15040115
CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS:
CONTRACTOR:
PERMIT NO: 15040115
10734 S STELLING RD CUPERTINO CA 95014 (359 22 005)
ZHI - QIANG WANG
SAN JOSE, CA 95132
OWNER'S NAME: CHUANG CHANGSYANG AND YUNG HO
DATE ISSUED: 02/01/2016
OWNER'S PHONE:
PHONE NO: (408)391-0484
LICENSED CONTRACTOR'S DECLARATION
BUII.DING PERMIT INFO:
License Class GENERAL BUILDING CONTRACTOR Lie. #861326
Contractor ZHI - QIANG WANG Date 07/31/2017
— BLDG _ELECT _PLUMB
MECH RESIDENTIAL COMMERCIAL
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.
JOB DESCRIPTION:
CONSTRUCT ONE STORY ADDITION (1970 SQ FT
; AND A
I hereby affirm under penalty of perjury one of the following two declarations:
ATTACHED GARAGE (425 .SQ FT).
1. I have and will maintain a certificate of consent to self -insure for Worker's
ompensafion, as provided for by Section 3700 of the Labor Code, for the
"REVISION #1 - COVERED CARPORT TO RE
AND
erformance of the work for which this permit is issued.
CONSTRUCT N GARAGE (469 S.F.) AT FRONT PORCH
AREA; ADD
2. I have and will maintain Worker's Compensation Insurance, as provided for by
2 N FLAT DORMERS AT THE REAR ADDITION -
ISSUED 7/13/2016
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
Sq. Ft Floor Area:
Valuation: $272000.00
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize
A Number:2005
Occupancy Type:
representatives of this city to enter upon the above mentioned property for
inspection purposes. (We) agree to save indemnify and keep harmless the
3599 22 005
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
PERMIT EXPIRES IF WORK IS NOT
STARTED
source regulations per the Cupertino Municipal Code, Section 9.18.
WITHIN 180 DAYS OF PERMIT ISSUANCE
OR
180 DAYS FROM LAST CALLED
SPECTION.
g tan tan ure Date 7/13!2016
OWNER DECLARATION
Issued by: ABBY AYENDE `
-BUILDER
Date: 02/01/2016 m
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
RE
1. I, as owner of the property, or my employees with wages as their sole
-ROOFS:
All roofs shall be inspected prior to any roofing material bei
g installed. If is
compensation, will do the work, and the structure is not intended or offered for
installed without first obtaining an in I agree to remo
eroof
a all new materials for
sale (Sec.7044, Business & Professions Code)
inspection.ption,
z. I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code).
Signature of Applicant:
I hereby affirm under penalty of perjury one of the following three declarations:
Date: 7/13/2016
s. 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
ALL ROOF COVERINGS TO BE CLASS "A"
OR BETTER
performance of the work for which this permit is issued.
-
z. 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
HAZARDOUS MAT R A S DISCLOS
I have read the hazardous materials requirements under
R
Chapter 6.95 of the
permit is issued.
California Health & Safety Code, Sections 25505, 2553
, and 25534. 1 will
3. I certify that in the performance,of the work for which this permit is issued, I
maintain compliance with the Cupertino Municipal Code
Chapter 9.12 and the
shall not employ any person in any manner so as to become subject to the
Health & Safety Code, Section 25532(a) should I store
r handle hazardous
Worker's Compensation laws of California. If, after making this certificate of
material. Additionally, should I use equipment or devices
which emit hazardous
exemption, I become subject to the Worker's Compensation provisions of the
air contaminants as defined by the Bay Area Air Quality
Management District I
Labor Code, I must forthwith comply with such provisions or this permit shall
will maintain compliance with the Cupertino Municipal Code,
Chapter 9.12 and
be deemed revoked.
the Health & Safe e, Sections 25505, 2553
, and 25534.
APPLICANT CERTIFICATION
/
or
I certify that I have read this application and state that the above information is
:Ovine
'.Date: 7/13/2016
correct. I agree to comply with all city and county ordinances and state laws
CONSTRUCTION LENDING AGEN
a
relating to building construction, and hereby authorize representatives of this city
I hereby affirm that there is a construction lending agency
for the performance
to enter upon the above mentioned property for inspection purposes. (We) agree
of work's for which this permit is issued (Sec. 3097, Civ
.)
to save indemnify and keep harmless the City of Cupertino against liabilities,
Lender's Name
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understands
Lender's Address
and will comply with all non -point source regulations per the Cupertino Municipal
Code, Section 9.18.
ARCHITECT'S DECLARRATION
I understand my plans shall be used as public records.
Signature Date 7113/2016
Licensed
Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR:
PERMIT NO: 15040115
EEEJ
10734 S STELLING RD CUPERTINO CA 95014 (359 22 005) (ZHI
- QIANG WANG)
SAN
JOSE, CA 95132
OWNEW S NAME: CHUANG CHANGSYANG AND YUNG Ho
DATE ISSUED: 02/01/2016
OWNER'S PHONE:
PHONE NO: 408-391-0484
LICENSED CONTRACTOR'S DECLARATION BUILDING
PERMIT INFO:
License Class D Lic. #861326
Contractor (7H1 - QIANG WANG ) Date 02/01/2016Cg
_ BLDG _ ELECT T PLUMB
RESIDENTIAL,— COMMERCIAL
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.
JOB DESCRIPTION:
CONSTRUCT ONE STORY ADDITION (1970 SQ FT); AND A
T hereby affirm under penalty of perjury one of the following two declarations:
ATTACHED GARAGE (425 SQ FT).
