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15100060CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15100060 19683 WHEATON DR CUPERTINO CA 95014 (316 28 009) (LYNSTAR ENTERPRISES INC) SAN JOSE, CA 95112 OWNER'S NAME: DATE ISSUED: OWNER'S PHONE: __ PHONE NO: LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: 66 3 T? 3 License Class Lic. # Contractor LYNSTAR ENTERPRISES INC) Datef ` 1 5 R _ 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: ADD 445 S.F. TO 1 ST FLR & 2NS STORY ADDITION OF I hereby affirm under penalty ofperjury one of the following two declarations: 871 S.F. (1,316 S.F. TOTAL), ADD COVERED PORCH & t. I have and will maintain a certificate of consent to self -insure for Worker's DECK W/TRELLIS (96 S.F.), COMPLETE REMODEL OF (E). Compensation, as provided for by Section 3700 of the Labor Code, for the 1,392 S.F. SFD, REPLACE (E) SIDING (1,276S.R) & performance of the work for which this permit is issued. RE -ROOF (10 SQ'S), REPLACE 12 (E) WINDOWS/DOORS, z, I have and will maintain Worker's Compensation Insurance, as provided for REPLACE HVAC & WATER HEATER, UPGRADE PANEL by Section 3700 of the Labor Code, for the performance of the work for which Sq. Ft Floor Area: Valuation: $400000.00 this permit is issued. APPLICANT CERTIFICATION 1 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 316 28 009 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 T 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 ED INSPECTION. Code, Section 18. Date ` l5 1f' sued / Date Ir Signatures OWNER -B TII DER DECLARATION RF. -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 installed without first obtaining an inspection, I agree to remove all new materials for following two reasons; 1. 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: 2. I, as owner of the property, am exclusively contracting with licensed Date: contractors to construct the project (Sec.7044, Business & Professions Code). ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: 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 Health & Safety Code, Section 25532(a) should I store or handle hazardous this permit is issued. material. Additionally, should I use equipment or devices which emit hazardous s. I certify that in the performance of the work for which this permit is issued, I that if in t air contaminants as defined by the Bay Area Air Quality Management District I shall t any person in any manner so as to become subject to the will maintain compliance with the Cupertino Munfcf al Code, Chapter 9.12 and Worker's Compensation laws of California. If, after waking this certificate of the Health & Safety Cod %, Section 25 ;' 533, 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 oxen be deemed revoked. Date�iA , I'S - t 5® CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) correct. I agree to comply with all city and county ordinances and state laws Lender's Name relating to building construction, and hereby authorize representatives of this city 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 N CITYOF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15100060 19683 WHEATON DR CUPERTINO CA 95014 (316 28 009) LYNSTAR ENTERPRISES INC SAN JOSE, CA 95112 OWNER'S NAME: LICENSED CONTRACTOR'S DECLARATION License Class B Lit. #563773 Contractor LYNSTAR ENTERPRISES INC Date 04/30/2017 I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business &c 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. 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 this permit is issued. 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, t e applica�unde[§_tands and will comply with all non -point source regulat Municipal Code, Section 9.18. Date 3/15/2017 hereby affirm that I am exempt from the Contractor's License Law for one of the vmg two reasons: i. 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. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). hereby affirm under penalty of perjury one of the following three declarations: 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. 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. 3. 