13070093 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 18781 ARATA WAY CONTRACTOR:SGK HOME SOLUTIONS, PERMIT NO:13070093
INC.
OWNER'S NAME: EDWARD LIN AND WEN-YU HUANG 3801 CHARTER PARK CT STE B DATE ISSUED:07/15/2013
OWNER'S PHONE: 4085963806 SAN JOSE,CA 95136 PHONE NO:(408)264-6964
❑ LICENSED CO CTOR'S DECLARATION/ JOB DESCRIPTION: RESIDENTIAL COMMERCIALE]
License Class s Lic.# C RE-STUCCO SFDWL 1,530 SQ FT
Contractor Date r
I hereby affirm that I am licens 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: Valuation:$15000 .
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:37512027.00 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 WITHIN 0 AYS 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 OM LAST 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 the Issued by Date �•� �
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.
RE-ROOFS:
Signature Date_717 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-B ILDER 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 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 unicipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Seen s33 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 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
CONSTRUCTION PERMIT APPLICATION p�3
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
'10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 2D
GUPtl2-rlkO (408)777-3228-FAX(408)777-3333-building aacugertino.ong
[:]NEW CONSTRUCTION ❑ ADDITION &TERA-171ON/T1 ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS APN# 3-15 12-
E-MAIL 2E MAIL
STREET ADDRESSCITY,STATE,ZIP ✓ / FAX
CONTACT NAME / PHONEO� �' EMAIL
STREET ADDRESS ` CITY,STATE,ZIP CtG FAX
❑OWNER ❑ OR'NER-BUILDER. ❑0. AGENT CTOR ❑CONTRACTOR ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR N LICENSE NUMB '- f)5— LICENSE E BUS.LIC#
COMPANY NAME E-MAIL 0Q FAX
STREET ADDRESS 2 —CITY,STA z Q / P D
ARCHITECUENGANTEERNAME LICENSENUMBER l [Jr BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK
wyK e
EXISTING USE I PROPOSED USE CONSTR TYPE #STORIES
USE TYPE OCC. SQ.FT. VA&ATION(S)
EXISTG NEW FLOOR DEMO TOTAL
AREA AREA AREA NETAREA
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECKMORCH AREA I GARAGE AREA DETACH
❑ATTACH
9 DWELLING UNITS: IS A SECOND UNrr ❑YES SECONDSTORY ❑YES
BEBNGADDED? ❑NO ADDITION? []NO
PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑ITS �CEIVED. a '`°`� ,: TOTAIL ATION: �q
PLANNING APPL# ❑NO PLANNINGAPPROVALIETTER EICHLER HOME? ❑NOAll
By my signature below,I certify to each of Y-2!
owing: I am the property owner or authorized agent to the property owner's behalf. I have read this
application and the information I h e vorrect. Ihave read the Description of Work and verify it is accurate. I ee to mply with all applicable local
ordinances and state laws relating truction. I authorize representatives of Cupertino to enter the above-id tiff for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFO TION REQUIRED oIITIi -
_New SFD or Multifamily dwellings: Apply for demolition permit for �_ � � � � � 10�
ULM
OVE�2 THECOUh� BUILD_ GPLAREVTE9[
existing building(s). Demolition permit is required prior to issuance of building - =
permit for new building. MExPREs rriA
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ®�sTIrDIJsicwo = -
form if any Hazardous Materials are being used as part of this project. , G t
_Copy of Planning Approval Letter or Meeting with Planning prior to
�s
SAN
submittal of Building Permit application. her M''aoR rITAztsERRDisTlu
B1dgApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 18781 ARATA WAY DATE: 07/15/2013 REVIEWED BY: Mendez
APN: BP#: "VALUATION: $15,000
%PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY PENTAMATION 1GENRES
___[USE: SFD or Duplex PERMIT TYPE: i
WORK RE-STUCCO SFDWL 1,530 SQ FT
SCOPE
M e
on
;Elect. Plan Check Plumb.Plan Check Elec.Plan check
k Tech. Permit Fee: Plumb.Permit I ee: Elec. Permit Fe.e:
Other,klech.Insp. Other Plumb Insp. E3_L_ Other Ele(.Insp.
Hech.Insp.Fee: Plumb. hul). Fee: Elec.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). These fees are based on the prefintina information available and are only an estimate. Contact the Dept for addn'1 info,
FEE ITEMS (Fee Resolution 11-053 E . 7/1/12) FEE QTY/FEE I MISC ITEMS
Plan Check Fee: $0.00 MKI s.f. Restucco
Suppl.PC Fee:. (j) Reg. 0 OT 0.0 hrs $0.00 $593.00 1STUCOAP7P
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Fee-.0 Reg. ® OT O.0 I hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Conswuction Tax:
A(lininistrative.Fee: 0
Work Without Permit? ®Yes (E) No $0.00 E)
Advanced Planning Fee: $0.00 Select a Non-Residential E)
Building or Structure 0
Travel Documentation Fees: �
Strong Motion Fee: 1BSEISMICR $1.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
$2.501 $593.00 ... $595.50
k*
Revised: 07/01/2013
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C O P E RT 1 N O Fax: 408-777-3333 .
CO TRACTOR/SUBCONTRACTOR LIST;
. k
JOB ADDRESS: PERMIT#
OWNER'S NAME: `' PHONE#
GENERAL CONTRACT BUSINESS LICENS
ADDRESS CITY/ZIPCODE:
*Our municipal code requires all businesses working in the city to have a City of Cupertino1busi ess license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND AL BC NTRACTORS HAVE OBTAINED A.'CITY OF CU PE INO
BUSINESS LICENSE.
I am not using any subcontractors:
ignature Date
Please check applicable subcontractors and c plete the following information
t/ SUBCONTRACTOR BU INESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring/Carpeting m
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