15040125CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS:
CONTRACTOR:
PERMITNO:15040125
10732 S STELLING RD CUPERTINO CA 95014 (359 22 005)
BLUEBAY BUILDERS
LLC
OWNER'S NAME:
DATE ISWED: 02/01/2016
OWNER'S PHONE: ( -
i
PHONE NQ: 408-391-0484
LICENSED CONTRACTOR'S DECLARATION
BUILDING
PERMIT INFO:
License Class $ tic. #861326
Contractor BLUEBAY BUILDERS LLC Date
_BLDG
_ELECT _PLUMB
MECH
RESIDENTIAL OMMERCIAL
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 AT] ACHED 2ND DWELLING UNIT
I hereby affirm under penalty of perjury one of the following two declarations:
(800 SQ
FT).
1. I have and will maintain a certificate of consent to self -insure for Worker's
REV #
j
- REVISE CEILING BEAM FOR 2ND UNIT - ISSUED
Compensation, as provided for by Section 3700 of the Labor Code, for the
12119/2p16
f
performance of the work for which this permit is issued.
z. Ifhave 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
Sq. Ft Floor
Area:
i
Valuation $103000.00
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
APN N
mber:
Occupancy Type:
information is correct. I agree to comply with all city and county ordinances
359 22 q05
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
PERMIT
EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit.
WITHIN
180 DAYS F PERMIT ISSUANCE OR
Additionally, the applicant understands and will comply with all non -point
source regulations per the Cupertino Municipal Code, Section 9.18.
180'
DAYS FROM LAST CALL SPECTION.
.? Date 12/19/2016
Issued
I ny: �
Date: d2/01
01
O R -B Til D R DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
1. I, as owner of the property, or my employees with wages as their sole
All roofs
installed
i
:
shall be inspected prior to my roofing material being installed. If a roof is
without first obtaining an in 3pection, I agree to remove all new materials for
inspection.
compensation, will do the work, and the structure is not intended or offered for
sale (Sec.7044, Business & Professions Code)
z. I, as owner of the property, am exclusively contracting with licensed
Signature
of Applicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 11/19/2016
�r
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER .
1. 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
performance of the work for which this permit is issued.
z. 1 have and will maintain Worker's Compensation Insurance, as provided for by
I have
F107oRnAt Ic ATFRIALS DISCLOSURE
read the hazardous mater'als requirements under Chapter 6.95 of the
Section 3700 of the Labor. Code, for the performance of the work for which this
California
Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain
compliance with the Cul erlino Municipal Code, Chapter 9.12 and the
permit is issued.
s. I certify that in the performance of the work for which this permit is issued, I
Health
material.
& Safety Code, Section 5532(x) should I store or handle hazardous
Additionally, should I u e equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the
laws California. If, making this certificate of
air cotaminants
as defined by th Bay Area Air Quality Management District I
Municipal Code, Chapter 9.12 and
Worker's Compensation of after
will maintain
compliance with the Cupertino
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Co e, Sections 25505, 25533, and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
-
APPi ICANT CERTIFICATION
Date:
_ -
1 201 _
I certify that I have read this application and state that the above information', is
I hereby
CONRTR TION .F.NDA = .N
affirm that there is a construction lending agency for the performance
correct. I agree to comply with all city and county ordinances and state laws
to building construction, and hereby authorize representatives of this city
of works
for which this permit is issued (Sec. 3097, Civ C.)
relating
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
LendeIes
Name
Address
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understandsTE
, S DECLARATION
and will comply with all non -point source regulations per the Cupertino Municipal
1 understand
my plans shall be u, ed as public records.
Code, Section 9.18.
Licensed
Signature Date 12/19/2016
professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: 15040125
10732 S STELLING RD CUPERTINO CA 95014 (359 22 005)
(ZHI - QIANG WANG)
SAN JOSE, CA 95132
OWNER'S NAME:
DATE ISSUED: 02/01/2016
OWNER'S PHONE:
PHONE NO: 408-391-0484
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class B Lie. #861326
Contractor ( ZHI - QIANG WANG ) Date 02/01/2016
— 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 ATTACHED 2ND DWELLING UNIT
I hereby affirm under penalty of perjury one of the following two declarations:
(800 SQ FT).
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
performance of the work for which this permit is issued.
r2'� I have and will maintain Worker's Compensation Insurance, as provided for
�t by -Section 3700 of the Labor Code, for the performance of the work for which
Sq. Ft Floor Area:
Valuation: $103000.00
this permit is issued.
