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
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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
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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
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