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15010054 (2)666 BETTE AVE 15010054 F DING HUI AND CUI LI SCANNED BOX #663 _ CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 866 BETTE AVE CONTRACTOR: GLOBUS BUILDER INC PERMIT NO: 15010054 OWNER'S NAME: DING HUI AND CHI LI 6350 LAUREL CANYON BLVD STE 400 DATE ISSUED: 03/18/2015 OWNER'S PHONE: 6503538655 N HOLLYWOOD, CA 91606 PHONE NO: (818) 760-7100 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ q 953 SQ FT ADDITION TO FRONT AND REAR OF SFDWL TO License Class Lie. # / o INCLUDE (3) BEDROOMS W/ BATHROOMS; REMODEL 576 h �/ rip r�- ContractorGLO ()r ,�I�O �`\ �_ UL Date SQ !s._V1�(!'- FT THROUGH OUT 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 fall 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 Sq. Ft Floor Area: Valuation: $200000 performance of the work for which this permit is issued. 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: 36924047.00 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 DAY_ - LED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, _S costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will compl Ate: with all non -point source regalo Municipal Code, Section 9.18. =Dac3-)2— RE -ROOFS: Signature All roofs shall a 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 (Sce.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 unicipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25 3, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner at, authorized agent: Date:s 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 Compensation laws of California. If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Cade, 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION 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 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 866 BETTE AVE CONTRACTOR: GLOBUS BUILDER INC PERMIT NO: 15010054 OWNER'S NAME: DING HUI AND CUI LI 6350 LAUREL CANYON BLVD STE 400 DATE ISSUED: 03/18/2015 OWNER'S PHONE: 6503538655 N HOLLYWOOD, CA 91606 PHONE NO: (818) 760-7100 10 LICENSED CONTRACTOR'S DECLARATION /� ` 2 p JOB DESCRIPTION: RESIDENTIAL COMMERCIAL 953 SQ FT ADDITION TO FRONT AND REAR OF SFDWL TO JO License Class Lic # R 0 / e) INCLUDE (3) BEDROOMS W/ BATHROOMS; REMODEL 576 SQ FT THROUGH OUT Contractor Date REV 4 1 - ALTER/SWAP LOCATION OF WINDOWS/DOORS I hereby affirm th am licensed under the provisions of Chapter 9 & RELOCATE LAUNDRY RM & GARAGE ACCESS & ADD (commencing wd Section 7000) of Division 3 of the Business & Professions (N) ELECTRICAL FIREPLACE - ISSUED 4/7/15 Code and that my license is in full force and effect, 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 One Labor Code, for the 11 performance of the work for which this permit is issued. I have maintain Worker's Compensation Insurance, as provided for by Sq. Ft Floor Area: Valuation: $200000 and will Section 3700 of the Labor Code, for the performance of One work for which this APN Number; 36924047.00 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 WORT{ IS NOT STARTED correct. 1 agree to comply with all city and county ordinances and state Imes 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 LAST CALLED 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 y: Date: granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per t�pertino Municipal Cade, Section RE -ROOFS: being installed. If a roof is 9.18. '` k �} Signature Dateo All roofs shall be inspected prior to any roofing material installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ WNER-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 'ch emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Are, Air Qua,' nagement District I performance of the work for which this permit is issued. will maintain compliance with the Cnperti�o Mnm, ' a ode, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by for the for this the Health & Safety Code, Sections 25 25533 2 534. "�,, 