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15050141CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10438 N STELLING RD CONTRACTOR: QUIROZ PERMIT NO: 15050141 CONSTRUCTION INC OWNER'S NAME: HONGQI HU 105 N 27TH ST DATE ISSUED: 05/22/2015 OWNER'S PHONE: 4088236838 SAN JOSE, CA 95116 PHONE NO: (408)999-0881 its LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL REPLACE (E) REDWOOD FENCE WITH NEW REDWOOD �� License Class Lie. # 9 f l atria FENCE IN REAR YARD (75 LF) Contractorl y G `���%a . �r/Z Dates 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. EI have and will maintain Worker's Compensation Insurance, as provided for by Sq. Ft Floor Area: Valuation: $2500 APN Number: 32630096.00 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which this 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 I + 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 F 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 Is Da S ZZ granting of this permit. Additionally, the applicant understands and will comply y: with all non -point source regulations per the Cupertino Municipal Code, Section 9 18. fir- �.t' Datoolt"7 Z.�t S RE -ROOFS: All be inspected to any roofing material being installed. If a roof is Signature (��� L [ roofs shall prior 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 of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and performance I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sect' s 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this AIL Owner or authorized agent: Dafen _ gZ-20l$ 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 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228• FAX (408) 777-3333 • buildingaQcupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS � APN # 0 0 a� —c7 1 !ou N �j-�in�� i OWNER NAME0 tPHONEE-MAIL Z'f 017 G O 6 �✓ 8.36 L-2 3 STREET ADDRESS CITY, STATE, ZIP FAX O cu e f4 1 ti on CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP ` FAX 11 OWNER ❑ OWNER-BuiLDER ❑ OWNERAGENr R'CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME / LICENSE NUMBER eq f _I 77SFTYPE2 BUS. LIC # n -tr G 11 YU COMPANY NAME E-MAIL FAX ivvz ori v e -e • STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEFR NAME LICENSE NUMBER „' (� BUS. LIC # COMPANY NAME ^; E-MAIL FAX U 1 � � C .►moi •t . STREET ADDRESS CITY, STATE, ZIP PHONE CM 6 lege- /,rd tleg 24 ly DESCRIPTION OF WORK en CLO A9= av f EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR- ,DEMO TOTAL AREA AREA AREA NET AREA BATHROOM. KITCHEN.. OTHER. REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK ORCH AREA GARAGE AREA: DETACH ❑ A T rACH # 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 YESRECE VALUATION:�, PLANNnNGAPPL# []NO' PLANNING APPROVAL LETTER EICHLERHOME? []NO`. By my signature below, I certify to each of the following: I am the property owner or authori gent t e 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 verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating t ilding construction. I au orize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: �G U Date: k Z ( S SUPPLEMENTAL INFORMATION REQUIRED ` y� LANCHE,CKTYP � _ �; _ �-. �ROUTIRG�,SLIPs '; ,••,��: New SFD or Multifamily dwellings: Apply for demolition permit for } f R TH)•<C�OURTER + �I; r , I]� BUII.DING PLAT REVIESV4k� � �' existing building(s). Demolition permit is required prior to issuance of building y� � F permit for new building, v❑ ExPss rtz ' PLANpIIrGPLAN REyIEW4 Commercial Bldgs: Provide a completed Hazardous Materials Disclosure CI 'sTANnARDr r ,3 § �PIYBLTwoRxs� _ form if any Hazardous Materials are being used as part of this project.Tdp n _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION 21 ADDRESS: 10438 N STELLING RD DATE: 05/22/2015 REVIEWED BY: MELISSA APN: 326 30 096 BP#: *VALUATION: $2,500 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY PENTAMATION 1GENRES USE: SFD or Duplex PERMIT TYPE: WORK REPLACE E REDWOOD FENCE WITH NEW REDWOOD FENCE IN REAR YARD 75 LF SCOPE Meeh. I'larr Check 11Iamb. Plan Check Elec. flan Check Alech. Permil Fee: I I Phrmh. Permit Tire: I I Rea Pe:rn:ii Fee: Other lt/ech. Insp. I I I I Other Plunsb Insp. I I I Other Elec. Insp. 1.1ech, Insp. Tee: I Phtrrtb. hssp. Fee: I Elec. Insp. Lee: NOTE: This estimate does not include fees due to other Departments (i.a Planning, Public Works, Fire, Sanitary Sewer District, School .. . . 1 -'-r_ _._a ___ ..r.. __ ,...4:.....t,. /n.,t. retia r)nn}fnrnddn'I info_ visirtey e[c .- FEE ITEMS (Fee Resolution 11-053 Ef' 7/f 1/13) Plan Check Fee: FEE $0.00 QTY/FEE MISC ITEMS =l.f. Fence $431.00 1FENCE>6FT I Fence, Non -Masonry >6' Suppl. PC Fee: (j) Reg. 0 OT 0.0 1 hrs PME Plan Check: $0.00 $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -(j) Reg. Q OT 0,0 I hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administrative I ec>; 0 Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure � Travel Uocumentatlon Fees: Strom Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldy Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $431.00 TOTAL FEE: $432.50 meviseu. va:u ncu i o uV J It X0438 N ste.lim RSI. I OFFIC PLOT PLANS DATE PLANNING DSI CUPERTINO Z 7EJD MAY 22 2014 g, W-66A*cotj eY e vac� Qa"t . 0 104--g Qfencoe P. CLjPERT NO Building Depa"""ent 222015. 1=OR CODE COMPLIANCE REVIEWED . Reviewed BY: CONINIUN ITY DEVELOPMENT PER ENT INO BUILDING .pPROVED ke tat the fans a�d soecifications MUST be P Itis unlawful to make any This set of p or to deviate job site during construction.on sarrP alterations , quilding Official. changeS Or royal from the therefrom, without app . sp` - i Va,,,ons SHALL NOT T,,o slam i rova'l of the violation ne d to o�b�)ealnl ancaorState Law. ��;-en_ JATE`= PERMIT # 2. Bovals- ?x8x6-' P, oc(yw000 3..Fbs� Trea�ted Doll4glas F�r Vlfeanc'her capp& d I. -V A 0 LO-Iff GV f-Uf-UJiVf.X),U 1- V 1 (Top af c-alca'i 1 Fence &:��dfiorj Redwood lenice DetaR WO trnn I L nC15 Ede v MAY 2 2 2015 REVIEWED FOR C' COS C 0MPL/AN(,E Reviewed By,.