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13050214 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS:.19862 PEAR TREE LN CONTRACTOR:ONE DAY COMPLETE PERMIT NO: 13050214 REPIPE OWNER'S NAME: WU YE&YAN ZHANG 662 N 12TH ST DATE ISSUED:05/31/2013 OWNER'S PHONE: 4089229398 SAN JOSE,CA 95112 16 PHONE NO:(408)603-0554 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIP'T'ION: RESIDENTIAL� COMMERCIAL License Class(-J J Q Li,.0 — UNIT 1-COPPER E FROM METER THRU SFDWL ^ �Contracto Gam. I hereby affirm that 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. 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: ah 6 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 APN Number:31631011.00 Occupancy Ty permit is issued. APPLICANT CERTIFICATION I certify that I have read this application.and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN W DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAY R M LAST CALLED INSP C ION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Issued b Date: granting of this permit. Additionally,the applicant understands and will comply y' with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signator D"ate'• — 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 inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,or my employees withwages 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 HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor.Code,for the performance of the work for which this Owner or authorized agent Date. ,3� 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 CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my.plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date GENERAL PERMIT APPLICATION M E P ELI] COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 � CUPERTINO (408)777-3228•FAX(408)777-3333•building(a)cugertino.ora U misc 0 PLUMBING ❑MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS go OWNERNAME (p PHONE '✓ �E-MAIL STREET ADDRESS �^ ITY,STATE,ZIP , FAX Zq8 "I (Uo- m ,nto. C116 CONTACT NAME PHONE E-MAIL STREET RE CITY,STATE ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ONTRACTOR CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR AME ^ LIC E LICENSE TYPE BUS.LIC '/ I COMPANY NAME 1� E-MAIL FAX Z= D CITY,STATE, PHONE ^ aL S Lip 0 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# �/ COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑ YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF WORK ' V ` .\ TOTAL VALUATION. RECEIVE By my signature b ow, ce Tfy to each.of the following: I am the property owner or authorized agent to act dn roperty owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is acc te. I agree to comply with all applicable local ordinances and state laws relating to buil ' construction. I4uthorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date::,V / s 115PLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY W ❑ OVER-THE-COUNTER ❑ EXPRESS U ❑ STANDARD Uz a ❑ LARGE a ❑ MAJOR MEPMiscApp_2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION sa ADDRESS: 19862 Peartree In DATE: 05/31/2013 REVIEWED BY: MENDEZ APN: BP#: *VALUATION: $6,800 *PERMIT TYPE: Plumbing Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY Sor Du lex PENTAMATION 1 RPRP FD PERMIT TYPE: USE: p WORK COPPer re i e from meter thru sfdwl SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Re-Pipe Interior 1PRREPIPE 1 # $13 TOTALS: $13.00 tifech.Plan Check Plumb.Plan Check 0.0 hrs $0.00 Elec..Plan Check iLtech. Penrrit Fee: Plumb.Permit Fee: 1PPERMIT lilec. Permit Fee: Other•R9ech.lnsp. Other Plumb Insp. 0.0 hrs $45.00 Other EYec.Insp. Li a9ech. Insp.Fee: Plumb. Insp.Fee.: glee.Insp..h•ee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These fees are based on the prelimina information available and are only an estimate. Contact the Dept or addn'1 info, FEE ITEMS (Fee Resolution 11-053 E . 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: SUFp1. PC Fee PME Plan Check: $0.00 Permit Fee: Suppl.Insp Fee PME Unit Fee: $13.00 PME Permit Fee: $45.00 Construction Tax: Administrative Fee: IADMIN $42.00 Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fees` Travel Documentation Fee: ITRAVDOC $45.00 i Strong Motion Fee: IBSEISMICR $0.68 Select an Administrative Item B1da Stds Commission Fee: IBCBSC $1.00 $146.68 $0.00 $146.68 Revised: 04/29/2013 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 t JOB ADDRESS: PERMIT#!eaw LN ' OWNER'S NAME: PHONE# gKJ,. GENERAL CONTRACTOR: USINESS LICfiNSlE 12" ADDRESS:(p CITY/ZIPCODE *Our municipal code requires all businesses working in the citrto.;have a City 0 C pertu o=business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILI::