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14060079 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21387 METEOR DR CONTRACTOR:PETER WANG PERMIT NO: 14060079 OWNER'S NAME: KUI ZHANG AND CAI LI-HONG 100 CONCORD CIR DATE ISSUED:06/12/2014 OWNER'S PHONE: 4088354420 MOUNTAIN VIEW,CA 94040 PHONE NO:(650)906-8788 X LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL f� (� REMODEL(E)MASTER&HALL BATHS,NO License Class C/ Lic.# d' STRUCTURAL G r Z r , CHANGES(158 S.F.) Contractor ��6`�/ Date 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. 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 rformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$8000 il ve and will maintain Worker's Compensation Insurance,as provided for by tion 3700 of the Labor Code,for the performance of the work for which this APN Number:32643009 00 Occupancy Type: ermit 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 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 DAY 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 the 2 granting of this permit. Additionally,the applicant understands and will co ssued b Date: with all non-point source regulations per the Cupertino Municipal Code, ction 9 18. RE-ROOFS: Signature o Date 2=`� All roofs shall be inspected prior to any roofing material erial 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 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: Da /Z^m 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 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildingaa.cupertino.org CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERA';TTION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS Z /L tA4rj O y ) 1/ APN# OWNER NAME ) I mA -SIG__ PHONE r 2� E-MAIL / 041 STREET ADDRESS CITY,STATE,ZIP Pip FAX AX e-d CONTACT NAME PHONE E-MAIL STREET ADDRESS ' ( V CITY,STATE,ZIP ^r L J FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ll CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER�J �Q ( LICENSE TYPE BUS.LIC# (� I COMPANY NAME E-MAIL /� FAX J / STREET YDRESS ,IfV, /,+� CITY,STATE,ZIP �, e / OIZO/ ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK ✓- 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 58" REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PTAREAGARAE AREA: DETACH ❑ATTACH#DWELLING UNrrS: IS A SECOND UNIT STORY YESBEING ADDED? N? ❑NOPRE-APPLICATION ❑YES IF YES,PROVIDE COPY DG AN ❑YES t' { mi% -TOTAL UATION: PLANMNG APPL# ❑NO PLANNING APPROVAL HOME? ❑NO '�k a�d"txks ' ,•, .sus" By my signature below,I certify to each of the following: I am the property owner or authorized agent act e property 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 accurate. I agree to comply with all applicable local ordinances and state laws relating to building connIction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date:SUPPLEMENTALINFORMATION UIRED ,tA� wPLa,7vc> cK�YPE , ,. RouTnvcsi>P. ,. na _New SFD or Multifamily dwellings: Apply for demolition permit for ` r � '� ❑�$UILDING�TA�REEw ER TFi1rCOUNTER m�' existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑�r��iFsa ' ❑�LaNrr>NGAiyx>Wvw� _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure rE� sA u ❑PUBLie��oRxs form if any Hazardo g Materials are being used as part of this project. ��a © ver C� LARGE � _Copy of Planning Approval Letter or Meeting with Planning prior to b:`, � © spy sRDisTRrcT ❑ MAJOR�`r'rz submittal of Building Permit application. �:��swi. �;.���`�' ,.,.-.:'�'..� . %�` ❑zENVII20NMENTAI;�HEALTH>:� ,. : BldgApp_201 1.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 21387 METEOR DR DATE: 06/12/2014 REVIEWED BY: MELISSA APN: 326 43 009 . BP#: "VALUATION: 1$8,000 xPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1 R3SFDRE WORK REMODEL E MASTER &HALL BATHS NO STRUCTURAL CHANGES 158 S.F. SCOPE C),lr� Icc'i. Iran. Other Plumb 7nsn. Ll Ll PvC. 11hol " hzaq). Fee: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . Theseees are based on the prelhiniina information available and are only an estimate. Contact the De t or addh7 info, FEE ITEMS (Fee Resolution 11-053 Elf.' 7/1/131 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F-158-1 s.f. Remodel,Bath(<=300 sf) Suppl. PC Fee: Reg. 0 OT 0.0 hrs $0.00 $626.00 IREMRESBAT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. ® OT0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C:onstr tic°tion 1 IIX: Work Without Permit? ® Yes No $0.00 Advanced Planning Feer $0.00 Select a Non-Residential Building or Structure 1i'tt�''f )t7'`Lti72e'.tllCdttflk71'Fees" 0� Strong Motion Fee: 1BSEISMICR $0.80 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 mn $1.80 $626.00 . TOTAL FEE: $627.80 Revised: 04/01/2014 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT 1 N O Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: -'e, ✓ - PERMIT# 06 0 OWNER'S NAME: PHONE O$ '' S`' Ll y'Za GENERAL CONTRACTOR: BUSINESS LICENSE# 2 / ADDRESS: CITY/ZIPCODE: a 4 *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 ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. 1 am not using any subcontractors• g 'Si nature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/Glazing Heating Insulation Lei Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date cot: /ktz 01) 4 JUN 12 2014 .fay Buric/iRa op-pa/N0 I REVIEVVED Co C Revi CdE CO erred 8y: �-- MPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION-CUPERTINO APPROVED This set of plans and specifications MUST be kept at the if job si`e during construction. It is unlawful to make any arc changes or alterations on same,or to deviate - th�.refrom,without approval from the Building Official. Th `'tamping of this plan and specifications SHALL NOTcc b. be hald to o e an aP--P70WI of the violation e or State Law. E83 DATE Z F T3„AI N0. ! I i , , t — i FA CUPERTINO Ruildino Dec:iartment,, REVIEWED FOR CODE COMPt, Reviewed By. f � n ; � i u.--f=ly ra-� i V t it 1 i� Jj /ter Sf 5 � ! jf 3 a3 V CUPERTINO ` BullclinQ f�1P�la�'�1'T'ie(�. _ ''t�C`IiP�lel F R VIEWED FOR GvDE Reviewed By — 1 ��C1