15100017CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19902 PORTAL PLZ I CONSTRAC TOION INC LIP ISAACS' I PERMIT NO: 15100017
OWNER'S NAME: YUNG-CHING WANG J- (/ it 0)e4'..e
OWNER'S PHONE: 4082576151
S,e Ti
LICENSED CONTRACTOR'S DECLARATION
License Class 3 G 17 Lic. # Z 76 7 7
Contractor Gia rr AJC _2 DateL2—LI
1 hereby affirm that I am licensed nder 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 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
fatance of the work for which this permit is issued.
nd will maintain Worker's Compensation Insurance, as provided for by
3700 of the Labor Code, for the performance of the work for which this
s issued.
APPLICANT CERTIFICATION
1 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
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 with
all non -point source regulations per the Cuperti9p*Mnicipal Code, Section 9.18.
Date f U Z 115
C
1 hereby affirm th t>L m'Cxempt from the Contractor's License Law for one of
the following two reasons:
1 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)
2. 1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
t. 1 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.
2. 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
permit is issued.
3. 1 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
become subject to the Worker's Compensation provisions of the Labor Code, 1
must forthwith comply with such provisions or this permit shall be deemed
revoked.
APPLICANT CERTIFICATION
I certify that 1 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
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 with
all non -point source regulations per the Cupertino Municipal Code, Section 9.18.
Sign
Date
7705 MOUNTAIN AVE I DATE ISSUED: 10/02/2015
ORANGEVALE, CA 95662 1 PHONE NO: (916) 852-8132
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
REPLACE LIKE -FOR -LIKE OF 4 WINDOWS AND 2 SLIDING
DOORS.
Sq. Ft Floor Area: I Valuation: $6400
APN Number: 36946009.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS LAST CALLED INSPECTION.
Issued by: Date: tot 2- /
RE -ROOFS:
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.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should 1 store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Ilealth & Safety Code, Sections 25505, 25533, and 25534.
Owner or an � s
Date: /
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
1 understand my plans shall be used as public records.
Licensed Professional
uvr9a.a irar.�n, uvrvivru� a i�yyeca L PLAN CHECK TYPE
ROUTING SLIP
CUPERTINO
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(a1cupertino.org I5 10 Ol/ I
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS D 2 IJp- r�' 71 �Z
7APN# 3 f _n jam/-
OWNERNAME j v �/�� I ll`�
PHONE Z� 7` (6/
E-MAIL
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STREET ADDRESS' 19910 11?C, 2-TA I P 1,Az A
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CITY IP�� C 4 Q/`
FAX
CONTACT NAME
-) Ir�� �,41 � .
PHONE
S/D • 27 •' ?_GO
E-MAIL
7�`C�Fr�r'`r. �� F C
STREET
Cr[YsSTATE, ZIP C A ��
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FAX/O7 31�
❑ OWNER ❑C OWNER -BUILDER ❑ OWNER AGENT ; CONTRACTOR CONTRACTOR AGENT 11 ARCHITECT ❑ ENGINEER ❑ DEVELOP
CONTRACTOR NAME '�,, I/1,P / [ LG
�1 1 J
LICENSE NUMBER6/7677
LICENSEE TYPE
BUS. LIC #
COMPANY NAME
C'./k C, • C �[:"� ill ,1i� � f 14+1f'f � .i1 C�
E-MAIL
C I [r1e'E!s% �'R-rN r'l sE 2JIG . Gv
FAX
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STREF,T ADDRESS
It �• E ��Z DZ
ITY, STATE, ZIP
N-A-�j,�_-Hoe_0I �I 9 Z
P ONE
/. A5 2
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
I v+ I I T If LjI j Docj ` _D - d pi9
EXISTING USE
PROPOSED USE CONSTR.
TYPE
# STORIES
USE
TYPE
OCC
SQ.FT.
EXISTG
AREA
NEW FLOOR
AREA
DEMO
AREA
TOTAL
NET AREA
BATHROOM
REMODEL AREA
KITCHEN
REMODEL AREA
OTHER
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH ARE
I GARAGE AREA: DETACH
❑ ATTACH
# DWELLING UNITS
IS A SECOND UNIT ❑ YES
BEING ADDED? ❑ NO
SECOND STORY ❑ YES
ADDITION? ❑ NO
PRE -APPLICATION ❑YF.S IF YES, PROVIDE COPY OF
PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER
IS THE BLDG AN ❑ YES
EICHLER HOME? )i NO
RE C
T TAL VALL
By my signature below, I certify to each of the following: I am the property owner or author' en o ton the property owner's behalf. I have rea
application and the information I have provided is correct. I have read the Description of Work an verify it is accurate. I agree to comply with all appl
ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection
Signature of Applicant/Agent: Date: "
SUP LEMEN ORMATIO
olition permit for
_ New SFD or Multifamily dwellings: AppK,,edprior
existing building(s). Demolition permit is to issuance of building
permit for new building.
