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14120099
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10416 PRUNE TREE LN CONTRACTOR:AC LIU CONSTRUCTION, PERMIT NO: 14120099 INC OWNER'S NAME: LIU ALEXANDER C AND DOROTHY 10416 PRUNE TREE LN DATE ISSUED:04/16/2015 OWNER'S PHONE: 6509682832 CUPERTINO,CA 95014 PHONE NO:(650)492-0857 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL qCONSTRUCT 2,913 S.F.(N)2 STORY SFD WITH 595 S.F. License Class Lic.# ! 0(Z 1 PORCH/BALCONY&462 S.F. ATTACHED GARAGE PP�-- Contractor� ba Wx �fi -"-'Sate Y h,6 /S_ 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:$600000 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:31633119.00 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 WITIIIN 180 D IT 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 *RO ED INSPECTI N. 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 ply tae. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 /-S S RE-ROOFS: Signature �--o Date 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:� �G Sr 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 1 CONSTRUCTION PERMIT APPLICATION v COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 \ CUPERTINO (408)777-3228• FAX(408)777-3333•buildingacupertino.or3 ❑NEW CONSTRUCTION E ADDITION ❑ ALTERATION/TI ❑ REVISION/DLFERRED ORIGINAL PERMIT# PROJECT ADDRESS % f I #APN/ ��k • OWNER NAME ( �{(Zx mN� [�UYG j�L hIu PHONE / _c�cE-MAIL STREET ADDRESS I� 1 l� I rum .7� L A ne— CITY, STATE,ZIP C-^ &I U ,r FAX CONTACT NAME pp PHONE / s )(Q �'C�C �. 1.1( (G d )is E-MAIL�IYx - �f U C`1 ll G2 CCh�1 STREET ADDRESS 1O,r & r Ll '1 � n CITY,STATE,ZIP FAX `�'l C-ct,�t•f�l�t�, C` OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME/IR LICENSE NU BFR L 1_-ENS TYPE BUS.LIC# /, ` cel �i' _ COMPANY AME i / I v / /} r FAX G !-i`u u +i S v►. ! J n� C E-MAIL C t l e! ^1 1`u �! �l(✓� L.C'Yt� STREET ADDRESSI 01F / Pru` Ti,,e'Z LA n CITY.STATE,ZIP` J� CA 61 5vi L( PHONE Z.L ARCHITECT/ENGINEER NAM �I�C LICENSE NUMBER BUS.LIC# Z COMPANY NAME CI �J / E-MAIL 1- IZSUI ` ✓l•\�e S FAX 4�17- I dp _�_3 STREET ADDRESSAV e- CITY,STATE ET "T S rl1��CQ�1 /\ S�K rw ne c 5 c-u C A `�41(2 PHONE 59 7'-2-oo- DESCRIPTION OF WORK2- P c ^ Z S v r ' v r EXISTING USE PROP SED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA 3 2 AREA i t f g NET AREA BATHROOM KITTCHEN 1 J GOTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GGE AREA: ACH ATTACH it DWELLNG UNITS: IS A SECOND UNIT ❑YF-S SECOND STORY ES BEING ADDED? QWO ADDITION? ❑NO PRE-APPLICATION ES IF YES.PROVIDE COPY OF IS THE BLDG AN TAL VALUATION: PLANNING APPL N [-]NO PLANNING APPROVAL LETTER EICHLER HOME:' ,. s --."4 i 0� OOD By my signature below,I certify to each of the following: I am the property owner th fazed agent to action the properry owner's behalf. I have read this application and the information I have provided is correct. I have read the Descrip Io1 on o€.Work"and verify it i:•accurate. I agree to comply with all applicable local ordinances and state laws relating to buildin ns ction. 1 authorize representatives of Cupertino to enter Ile above-identified property for inspection purposes. Signature of Applicant/Agent: u4 _ Date SUPPLEMENTAL INFO MAT10N REQUIRED PLAKct cicTYre RppTTNGSLiP _New SFD or Multifamily dwellings: Apply for demolition permit for El existing building(s). Demolition permit is required prior to issuance of building OVER-THE-COUNTER ❑ BITtILDING PLAN REVTEw permit for new building. ❑ EXPRESS CD.PLANNING PLAN REVJEW , _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARE, ❑ PUBLIC WORKS, form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. ❑ MAJOR ❑ SANITARY SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH B1dgApp_2gl Ldoc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10416 PRUNE TREE LN DATE: 12/18/2014 REVIEWED BY: MELISSA aA PN: 316 33 119 BP#:: *VALUATION: 1$600,000 I- ERMIT TY PE:: Building Permit PLAN CHECK