15050152-CANCELLED i
NOV 0 9 2015
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 22673 WOODRIDGE CT CONTRACTOR:T PERMIT NO:15050152
OWNER'S NAME: TUNG TUNG-SUN AND MARIA DATE ISSUED:05/26/2015
OWNER'S PHONE: PHONE NO:
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL
REPLACE(E)800 S.F.WOOD SIDING WITH NEW
License Class Lic.# -7 5 A HARDIBACKER SIDING(800 SQ FT),REPLACE(E)PATIO
WALL&REPLACE 10 LF OF(E)6'REDWOOD FENCE(NO
Contractor i/!�r- � rL��� Date �'� ''
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.
affirm under penalty of perjury one of the following two declarations:
11 have and will maintain a certificate of consenta -'n.sure f Worker's
Compensation,as provided for by Section 3700 oto L e,for the
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$15000
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:34215075.00 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 WITHIN 180 DAYS OF PERMIT 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 FROM L D 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 Issued b Dat
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section
918.
- OOFS:
Signature Ift Date All roofs shall be inspected prior to any roofing material being itistalled.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. I 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: 1)a2&�6 7
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
CONSTRUCTION PERMIT APPLICATION r\\�
COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION V
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
r'UPERTINO (408)777-3228• FAX(408)777-3333•building(G),cupertino.org
❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT;#
PROJECT ADDRESS `-� WQgJd6e,
c1 APN#
4� ddd c.� L f
OWNER NAME , �N PHONEg0 A S�- g13'$ E�-MCAIL4� _ alUd. C
STREET ADD 2ES�1- 01-1
y O.d r'� e,ur CITY, STATE AZIP
16 915,16/y
J FAX
CONTACT NAMEILLIG 1ti!/de PC(,gj1/jlN� �' 4f,/ f.�. fy1,.
/1lG 9,vlitr .i �f`r
ST REE ,?D S� JI �h CITY,STJ'h _ /�q SLi A^ /��//� FFAX
❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT [❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR A LICENSE NUMBE LICENSE TYPE BUS.LIC#
� 6� C�r� Iw�7 5546
COMPANY N /] �+ E-MAIL /� FAX
eta) s Cow-5 I' L;,�,MM1 SJ sre *YC (441"01' C(7M
STI&4VDRESSu CIrYLTr�IP�a /_ ^� Pra 3�6';p �
ARCHITECT/ENGINEER NAME LICENSE NUMBER CJv C BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIP O O M%^�`
WV a D kV e0T W PKdO. J AIMA66P -S)91--O /1 •e' S yr a �—
/ Xoee /o o`f'/ jc-tt ud
STINg USEi�� e4(A
CONSTR. E #STGRIES USE TYPE OCC. SQ.FT. VALUATION(S)
EXISTG NEW FLOOR DEMO —
TOTAL
ue()V
AREA AREA AREA NET AREA
BATHROOM KITCHEN V OTHER
REMODEL AREA REDIODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: 0 DETACH
[]ATTACH
#DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY []YES
BEING ADDED? ❑NO ADDITION? []NO
PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑ RE
s TOTAL VALUATION:
PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO
By my signature below,I certify to each of the following: I am the property owner or au age oemon the property owner's behalf. I have read this
application and the information I hav !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 relating t ® _ mtruction, j authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: Dater
SUPPLEMENTAL INFORMATION REQUIRED
SEN.i.._LAh CHECK TY�'E, _- n I20UTII�G;SLIP° t:.
_New SFD or Multifamily dwellings: Apply for demolition permit for ; " `t
OVER THE-COIJhTER -C�
existing building(s). Demolition permit is required prior to issuance of building r k s a f F} r�r z a u zE«�BUILDINGPLANREVIEw,4r ra v
permit for new building EXPxEss ,y s � "PLAivnlnGriAivxEEy#Ew
tiiGu 4 •'t �i' a �sZ �i
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ry��sTANnARD} r'�h"n g a F+ PUBcwoRicsfi a {L„m �
{ at 1 w c r",4 r x4u q.
form if any Hazardous Materials are being used as part of this project. 0 � r w
• ti s®r Y.A�tG'L`�.�� �," �3^�t�� ' �
_Copy of Planning Approval Letter or Meeting with Planning prior to
�'� MAJOR "`x �'` '-"� DG+SAI�TPARSER'ERDISTRI „ +
submittal of Building Permit application. t �t
' t � ,* .O,,ENLYIROTIMEI�.�J.IstIIEAliTPIv" .. '.µ,.
B1dgApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 22673 WOODBRIDGE CT DATE: 05/26/2015 REVIEWED BY: MELISSA
APN: 342 15 075 BP#: *VALUATION: $15,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Repair
PRIMARY SFD or Du lex PENTAMATION 1GENRES
USE: p PERMIT TYPE: i
WORK REPLACE E 800 S.F. WOOD SIDING WITH NEW HARDIBACKER SIDING 800 SQ FT REPLACE
SCOPE (E) PATIO WALL& REPLACE 10 LF OF (E) 6' REDWOOD FENCE (NO PERMIT REQ'RD)
Afech. Plan Check Plumb. Plan Check Flec..Plan('heck
Mech. Penni!Fee; Plumb,Permit Fec: Rec. Permit Fee:
Other A/ech. Insp. Other Plumb Insp. Other Elec.Insp. LJ
11ech.Insp.Fee: Phtrrrb. Insp. Fee: Elec.Insp.Fee:
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,eta). These fees are based on the prelimina information available and are only an estimate. Contact the Dept-for addn'1 info.
FEE ITEMS(Fee Resolution 11-053 Eff 7/1/13) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 800 s.f. Siding
Supp/.PC Fee: Reg. OT 0.0 hrs $0.00 $646.00 ISIDEOTHER All Other
PNM Plan Check: $0.00
Permit Fee: Hourly Only? 0 Yes Q No $0.00
Suppl. Insp.Fee:Q Reg. Q OT 0.0 1 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Construction Tax:
Administrative Fee:
Work Without Permit? 0 Yes (F) No $0.00
Advanced Planning Fee: $0.00 Select a Non-Residential
Building or Structure
Travel Documenlalion Fees: L I
Strong Motion Fee: IBSEISMICR $1.95 1.0 hrs Inspections
Bldg Stds Commission.Fee: IBCBSC $1.00 $143.00 1STINSP Inspection,Hourly
SUBTOTALS:z $2.95 $789.00 TOTAL FEE: '
Revised: 05/07/2015
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N® Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: ZZ 0 C) V't PERMIT#
OWNER'S NAME:(-;Z -Vf Cy,y4,V+14PHONE# 41�71?�
GENERAL CONTRACTOR: J rU st" �d,A BUSINESS LICENSE# 5 Q
ADDRESS: Cl -e'ww'%Q � �/!� CITY/ZIPCODE:
*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. 0 r
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
Cement Finishing
Electrical
Excavation
Fencing
Flooring/Carpeting
Linoleum/Wood
Glass/Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting/Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
I
rgib9MUNITY DEVELOPMENT TENT
NT
BUILDING UPERNO
OFFIC ,E Copy
APPROVED at the
This set of plans and specifications MUST be kept
job site during construction. It is unlawful to make any e^pGN�M
changes or:alterations on same, or to deviate
therefrom,without approval fro*, . ilding Official ? o� o xo�q v,sxo $
The Stamping of this pian and s e�'aifL:�fl4%s SHALL NCH
be held to ped it or to be an to Law. 5� i
of any pi '
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