13120100-PUB903 S STEELING RD
13120100
F
Ll WANG
SCANNED BOX #596
Building Department
CUPERTINO
CONTRACTOR / SUBCONTRACTOR LIST
City Of Cupertino
1030Ci Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: q03
P'o(
PERMIT #' 7iU vv
OWNER'S NAME: \ jGt
PHONE #
GENERAL CONTRACTOR:
ICE L ( G,
BUSINESS LICENSE # i
ADDRESS: 101pj, T.j ) i r-.e
(,tv v 151 V
CITY/ZIPCODE:
*Our municipal code requires all businesses work&ng 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:
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring / Carpeting
Linoleum / Wood
ILI
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner /
Date
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 903 S STELLING RD
CONTRACTOR: EVERSPRING
PERMIT NO: 13120100
CONSTRUCTION INC
OWNER'S NAME: LI WANG
1131 S DE ANZA BLVD
DATE ISSUED: 06/11/2014
OWNER'S PHONE: 4087817676
SAN JOSE, CA 95129
PHONE NO: (408) 446-8398
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
1610 SQ FT ADDITION TO INCLUDE 655 TO 1ST FLOOR,
License Class Lic. # 6 O
2ND FLOOR ADDITION 955 SQ FT, REMODEL EXISTING
�i/E 4f!LIj c, (�S'le-vu—m''
Contractor ate � �
1000 SQ FT THROUGH OUT, PANEL UPGRADE
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:
l 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: $350000
performance of the work for which this permit is issued.
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
LPN Number: 35906015.00
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that l have read this application and state that the above information is
PERMIT EXPIRES IF W T STARTED
correct. l agree to comply with all city and county ordinances and state laws relating
WITHIN 180 DA +PERM SUANCE 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 ED 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
Is y: Date:
with all non -point sour a regulations per the Cupertino Municipal Code, Section
9.18.-- --- —
E-ROOFS:
Signa Date C << %
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)
1, 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. I will
1 hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.I2 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 25.534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized �_�---- =---'Date:
age_�—
permit is issued.
1 certify that in the performance of the work for which this permit is issued, 1 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, 1
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
CUPERTINO
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building0cu ertino.orp 0 V
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT r
PROJECT ADDRESS
.APN # �j
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OWNERNAME
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STREETADDRESS �� /
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CITY, STATE, ZIP
FAX
CONTACT NAME
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CITY, STATE, ZIP
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❑ OWNER ❑ OWNER-BUIIAER ❑ OAT'ERAGENT ❑ CON'ERACTOR ❑COI.TRACTORAGENT ❑ ARCHITECT L NG ER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAMfiIWgip
LICENSE NUMBER
-7 LICENSE TYPE
BUS. LIC ff
CONIPANY NAME
E-MAIL
FAX
STREETADDRESS
CITY, STATE, ZIP
PHONE
ARCHITECT/ENGINEERNAME LICENSE NUMBER
BUS. LTC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK / r I
C 7
3
iN� v�l
EXISTING USE
PROPOSED USE CONSTR
TYP
KSTORIE
S Y
I `-
/
V %TOTAL
L
USE
TYPE
CC.
SQ.FT.
VALUATION (S)
EXISTG
NEW FLOOR
DEMO
AREA 1
AREA r.
1
bVim/ AREA ,'1 NET AREA
BATHROOM
REMODELAREA
CHEN
REMODEL
I
OTHER
REMODELAREA 16't-
21 C,
PORCH AREA
DECK AREA
TOTAL DECK/P RCH AREA
GARAGE .AREA: LJ DETACH
I D
't?
t 17% [] ATTACH
#DWELLING UNITS:
IS A SECOND UNIT ❑ YES
SECONDSTOIkY &TES
f
BEING ADDED? 0
ADDITION? []NO
PRE -.APPLICATION IF YES, PROVIDE COPY OF
IS THE BLDGAN rl YES
RECENE
B ,�fv
TOTAL VALUATION:
PLAN'NXgGAPPL# ❑NO PLANNING APPROV
EICHLERHOAIE? PNO
By my signature below, I certify to each of the following: I am the property owner or authorized agen to act on the property om•ner ead this
application and the information I have provided is coiTect. I have read the Description of Work and verify it is acculate. I agree to comply with all applicable local
ordinances and state laws relatiaz to building construction. I authorize representatives of Cupertino to enter t`heabove-identified property for inspection purposes.
