Loading...
15100058 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10160 FULLCREST RD CONTRACTOR:TING'S CONSTRUCTION PERMIT NO: 15100058 OWNER'S NAME: GROSS STEPHEN J AND MEI YAN 130 STAPLES AVE DATE ISSUED: 10/07/2015 OWNER'S PHONE: 4083433115 SAN FRANCISCO,CA 94112 PHONE NO:(415)586-8435 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ REMODEL KITCHEN(210 ST.);NO STRUCTURAL CHANGES License Class_ Lic.# 7 l� OR EXTERIOR WORK � Contractor / Date /0 /<Q 261r 1 hereby affirm th 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: Sq.Ft Floor Area: Valuation:$20000 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 APN Number:32616071.00 Occupancy Type: performance of the work for which this permit is issued. (•1-4 1 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 permit is issued. PERMIT EXPIRES IF WORK IS NOT STARTED APPLICANT CERTIFICATION WITHIN 180 DAYS OF PERMIT ISSUANCE OR I certify that I have read this application and state that the above information is 180 DS FROM LAST ALLED INSP C ON. 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 �(� ,S �j upon the above mentioned property for inspection purposes. (We)agree to save Issued by. \^LOv Date: 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. RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is Signature Date �O/ installed without first obtaining an inspection,1 agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that 1 am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER the following two reasons: 1 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 HAZARDOUS MATERIALS DISCLOSURE sale(Sec.7044,Business&Professions Code) 1 have read the hazardous materials requirements under Chapter 6.95 of the z I,as owner of the property,am exclusively contracting with licensed contractors to California health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain construct the project(Sec.7044,Business&Professions Code). compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Safety Code,Section 25532(x)should I store or handle hazardous material. I hereby affirm under penalty of perjury one of the following three declarations: Additionally,should 1 use equipment or devices which emit hazardous air 1 1 have and will maintain a Certificate of Consent to self-insure for Worker's contaminants as defined by the Bay Area Air Quality Management District I will Compensation,as provided for by Section 3700 of the Labor Code,for the maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the performance of the work for which this permit is issued. I lealth&Safety Code,Sections 25505,25533,and 25534. 2. 1 have and will maintain Worker's Compensation Insurance,as provided for by Owner oS aut orized agent- Section Section 3700 of the Labor Code,for the performance of the work for which this Date: 1S .�e�/ s permit is issued. a. 1 certify that in the performance of the work for which this permit is issued,I shall CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of work's become subject to the Worker's Compensation provisions of the Labor Code,1 for which this permit is issued(Sec.3097,Civ C.) must forthwith comply with such provisions or this permit shall be deemed Lender's Name revoked. Lender's Address APPLICANT CERTIFICATION ARCHITECT'S DECLARATION I certify that 1 have read this application and state that the above information is I understand my plans shall be used as public records. correct.1 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 Licensed Professional 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. Signature Date CONSTRUCTION PERMIT APPLICATION ,SJOCC5-f) COMMiUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ruo 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 ig (408)777-3228 • FAX�ILTEaATION/TI 3333•buildinci cuoer;ino.ora CUPERTINO ❑ 1,EW CONSTRUCTION ❑ ADDITION ❑ REVISION/DEFERR///ED ORIGP4A1 PERMIIT PROJEC'rA.DDPDSS �'O / li//cre5^^7r nn I6 U71 OWNERNAME�7�' / �� PHONE 4�,O8 -:31431116— E-MAR STREET ADDRESS 16 /6O l7/1//CrPSir 'e CITY, STATE,ZIP 1 d AX �u er7, o �,4 9S`o CONTACT NAME `y PHONE/ _ E-MAR. STREET ADDRESS CITY,STATE, ZIP s FFAX OWNER ❑ OWNER-BUILDER ❑ OWI.cRAGENT $1ON7RACTOR ❑CON MIXTORAGENT ❑ /.P.0=CT ❑ENGINE-zR ❑ DE\=LGPER ❑ TENA!.T CONTRACTORNAME %,� %.nG. I LICENSE NUI .BET�i I LICENSETYPE ,. ( BUS.LICk bOM?ANYNAI, �( EMAIL ^^TT FAX STREET ADDRESS '� - S C STA t CA CN_I PHONES ARCHITECTIENGINE£RNA.ME —�- _ I LICENSENIJISER l T`- BUS.LIC9 COMPANY NAA . —JI—_ EMAIL FAX STREET ADDRESS CITY,STATE,ZIP PHOI,IE DESCRIPTION OF' Clln,, ogre , 2 �._,04 EXISTING USE PROPOSED USE CONSTR.n-PE 1 4 STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXLSTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTKER REMODEL AREA REMODEL AREA _ �1 REMODEL AREA PORCH AREA DECK AREA TOTAL DBCK?ORCH!.RSA GARAGE AREA: LIDETACH ❑ATTACH DWELLINGUNTTS: IS A SECOND UNrr [I YES SECONDSTORY -0—YES ' BEING ADDED? ❑NO ADDITION? ❑NO PRE-APPLICATION ❑}'ES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑}­EsM TOTAL VALUATION: PLANNING.APPL k ❑NO PLANT'DNG APPROVAL LETTER EICHLER HOME? ❑NO By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this a - 1 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 to building construction. I authorize representatives of Cupertino to enter the above-identified property f r inspection purposes Ssna reoi -71iC_-nt'AE:cnt: Date: (::2 7 D% SUPPLEMENT INTFORA ON REQUIRED New SFD or Multifamily d\vellings: Apply for demolition permit for �� 4�' OBER-T KOUATER t s EBUIIDL\G PL ANRE� ys existing building(s). Demolition permit is required prior to issuance of building permit for new building' 1 0 PLA�I�L�Cr PL41 REQ IE}N .a-. ks 5 .-a-.,, �• r Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. AM, _Copy of Planning Approval Letter or Meeting with Planning prior to t�1 Q submittal of Building Permit application. o s' ATARR s �R Isr - Ft g r I�ba.,- .... �;�, �� Eiz7Roi.�nraLli�Al,ra'•�. i�� B1d9,4pp_2011.doc revised 06/21/11 CITY OF CUPERTINO jfr 1000 300 FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10160 Hillcrest Rd. DATE: 10/07/2015 REVIEWED BY: PAUL APN: 326 16 071 BP#: `VALUATION: 1$20,000 -PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex PENTAMATION 1 R3SFDREM USE: PERMIT TYPE: WORK Remodel Kitchen 210 S.f. No structural changes or exterior work SCOPE NOTE: 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 preliminarl information available and are onit,an estimate. Contact the De t or addn'l info. FEE ITEMS Il•cc Resolution 11-053 Ell. ,,1%131 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 2_1 07 s.f. Remodel, Kitchen(<=300 sf) Suppl. PC Fee: C) Reg. O OT 0.0 1 hrs $0.00 $645.00 IREMRESKIT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:O Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? O Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential g Buildin or Structure ;rn •1/>otnnninrrtion 1 Strong Motion Fee: IBSEISAIICR $2.60 Select an Administrative Item Bld�_, Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $3.60 $645.00 TOTAL FEE: $648.60 Revised: 10/01/2015 awn RECEIVED OCT 42015 BY OFFICE -COPY / r V 0 0 �— ro COMMUNITY DEVELOPMENT DEPARI MENT BUILDING DIVISION CUPERTIN APPROVED— This PPRO LDThis set of plans and specifications MUST a kept at the Job site during construction. It is unlawful to make any changes or alterations on same,or to deviate CUPERTINO thorofrom,without approval from the Building Official. Building Department The stamping of this plan and specifications SHALL NOT be held to permit or to be an approval of the violation OCT 0 7 2015 of a rovision sof any Ci�y Ofdin?nce or State Law. BY REVIEWED FOR CODE COMPLIANCE DATE Reviewed By: TRJO M-Vwj PERMIT NO. ww, ro.-s -12 1�4 ALI ---------- CUPERTINO Building Department OCT 0 7 2015 REVIEWED FOR CODE COMPLIANCE Reviewed By.