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14080038 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22149 RAE LN CONTRACTOR:'IV7 fc cn[ .rt PERMIT NO: 14080038 v ' S OWNER'S NAME: CHI SIM TANG DATE ISSUED:08/06/2014 OWNER'S PHONE: 6617480240 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑ � REMODEL(E)MASTER BATH, 140 S.F. C License Class �J Lie.# �6 Pq 0 Contractor CJP4-GnQV���il!l�Date2/6 /14. 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:$7000 W 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:35607070 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 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 D L ALLED 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 granting of this permit. Additionally,the applicant understands and will compl ed e' with all non-point source regulations per the Cupertino Municipal Code,Section 918. " RE-ROOFS: Signature Date 6 a/ 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. 1 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: Date: 81411q 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 �O COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 0 (408 777-3228•FAX 408 777-3333•buildin ertino.or CUPERTIte(t3 ) ( ) 9@cu p a ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS r2_ 1 I 'G- a D r .� D APN# �I ,576 / — ,/�� I0 /1 OWNER NAME \ l "'V vl I"YM / v LL (� /'� ONE ' �t. 1 1 ��l Cil.�) y O E-MAIL �+ I_ , VI'1 1'f'�!"l, STREET ADDRESS » A. CITY,STATE,ZIP 1111' 1 1�1'rGa. L,A vl5(AVLI, FAX CONTACT NAME t`- (6 5Ita ,�O �L PHONE � -�I E-MAII, YT P )2� -�f/3q 4vt' Jtr5.c,pm. STREET ADDRESS 5155 f CITY,STATE,ZIP FAX �i v wok 5k.�3Zq Du to Po l�o C� a`�3ot ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME � LICENSE NUMBER �I J p 0� LICENSE TYPE BUS.LICC# - COMPANY NAME /1EMAIL C) til ��L►1 jrG�j�bfJi IOtrS.COP/�FAX C4rJ�T rzcr�QtJ�s�ty;1^c�trS rgn�'•C� . STREET ADDRESS 55 C '5r e4 n'� S�.��L,ry CITY,STATE,ZIP �p I C�140,0 r�, .�j� �.. PHONE�,`� o oc ARCHITECT/ENGINEER NAME "� LICENSE NUMBER '1 BUS.LIC# 1 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK 70 D EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NEr AREA BATHROOM KITCHEN OTHER REMODELAREA REMODEL AREA REMODELAREA PORCH AREA DECK AREA 1 TOTAL DECK/PORCH AREA GARAGE AREA: ODETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT OYES SECOND STORY OYES BEING ADDED? ❑NO ADDITION? ❑NO PR&APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YEVALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑N .� v' s moo. t, By my signature below,I certify to each of the following: I am the property d agentt 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 anit is accurate. I agree to comply with all applicable local ordinances and state laws relating to building cons I authorize representatives of Cupertino to enter the above-ide t/ifiied property for inspection purposes. Signature of Applicant/Agent: � Date: _ a/y�/ L4 SUPPLEMENTAL INFORMATIO QUII2ED New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building Z u{ `a , '. permit for new building. ­n. VIEW, (C Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ` rawU form if any Hazardous Materials are being used as part of this project. � 'aw'' " _Copy of Planning Approval Letter or Meeting with Planning prior to o ` submittal of Building Permit application. BldgApp_201 Ldoc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 22149 RAE LN DATE: 08/06/2014 REVIEWED BY: MELISSA APN: 356 07 070 BP#: *VALUATION: 1$7,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1 R3SFDRE WORK REMODEL E MASTER BATH 140 S.F. SCOPE f c:ii t'>rruia Fee: 1'Iamb, Permit i,c <-: 00)Y CP1'11102Llrisy>. t?t`ic>r r nSt-- P,'� h. lisp. Fee". :<r. to • r, NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These ees.are based on the prelimina information available and are only an estimate. Contact the Dept-for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. Remodel,Bath(<=300 s fl Suppl. PC Fee: Reg. ® OT 0.0hr's $0.00 $645.00 IREMRESBAT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. ® OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? 0 Yes Q) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential E) Building or Structure 0 Strong Motion Fee: 1BSEISMICR $0.91 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 x . . '0M'" $1.91 $645.00 TOTAL FEE: $646.91 M ;. Revised: 07/10/2014 Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOBADDRESS: 22.[4.C( Rove, Law, PERMIT# O OWNER'S NAME: 'Tn PHONE# (6!j2) q4-S-6000 GENERAL CONTRACTOR: 44fs BUSINESS LICENSE# C11566-40 ADDRESS: J555 b f a nj S'I', 2 CITY/ZIPCODE: % A 1+o GA q 4 o f *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Sig atu Date Please check applicable subcontractors and complete the following information V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork 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 z SCOPE: 1) REMOVE AND REPLACE VANITY IN EXISTING 11 1' 11 LOCATION, USING EXISTING PLUMBING LOCATIONS. z LAVATORY FAUCETS TO BE<_ 1.5 GPM @ 60 psi. O 11 �� 2) REMOVE AND REPLACE SHOWER AND TUB IN O 6 -9 4 .8 EXISTING LOCATIONS, USING EXISTING PLUMBING J a <E>WINDOW LOCATIONS,WITH SHOWERHEAD TO BE<_2.0 gpm @ 80 L.L psi. SHOWER GLASS TO BE TEMPERED \ 0 3) NEW TOILET TO BE<_ 1.28 GAUFLUSH Ur O 4) BATHROOM TO INCLUDE AT LEAST ONE HIGH- iii J EFFICACY LUMINAIRE. ALL OTHER LIGHTING TO BE (y„ HIGH EFFICACY OR CONTROLLED BY VACANCY CpMMUN SENSORS, 9UILplIyG 5) GFCI RECEPTACLE TO BE ON SEPARATE 20 AMP. w nING MSIpN ENT DEP CIRCUIT = x .. CUPeRrINp Eld7 6) REPLACE TILE FLOOR,TUB DECK AND SHOWER cn W c::: Thea °f plans and PRO'e� ENCLOSURE job site during constr�cnications M!! be ke Changes or alter coon. !t is unla(y ful to pt at the be�om, without app at1ons on Sam make any roval from the g to deviate J � [E-"MASTER \ _ The Stamping of this lan Bu Official. W be held to p and specifi *'I 0 BATH c °ns a viol Nor oO approval of the violation � � T / DATEnce or State Law. �' W / .. W \ REftrr NO. zO z Q U W O Q I- - - T\(— � - - - W ,� RECE� vo� o o qC o o MASTER BDRM _ � C W � LU pUG 0 c Z r ,__, aLQ 3 ° N < a N U 2: BY DATE: (? CLOSET CUPERTINo 7/28/2014 LOCUBuilding Department . 'i SCALE : L—j A I REVIEWED FOR CODE COMPLIANCE 3/8 1 Reviewed By. APPLICABLE CODES AND REGULATIONS 2013 California Building Code 2013 California Residential Code 2013 California Mechanical Code 31-4112013 California Plumbing Code SHEET: 2013 California Electrical Code 2013 California Green Building Code(CALGreen) 2013 California Fire Code(with local amendments) 2012 International Property Maintenance Code 20( 2699 State of California Title 24 Energy Regulations Sunnyvale Municipal Code(including local amendments to the above adopted codes and local green building requirements)