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13110095-public18650 CYNTHIA AVE 13110095 I LI KUO TSAI AND LIU PEISHAN SCANNED BOX #598 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18650 CYNTHIA AVE CONTRACTOR: HOMESTEAD PERMIT NO: 13110095 CONSTRUCTION INC OWNER'S NAME: LI KUO TSAI AND LIU PEISHAN 10080 STERN AVE DATE ISSUED: 07/16/2014 OWNER'S PHONE: 4088871382 CUPERTINO, CA 95014 PHONE NO: (408) 255-8999 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ CONSTRUCT 2 STORY SFDWL TO INCLUDE IST FLOOR License Class_Lic. 4 J 1231 SQ FT, 2ND FLOOR 912 SQFT AND ATTACHED GARAGE Contractor > > �`� 420 I hereby affirm that I am licensed under the provisions of Chapter 9 SQ FT (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 Y4 performance of the work for which this permit is issued. Sq, Ft Floor Area: Valuation: $285000 ` 1 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: 37522028.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPI IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 18 DAYSERMIT 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 DAYS FR M LAST CALLED 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 comply Issued by: Date: l with all non -point source regulations per.# Cupertino Municipal Code, Section 9.18. �/ RE -ROOFS: Signature Date b� 'T 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: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1, 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) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will 1 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 1 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 255595, 2.553 _- Z2553 Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Z_ 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 1 certify that 1 have read this application and state that the above information is correct. l 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 CUPERTINO XNEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a)cupertino.org ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED 311 ORIGINAL PERMIT # PROJECT ADDRESS t APN # � OWNER NAME, 1 PHONE�-�, STREET ADDRESS N H t H A V& CITY, STATE, ZIP Rlt,� (4_ L v rz(:Z (Wo C'/,) FAX . CONTACT NAME �AV1� PHONE 1_4Le ) �9�- �a f� E-MAIL de� STREET ADDRESS i o_ G8 8AN DLE�DR. jl(OZ CITY, STATE, ZIP C.c I k/C A'i - E4 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME h LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME J—� LICENSE NUMBER C 2 (� �i K} BUS. LIC # COMPANY NAME A V (tom �R�-14- E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES S F. D. S I Ir-8 2 USE TYPE OCC. SQ.FT. VALUATIONS) EXISTG AREA NEW FLOOR EMO AREA AREA TOTAL NET AREA - �I4;t BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA w PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ��S -4d ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES BEINGADDED? NO SECOND STORY [] YES ADDITION? NkO 7YES PRE -APPLICATION YES IF YES, 4WIDOPY OF IS THE BLDG AN - RECEIVED - TOTAL VALUATION: PLANTIING APPL # ❑ NO P P 0 R� EICHLER HOME? ❑ NO 2 0 Uv By my signature below, I certi to each of& f 1 wing: I am the property owner or authorized nt 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 v it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building co ction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION UIRED PLAN CHECK TYPE a ROUTING SLIP <r ' , r _ New SFD or Multifamily dwellings: Apply for demolition permit for t" OVER THE -COUNTER s BUH.DINGPLAN REt3EW existing building(s). Demolition permit is required prior to issuance of building ah • x k z for new building. p g ❑ xP ss` ING Permit PLAN REVIEW �` , g _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. :STAN'DARDM PUBLIC�VtORKS ❑ ;.,,"k Copy of Planning Approval Letter or Meeting with Planning prior to,: �a ❑ _ submittal of Building Permit application., MAJOR ::AIVTTARYSEWERDIST�IC I . ENVIRONME \TAL HEALTH , BldgApp_2011.doc remised 06121111 CITY OF CUPERTINO FEW FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 108650 Cynthia ave DATE: 11/14/2013 REVIEWED BY: mendez APN: BP#: VALUATION: 1$285,000 %PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY SFD or Duplex USE: 2nd Unit? Yes • No PENTAMATION 1 R3SFDW PERMIT TYPE: WORK construct 2 story sfdwl to include 1st floor 1231 sq ft 2nd floor 912 s ft and attached garage 420 sq ft SCOPE 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 2,563 $2,897.01 IR3PLNCK $2,739.24 IR3INSP TOTALS: 2,563 $2,897.01 $2,739.24 1lajr l 6irc {r 1'l+uilb. ly(;,il (Jle �� Af 0�'r�.'- £'filar f "l4A 4, NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Dietrirt- etr_! Theve foev ara ha.ced an the nreliminary information avoilahle and are only an estimate Contact the Dent far addn'1 info. FEE ITEMS (Fee Resolution 11-053 E ..� 7i1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,897.01 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $2,739.24 Suppl. Insp. Fee-0 Reg. Q OT T0.0Thrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXR 1 # new units $650.84 I ;tatrist;mro, 0 Work Without Permit? ® Yes 0 No $0.00 Advanced Planning Fee: IPLLONGR $358.82 Select allon-Residential O Building or Structure / 1'�cli('_ 1)t)t'flli7i'Miladlf>il 3`c'�J_ Strong Motion Fee: IBSEISMICR $28.50 Select an Administrative Item Bldu Stds Commission Fee: IBCBSC $12.00 SUBTOTALS: $6,686.41 $0.00 TQTAL FEE: $15,686.41 Revised: 10/01 /2013 Building Department City Of Cupertino 10300 Terre Avenue Cupertino, ("A 9501.4-3255 CUP �TI�I� Telephone:408-777-3228 Fax:408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: 18650 Cynthia Ave, Cupertino PER_MI T # 13110095 OWNER'S NAME: Li Kuo Tsai And Liu Peishan PHONE #� 408.887.1382 .................... .............................................._....................._......._....._................. GENERALomestead Construction, Inc. .C'("iNTRACTOR:HBUSINESS .LK ENSF # .� ..._..........-__......._.......___"_ ADDRESS: 10080 Stern Ave, Cupertino-........—...._............_.......____ a CITY/ZIPCODE: 95014 *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL. CAR FINAL OCCUPANCY INSPECTION(S) WILL. BE SCHEDULED UNTI.I., THE GENERAL, CONTRACTOR AND ALL SUBCONTRACTORS HALVE OBTAINED A CITY OF CUPI+WFINO BUSINESS LICENSE. I am not using aw subcontractors:.... .................... .......... _.... _. S ig n atu�"c� Date Please check applicable subcontractors and complete the following, information: V ._._...._ SUBCONTRACTOR .....,... .......... - ...... -- ----...._........................... BUSINESS NAME ._. .......... _.._........ BUSINESS L.IC.ENSE# Cabinets & Millwork. .. .. ............_._._......._ _ .._........ ..�......... ....................__�_........................�.__..,...._... x Cement Finishing M S Construction _._.._.. 31031' __._........ _....... —___. -..__._ 2-7 Electrical 1 ,,,, Excavation Fencing Flooring I Carpeting Linoleu n 1 Wood Glass / Glazing - --._................. .... _.......... _...... _........-........ .... _. Heating Insulation _.... mS� p 3U Landscaping Lathing Masonry Painting / Wallpaper Paving .............. _..- Plastering --._................... ............. ........ ..... . Plumbing �F`.___ _ Z77 Roofing 14 Svt a.,_. 7eA\ 0- -..._....._............._........... Septic `Tank. __._.___........._.........._...._............_....._.. Sheet. Metal Sheet R.ock Tile u j n .ractor Sign- Wure Date