TYPE: New Construction PRIMARY SFD or Duplex 2nd Unit? Yes • No PENTAMATION 1 R3SFDW USE: PERMIT TYPE: WORK CONSTRUCT 2,913 S.F. N 2 STORY SFD WITH 595 S.F. PORCH/BALCONY & 462 S.F. SCOPE ATTACHED GARAGE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,III-B,IV,V-B 3,508 $3,190.71 IR3PLNCK $3,297.93 IRMNSP U (Private Gar/Ag Bldg) II-B,III-B,IV,V-B 462 $0.00 I UIPLNCK $1,290.00 l UIINSP TOTALS: 3,970 $3,190.71 $4,587.93 NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS (Fee Resolution II-053 a.' 7`1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,190.71 Select a Misc Bldg/Structure Su 1. PC Fee: Re OT 0.0 hrs or Element of a Building pP � g• $0.00 PME Plan Check: $0.00 Permit Fee: $4,587.93 Suppl. Insp. Fee:Q Reg. OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 #new Construction Tax: IBCONSTAXR 1 units $667.73 Work Without Permit? 0 Yes (j) No $0.00 Advanced Planningy Fee: IPLLONGR $555.80 Select a Non-Residential Building or Structure i Strong Motion Fee: IBSEISMICR $78.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $24.00 SUBTOTALS: $9,104.17 $0.00 TOTAL FEE: $9,104.17 Revised: 10/01/2014 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10416 PRUNE TREE LN DATE: 05/11/2015 REVIEWED BY: MELISSA APN: 316 33 119 BP#: 14120099 *VALUATION: $0 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION USE: pPERMIT TYPE: 1GENRE WORK REV# 1 - REVISE THE APPROVED FOUNDATION PLANS TO INCLUDE N SUPPORT DETAIL SCOPE CHANGES - IISUED 5/11/15 4 �a L1ech. Plan Check PLunnb. Plan Check Elec..Plan Check 1ec'th. Permit Fee: Plumb.Permit Tire: Elec. Permit Fee: Other Rlech. Ins[). Li I Other Plumb Insp. Other A/cc.Insp. EIF 'Icch.Insp.Fee: Plumb.Insp.Fee: 1,lec.Insp. Fee: NOTE:This estimate does not include fees due to other Departments(i.a Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These.Lees are based on the prelimina information available and are onLy an estimate. Contact the De t or addn'1 info. FEE ITEMS (Fee Resolution 11-053 Ef. 7/f 1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes E) No $0.00 0 hours Plan Check,Hourly Suppl.PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $143.00 ISTPLNCK PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee-E) Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construciion Tax: Administrative Fee: Q Work Without Permit? 0 Yes No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential E) Travel Documentation Fees: Building or Structure 0 -StromNlotior F-ee. $0.0 Select an Adminis rt a i�I em Bldp,Stds Commission Fee: $0.00 suB ®TAs:;` $0.00 $143.00 TOTAL FEE $143.00 Revised: 04/01/2015 B ilding Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 C O P E RT I N O Telephone: 408-777-3228 Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: 10Z'16 PRUVE 7/2E-E- Lf}ry L- PERMIT# / 4t 2-0 0"7 OWNER'S NAME: A L.&x i— 1 U PHONE# 6 5-0 -02-- Og"S" GENERAL CONTRACTOR: Ll LI C-CW57XKe-TJ0A1 r d USINESS LICENSE# j Z 13 ADDRESS: 1+7Z- /0;P_INC& CVA- CITY/ZIPCODE: S f tNN Y ALE L7400 *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 Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE# Cabinets &Millwork L Liy 3 2- 3 Cement Finishing a ffA-ew�s 60nC,/"r't� 32— 39- Electrical rive SfAr 7,mer4 C c-h'c-c !/�Z Excavation /14 tl,tcv Cmvc re fer 3ZP 3 9- Fencing sr-e rr* r5t&cp 4. Lw-,w h..&r- l ffS`7 Flooring/Carpeting Harwcvoo Ro o-Ks 5'&e (� Linoleum/Wood AI A- Glass/Glazing 'd apt d S 4oale v- r DFA ke- c© d 3 3 jS3 D K Heating P Z- - s vr`c� 25-42-7 Insulation C a5� s�ja-�� Corti�yv=e�s /5-4163 Landscaping a;h 2- i A+' �RHei�t.2 3 Lathing O `I/O i P/'&t �A ren 33 8'6 Masonry +- K rW AlAsoni-iLl Inc Z � Painting/Wallpaper -F. �l�, 'h SI,-v;L-P-s 2�S Paving ///'- Plastering �ob Vat P It Plumbing "i( a r r e re-( CCXsbch' 3(/4 2 Roofing 2 Septic Tank - VIA- Sheet Metal P — �ti,� 2.S42 -Sheet-Rock Cft-1-f-Z)r ti/ 1- - �-� Tile R Itle v-A R Crake 1A e— 32-8-7 Owne /Contractor Signature Dat