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14040014 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19881 PORTAL PLZ CONTRACTOR:PHILLIP ISAACS' PERMIT NO: 14040014 CONSTRUCTION INC OWNER'S NAME: YUN LIU 7705 MOUNTAIN AVE DATE ISSUED:04/02/2014 OWNER'S PHONE: 3127526256 ORANGEVALE,CA 95662 PHONE NO:(916)852-8132 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL / INSTALL 4 RETOFIT WINDOWS&2 RETROFIT PATIO License Class Ct Lic.# /0 7(y ? 7 DOORS,LIKE FOR LIKE,NO SIZE CHANGE(WILL MEET r— Z It EGRESS&BE TEMPERED WHERE REQUIRED BY CODE) Contractor Date I hereby affirm that I am lic rsed 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 ompensation,as provided for by Section 3700 of the Labor Code,for the reance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$6392 d will maintain Worker's Compensation Insurance,as provided for by 700 of the Labor Code,for the performance of the work for which this APN Number:36946003 00 Occupancy Type: 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 PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter SPECTION. upon the above mentioned property for inspection purposes. (We)agree to save 1 _ - indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Iss Date: 2 granting of this permit. Additionally,the applicant understands and will comply - with all non-point source regulations per the Cupertino Munici de,Section - 9 18. C L 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. ❑ OWNE DER 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 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, Business&Professions Code) .1,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: ate: 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 CONSTRUCTIDING 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 1�` CONSTRUCTION PERMIT APPLICATION O COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•build ing(Wcupertino.org ^ADDITION ❑ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# El NEW CONSTRUCTION ❑ PROJECT ADDRESS � � q� ' �/0., '` ,1` I 'PAPN# OWNER NAME Yj JJ L1 ITS \ PHONE� STREET ADDRESS r P I �U(J'Z r A, .�I/T LZ A,T CITY,STATE,ZIP FAX CONTACT NAME (r�A.-.w f�1 1 r r1 PHONE • 952--9( 3Z- E-MAIL STREET ADDRESS 1V 36<"T�7 �' ` /rd,7f-Z / Cj�Y,S�( �tZ•I'tPG7 C�I-z /'� —A F X �•� ❑OWNER ❑ OWNER-BUILDER K-'❑r yOWNEER`AG�ENT CONTRACTORL❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME � � ENS `PE BUS.LIC#Prt ? -w--7-7 C AIL COMPANY NAME Ei/1ZZJIh Et,-nGY G� STREU ADDRESS , � ZPHONE 512 Age TAT; 416 1S 2•V32 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK __,��7 1 , _ 1 � ��-,7 Q �I JD /V® ( ��'� AJ EXISTING USE PROPOSED USE CONSTR.TYPE I ftSTORIES eS tJ0 USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODELAREA REMODELAREA REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH []ATTACH #DWELLING UMTS: IS A SECOND UNIT ❑YES SECOND STORY []YES BEING ADDED? []NO ADDITION? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES �ton TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ By my signature below,I certify to each of the following: I am the property owner or authty owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and vefTfy it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize repre to enter the ah--identified t roperty for inspection purposes. Signature of Applicant/Agent: Date: 7— SUPPLE INFO ON RE D PLAN CHECK TYPE ROUTING SLIP _New SFD or Multifamily dwell' y for demolition permit for ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 19881 PORTAL PLZ DATE: 04/02/2014 REVIEWED BY: MELISSA APN: 369 46 003 BP#: *VALUATION: 1$6,392 rPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1GENRE i WORK INSTALL 4 RETORT WINDOWS & 2 RETROFIT PATIO DOORS LIKE FOR LIKE NO SIZE CHANGE SCOPE (WILL MEET EGRESS & BE TEMPERED WHERE REQUIRED BY CODE) p Vech. P.'ct77 U&'(_ I'hwib. Mari Check f 1ec. 111,w-Ch,,(-;< 11 ;ir. t.-,qui lae; t'?amb_ Pcrmrr7 ae: I Ofh(s i�cc h. Iasi_=. (hi,cPh rrtl>Trasr>. Li flthe>r , r_IYrs�:. filerk h? i` v phimb fnsp' hee_ Z-1-10 Imp NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,eta). These _f 7 -fees are based on the relimina information available and are onlyan estimate. Contact the Det info. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 © # Window/Sliding Glass Door Suppl. PC Fee: (E) Reg. 0 OT 0.0 hrs $0.00 $418.00 1 WINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: _T__T $0.00 ("Onslj wciion Work Without Permit? ® Yes (j) No $0.00 1 E) Advanced Planning Fee: $0.00 Select a Non-Residential E) Via-<a.;el Fees: Building or Structure 0 Strom Motion Fee: IBSEISMICR $0.64 Select an Administrative Item Bldg.Stds Commission Fee: IBCBSC $1.00 _ .� F ' $1.64 $418.00 TOTAL FEE: $419.64 Revised: 04/01/2014 Yun Liu 19881 Poral Plaza Cupertino,CA 95014 i ! _. __._ � _. I �'�� �,,� �.I,,r� •fid SI�� Bedroom 2 5� SECOND FLOOR Bedroom 1 6050 _. bq � EckDAqr - 4040 X0 r, �r 1 tly h4rq Jit Dril, Wit!�UUI<: The C%i�!3f iIIS k El UK.'. ?11C.:, `i'iv v!I-a 1 r N -' i 4�3E'-Trilt OY�c? :s -.., c ;; Jal Of the vtCliciliva d Ila ce or late Law. BLJj�o FIRST FLOOR Kitchen PERMIT NO. Wing Room $ 6068 Pado Door to } �® ICE4040 XO 4040 KO 1