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07050082�5ao�2 Fl� e 0 A., A IV 941 09 File Edit Actions Details Links Favorites Help Permit. Information Permit Number " 107050082 Status v Master Number ® - Notes 0 Project - - _- - Apply Date' 05/10 Operator christya Permit Issue Date 08/16/2007 Operator g Certificate Issued 12/23/2008 Operator PALM Certificate Type Certificate Number Permit " Property Permit Details Permit Type' Usage Class' Applied Value ' SQUARE FT. Calculated Value US C-404 Type Permit Form ' Ownership Project Size Zoning Applicant Contractor Defined Fields SFDWL-NEW1 DO NOT USE — ` — II D -WNEW [C DWELLING TYPE 5 WOODNEW _ -- - 705200 3551 801494 A Location Information Address " 120896 ELENDA DR - City/State/Zip CUPERTINO APN-32630023.00 Unit - CA 95014 Ov,rer Er-,tity Information Owner Name " MALICE TAN Use Default ❑ Address Home 2672 BAYSHORE PKWY #702 City/State/Zip MOUNTAIN VIEW CA 94043 AUTOPERM -PERMIT v' 1 -Private v' Purpose/Special Conditions SFDWL-2-STORY W/ATTACHED 2ND UNIT -LIVING 3551' GAPAG 661', PORCH 92.7 ' DEMO PERMIT NEEDED. NEED SANITARY RELEASE LETTER REVISION - 907090029 3/19/08 LETTER FROM K&M DEVELOPMENT, INC. STATING TERMINATION AS GENERAL CONTRACTOR FOR THIS PROJECT 5/30/8/ - UTILITY LETTER SIGNED BY OWNER& NOT REQUIP SIGNTURE OF CONTRACTR FILMED-2011 FE—OAdd Default Text 4 > You have chosen to bypass the holds for this permitjparcel Enter permit status OK l F4v Back [In Contractors ?fees (may Plan Reviews Inspections Print Permit Itt Adjustments (r Holds W Copy Permit Close Permit Overrides �i Supplementalfields ( Notes (Attachments CITY OF CUPERTINO BUILDING DIVISION PERIVIITR3FC21kiATior; ` BUiLQI 11�� PE RMIT NO. 0 $�yD� ELENDA DR TBD - TO BE DETERMINED 07050082 OWNER'S NAME: PERMIT ISSUE DATE ALICE TAN 08/16 2007 PHONE: SANITARY NO. CONTROL NO. A.RCHITECTIENGINEERR BUILDING PERMIT INFO SFDWL-2-STORY W/2ND UNIT- BLDG ELECT PLUMB MECH LICENSED CONTRACrOWSDECLARATION O Description :. 1 hereby affirm that I am licensed under provisions of Chapter 9 (Commixing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full' force and effect License Claz Lie. 0 741 Date Conuactor OZE P I 6 ,„ �G, RCHITEcrS DECLA ATION 1 errs crstand my plans shall be used as public records Licensed Pmfcssional OWNER -BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License law for the following reason. (Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct. allcr, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement Contractor's License Law (Chapter 9 Sq. Ft. Floor Area Valuation that he is licensed pursuant to the provisions of the (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of APN Number Occupancy Type Section 70315 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (Sb00). 1, as owner of the property, or my employees with wages as their sole compensation, Required Inspections will do the work. and the structure is not intended or offered for sale (Sec.7044. Business and Professions Code: The Contractors License Law does not apply toe an owner of 9 P property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion. The owner. builder will have the burden of proving that he did not build or improve for purpose of sale.). 1, as owner of the property, am exclusively contracting with licensed comracmrs to construct the project (Sec. 7044, Business and Professions Code:) The Comuactoes Li- ccnse law does not apply to an owner of property who builds or improves thereon, and . who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License law. I am exempt under Sec , B & P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby alarm under penalty of perjury one of the following declarafio m 1 have and will maintain a Certificate of Consent to self -insure for Worker's Compen- sation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued Q I have and will maintain Worker's Compensation Insurance, as required by Section 370p of the labor Code, for the performance of the work for which this permit is issued My Workeess�Coommpensatii000nn insurance carrier and Policy numberam: 2 Carrier: ;S v/fr /��a'�7C� Policy No.: / ✓ •� CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollar; ($100) or less.) 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 Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Ccnifrcalc of Exemption, you should become subject to the Worker's Compensation provisions of the labor Coda you must forthwith comply with such provisions or this permit shall be deemed revoked " CONSTRUCTION LENDING AGENCY + I hereby affirm that there is a construction lending agency for the performance of y the work for which dds permit is issued (Sec. 3097, Civ. C) Lender's Name , r Lender's Address 1 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 stale laws relating to building construction, and hereby authorize representative of this city to enter upon the above -mentioned property for inspection purposes_ (Wc) agree to save• indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue againstsaid City r in consequence of the granting of this permit. � " APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT /, Issued by: Date-( SOURCE REGULATIONS. Re -roofs Type of Roof Signature of t/Corttractor Da LI ARD S MATERLS DISCLOSURE Will the care building occupantstore or handle hazardous material as dcfincd by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety Code, Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes — \° If a roof is installed without first obtaining an inspection, I agree to remove - Will the applicant or future building occupant use pp g pa equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? Wlo p Yes I have read the hazardous materials requirements underChaptcr 6.95 of the Califor- nia Health & Safety Code, Sections 25505.25533 and25534. I understmd thatif the building does not currently have a tenant, that it is my responsibility to notify the occupant of the . 'requirements which must be met prior to issuance of aCenifi r cupaa _ Signature of Applicant Date �— 6 All roof coverings to be Class "B" or better on-rn a Datc 00s00g'z lz or CUPEFINO CITY OF CUPERTINO NEW SINGLE FAMILY DWELLING PERMIT APPLICATION FORM APN # � 2 / _ � 0 _ d 2,3 3 - i Date: �A ,aA, i d e ,zoo Building Address: & r l-a-hd Mailing Address (if different from building address): Dr, 20"b', Owner's Name: Phone #: / � �/ 4 Al I c� Contractor: License #: Contact: ii ^^ Phone: LfJj - LKkq-ob 41 Cupertino Business License#: J-L Fax: 4,� - o 3 Building Permit Info: �� }� ter- 1 r} s"/"-O -"A Zyl/l kA ^t- Single Story ❑ Two -Story Three -Story ❑ Basement ❑ Sq.Ft. Floor Area: � oY� ,, SF e,�t�;-F q2,-1 SF $/Sq.Ft.: -i S F Cost of Pr ect: o Type of Construction: Project Size: Standard ❑ Large ❑ Major ❑ Quantity. Fee ID Fee Description Fee Group BCONSTAXR Constax - Resi/Mobile BUILDING BELEC 1000 Elec 600V <= I OOOA ELECTRICAL BELEC 1001 Elec 600V > 1000A ELECTRICAL % BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATR Res. Housing Mit Fee BUILDING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING / BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING 1 of 3 CITY OF CUPEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: 2-b-Fis �r PERMIT # OWNER'S NAME: r C z PHONE # GENERAL CONTRACTOR: FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date