Signature ofApplicant/A ef:��/7_i—"�
Date"` LlZ/Z�0�3
SUPPLEMENTAL INFORMATION REQUIRED
PLAI.CFIECKIYPE_.xu 5
:',s,:-,RO.UTI�GSLIP <a x=<' N
New SFD or Multifamilydwellings: Apply for demolition elmit for
pp Y p
❑ OVER THE COUl\TER,,�
� $ ''
RE\ IEvy z
- .
existing bulldrng(s). Demolition pennrt Is required prior to Issuance ofbuilding
z
_ €a
BIIILDI �GPLAN
permit for new building,
L� REss
. PLAN'I�ING.PLAT1R ViEiY� s§
_ Conlniercial Bldgs: Provide a completed Hazardous Materials Disclosure
TAADARD
ptBLlct�oRxs �f
form if any Hazardous Materials are being used as part of this project.
Copy of Planning Approval Letter or Meeting with Planning prior to
Building Pennit
F
" 3AJOR'
AialTAI;YSEXI-TRDISTRICT
suFihiittal of application.
.
❑ 'AENVIRONIIIE �TAL H$ALTTi
BldgApp_2011.doc reidsed 06121111
CITY OF CUPERTINO
IM-E FEE ESTIMATOR — BUILDING DIVISION
1AADDRESS:
903 s stelling rd
DATE: 12/12/2013
REVIEWED BY: Mendez
APN:
BP#: oZ0 ,/ 1�'rj
"VALUATION: 1$350,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Addition
PRIMARY SFD or Duplex
USE: TOTC?
2nd Unit? Yes .' No
® Yes 0No
PENTAMATION 1 R3SFDADD
PERMIT TYPE:
WORK
1610
SCOPE
sq ft addition to include 655 to 1st floor, 2nd floor addition 955 sq ft, remodel existing 1000 sq ft p
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
1,610
$2,717.21
IR3PLNCK
$2,119.25
IR3INSP
TOTALS:
1,610
1 $2,717.21
$2,119.25
MECR, 80URLX : Yes (! N�
PLUMB, HOURLY d Yes Q Na
ELEC, HOURLY Q Yes O No
0" 6 I'tarr i °F < c b
birmh )yu,dr,t t fi�a ,4
Elec. Plan Check 0.0 hrs $0.00
Elec. Permit Fee: ]EPERMIT
)rrrt; ,-.��.
, <-, ref ,,�t� fif-_:
Other Elec. Insp. 0.0 hrs $47.00
,�'kch. �i;v), t'c'<':
F'17R,r, _ 17p �'j;, .- ...
�tiC_ h3�w.1"v'
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District etc ). These fees are hased on the nreliminary information available and are only an estimate. Contact the Dent for addh 7 info.
FEE ITEMS (Fee Resolution 11-053 E ' 7/1,g3)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,717.21
200 amps Electrical
$47.00 1BELEC2oo Services
Suppl. PC Fee: 0 Reg. Q OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$2,119.25
Suppl. Insp. Fee.S Reg. OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$47.00
(.'rnwruction Tax:
4 duairu.srrorivc
0
Work Without Permit? Yes Q No
$0.00
Advanced Planning, Fee: 1PLLONGR
$225.40
Select a Non -Residential
Building or Structure
A
Travel Documentation Fee: 1 TRAVDOC
$47.00
Strong Motion Fee: 1BSEISMICR
$35.00
Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC
$14.00
SUBTOTALS:
1 $5,204.86
$47.00
x TOTAL PEE.
$5,251.86
Revised: 10/01/2013