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
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
11/13/15-EXTENDED PERMIT APPL TILL 1/13/16
Sq. Ft Floor Area:
Valuation: $272000.00
this permit is issued.
APPLICANT CERTIFICATION
certify that I have read this application and state that the above
information is correct. I agree to comply with all city and county
APN Number:
Occupancy Type:
ordinances and state laws relating to building construction, and hereby
359 22 005
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
PERMIT EXPIRES IF WORK IS NOT STARTED
expenses which may accrue against said City in consequence of the
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally, the applicant understands and will
comply with all non-point source regulations per the Cupertino Municipal
180 DAYS FROM LAST CALLFDINSPECTION.
Code, Section 9.18.
Issued by: MELISSA
Signature ✓ - Date 02/01/2016
Date: 02/01/2016
OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of the
All roofs shall be inspected prior to any roofing material being installed. If a roof is
first obtaining an inspection, I agree to remove all new materials for
following two reasons:
1, as owner of the property, or my employees with wages as their sole
installed without
inspection.
1.
compensation, will do the work, and the structure is not intended or offered
for sale (Sec.7044, Business & Professions Code)
Signature of Applicant:
2. I, as owner of the property, am exclusively contracting with licensed
Date: 012/01/2016
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1. 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
HAZARDOUS MATERIALS DISCLOSURE
performance of the work for which this permit is issued.
I have read the hazardous materials requirements under Chapter 6.95 of the
2. I have and will maintain Worker's Compensation Insurance, as provided for
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
by Section 3700 of the Labor Code, for the performance of the work for which
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Code, Section 25532(a) should I store or handle hazardous
this permit is issued.
3. I certify that in the performance of the work for which this permit is issued, I
Health & Safety
material. Additionally, should I use equipment or devices which emit hazardous
defined by the Bay Area Air Quality Management District I
shall not employ any person in any manner so as to become subject to the
air contaminants as
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
Worker's Compensation laws of California. If, after making this certificate of
Compensation of the
the Health & Safety Code, Sections 25505, 255331 and 25534.
be deemed revoked.
Date: 02/0112016
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
CONSTRUCTION LENDINGAGENCY
I hereby affirm that there is a construction lending agency for the performance
C.)
correct. I agree to comply with all city and county ordinances and state laws
of work's for which this permit is issued (Sec. 3097, Civ
relating to building construction, and hereby authorize representatives of this city
Lender's Name
to enter upon the above mentioned property for inspection purposes. (We) agree
to save indemnify and keep harmless the City of Cupertino against liabilities,
Lender's Address
judgments, costs, and expenses which may accrue against said City in
ARCIFHTECT'S DECLARATION
consequence of the granting of this permit. Additionally, the applicant
will comply with all non-point source regulations per the
I understand my plans shall be used as public records.
understands and
Cupertino Municipal Code, Section 9.18.
Licensed
Signature Date 02/01/2016
Professional
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
imlADDRESS: 10734 S STELLING RD
TYPE OF
CONSTR.
DATE: 04/16/2015
REVIEWED BY: MELISSA
APN: 359 22 005
BP#:
BP FEE ID
*VALUATION: 1$272,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE:
Addition
PRIMARY
SFD or Duplex
USE:
2nd Unit? Yes No
I OTC.,, Yes (2)No
PENTAMATION
PERMIT TYPE: 1 R3SFDADD
WORK
ADDITION OF 2009 S.F. TO ADD 3 H
BEDROOMS 3 N BATHS
N LAUNDRY & N` FAMILY
SCOPE
I ROOM
PME Unit Fee:
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
R-3 (Custom)
It-B,III-B,1V,V-B
2,009
$2,880.93
IR3PLNCK
$2,479.01
IR3INSP
Permit Fee:
$2,479.01
Suppl. Insp. Fee:Q Reg. Q OT
0,0
1 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Clonstrniction :Tax:
Adfi inistrative Fi'e
Work Without Permit? 0 Yes E No
$0.00
TOTALS:
2,009
$2,880.93=
Travel Documentation Fees:
$2,479 01
Strong Motion. Fee: IBSEISMICR
ech. Plein Check Phimb, Plein Check Elec:. flan Check
L1ecA Permit Fee: /'hunb. Permit Fee: Dec. Permit Fee::
Other bkch. Insp. Oiher Pluinb Ajsp. C111zer Elec. Insp.
A,Iech..Insp. Fee: Plun7h I isp, Fee: Ekl c. Insp. Fee:
NnTF- Thk estimate does rant include fees due to other Departments (i.e. Planning. Public Works, Fire, Sanitarp Sewer Disj
District etc.. These ees are based on the Prelimina information available and are only an estimate. Contact the Dept jW addn'1 info.
FEE ITEMS (Fee Resolution 11-053 F f 711113)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,880.93
Select a Mise Bldg/Structure
or Element of a Building
Suppl. PC Fee: (E) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$2,479.01
Suppl. Insp. Fee:Q Reg. Q OT
0,0
1 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Clonstrniction :Tax:
Adfi inistrative Fi'e
Work Without Permit? 0 Yes E No
$0.00
Advanced Planning Fee. IPLLONGR
$281.26
Select a Non -Residential E)
Building or Structure 0
A
Travel Documentation Fees:
Strong Motion. Fee: IBSEISMICR
$35.36
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$11.00
$5,687.56
$0.00 _ TALIjE.
$5,687.56
Revised: 04/01/2015