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
PLAN CHECK TYPE ROUTING
❑ OVER-THE-COUNTER ❑ BUILDING PLAN 1
❑ EXPRESS ❑ PLANNING PLAN
❑ STANDARD ❑ PUBLIC WORKS
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
NUT E: 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 reliminarp in ormation available and are oni), an estimate. Contact the Dent for addn7 info.
FEE ITEMS (Fee Resolution 11-053 La. 711,113)
ADDRESS: 19902 Portal Plaza
DATE: 10/02/2015
REVIEWED BY: Phuong
APN: 369-46-009
BP#:
'VALUATION:
$6,400
'PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Addition
PRIMARY SFD or Duplex
USE:
0.0
PENTAMATION 1GENRES
PERMIT TYPE:
WORK
Replace like -for -like of 4 windows and 2 sliding doors.
SCOPE
$0.00
NUT E: 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 reliminarp in ormation available and are oni), an estimate. Contact the Dent for addn7 info.
FEE ITEMS (Fee Resolution 11-053 La. 711,113)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
F-67 #
$431.0011
Window / Sliding Glass Door
WINREP Replacement
Suppl. PC Fee: (F) Reg. O OT
0.0
1 hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee -0 Reg.
Q OT
Q Q
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
onsli'liclion 121_
0111i111,111'l1/il 1'Ci .
O
0
Work Without Permit? O Yes 0 No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
0
0
/" ! I'C1 1)(), .11111('111 r lI h111 1' ,
Strong Motion Fee:
IBSEISMICR
$0.83
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$1.83
$431.00
TOTAL FEE:
$432.83
Revised: 07/02/2015
Portal Plaza Homeowners Association
c/o Associa Northern California
2542 South Bascom Ave., Suite 170
Campbell, CA 95008
408.540.5050 Phone / 408.371.5130 Fax
emily.ramirez@associa.us
September 17, 2015
Yung -Chin Wang
19902 Portal Plaza
Cupertino, CA 95014
REF: Architectural Application Approved
19902 Portal Plaza
Dear Homeowner(s):
We are pleased to inform you that your application to replace all the windows and the glass sliding door to
double pane windows, work done by California Energy Consultant Service has been APPROVED by the Portal
Plaza Homeowners Association Board of Directors.
Any additions or modifications to the above referenced work will require a new application. Please be sure that
your modifications comply with any applicable municipal codes and that you receive any additional approvals
as necessary.
Please contact me at emily.ramirez@assoeia.us if you have any questions or comments. Thank you for your
cooperation.
Sincerely,
Emily Ramirez, CCAM, CMCA on behalf of:
The Board of Directors
Portal Plaza HOA
cc: Property File: 00187-9625
Architectural Committee
Board of Directors
APPL2 — Architectural Application Approved
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SIT
CUPERTINO
Owner Name
Address l
WATER -CONSERVING PLUMBING FIXTURES =
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildin cu ertino.or 1r D 00/7
e /_9d -- Vrr Vtl ` ?/ /a d/74 Permit No.
U TU`
1. Is your real property a registered historical site?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
Z1. No Go to Question 2.
2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its
plumbing, installation of water -conserving plumbing fixtures is not technically feasible?
❑ Yes Civil Code Sections 110 1. 1 through 110 1. 8 do not apply.
❑ The licensed plumber's certification has been provided to the Building Division.
Skip the rest of the form and sign bottom of form.
�i No Go to Question 3.
3. Is water service permanently disconnected for your building?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
: q -No Go to Question 4.
4. Is your real property built and available for use or occupancy on or before January 1, 1994?
❑ No My real property is built and available for use or occupancy after January 1, 1994.
Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
LYYes My real property is built and available for use or occupancy on or before January 1, 1994.
Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign
bottom of form..
Please check ONE of the following:
My property is a single-family residential real property. See Civil Code Section 1101.4.
On and after January 1, 2014, building alterations or improvements shall require all non-coinpliant plumbing fixtures
to be replaced with water -conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non-
compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether
property undergoes alterations or improvements).
❑ My property is a multifamily residential real property. See Civil Code Section 1101.5.
On and after January 1, 2014, specified building alterations or improvements shall require non- compliant
plumbing fixtures to be replaced with water -conserving plumbing fixtures.
On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water -
conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or
improvements).
❑ My property is a commercial real property. See Civil Code Section 1101.5.
On and after January 1, 2014, specified building alterations or improvements shall require non- compliant
plumbing fixtures to be replaced with water -conserving plumbing fixtures.
On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving
plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements).
I, as the owner or owner's agent of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be
replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 110 1. 1
through 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's
installation requirements, and that the water -conserving plumbing fixtures comply with the requirements as indicated in the
table on the followinia pate.
Owner or Owner Agent's Signature: / - Date:
Upon completing and signing this Certi rcate, Vease return it to the Building Division in order to final your building permit.
SB407 2015.doc revised 08/26/15