19 Section 3700 of the Labor Code, the performance of work which Owner or authorized agent: ^'~ Date:b��/ 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 CONST CTION 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, works 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 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 866 BETTE AVE CONTRACTOR: GLOBUS BUILDER INC PERMIT NO: 15010054 OWNER'S NAME: DING HUI AND CIA LI 6350 LAUREL CANYON BLVD STE 400 DATE ISSUED: 03/18/2015 OWNER'S PHONE: 6503538655 N HOLLYWOOD, CA 91606 PHONE NO: (818) 760-7100 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL —)Cf 5&c�, N 953 SQ FT ADDITION TO FRONT AND REAR OF SFDWL TO License Class, -�>, Lic. # INCLUDE (3) BEDROOMS W/ BATHROOMS; REMODEL 576 Contractor, f- -• Date /GJr�/ SQ FT THROUGH OUT REV # 2 - REVISE SHEARWALL TO FRONT ELEVATION - I hereby affir mYfam licensed tinder the provisions of Chapter 9 ISSUED 7/16/15 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in fall force and effect. I hereby affirm tinder 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 Sq. Ft Floor Area: Valuation: $200000 performance of the work for which this permit is issued. MI,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: 36924047.00 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 D F 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 ITA�T C-AL ED INSPECTION, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence oft _ granting of this permit. Additionally, the applicant understands and will comply Y. Date: /'[ 6 with all non -point source regulations pe he Cupertino Municipal Code, Section 9.18. Signature Date All roofs shall be in p ct r 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 (Sce.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. 1 will 1 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 Cupe 'no Municipal e, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 2 5, 25533, an 534. Section 3700 of the Labor Code, for the performance of the work for which this Owner Lam"'" llafe: d-`"i permit is issued.rt: or authorized agm 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 Compensation laws of California. If, after making this certificate of exemption, I 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 ibis 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 conch action, 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, ARCHITECT'S DECLARATION 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 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buildinggilouuertino.org ❑ NEW CONSTRUCTION ❑ADDITION ❑ALTERATION/TI N-CVTS�1-01D DEFERRED ORIGINAL PERMITnI S� PROJECTADDRESS nt APN9 � OWNER NAME �,` PHONE gO 35� E-MAIL �l _ C 68 (VY_ /__, �NG�� STREET ADDRESS 1 _A �Y 1-- © CITY, STATE, ZIP riA �,._d...�-]� \�I BNV y 1 ,P,f tyUM�rGI-Gc4 Y T`1�D FAXIJK CONTACT NAME PHONE E-MAIL STREETADDRESS CITY, STATE, ZJP FAX OWNER O OWNEI'R.y-Bt�R El ❑ OWNER AGENT ( CONTRACTOR CONTRACTOR AGENT El ARCHITECT ❑^ENGINEER ❑ DEVELOPER El TENANT CONTRACTORNAME /I' LICENSE NUMBER v 3 LICENSETYPE fl BUS. LIC 0 C3/ t01 /f�, COMPANY NAME 4"V4 � wW/ 1 f�`J E-MA1L �// In/b {�r FAX STREETADDRES�� o„ ,(�e.(/ . O FYp /b] CITY, STATE, ZtP.:/ 1�(,VL7._. // C •µ^me PHONE �ll�� (y'{fvV r ARCHTTECT/ENGMEFRRNNAVME LIICENSENUMBER BUS. LICK COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK EMSTINGUSE PROPOSED USE CONSTRTYPE 9STORIES I USE TYPE OCC, SQ.FT. VALUATION($) EXISTG NEW FLOOR DIMO TOTAL AREA AREA AREA NETAREA ._ BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCHAREA DECK AREA TOTALDECK/PORCHAREA GARAGEAREA: DETACH ❑ ATTACH ,". DWGLLINGUNITS: ISASECONDUNIT []YES SECOND STORY ❑YES BEING ADDED? NO ADDITION? El NO PRE -APPLICATION []YES E YES, PROVIDE COPY OF PLANNINGAPPLO ❑NO PLANNINGAPPROVALLETTER IS THE BLDG AN ' I ❑YES EICHLER HOME? ❑NO -1 .g:_ _ _� TOTAL VALUATION: By my signature below, I certify to each of the following heproperty owner or authorized agent to actoryth roe beha =ha read this application and the information I have provide correct, I �e read the Description of Work and,�ctj 4i4 ra e. I agree tocomply with stl appTlCa1>Le local ordinances and state lags relating to buildine,Lcf�onstructien authorize representatives of Cupertino to enter the abov�idemifred rope for spection ores. S ignature of Applicant/Agent Z.Date: C/ SUPPLEMENTAL rF ON RE RED - -a -- Y.ICHECRIIPE'-�� OIT�LN�SL(; New SFD or Multifamily dw ' as: Apply for demolition permit for existing buildings . Demolition permit is required prior to issuance of buildin vg permit for new building. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure©�raavARDp�6: �.ExESEs �-©f TSLA.N �2EV�i`F _ form if any Hazardous Materials are being used as this - --z part of project _ AROP—t'�iA?�IF.�x� -_-�-- _ Copy of Planning Approval Letter or Meeting with Planning prior to Building Permit ,y � AaseRVls t�3' submittal of application.QR Ys -.�=�-�- ��"k.�� t;vmorr�nrn7<F�Aisvar ��T B1dgApp_2011, doc revised 06121111 Im CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 866 BETTE AVE DATE: 07/16/2015 REVIEWED BY: MELISSA APN: 369 24 047 BP#: 15010054 'VALUATION: $0 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: p PENTAMATION PERMIT TYPE: 1GENRES , WORK REVISE SHEARWALL TO FRONT ELEVATION -ISSUED 7/16/15 SCOPE Mesh. Phan Check Pfiwlb. Plan Check Elec. Plan Check Alech_ Permit Fee; Plwnh. Permit Fee: Idles Permit Fee: Other dlech. frup. other Plumb lnsp.Ll Oder Elec. Inap.Lj Mech.Insh. Fee: Phaob. hccp. Fee: Flec. Insp. kee: 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 based on the preliminary information available and are only an estimate. Contact the Dept for addn'I info. FEE ITEMS (Fee Resolution 11-053 E f 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes Q) No $0.00 0 hours $143.00 Plan Check, Hourly ISTPLNCK i Suppl. PC Fee: (j) Reg. ® OT 0.0 I Ins $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? ()Yes (D No $0.00 Suppl. Insp. Fee:0 Reg. Q OT 0.0 Ins $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consiruction Tax: Administrative Fee: E) Work Without Permit? ® Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential E) Building or Structure 0 i Travel Documentation Tees: Strong Motion Fee: $0.00 1.0 Ins $143.00 Inspections ISTINSP I Inspection, Hourly Bldg Stds Commission Fee: $0.00 SUBTOTALS:''1 $0.00 $286.00 TOTAL Fkk.` $286.00 Revised: 07/02/2015 CUPERTINO I n NRW CONIRTRIICTTON CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300TORRE AVENUE - CUPERTINO, CA 95014-3255 B (40r8-)�777-3228 • FAX (408) 777-3333 • builds-i'nnp a>.cupartino.ora I 1 bU 5` l I I AnFUTRlN � Al TFR ATTnNr/Tr IR UCl)icin�r I nnccon cn nnrn*wInT n PROSEC'f ADDRESS %/ -C— APE '0, / L ii% OWNERNAME L, 9 r``'"'�' PHONE �}�yJ 3Y�1 � i r/� E-MAIL I I`J� /� t ! / p ' / Iy6 (/FFAX STREETADDRESS 5y-�_r CITY, STATE, ZIP CONTACT .NAME r /'Y�� PHONE 6 S 0 %j 5 3� �S E-MAIL Li (,(4 6 d�]D/44" ` STREET ADDRESS{/�!�) / Prlva- CITY, STATE, ZIP gowm ❑ OWNERR--BUIDERR 11 OWNERAGENT ❑ CONTRACTOR ❑CONTRACTO/RPAIGErNT� EI ARCHITEVICT ❑EENNGGTWEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME a% LICENSE NUMBER,,. �+ _ V LICENSETYPE F BUS. LIC# COMPANY NAME J /0� &MAIL C(i _ 6aroK C�J Wa( `�1 FAXSI '�/,,•o)_,�,� STR 7'. DD0SS ram . 0„ /! / f_ v© t'Lt� //'/l/-( CITY, STA�Fa ZIP ^ 9 %r /' PHONE 13 l - C /� l `l(Z?(® ARCHITECDENGINEERNAME �I in LICENSE. NUMBER BUS. LIC.# COMPANY NAME. EMAIL YQ G-L 923t LR , wrn FAX STREETADDRESS CITY, STATE, ZIP PHONE %5 U Z6Sa7 p7.� [y(% e DESCRIPTIONOFWORK rAYr, Q'- gy, C�vSef Jn.Fv�1 � . ® ye~ a wiw�>✓ v nzo ✓ Fins ' EXISTING USE PROPOSED USE B. CONSTTYYP/E # STORIES USE TYPE OCC. SQ.FT. VALUATION($) EMSTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA .. BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCHAREA DECK AREA TOTALDECK/PORCHAREA GARAGE AREA: DETACH ❑ATTACH #DWELLDNGUIuTS: ISASECONDUNIT ❑YES SECONDSTORY ❑YES BEINGADDRD? ❑NO ADDITION? NO PRE-APFLiCATION []YES DYES, PROVIDF,COPY OF PLANNING APPL# ❑NO PLANNDJG APPROVAL LETTER ISTHEBLDGAN ❑YES EiC11I,ER HOME? ❑NOfflw �z _ -T-; - ,� -_ - : TOTAL VALUATIO T ®' By my signature below, I certify to each of the following: I am the property owner or authorized a on the property owner's behalf I have read t 's 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 bin ding construe . I authorize representatives of Cupertino to enter the above-idennt/t�iifie prop rTy For inspec<yDnpurposes. y /J Signature of ApplicanUAgent: Date: 'T ( SUPPLEMENTAL INFORMATION REQUIRED Plax cm>cx�iP% �n �..�,izo rc sLt>' _ New SIT) or Multifamily dwellings: Apply for demolition permit for building(s). Demolition - O➢ER-_THEG07It�TER by L�"IIILDING PLAN REC7EW existing permit is required prior to issuance of building „ T _'II4 mm Ise permit for new building. Bldgs: Provide a completed Hazardous Materials Disclosure ❑ ExPxess� ❑ � ^r 0rl,Ar GrLnrrR� F _Commercial saaNDAtrn r i uBLl�woxzcs 4 � - Term ifany Hazardous Materials are being used as part ofthis project. Copy 1ARGE -9 , d. I'.HtED-�EP3'3E" t"i. _ of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. =SANITARY SEWER➢ISTRI� BldgApp201 L doe revised 06121111 >7 '79 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 866 BETTE AVE DATE: 04/07/2015 REVIEWED BY: MELISSA 369 24 047 BP#: 15010054 'VALUATION: $0 EAP *PERMIT: Building Permit PLAN CHECK TYPE: Alteration /Repair PRIMARY SFDorDuplex 1GENRES USE: PERMIT TYPE: PERMIT WORK REV # 1 - ALTER/SWAP LOCATION OF WINDOWS/DOORS & RELOCATE LAUNDRY RM & SCOPE GARAGE ACCESS & ADD (N) ELECTRICAL FIREPLACE -ISSUED 4/7/15 Alech. Dian Check Phi nb. Plan Chee% Ekv. Nan Check llech. Perreil Fee: Plumb. Permi! Fee: hlec Permif Pee: Other d9e;ch. 7n-sp_ Other Plumb /nsp. UtherLSlec. Insp. itech. Insp. Pee: /'htnib. f sp. N'e: Elec.lnsp. Pee: NOTE: This estimate floes not include fees due to other Departments (i.e. Planning, Public works, fire, sanitary sewer Disinct, scaorn D' t TI a are baser! on the relimina information available and are onlyan estimate. Contact the Dept or addn'1 info. istrtct, a c.. tese e s FEE ITEMS (Fee Resolution 11-053 ML.' 711113 FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes Q No $0.00 0 hours Plan Check, Hourly $286.00 ISTPLNCK Suppl. PC Fee: 0 Reg. Q OT 0.0 his $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-.0 Reg. Q OT 10=01 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administrative Fee: � E) Work Without Permit? Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) i Travel Doewnentation Fees; Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $286.00 TOTAL FEE: $286.00 Revised: 02/14/2015 CUPERTINO n CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(@cupertin).Org R .,...,T,nv M nl ion Alum l Tr n PPVUUnEJinFRFRRWI B f1RH;ittERIIT # "NEW CONS RUv ,.,,, W` nuuauuu ••••••• ••••�^ �� ' PROJECT ADDRESS IZ ,• -�1[� , /� V I•J6y APN N t OWNERNAMF. PHONE 65.Io 3r3 8bs�E-MCAAIIIL LlJi`__'"�'i�/` V � STRCETADDRLSS O �nn fir. r I CITY, STATE, ZIP It/' tL I ' _ _� / �/E-�MA`'ILY ,^I'16S hX CONTACT NAME \ t � 7 / PHONF�M 0 6> G ii , L dal �I t rlsu Zoo Z STREET ADDRESS CITY,STATE. ZIP FAX RR� ❑ OWNER ❑ OWNER -BUILDER El OWNER AGENT ❑ CONTRACTOR El CONTRACTOR AGENT N ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRCC-PORNAMP 1 SENUMBER LICENSETYPE BUS. LIC# COMPANY NAME E-MAIL FAX STRF.P.T ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC U COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK ' I _ / —I/ ...�11.qft ( Y CXIs'rINGUSE PROPOSED USE CONSTRAYPE 4STORrES U58 TYPE OCC. VALUATION ($) EXISTO NEW FLOOR DEMO AREA TOTAL HE AREA /}^ jSFT. j AREA AREA VV BATHROOM KITCHEN OTHER REMODCLAREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TO'PALDECKAORCHARCA GARAGE AREA: El DETACH ❑ ATTACH IIOWF,LLING UNITS: IS ASECOND IINIT ❑YES SI?COND STORY EYES BEING ADDED? ❑NO ADDITION? ❑NO PRE -APPLICATION ❑YES )R YES, PROVIDC COPY OP�.LDIII RECEIVED:BY: 'DOTAL VPLANNINGAPPLU ❑NO PLANNING APPROVAL LErI EI By my signature below, I certify to each ofthe following: I am the property owner or authorized agen act on the propyrty owner's behalf, I have read this application and the information I have provided is correct. throe read the Description of Wolk and verify His accurate agree to comply with all applicable local ordinances and state laws relating tobuildingco1l�Strllotion. I authorize representatives of Cupertino to enter die above -identified property for inspection purposes. Signature of Applicant/Agenk - Date: rIt SUPPLEMENTAL INFORMATION REQUIRED 'PLAN CIICCK TYPE -ROUTING SLIP ❑ OVER-THE-COUNTER 5 PLAN REVIEW New SED or Multifamily dwellings: Apply for demolition permit for _ existing building(s). Demolition permit is required prior to issuance of building ,. - permit for new building. PL `*`HXG PLAN REv1Ew Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ;1;TZ1.AR1 ' P -CC NYS ' - _ form if any Hazardous Materials are being used as part of this project. • ❑ LARGE PIR PT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ mAaoR sANITARv SEWER msrmer submittal of Building Permit application. ❑ ENVIRONhtEN'I'AL IiEALTH BldgApp_201 I.doc revised 06121111 -M V WW���,,�� CITY OF CUPERTINO I I FEE ESTIMATOR — BUILDING DIVISION jaADDRESS: 868 bette ave DATE: 01/0812016 REVIEWED BY: Mendez APN: BP#: �S "VALUATION: $200,000 *PERMIT TYPE: Building Permit PLAN CHECK TV E: Addition PRIMARY USE: SFD or Duplex 2nd Unit? - Yes 0 No OTC? Dyes ONo PENTAMATION PERMIT TYPE: 1R3SFDADD WORK 953 s ft addition to front and rear of sfdwl remodel 576 s ft through out SCOPE OCCUPANCY TYPE: TYPE CONSTR.R. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) I-B,III-B,IV,V-B 953 $2,654.00 IR3PLNCK $1,666.00 1R31NSP TOTALS: 953 $2,654.00 $1,666.00 MECH, HOURLY 0 Yes (� No PLUMB, HOURLY 0 Yes 0 No ELEC, HOURLY 0 Yes Q No ,Hach Plan Check PhunhPkua Chc(A' Nee. Plan Check :Voch Permil III!" : Phmab. Pecma Fee: hlec Permit Feer Ohher BA¢ch. /nsp Ocher Numb fray, CiherElec. Insp.El �VAech. Insp. hire: Plwflh. hup. Fee: Elcc. Insp, Pee - NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitmy Sewer District, School IliM�lnt ofn ) Tlhnco feae nre hated on the mrlirninary information available and are onlv an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resohifion 11-053 E ' 7/U131 FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,654.00 576 s.f. $503.00 Remodel, Other iPxmREsOTi1 Suppl. PC Fee: (D Reg. 0 OT 0.0 hrs $0.00 PMB Plan Check: $0.00 Permit Fee: $1,666.00 Suppl. Insp. Fee:e) Reg. 0 OT 0,0 Ins $0.00 PMB Unit Fee: $0.00 PMB Permit Fee: $0.00 Consn-nettcon Tan: Administrative Fee: 0 0 Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: IPLLONGR $133.42 Select a Non -Residential Building or Structure 0 0 d Inn el Docvemeniation Fee, Strom Motion Fee: ISSEISMICR $26.00 Select an Administrative Item Bldg, Stds Commission Fee: IBCBSC $8.00 SUBTOTALS: $4,487.42 $503.00 TOTAL FEE: $4,990.42 Revised: 01/06/2015 Sep.09.2015 03:13 PM GLOBUS BUILDERS 8187602600 PAGE. 1 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Tore Avenue Cupertino, CA 95014-3255 Telephone:408-777-3228 Fax:408-777-3333 IOBADDRL-SS: i ? no PERMIT# OWNER'SNAME: 1. • IPHONE# 760-'ISO GENERAL CONTRACTOR: Cjlobilz SuAdak, C. I BUS INESSLICENSE # 3Z 6O ADDRESS: L g(V ( CITY/ZIPCODE; �Om• municipal code requires all businesses working in the city to have a City of Cupertino business license.' NO BUILDING FINAL OR FINAL, OCCUPANCY 1NSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS .HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE, r I am not using any subcontractors: / / J Signature Da e 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 Glass / Glazing Heating Insulation Landscaping ^-- -- -- Lathing Masonry Painting, / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date