15070081CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7429 STANFORD PL
CONTRACTOR: MICHAEL'S BUILDER
PERMIT NO: 15070081
OWNER'S NAME: XU TETE AND RUI SHI
39120 ARGONAUT WAY STE 165
DATE ISSUED: 08/07/2015
OWNER'S PHONE: 4087866574
FREMONT, CA 94538
PHONE NO: (510) 791-1588
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL E]
p / o
License �J® ��
CONSTRUCT 1 STORY ADDITION (380 S.F), REMODEL 2
Class Lie. # `
(E) BATHROOMS (90 S.F); INSTALL (N) FURNACE IN
Contractor M)�_ G _ b� dI l
C�OI°Pi� S
ATTIC.
I hereby affirm that I am licensed under the provisions of C apter 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
Sq. Ft Floor Area:
Valuation: $70000
performance of the work for which this permit is issued.
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
permit is issued.
APN Number: 35932034.00
Occupancy Type:
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
to building construction, and hereby authorize representatives of this city to enter
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City Cupertino
180 D S FROM LAST CALLED INSP CT ON.
of against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
of this Additionally,
6�.
Issued by: Date:
granting permit. the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature Date 44VRE-ROOFS:
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
I hereby affirm that I am exempt from the Contractor's License Law for one of
Signature of Applicant: Date:
the following two reasons:
I, as owner of the property, or my employees with wages as their sole compensation,
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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
I hereby affirm under penalty of perjury one of the following three
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's
Health & Safety Code, Section 25532(a) should I store or handle hazardous
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 505, 25533, and 25534.
Section 3iss of the Labor Code, for the performance of the work for which this
permit is issued.
Z�3�J�
Owner or authorized agent. Date{�Q—" �'
I certify that in the performance bf 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
Lender's Address
APPLICANT CERTIFICATION
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
ARCHITECT'S DECLARATION
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
W
CUPERTINO
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildingCaD-cupertino.orq
❑ NEW CONSTRUCTION M ADDITION ` n AT .TR.R ATInN / TI n
7 DT:DA,DT.0
PROJECT ADDRESS �%�ndj C_1�, �w' IF1 I
V
APN#-3 9 w .�2... a+-3
; 15 f
OWNER NAME 1z" 1
PHONE (46y) 79 4.457
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E-MAIL
STREET ADDRESS S /, ., � / e a 1 m� 1e
CITY, STATE, ZIP
FAX
CONTACT NAME 1 �� p,•p y�
PHONE (g7.0)
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STREET ADDRESS �•30 /� a� 6�
CITY, STATE, ZIP97iR,/Ai (/11��e! w it � FAx
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❑ CONTRACTOR ❑CONTRACTORAAGNT/r
❑ OWNER ❑ OWNER -BUDDER �AGENT E ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
LICENSE NUMBER
LICENSE TYPE
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
ARCHITECT)ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME Wil .�'� �j/ ` t O
vuvT /
WQ�ji
STREET ADDRESS k_ `V/�
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CITY, STATE, ZIP /j �ry�� Ui eW` /,(}�
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PHONE / �/d� 34? I �(j
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DESCRIPTION OF WOJRKt
1� 7 Ij yA4, A -3O D 1. �e
2. o CZ) P.,9(M-t h s
S tte�-
EXISTING USE
•�
PR(22SED USE CONSTIL
9�
TYPE
V9"'
# STORIES
USE
TYPE
OCC.
SQ.FT.
VALUATION ($)
EXISTG ee''1
AREA [ JAV
=FLOOR, EMO �{
AREA AREA K -
TOTAL
NET AREA t 2%
BATHROOM p� �(
REMODEL AREA
KITCHEN
REMODEL AREA
OTHER _
REMODEL AREA
PORCH AREA
-y
DECK AREA
@'
TOTAL DECK/PORCH AREA
GARAGE AREA DETACH
ATTACH
sl ®
7 `'
/
# DWELLING UNITS:
1
IS A SECOND UNIT []1YES
BEING ADDED? 1j�tV0
SECOND STORY ❑ YES
ADDITION?