APPLICANT CERTIFICATION
certify that I have read this application and state that the above
APN Number:
Occupancy Type:
information is correct. I agree to comply with all city and county
35922 005
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
PERMIT EXPIRES IF WORK IS NOT STARTED
expenses which may accrue against said City in consequence of the
WITHIN 180 DAYS OF PEFMT 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 CALLEDiNSPECTION.
Code, Section 9.18.
Issued by. MELISSA NAM
Signature ` Date0'2101-/2,0-16,,,
Date: 02/01/2616
OWNER-BUILDERDEC ATION
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
following two reasons:
installed without first obtaining an inspection, I agree to remove all new materials for
t. I, as owner of the property, or my employees with wages as their sole
inspection.
compensation, will do the work, and the structure is not intended or offered
for sale (Sec.7044, Business & Professions Code)
Signature of Applicant:
1 I, as owner of the property, am exclusively contracting with licensed
Date: 02/01/2016
contractors to construct the project(Sec.7044, Business & Professions Code).
ALLROOF COVERINGS TO BE CLASS "A" OR BETTER
I hereby affirm under penalty of perjury one of the following three declarations:
t. 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
Health & Safety Code, Section 25532(a) should I store or handle hazardous
this permit is issued.
s. I certify that in the performance of the work for which this permit is issued, I
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants defined the Bay Area Air Quality Management District I
shall not employ any person in any manner so as to become subject to the
h
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
l
Worker's Compensation laws of California. If, after making this certificate of
the Health & Safety Code, Sections 25505, 25533, and 25534.
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
Owner or authorized agent:(
be deemed revoked.
Date: 02/0112016
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance
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 C.)
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
Lender's Address
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City in
ARCHITECT'S DECLARATION
consequence of the granting of this permit. Additionally, the applicant
I understand my plans shall be used as public records.
understands and will comply with all non -point source regulations per the
Cupertino Municipal Code, Section 9.18.
Licensed
Professional
Signature Date 02/01/2016
CITY OF CUPERTINO
FEW _FEE ESTIMATOR — BUILDING DIVISION
JimADDRESS: 10732S STELLING RD DATE: 04/16/2015
APN: 359 22 005 BP#: % �` 5
REVIEWED BY: MELISSA
*VALUATION: 1$103,000
xPERMIT TYPE: Building Permit
PC FEES
PLAN CHECK TYPE:
Addition
PRIMARY
USE: SFD or Duplex
R-3 (Custom)
2nd Unit? •' Yes No
OTC? Yes No
PENTAMATION
PERMIT TYPE: 1 R3SFADZND
WORK
ADD N 2ND UNIT 761 S.F.
WITH 2 BEDROOMS & 1 BATH
1R31NSP
SCOPE
Suppl. Insp. Fee. Reg. Q OT
F-01
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
R-3 (Custom)
II-B,111-B,IV,V-B
761
$2,654.00
IR3PLNCK
$1,666.00
1R31NSP
Permit Fee:
$1,666.00
Suppl. Insp. Fee. Reg. Q OT
F-01
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: 1BCONSTAXR
F1
# new
units
$ 677.77
cltnirti,sia'Pive .1`'ct
Work Without Permit? 0 Yes (j) No
$0.00
TOTALS:
761
$2,654.00
1 nivel Doc .mentation Fees.
$1,666.00
Strong: Motion. Fee: IBSEISMICR
Mech. Plan Check I I Phimb. Plan Check I Iflee. Plan Check
:,tech. Perwit F*ee: Phimb. Permit Fee: flee. PermitFee:
Other .ilech. Insp. Other Plumb Insp. Other Elec. Insp.
.Alech. 1n,sp, Fee: PIUT17b. hasp, Fee: 1,"1ee. Insp Fee
nrnTF• Thh ocdmato dnoc Nest inrh.do fvoc duo to nthor Denartments (i.e. Plannine. Public Works. Fire. Sanitary Sewer District, School
District etc). These fees are based on the prefindna information available and are only an estimate. Contact the Dept or addn7 info,
FEE ITEMS (Fee Resolution 11-053 L f . 7/f 1113)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,654.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl, PC Fee: (F)Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$1,666.00
Suppl. Insp. Fee. Reg. Q OT
F-01
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: 1BCONSTAXR
F1
# new
units
$ 677.77
cltnirti,sia'Pive .1`'ct
Work Without Permit? 0 Yes (j) No
$0.00
Advanced Planning Fee: IPLLONGR
$106.54
Select a Non -Residential E)
Building or Structure 0
L A
1 nivel Doc .mentation Fees.
Strong: Motion. Fee: IBSEISMICR
$13.39
Select an Administrative Item
Bldg Stds Commission .Fee: IBCBSC
$5.00
-UBT�S:
IJ p
$5,122.70
$0.00 saQ�
$5,122.70
Revised: 04/01/2015