15050149!n
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10598 STERLING BLVD
CONTRACTOR: PAB CONSTRUCTION
PERMIT NO: 15050149
INC
OWNER'S NAME: YE FEI AND ZHANG ZISHAN
21060 HOMESTEAD RD STE 216
DATE ISSUED: 08/10/2015
OWNER'S PHONE: 4088399905
CUPERTINO, CA 95014
PHONE NO:
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL
License Classn�}
CONSTRUCT (N) 2 STORY SIT) WITH 2,469 S.F. LIVING
Lic. # '
SPACE, 761 S.F. OF PORCHESBALCONIES/PATIO AREAS
Contractor hl ` f c�� cQate 5
&
f
I hereby affirm that I am licensed under the provisions of Chapter 9
426 S.F. ATTACHED GARAGE
(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.
I have and will maintain Worker's Compensation Insurance, as for by
Sq. Ft Floor Area:
Valuation: $500000
provided
Section 3700 of the Labor Code, for the performance of the work for which this
APN Number: 37523025.00
Occupancy Type:
permit is issued.
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
PERMIT EXPIRES IF WORK IS NOT STARTED
to building construction, and hereby authorize representatives of this city to enter
WITHIN 180 DAYS OF T ISSUANCE OR
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities,
180 DA INSPECTION.
judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this Additionally,
�1104 t�
permit. the applicant understands and will comply
Date:
with all non -point sourc re a ions per the Cupertino Municipal Code, Section
9.18.
Q
Signature Date G p ��
RE -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
ElO R -BUILDER DECLARATION
inspection.
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 ROO# 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. I will
declarations:
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
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
Compensation, as provided for by Section 3700 of the Labor Code, for the
material. Additionally, should I use equipment or devices which emit hazardous
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 pe i o Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Section 550 5563, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
Owner or authorized agent: Date:
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
CONSTRU ION 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
granting of this permit. Additionally, the applicant understands and will comply
I understand my plans shall be used as public records.
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• buildinp(r�cu ertino or
CUPERTINO� I -� D . q
VV NF_W rOM.RTRT Trn()M I I - I AnnTTTnv I I AT TFD ATTnAT /TT I 1 DV%TTQTnM /r%MT:VVDVn nDT(_TATAT ln=%XTm.0
PROJECT ADDRESSh
WFS+Q `, j ` n m L /' .p
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OWNER NAME
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PHONE , _ _ 83 _ I v,r
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E-MAIL n ,n 410 00-?@ 44. c
STREET ADD
CITY, STATE, ZIP
��( FAX
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CONTACT NAME
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E-MAIL (�
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STREET ADDRESS
CITY, STATE, ZIP
FAX
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❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT
YARCEIITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME U ( �i
LICENSE NUMBER
LICENSE TYPE
BUS. LIC #
COMPANY NAME /
E LCO
FAX
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rn
STREET ADDRESS
CITY, STATE, ZIP
PHONE
ARCHITECT/ENGINEER NAME F(0, V
RV
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
`
FAX
STREET ADDRESS CITY, STAT$ ZIP
PHONE
DESCRIPTION OF WORK
.� 2
sF
n
_ `
S `6- ? 6
r
EXISTING USE
PROPOSED USE CONSTRTYPE
#STORIES
USE TYPE OCC.
SQ.FT.
VALUATION (S)
EXISTG
AREA
NEW FLOOR•DEMO
�TI� /
AREA 7 Y6 0/
AREA
TOTAL
NET AREA
BATHROOM.
KITCHEN..
OTHER.
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
. GARAGE AREA: DETACH
:y 6
J17,4 �'ATPACH
# DWELLING UNITS:
IS A SECOND UNrr ❑ YES
SECOND STORY ❑YES
BEING ADDED? [3NO
ADDrrION? []NO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
PLANNING APPL ,k ❑NO PLANNING APPROVAL LETTER
IS THE BLDG AN ❑ YES
EICHLERHOME? []NO
.....
By my signature below, I certify to each of the following: I am the property owner or auth
'_ agent to act a erty owne ' behalf. ave read this
application and the information I have provided is correct. I hFISP read the Description of Work and ve curate. I agre compl Ith all applicable local
ordinances and state laws relating to buildi s I AuLprize representatives of Cupertino to enter the above-ide ed pr7jo for inspection purposes.
Signature of Applicant/Agent:
Date: , ri0
SUPPLEMENTAL INFORMATION REQUIREDcicKYP�}:
j� _.x�otrruc�siiP sem.
New SFD or Multifamily dwellings: Apply for demolition permit for
I] OVER rHFr�GOi7IrTER O�
ME
1A
BUILDING eI§AYRE3'IESi'i`
existingbuilding(s). s Demolition permit is required prior to issuance of building1"^
g� )• P 4 P
���a
�C��pi 4w
permit for new building.�XPs
a'r�
�a
#v, bifid 23ryc4'
�n� .
}•�Z4
_ Commercial Bldgs: Provide a completed Hazardous Materials DisclosureQ
n'I 4 b p .
form if any Hazardous Materials are being used as part of this project.
