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B-2016-1293 Permit, App, Fee Est, Cupertino Sanitary ApprovalCITY OF CUPERTINO BUILDING PERMIT B-2016-1293 8077 HYANNISPORT DR CUPERTINO, CA 95014-4011 (356 11 010) OWNER'S NAME: RICKMAN WILFORD M TRUSTEE & ET AL OWNER'S PHONE: 408-828-2597 LICENSED CONTRACTOR'S DECLARATION License Class B Lic. # 00] 40300 Contractor (JIN HAN YUN INC ) Date 212/2016 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: r. 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. 2. I have and will maintain Worker's Compensation Insurance, as provided for Zqby Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 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, 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. 2/2/2016 I hereby affirm that I am exempt from the Contractors License Law for one of the following two reasons: r. 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 Cade) 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sce.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: r. 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. 2. 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. s. 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 become subject to the Worker's Compensation provisions of the Labor. Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certify that I have read this application and stale 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. I -LAN YUN INC) LOSE, CA 95129 ISSUED: 02/02/2016 NO: 408-761-8822 PERMIT INFO: —ELECT _ PLUMB X RESIDENTIAL COMMERCIAL DESCRIPTION: ODEL 2ND FLOOR BEDROOM (250 S.F.); ADD BATHROOM AT FLOOR BEDROOM (49 S.F.); ENCLOSE (E) WINDOW IN 2ND 3R BEDROOM; REMOVE (E) ROOF AND INSTALL (N) HOOD AND (N) LIFETIME COMP SHINGLES (23 SQ'S) Ft Floor Area: Valuation: $21000.00 APN N0um0ber; Occupancy Type: 356 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. by: 1981 ,L 51 aw (W - RE -ROOFS: All roofs shall be inspected prior to anyroofing 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: 2 2 2 16 HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I 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 Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent-—'' Date: 2 2 2 1 CONS T F. I hereby affirm that there is a construction lending agency'fiSr the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Address ARCHITECT'S DECLARATION understand my plans shall be used as public records. Signature Date 2 20 6 CUPERTIH0- FK. CONSTRUCTION CONSTRUCTION PERMIT APPLICATION B'o COMMUNITf DEVELOP1,0EN T DEPARTPEN T BUILDING DIVISION 1030070RRE AVENUE • CUPERTINO, CA 95014.3255 (408) 777-322B' FAX (;(408) 777-3333 • build! norGuoerino. oro n ADDIiiON I'K 4.l_T7RAT70N/7T n'R glnN IF.st nTTr,-wsT nsat.�r-L 0RT2R NAlS d s CJi M I ?HONn STREET f.DDR=SS r C Y, STA. t _, ZIP CONTACT NfN. aIM ws A,�OVe_ PHON7 I e STP7=r fDO?SSS O.TY, ST.57?, Z:? I FA 1A-1WER R ON'N=R-nLiD ❑ DgTZi AC=1ir ❑ CONt�..hCTOR ❑ CONtYRlCTOR.4C._Tl' ❑ fR=,TCT ❑ BOG➢c__ ❑ ❑—u.�-.- CONR.AMRNf.lr , 9 1n� tuv� I LiC=NS=t+l71%'-?. �o�n30 LICEN 7Y7=- BUS LTC' C014.°fTN NMI �FI`v LA r'v )/Iyin 57RE'sT fDDRB55�/_I' /] /' . � _fy I2C1 I Pii�O�lvoO f3.ChTi iC'hC.rdG�<EE?kfld? LICcNS: hLT3cd BUS. LiC COMPAN N' AfS FAX STF-H7 AT) 0?_= M I GTT, STAT-q ZIP tt — DSCF.cFTiON 0i 9JOP.i:� ' M�e. .•�- o I .�V't el �� or 49 iti----- "Ya°�i!n\yvao D;OSTLnG US° RD. OSc UrT 5= C.ON$iR TI?8 kgT01LTS SYi-Vm L � ° �� �f„- N L'Sc I il''Pc_ I bCC. cQ.7T. VAI,UAT70?� ;Sl =-Afo — h7ly FLOOR 13'cl„0 r TOTf._ AREA /3EA MR --AI 'TO AREA RWOD_Lf-�-A I ' I P�z7.40DPL AREA P�M=—L fRE.A '�•f il. I _ 7 d C1J BEING Ann€o? I]NO I A➢n Mox? ❑NO P?17-iP.'_ICATION ❑Y's 1S, PROJIDE COPY OF I IS Tr:n SLDG f]2 i'^ '. ♦ - —^-- ?LfTTTGit'PL: ❑ND ?LF!.'iv-S.'GfP'POVALL_Ti_ EICHL.R NO By my signzte below, I ce: �iy to etch of the follo,viae: lam the prope.-,y owner or zwhorized a_sent to e property oh7er's behalf. I have ;ezd tnis application and the information I have prov!ded is cor;eat. I have re-d the Desaipdon of l6%ork and v • IS EWc Eta. I a57ee toeomply with all aeplic nle local ordinances and sta:e!zsas relz5s:� <o beilding constzctio e;ir.-w_--^ ntsives at CLocytino to cuter the aboV"iie�'en5*led ope ;or iD_ action purposes. Si=;,zlra of:;pulicanU"-.=er!t:_ -�-�- - / Date: ('�°� / ` -,7 Vl r New EFT) w Multif=arnily d-,veliings; Apply for dernolition pa, —•it for existi➢g SuildiDe(s). Deaolition pe-?it ig ec',ed prier to essti �. ce of buildi➢g at -it for new building. _ Corn-ercial 31des: Provide a.conp!ete.d Haz does Material, Disclesu;e Torn i f=�y F=. does Materials € e be��� _Sod ES p2 ii oc'this project. Copy of Plea,_ ps Approval Letter or Meeter:g with PI __, :,g prier to sLbmilal ofBLIIdLg PtiIlit application. Bla!