The URL can be used to link to this page

15100218CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10315 ANN ARBOR AVE NAME: ONISHI STEVEN T AND CHAO CONSTANCE 'S PHONE: 4088367083 LICENSED CONTRAC.T/OR'S DECLARATION License Class ��++aa Lic. # 1 i��rr�� ContractorlGi�� `� #"7mroQ �01T • • 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: 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. 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. APPLICANT CERTIFICATION 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 - source regulations peI the Cupertino Municipal Code, Section 9.18. f Date Is ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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 performance of the work for which this permit is issued. 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. 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 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 Pimthe above mentioned property for inspection purposes. (We) agree to save ?Innify and keep harmless the City of Cupertino against liabilities, judgments, —o, 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. Signature Date CONTRACTOR: TE- . JOB DESCRIPTION: RESIDENTIAL CONSTRUCT A ATTACHED (578 SQ FT). Sq. Ft Floor Area: PERMIT NO: 15100218 DATE ISSUED: 01/06/2016 PHONE NO: COMMERCIAL D DWELLING UNIT Valuation: $120000 APN Number: 32655023.00 I IOccupancy Type: I PERMIT EXPIRES IF WITHIN 180 DAYS Q 180 DA A, Ja. All roofs shall be inspected prior to any installed without first obtaining an inspt inspection. Signature of ALL ROOF COVERINGS TO I have read the hazardous materials regc California Health & Safety Code, Sectior maintain compliance with the Cupertino Health & Safety Code, Section 25532(a) s material. Additionally, should I use equi air contaminants as defined by the Bay A will maintain compliance witjl&e Cuper the Health & Safety Code, Sqtio s 2,150! Owner or authorized agent: IS NOT STARTED t-ISSOANCE OR 0 g material being installed. If a roof is I agree to remove all new materials for Date: CLASS "A" OR BETTER •ements under Chapter 6.95 of the 25505, 25533, and 25534. 1 will [unicipal Code, Chapter 9.12 and the ould I store or handle hazardous hent or devices which emit hazardous ea Air Quality Management District I no Mumc al Code, Chapter 9.12 and 255^afib 25534. Date: 1"4.140 I hereby affirm that there is a construction Inding agency for the performance of work's for which this permit is issued (Sec. 097, Civ C.) Lender's Name Lender's I understand my plans shall be used as Licensed records. CONSTRUCTION PERMIT APPLICATION I COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255*° CUPERTWO- (408) 777-3228 • FAX (408) 777-3333 - building ftuoeltno.ora ❑ NEW CONSTRUCTION ADDITION . ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORI INAL PERMIT PROJECT ADDRESS p\ APN R OWNERNAIvM/ B 1 I PHO Cao?® t.�2AR ��C�CQ A, A STREET ADDRESS i r� � 3 _ _ _ CITY, STATE. ZIP � /o y\ I FAX CONTACT NAME STREET ADDRESSFy er i� \ ` , i� CITY, STATE, ZIP - �C C� 6\ FAX OgNER R OwNEER-BuILDEER ❑ oArNEp AGENT ❑ CONTRACTOR CON7RACTORAGENT X ARCA BCT CIENGRISM, ❑ DEVELOPER ❑ TENANT CONTRACTORNAME LICENSENUMBER LICENSETYPE BU . ICS to COIAPANY NAME `�C3 0�(� c` `t- E-MAIL I FAX ° �/ puk�t'1'-i. STREET ADDRESS q,5-1 ARCHITECT GiNEERNP1fE �� LICENSENMaER 1w COMPANY NAM E-MAIL FAX STREET ADDRESS ��jj , P ,ee i o . \ CITY, STATE, ZIP g� 0 5 P�e / cb 2>2 \�(� �p DESCRIPTION OFWORKS` EXISTINGUSE I PROPOSED USE I CONSTRTYPE S®RIES i USE TYPE WC. I SQ- FT. VALUATION($) AREAI NEW FL 0 DEMO AREA TOTAL NET AREA ® / AREA AREA .