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13070020 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11551 LAKE SPRING CT CONTRACTOR:KUANG'S PERMIT NO: 13070020 CONSTRUCTION CO OWNER'S NAME: CHOU WILLIAM T HUA ET AL PO BOX 4802 DATE ISSUED:07/03/2013 OWNER'S PHONE: 4082181684 ELDORADO HILLS,CA 95762 PHONE NO:(916)941-2378 Q5 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIALE] License Class Lie.# 7 © 112 REMODEL(E)KITCHEN(110 S.F.).INSTALL RECESSED LIGHT FIXTURES IN BEDROOMS&FAMILY RM Contractor (MAXIMUM OF I hereby affirm that I am licensed under the provisions of Chapter 9 25 LIGHT FIXTURES) (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:$8000 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:36654022.00 Occupancy Type: 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 WITBIN 180 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 DA L CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of ther� granting of this permit. Additionally,the applicant understands and will compl Date: 13 with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date_7��_ 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 I hereby affirm that I am exempt from,the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 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 rqunicipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,255 3,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date:' 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 CONSTRUCTION LENDING AGENCY 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 CONSTRUCTION PERMIT APPLICATION V- COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION h� 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 �L�J.J CUf?1= tTCt�tO (408)777-3228• FAX(408)777-3333•building(a.cupertino.org \_! ❑NEW CONSTRUCTION ❑ ADDITION ❑ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS ��7/ f � APN# OWNER NAME IL I LL Off//�� P O�� �S 1�$ E-MAIL �J STREET ADDRESSv (� CTTY, STATE,ZIP FAX ti ( ... CONTACT NAME /4J � "'' ' PHONEJ/ - -b?4-360k E-MAIL GL �� STREET ADDRESS I� ��� CITY,STATE,ZIP �v /-7 FAX ❑ OWNER ❑ OAINER-BUILDER ❑ OWNERAGENT I CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHiTECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME \/�,J"f LICENSENUMBER7� n LICENSF�TYPE BUS.LIC# COMPANY NAME T f/^ �� _ ,,���,• EMAIL f ,, Lj Gam`� �/��` FAX STREET ADDRESS,-r::,,O a .tet �X(�©� CITY,STATE,ZIP(5` tT/ILT i Z PHONE 'P ARCHITECT/ENGINEER NAME 'Jr+ !�(� LICENSE NUI SER L (� BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WO s . ZS M EXISTING USE PROPOSED USE CONSTR TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER . REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA I GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS ASECOND UNrr []YES SECOND STORY ❑YES BEING ADDED? []NO ADDrr1ON? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES ETREC �' Rot � -- OT ALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LEITER EICHLER HOME? ❑NO v* - - l By my signature below,I certify to each of the following: I am the property owner or authorized agent to act o t property owner's behalf. �al.lap read this application and the information I have provided is Corr t. I h ve read the Description of Work and verify it is accurate. I agree to comply witp' ble local ordinances and state laws relating to buil ng cons ti uthorize resentatives of Cupertino to enter the above-identified pro for ition pure Signature of Applicant/Agent: Date: SUPPLEMENTAL TION R.EQU ll = k P1 t1N CHECKfiYPE n � ItOUTI1IGSLIg _New SFD or Multifamily dwellings: Apply for demolition permit for tON I]-0VE;2 THE COUM1�ER � !k BUILDM FLAIXRE\IESi existing building(s). Demolition permit is required prior to issuance of building € a permit for new building. k©Rm ss, y PLAI,^,l G zAl� t>�3Ew _Commercial Bldgs: Provide a completed HazarWX dous Materials Disclosure ,L s N. L3 r� cwoRxs � ME form if any Hazardous Materials are being used as part of this project. rr _ Copy of Planning Approval Letter or Meeting with Planning prior to � � a submittal of Building Permit application. MAOR t sA�"IxAxY sxDisTxrex�f M1 �_��.Via , '�"�F•�� � �.�, -� ��k� -��'���"' �� � - BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 11551 LAKE SPRING CT DATE: 07/03/2013 REVIEWED BY: MELISSA APN: 366 54 022 BP#: *VALUATION: 1$8,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Du lex PENTAMATION 1R3SFDREM USE: p PERMIT TYPE: WORK REMODEL E KITCHEN 110 S.F. . INSTALL RECESSED LIGHT FIXTURES IN BEDROOMS & SCOPE FAMILY RM (25 FIXTURES) Xlech. Plan Check Plumb.Plan Check Elec.Plan Check 0.0 hrs $0.00 Vlech. Permit Fee: Plumb.Permit Fee: Elec.Permit Fee: IEPERMIT FI,,h. ;Much.Insp. Other Plumb Imp. Li l G Other Elec.Insp. 0.0 hrs $45.00 In.sp. Ft e: Plumb. lisp.Fee: Etee.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(i.a Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). ThesejW are based on the relimina information available and are onlyan estimate- Contact the Det or addn'1 in o. FEE ITEMS (Fee Resolution 11-053 E . 711/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 110 s.f. Remodel,Kitchen(<=300 s� Suppl. PC Fee: (F) Reg. ® OT FO.0 bus $0.00 $626.00 IREMRESKIT PME Plan Check: $0.00 F-2-5771 Electrical Permit Fee: $0.00 $100.00 IBREw= Fixtures,Lighting Suppl. Insp.Fee-.0 Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $45.00 ( Onstruction Tax: Administrative Fee: IADMIN $42.00 Work Without Permit? ® Yes (E) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential Travel Documentation Fee: ITRAVD0C $45.00 Building or Structure i Strong Motion Fee: IBSEISMICR $0.80 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 _ j $859.80 $133.80 $726.00 a ��� Q �2evised: 07/01/2013 Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 L31 Telephone: 408-777-3228 C U P E RT I N O Fax:408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# 3 b U2v OWNER'S NAME: ON PHONE# l — 6 v GENERAL CONT CTOR: BUSINESS LICENSE#` ADDRESS: D 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 ZALL;SUBCO TRACTORS HAVE OBTAINED CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information.- ; V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork x, 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 - r - -- 19 �^7 V COMMUNiTY:DEvELGPMENT b(PARTMENT BUILDINGfltVFSION--GH . TINO.. - APPRCIV - - __ This set of plans and specific4tions MUST be kept at the job situ during con struction.'!It is unlawful to make any - - - - c,Znges or alteratior -o -sbrn6 or to-deviate there`rrom,withoutt-ap�rovaffrom-tl a Building - iclaL _ The f' nping of this plan andlspeci#, atioOT - - - - - _ b:.hal to permit or aV of fhe vi yW` t of an ons _ mance or Sia La BY vx DATE 3- -- PERMIT NO. - L L , - J w 9 , `T ov o- ti� 5C-IDa ink pfZ ATO:; p car AA 7�-E:-w f cx-rRas!S �.l f-f ED vi V14 10 O:v $ v ol 4 -_ - dd : ILL i LLLJ : --- d - -- - - `00 a� _a cxmoo- - CPA-f : � i r l ,rte- 0 \ i F AGF 9 20 F k t2- � i 1_ �J �Z v L T> ------------ (fH&)\J 1