is a construction lending agency for the performance of work's
or which this permit is issued (Sec. 3097, Civ C.)
.lender's Name
lender's Address
ARCHITECT'S DECLARATION
understand my plans shall be used as public records.
Acensed Professiona
File Edit Actions Details Links Favorites Help
f �.1� •_�' Cr.`Glib c'e 7—..tr�`', .i'
Permit Number09070173
Status " C - Closed
Zoning Applicant
Master Number
IQI Notes
Project
Apply Date " 07/27/2009
Operator
Permit Issue Date 07/27/2009
Operator
Certificate Issued
Operator
Certificate Type
II/III B.
Certificate Number
Address" 1151 S STELLING RD
City/State/Zip CUPERTINO
0 APN 36222016.00
IQI Unit
patg
patg (Owner Name'I JOANNE PARK
Use Default
Address Home -1151 S STELLING RD
Permit ' Property
Zoning Applicant
Contractor " Defined Fields
Permit Details
Permit Type
1R3SFDADD
IQI
SINGLE FAMILY DWELLING
ADDITIO
Usage Class "
II/III B.
IQI
II/III B, IV-HT,V-B NEW
Applied Value "
0
SQUARE FT.
0
Calculated Value
01,21
US C-404 Type
434
IQI
ALT: RESIDENTIAL
Permit Form'
AUTOPERM -PERMIT
Ownership
1 -Private
Project Size
COUNTER - OVER THE COUNTER
Permit issued 0712712009
FnF.r Fha ni irnnca nr Anv cnarW rnnHihinnc Fnr Fhic narmiF
City/State/Zip CUPERTINO
CA 95014
CA 95014
Purpose/Special Conditions
REVISION, REVISE ENG. DETAIL 10/S2-1,ADD DETAIL
1/S2-1 6 2/S2-2 6 RE—SIZE LISTING ROOM idINDOLI;ORIG
#09040061—HOSTED PRIVACY PROTECTION HOLD TO ORIG
PERMIT #09040061
SCANNED/FILMED 8/20111
N1
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1 151 S STELLING RD
CONTRACTOR: BB CONSTRUCTION
PERMIT NO: 09070173
OWNER'S NAME: JOANNE PARK
3535 ROSS AVE #105B
DATE ISSUED: 07/27/2009
OWNER'S PHONE: 4088737019
SAN JOSE, CA 95124
PHONE NO: (408)266-6266
❑ LICENSED CONTRACTOR'S DECLARATION
r— r,
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class rj Lic. # f � 67 S3—/
� I �
MECH RESIDENTIAL COMMERCIAL
Contractor Date 7Z7
I hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: REVISION, REVISE ENG. DETAIL 10/S2-I,ADD
(commencing with Section 7000) of Division 3 of the Business & Professions
DETAIL
Code and that my license is in full force and effect.
1/S2-1 & 21S2.2 & RE-SIZE LIVING ROOM WINDOW
I hereby affirm under penalty of perjury one of the following two declarations:
1 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: $0
1 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: 36222016.00
Occupancy Type:
APPLICANT CERTIFICATION
1 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 L CALLED INSPECTION.
granting of this permit. Additionally, the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code, Section
9.18.
Issued by:C Date:
Signature Date 2-714
, 2 0
❑ OWNER-BUILDER DECLARATION
RE-ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
hereby affirm that I am exempt from the Contractor's License Law for one of
installed without first obtaining an inspection, 1 agree to remove all new materials for
the following two reasons:
inspection.
1, 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
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. 1 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 1 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
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
Owner or
become subject to the Worker's Compensation provisions of the Labor Code, I must
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, 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.
Licensed Professional
Signature Date
CITY OF
CUPEVINO
CITY OF CUPERTINO
REVISION/DEFERRED
PERMIT APPLICATION FORM
0go7ot-73
APN #
Date:
Original Permit #:
Building Address:
l�S! 5. S re- CL i6Li KD
Mailing Address (if different from building address):
Owner's Name:
Phone #:
To
Contractor:
Phone:
UYI S�YIit C� lln
Fax: '.
Contractor License #:
Cupertino Business License #:
Contact:
Phone:
J b G1,wl Q Pa,',k
Fax:
Building Permit Info:
Bldg Elect ❑ Plumb ❑ Mech ❑
Residential ❑ Commercial ❑
Job Description:
�Vqts.% �+�'Tb�- u/52 -f
/�
b � e9&fA-d- .11S2.1 f 2K'2=Z
Sl� he L.-\°Vw4 V--44.* ln(IIJ1�6�
Is the project in the Wildland- Urban Interface Fire Area? Yes ❑ No ❑
Type of Construction (Usage Class):
* Occupancy Type:
1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV -HT, V -B ❑
Valuation (cost of project):
Project Size: Express ❑ Standard ❑ 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 www.builditp_reen.org
Revised 01/07/09
CITY OF CUPERTINO
CUPEf OFINO REVISION/DEFERRED
PERMIT APPLICATION FORM
FEE SCHEDULE
Quantity
Sq Ft
Fee ID
Fee Description
Fee Group
Permit Type
1
113CBSC
Cal Bldg Standards Commission
Fee
B
ALL PERMIT
TYPES
1REVCOMNEW
Revision Commercial New
B
1*
1REVCOMTI
Revision Tenant Improvement
B
1* TI
1REVSFDWL
Revision SFDWL
B
1R3SFDW
1REVRESADD
Revision Addition
B
1R3SFDADD
1REVRESREM
Revision Remodel
B
1R3SFDREM
1DEFINSP
Deferred Submittal not R-3
Inspection
B
IDS
1DEFPLNCK
Deferred Submittal not R-3 Plan
Check
B
IDS
1DEFR3INSP
Deferred Submittal Inspection
I y
B
1DSR3
1DEFR3PLNCK
Deferred Submittal R-3 Plan Chk
B
1DSR3