�Pp_2011. c'oc revised 06/2L11 CITY OF CUPERTINO 506 M3 FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 8077 Hyannisport Dr DATE: 02/02/2016 APN: 356-11-010 BP#: REVIEWED BY: PAUL "VALUATION: $21,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: p PENTAMATION PERMIT TYPE: 1 R3SFDRE A WORK REMODEL 2ND FLOOR BEDROOM 250 S.F. ADD BATHROOM AT 2ND FLOOR BEDROOM 49 SCOPE S.F.); REMOVE (E) ROOF AND INSTALL (N) PLYWOOD AND LIFETIME COMP SHINGLES (23 p s. :Wecn. Plan Check Plwnb. PI<ar 010 A Pter;. Man (,`treeI; rtlerb.1"I n!Pee: Phmib. Ai mit F iec_ Elvc. I''earreii Other;Lte h1 hup. Other }'lour/ fntip. Ehhe! 61h'c. Ir:.sp. tech, lrtsp. Fern Ftwo l ssz i,'v' flee.. tnsp. 1'se: NOTE: This estimate Floes not include fees clue to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the meliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (F'ee Resolution I1-053 ff. L L13 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 49 s.f. $645.00 Remodel, Bath (<=300 sf) 1RL'MRESB11T Suppl. PC Fee: (D Reg. Q OT FO.0 Ins $0.00 PME Plan Check: $0.00 250 s.f. $431.00 Remodel, Other IREMRESo7'll Permit Fee: $0.00 Suppl, Insp. Feel@ Reg. Q OT 0,0 Ins $0.00 2,300 s.f. Re -roof $391.00 /RERooFt t S PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consvruction let: AekninWr<rtfre Fee: G Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 a 7i nzll7cicvrrietra<xfion tees: Strong Motion Fee: IBSBISMICR $2.73 Select an Administrative Item f_. Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $3.73 $1,467.00 " TOTAL F EE• $1,d70.73 Revise : 01/01/2016 DISTRICT MANAGER -ENGINEER MARKTHOMAS & COMPANY, INC. RICHARD K. TANAKA DISTRICT COUNSEL ATKINSON • FARASYN, LLP. MARC HYNES February 1, 2016 City of Cupertino Building Department 10300 Tone Ave. Cupertino, CA 95014-3202 SANIT4,?PA epl'4411SHEID,%S 20863 STEVENS CREEK BOULEVARD, SUITE 100 CUPERTINO, CALIFORNIA 95014-2154 (408) 253-7863 PHONE • (408) 253-5173 FAX www.cupertinosanilarydistrict.org Subject: Addition and Remodel — Approved Name: Ni Residence Address: 8077 Hyannisport Drive APN: 356-11-010 Permit No. NA Over The Counter BOARD OF DIRECTORS ANGELA S. CHEN JOHN M. GATTO STEVE C. ANDREWS WILLIAM A. BOSWORTH PATRICK S. KWOK File: CSD —MOP #16-020 Building Dept. — Cupertino Approved For Issuing Build€i Plumbing Permits The Cupertino Sanitary District has reviewed the plans for the subject project: Sanitary sewer is available and the existing building is connected to sanitary sewer, see conditions/requirements listed below. The following Conditions/Requirements are made: • Cupertino Sanitary District plan review and inspection fee ($350) is required for the subject improvements. Please do not issue any Building Permits. (O.C. 5203) Install new property line cleanout to District's standards or locate and raise to grade an existing property line cleanout. Property line cleanout must be within 5 feet of the property line. Cleanout shall be the same diameter as the street portion of the service lateral. Gravity lateral is 4" diameter minimum. (O. C. 4101) • Closed-circuit video of the existing/new property line cleanout, point of connection and District lateral is required prior to clearance for City of Cupertino Final Inspection. Owner to call District at least 48 hours prior to video inspection to schedule a District Inspector. District to provide Building Department with written notification upon completion of inspection. (O.C. 5104) Page 2 Subject: Addition and Remodel — Approved Name: Ni Residence Address: 8077 Hyannisport Drive APN: 356-11-010 Permit No. NA Over The Counter • Fees can be paid at the District office located at 20863 Stevens Creek Boulevard, Suite 100 in Cupertino, CA by cash or check (payable to "Cupertino Sanitary Districf'). All conditions, requirements and recommendations are to be completed at the (owner/developer)'s expense. Storm water from surface or roof drains, other general surface runoff water or condensate from any residential HVAC equipment shall not be discharged to the sanitary sewer. Yours very truly, MARK THOMAS & COMPANY, INC. District Manager -Engineer �w� �4 Richard K. Tanaka If you have any questions or need additional information, please call Ivy To at 408-253-7071. U:\Administration\Correspondence - General\Letters\2016\Letter #16-020 Cupertino Building Department_NA Over The Counter —Addition and Remodel_8077 Hyannisport Dr_Approved_02-01-16.doc SUPPLYING SANITARY SEWERAGE SERVICES FOR: CITY OF CUPERTINO. PORTIONS OF THE CITIES OF SARATOGA, SUNNYVALE, Los ALTOS AND SURROUNDING UNINCORPORATED AREAS