Ko
1
r❑l
PRE-APPLICATION ❑ YES IF YES, PROVIDE COPY OF
PLANNING APPL # PLANNING APPROVAL LETTER
IS THE BLDG AN YES
EICHLER HOME? KNO
-
TOTAL VALUATION:
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the 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 relatirig to building cqRsOuction. L authorize representati o to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFO TION REQUIRED
1tcUTrxsicite
New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
P kUNFF�R
$UIY,iILHCr�REVIvP
-�
z
permit for new building.
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
�'sAtvli�iRu
L1 �tJBi t0 4Vgrti�S
form if any Hazardous Materials are being used as part of this project.
❑=•L�AR�Ja'E'
i�l
_ Copy of Planning Approval Letter or Meeting with Planning prior to
Building
❑ I qlz #
PsJi�+``�E`.rP�'`
�nrlrlatt w�RAIST O;c
submittal of Permit application.
1
� k�}�+gtUi�iIVtEN`ftLL`HHrAL'Ct[ ,
BldgApp 2011.doc revised 06/21111
CITY OF CUPERTINO `
FEE ESTIMATOR - RITII DING nlvrcrnV 1C �I
OCCUPANCY TYPE:
ADDRESS: 7429 Stanford Place
FLR AREA
(s.f.)
DATE: 07/13/2015
REVIEWED BY. Paul
. BP FEES
APN: 359 32 034
BP#:
I "'VALUATION: 1$70,000
PERMIT TYPE: Building Permit
$1,626.00
PLAN CHECK TYPE:
Addition
PRIMARY SFD or Duplex
USE:
2nd Unit? % Yes E, No
OTC? 0 Yes (E) No
PENTAMATION
PERMIT TYPE: 1 R3SFDADD
WORK Construct 1 Story addition 380 S.fl,
Remodel 2 E Bathrooms 90 S.
SCOPE
Permit Fee:
$1,323.00
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
(s.f.)
PC FEES
I
PC FEE ID
. BP FEES
BP FEE ID
R-3 (Custom)
II-B,III-B,IV,V-B
380
$1,626.00
IADDPLCK
1,323.00
IADDINSP
Elec. InSf7. Yee:
$0.00
i
Permit Fee:
$1,323.00
Suppl. Insp. Fee:Q Reg. Ct OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit -Fee:
$0.00
TOTALS:
380
$1,626.00.
$1,323.00
MECH, HOURLY .: Cl .Yes No
PI:UMB; HOURLY .' Yes 'No
ELEC, HOURLY �; Yes
Mech. Plan Check
Phimb. Plan Check
Elec. Plan Check
9ech. Permit Fee:
Fl b. Permit Fee:
Oec. Permit I'ee:
C)ther Hec•h. hisp.
Other- Plunrb Insp.El
Other Elec. Insp.
Mech: Imp. Fe'.
Pl imb. /r;.sp. Fee:
Elec. InSf7. Yee:
...�r;.- ..us es::n:ute uves not inctuaefees aue to otter vepartments (Ie. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc). These fees are based on the nreliminary infnrmadnn avnilahla and ara n"h, nca acfs»nro !'nw mar sh. 11-0 f-. -.4,1—P1 :..r
FEE ITEMS (Fee Resolution 11-053 Eff.' 7/1/13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$1,626.00
= s:f.
$645.00
Remodel, Bath (<=300 sf)
IREMRESBAT
Suppl. PC Fee: E) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$1,323.00
Suppl. Insp. Fee:Q Reg. Ct OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit -Fee:
$0.00
Construction Ta .-
,ldininistrative Fee:
0
0
Work Without Permit? 0 Yes No
$0.00
Advanced Planning Fee: IPLLONGR
$53.20
Select a Non -Residential
Building or Structure
E)
0
i
T'ruvel Doeu.inewai.ion Fees:
Strong Motion Fee: IBSEISMICR
$9.10
Select an Administrative Item
Bldg- Stds Commission Fee: IBCBSC
$3.00
SUBTOTALS:.=
$3,014.30
$645.00
TOTAL FEE
$3,659.30
Revised: 07/02/2015
/'