3❑w—X3AR�
irsl j''P
u°�IRD�PCN `zt i
_ Copy of Planning Approval Letter or Meeting with Planning prior to
submittal of Building Permit application.
�i❑1kI�170R
«sEwER� �tYe
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BldgApp_201136c revised 06/21/11
M
CITY OF CUPERTINO
FEE ESTIMATOR — RITIT.nIIVf_ DTV1Q1n1V
19
ADDRESS: 10598 STERLING BLVD
DATE: 05/26/2015
REVIEWED BY: MELISSA
PC FEE ID
APN: 375 23 025
BP#: /,50 so,/
*VALUATION: 1$500,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY SFD or Duplex
USE:
2nd Unit? Yes •- No
'
PENTAMATION
PERMIT TYPE: 1 R3SFDW
WORK
CONSTRUCT N 2 STORY SFD WITH 2,469 S.F. LIVING SPACE 761 S.F. OF
SCOPE
PORCHES/BALCONIES/PATIO AREAS & 426 S.F. ATTACHED GARAGE
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
R-3 (Custom)
II-B,III-B,IV,V-B
3,656
$3,211.32
1R3PLNCK
$3,345.56
IR3INSP
Permit Fee:
$3,345.56
Suppl. Insp. Fee: Reg. 0 OT
;blecth. Permit Fee:
hrs
$0.00
Plumb. Permit Fee:
$0.00
PME Permit Fee:
rle.c. Permir Fee:
-
Construction Tax: IBCONSTAXR
1
# new units
$677.77
Administrative Fee:
0
E)
Work Without Permit? 0 Yes No
$0.00
TOTALS:
3,656
$3,2
1.32
_
$3,345.56
;.
Onccr ikc•h. lrrsrz I I Other Plumb trap. u Other Elec. Lzshr.
tlech. ,'nsp. Fee: Plrtnrb. hrsX�. her: Elec. Insp. Fee:
IYUIZ: INS estimate does not include fees due to other Departments r e. Planning, Public Works, Fire, Sanitary Sewer District, School
FEE ITEMS (Fee Resolution 11-053 E f 7/1/13)
FEE
QTY/FEE
MISC ITEMS
Mech. Plan Check
$3,211.32
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: (j) Reg. 0 OT
I'Ir1/0.
Plan Check
$0.00
PME Plan Check:
$0.00
Lice. flan (_'heck
Permit Fee:
$3,345.56
Suppl. Insp. Fee: Reg. 0 OT
;blecth. Permit Fee:
hrs
$0.00
Plumb. Permit Fee:
$0.00
PME Permit Fee:
rle.c. Permir Fee:
Onccr ikc•h. lrrsrz I I Other Plumb trap. u Other Elec. Lzshr.
tlech. ,'nsp. Fee: Plrtnrb. hrsX�. her: Elec. Insp. Fee:
IYUIZ: INS estimate does not include fees due to other Departments r e. Planning, Public Works, Fire, Sanitary Sewer District, School
FEE ITEMS (Fee Resolution 11-053 E f 7/1/13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$3,211.32
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: (j) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$3,345.56
Suppl. Insp. Fee: Reg. 0 OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
-
Construction Tax: IBCONSTAXR
1
# new units
$677.77
Administrative Fee:
0
E)
Work Without Permit? 0 Yes No
$0.00
Advanced Plannin. Fee: 1PLLONGR
$511.84
Select a Non -Residential 0
Building or Structure 0
Truvel Dnt•t..crrie�nlratiort Fees:�
Strong Motion. Fee: IBSEISMICR
$65.00
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$20.00
SUBTOTALS:
$7,831.49
$0.00 TOTAL FSE:',
$7,831.49
Revised: 05/07/2015
CUPERTINO
CONTRACTOR / SUBCONTRACTOR LIST
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: tG 5 Ck fS S er 1 nr �� V8
PERMIT # () %)
OWNER'S NAME:
PHONE # L% 0 e — 2e, 4,6 h q S
GENERAL CONTRACTOR: CCA S T f v c t) ! A
BUSINESS LICENSE # 324,',;�--4
ADDRESS: 'ZW 60 C& # 216
CITY/ZIPCODE: CO Qe Cfi;')� (f� 5 e LF
*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.
I am not using any subcontractors:
Signature
Please check applicable subcontractors and complete the following information:
Date
V
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Be -"o e Cc r) S� Yv C_ '1'0 n
3 226 qq
Electrical
eorSg C.(e-CiV1,C
2 C5>c(\�
Excavation
& b e► Cc n StCv C+)'0 n
�v 3'S 14Q
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing
Heating
/✓ d a' Ci.� \^ecj;
-6056)
Insulation
Landscaping
Lathing
a,lb e 1 Cc n '3t ! �j ct e&1
3 3 5 jq 9
Masonry
rV
3 3 S Q
Painting / Wallpaper
Paving
Plastering
4 b ` Ca- o Sfi rve-ti c h
3 14+ 4
Plumbing
Q A 13n S r{ U �` '^
u 6 F14
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Own
Signature
02-2-14-16
Date