-T KITCHEN REMODEL AREA OT4TR. REMODEL AREA I I BATHROOM REMODEL AREA PORCH AREA11ECK AREA TOTALDECKIPORCHAREA GARAGEAREA: ATIACIiWELLINGU IS A SECOND u 'rr ❑ YES SECOND STORY OYES I BEING ADDED? rJNO ADDITION? []NO PP.E-APPLICATION []YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES - TOTAL VALUATION: 'E? PLANNING APPL m ❑ NO PLATNLNG APPROVAL LETTER £ICHLER H0 OTO I By my signature below, I certify to each of the following: I am the property owner or authonz agent to act on the grope, oumer's behalf. I have read this. it is accurate. I a ee to comply -with all applicable local application and the information I have provided is correct. I have read the Description of Work and verify epresentatives of Cupertino to enter the b ve-idem feed property for inspection purposes. I ordinances and state laws relatin uiiding construction. a! on Date L 2 Signature of Applicant/AQent: NTAL INPORMTION REQUIRED P CHECK T PE b - 3tOUTGSLIT _ SUPPLE _ New SFD or Multifamily d« ellings: Apply for demolition permit for �oR o EBtaIIDr.GPLx�x building eXisting building(s). Demolition permit is required prior to issuance of permit for new building. r Commercial Bldgs: Provide a completed Hazardous Materials Disclosure TIARD�osfl r. _ Form if any Hazardous Materials are being used as part of this project.No- MMM _ of Planning Approval Letter or Meeting with Planning prior to paw g YsDTsRIcr Copy submittal of Building Permit application. BldgApp 2011.doc revised 06/21/11 /`<TTtT !\T !'1T Till TlTTI►T!l FEE ESTIMATOR BUILDING DIVISION l ADDRESS: 10315 Ann Arbor Ave TDATE: 10/27/2015 REVIEWED BY: PAUL APN: 326 55 023 BP#: *VA L ATION: 1$120,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Suppl. PC Fee:0 Reg. 0 OT Addition PRIMARY SFD or Duplex USE: - '. 2nd Unit? Yes No OTC? 0 Yes (j) No PENT PERMIT MATION 1 R3SFDADD TYPE: WORK Construct N 1 Story Rear Addition 578 S.F. ; Install N A/C Unit 1'himb.r'er rr, , 1° r. e:: SCOPE $1,666.00 I T c . Pe; wit fee: ther Mech. Insp. OCCUPANCY TYPE: TYPE OF FLR AREA I PC FEES I PC FEE I BP FEES I BP , EE ID CONSTR. s.f. R-3 (Custom) 11-8,111-B,1V,V-B 578 1 $2,654.00 1R3PLNC 1 $1,666.00 1R3INSP TOTALS: 578 $2,654.00 k $1,666.00- 1 MECH, TO . Yes';12LUNI1xHQijRLY' QTY/FEE pies NoU1t�3F= /.:Yes :11�T Mech. Plan Check 0.0 hrs $0.00 f hinzb. Plan Cheek Suppl. PC Fee:0 Reg. 0 OT 0.0. hrs laec. Plan Chee-k PME Plan Check: $0.00 Mech. Permit Fee: IMPERMIT 1'himb.r'er rr, , 1° r. e:: Permit Fee: $1,666.00 I T c . Pe; wit fee: ther Mech. Insp. 0.0 hrs $48.00 Ocher- Plotz Tmp. PME Unit Fee: $0.00 Other t Tec hasp. $48.00 ile, Itz_z z. l ee: C."onstrrtuellon 1 ax., I'hrrrb. Ins:z 1<< e: Elec. h-qp. f'ee: NOTE: This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Fire, Sanitary Sewer District, School nivirict. etc 1. Theca feev are hayed nn the nrolirninary infnrtnadnn availahle and are nnlv an estimdte. ontaet the Dent for addn7 info. FEE ITEMS (Fee Resolution 11-053 Eff.' 711/13,) FEE QTY/FEE ISC ITEMS Plan Check Fee: $2,654.00= # $72.00 Mechanica IBREMAIR A/C Units (<=10K efin) Suppl. PC Fee:0 Reg. 0 OT 0.0. hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,666.00 Supp/. Insp. Fee:Q Reg. OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $48.00 C."onstrrtuellon 1 ax., 0 ork Without Permit? 0 Yes (D No $0.00 [AdvancedPlanning Fee. IPLLONGR $80.92 Select a on -Residential Building or Structure OA ravel Documentation Fee: ITR,4VDOC $48.00 -itron Motion Fee: IBSEISMICR $15.60 Select in Administrative Item Bldjz Stds Commission Fee: IBCBSC $5.00 SUBTOTALS $4,517.52 $72.00{- $4,589.52 IRevised: 10/01/2015