The URL can be used to link to this page

14060161 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10215 S FOOTHILL BLVD CONTRACTOR:GRAND NEST PERMIT NO: 14060161 CONSTRUCTION OWNER'S NAME: XIE WEN TING AND LIU WESLEY W 13428 CHRISTINE DR DATE ISSUED:06/25/2014 OWNER'S PHONE: 4083984841 SARATOGA,CA 95070 PHONE NO:(408)891-8059 Ly LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL E] ��(�� !� �/,/, INSTALL TEMPORARY POWER License Class_ Lic.# — � Contractor Date 1� 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 performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$200 LJ�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:34214076.00 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 180 DA UANCE 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 18 O D 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 Date: -d2 S granting of this permit. Additionally,the applicant understands and will co with all non-point source regulations per the Cupertino Municipal Code,Section 9 18. RE-ROOFS: Signature Dat 1-61 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 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 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: Dater% /1� 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 \MEP GENERAL PERMIT APPLICATION � 6 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION �/� 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 bAgML (40B) 777-3228• FAX(403)777-3333•buildinge-cuDerino.ora m I S ❑PLUhS G ❑MMIi;A'ICAL []ELECTRICAL ❑MLSCELLAh-POUS PROS CT f DDRESS ©�� yr nit- L-V,r> .y 2 ( ! — D -2-� 04"��"'7r,t NAl✓i: I PiiONE I E-}✓°•�, ��e- *Xom/ Cl-,L, STREET ADDRESSI CTrY, STATE,Zu'• FAX �o Gm �v O CONTACT N•A.I s PROLATE E-14#1. FAX ST?.'r i ADDRESS CITY,STATE,ZIP OV,T�t 'L'7 OV•Ta�•BUIIJ ❑ owizExAQ�u ❑ CON-11L4CTOR ❑CONMICTORA�E\rr ❑ ARC=EcT ❑ENGnr-R ❑ D1 .OP EL ❑TE?NA•NI Cohn?'CTORI LICENSE SER I LICE.NSETYPE I BUS.LIC n CON'ANY N!I✓E E-]✓LdII I FAX CRY,STATE ZIP '2 7 ® STR'cT ADD - S (/ L ARCFETECl/ENGIt� RNSI✓� I LICENSENUN�ER. BUS.LIC CON2P-VYNAt✓-' E 1✓'ATf. FAX STREET ADDRESS CITY,STATE,ZIP P iONH USE OF ❑SFD W DUPL'r_X ❑ MMTI•FAMMY I,PROJECT LN WUZLAND ❑ YES I PROJECT IN ❑YES I IS TIM BLDG AN ❑YTS NO FLOOD ZOITE BUII DING p COMMERCLAL URBAN NTERFACE AREA p ❑NO EICFmoll-M?2moll-M? ❑ NO DESCRIPTION OF woRx ,r IVrA- TOTAL VATUATION: G® {^ --- .......�x� r By my signature below,I certify to each of the following: I m the proper ry o1,-,ier or authorized anent to act on the property oN�me•s behal I have read thss application and the information I have provided is correct. I have read the Description of 5%'ork and verify it is actuate. I agree� compl duh all applicable local ordinances and state I a,vs relating to buildi cons-uction. I au` rite representatives of Cupertino to enter the above-identifie ,for inspection purposes. S i mmture of Applicmt/Agent: Date: SUPPLEMEN LNFORI�IATION REQTJ D oFt�c> ,cE InL� !v1EPhj7scXpp_M1.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10215 S FOOTHILL BLVD DATE: 06/25/2014 REVIEWED BY: MELISSA APN: 342 14 076 BP#: *VALUATION: $200 PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY SFD or Duplex PENTAMATION 1 REAP14 USE: p PERMIT TYPE: A WORK INSTALL TEMPORARY POWER SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Temporary Power 1 ERT<200 100 Amps $47 TOTALS: $47.00 1,10c , IN 1h%;/ ('meek P(trttrb. 1'Irarr(:hec-A Elec.Plan Check 0.0 1 hrs $0.00 ;Ll�, Pe,,nrl F'e=e' tPzemb. Elect.Permit Fee: IEPERMIT 3;l,e•r rt tec 17t,5 y- oiller 1'111mb imp. Other Elec.Insp. 0.0 hrs $47.00 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 relimina in ormation available and are onl an estimate. Contact the Det or addn'l info. FEE ITEMS(Fee Resolution 11-053 Eff 711113) FEE QTY/FEE MISC ITEMS Plan Checf'� :`Flipp!. P('1 PME Plan Check: $0.00 PME Unit Fee: $47.00 PME Permit Fee: $47.00 Administrative Fee: ]ADMIN $44.00 Work Without Permit? ® Yes (F) No $0.00 H ca`t1t�<`ea Plarming Fees: Travel Documentation Fee: ITRA VDOC $47.00 A Strom Motion.Fee: IBSEISMICR $0.50 Select an Administrative Item 131da, Stds Commission.Fee: IBCBSC $1.00 186.50 $0.00 ` TOTAL FEE: $186.50 Revised: 04/01/2014