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 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. Signature Date 3/15/2017 ISSUED: 01/15/2016 NO: (408) 280-1848 BUILDING PERMIT INFO: BLDG _ ELECT _ PLUMB MECH _ RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: ADD 445 S.F. TO 1 ST FLR & 2NS STORY ADDITION OF 871 S.F. (1,316 S.F. TOTAL), ADD COVERED PORCH & DECK W/TRELLIS (96 S.F.), COMPLETE REMODEL OF (E) 1,392 S.F. SFD, REPLACE (E) SIDING (1,276S.F.) & RE -ROOF (10 SQ'S), REPLACE 12 (E) WINDOWS/DOORS, REPLACE HVAC & WATER HEATER, UPGRADE PANEL REV #1: REVISED FOUNDATION SYSTEM TO PIER AND GRADE BEAM - ISSUED 4/26/2016 REV #2: CHANGE GARAGE HEADER - ISSUED 12/20/2016 REV #3: 03/14/2017 CHANGE EXISTING FURNACE - GARAGE - ISSUED 3/15/2017 Sq. Ft Floor Area: I Valuation: $400000.00 "N Number: Occupancy Type: 316 28 009 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. by: Alex Vallelungq RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtain' g aainspe , I agree to remove all new materials for Signature ofApplicant: Date:/315/2017 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 upaf pal ode, Chapter 9.12 and the Health & Safety Code, e 2553 and 25534. Owner or authorized agent: Date: 3/15/2017 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ CJ CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15100060 19683 WHEATON DR CUPERTINO CA 95014 (316 28 009) LYNSTAR ENTERPRISES INC SAN JOSE, CA 95112 OWNER'S NAME: PHONE NO: (408) 280-1848 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class 5 Lic. #55377a L ENTERPRISES INC Date 04/30/2017 _ BLDG _ELECT —PLUMB Contractor YNSTAR _ 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 JOB DESCRIPTION: license is in full force and effect. ADD 445 S.F. TO 1 ST FLR & 2NS STORY ADDITION OF 1 hereby affirm under penalty of perjury one of the following two declarations: 871 S.F. (1,316 S.F. TOTAL), ADD COVERED PORCH & i. I have and will maintain a certificate of consent to self -insure for Worker's DECK W/TRELLIS (96 S.F.), COMPLETE REMODEL OF (E) as provided for by Section 3700 of the Labor Code, for the 1,392 S.F. SFD, REPLACE (E) SIDING (1,276S.F.) & –Compensation, - performance of the work for which this permit is issued. RE -ROOF (10 SQ'S), REPLACE 12 (E) WINDOWS/DOORS, r z: I have and will maintain Worker's Compensation Insurance, as provided for by REPLACE HVAC &WATER HEATER, UPGRADE PANEL v, Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. REV #1: REVISED FOUNDATION SYSTEM TO PIER AND GRADE APPLICANT CERTIFICATION I certify that I have read this application and state that the above BEAM -ISSUED 4/26/2016. REV #2: CHANGE GARAGE HEADER - ISSUED 12/20/2016 information is correct. I agree to comply with all city and county ordinances and statelaws 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 applica understands and will comply with all non -point Sq. Ft Floor Area: Valuation: $400000.00 source regulati , ns per t _ {no Municipal Code, Section 9.18. r � 1 2 ' 0 � r4- APN Number: Occupancy Type: ( .Signat re 316 28 009 ^Ixnvcn urm n1 R DECLARATION PERMIT EXPIRES IF WORK IS NOT STARTED I hereby affirm that I am exempt from the Contractor's License Law for one of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR following two reasons: 1. I, as owner of the property, or my employees with wages as their sole 180 DAYS FROM LAST CALLED 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 Issued by: ABBY AYENDE contractors to construct the project (Sec.7044, Business & Professions Code). Date: 01/15/2016 I hereby affirm under penalty of perjury one of the following three declarations: Certificate of Consent to self -insure for Worker's RF ROOFS: 1. I have and will maintain a Compensation, as provided for by Section 3700 of the Labor Code, for the All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for performance of the work for which this permit is issued. inspection. z. 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. 3. 1 certify that in the performance of the work for which this permit is issued, I Signature of Applicant: Date: 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 ALL ROOF COVERINGS TO BE CLASS "At' OR BETTER 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 HAZARDOUS' MATERIALS DISCLOSURE be deemed revoked. I have read the hazardous materials requirements under Chapter 6.95 of the Health & Safety Code, Sections 25505, 25533, and 25534. I will APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is California maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous 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 material. Additionally, should I use equipment or devices which emit hazardous by the Bay Area Air Quality Management District I to enter upon the above mentioned property for inspection purposes. (We) agree air contaminants as defined 25534- 9.12 and the City of Cupertino against liabilities, will morn the compliance mpthh&Safety ns 1C12553 to save indemnify and keep harmless expenses which may accrue against said City in Code, recti and judgments, costs, and consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Owner or authorized agernt• Code, Section 9.18. Date: C^NSTRUCTION LENDING AGENCX lending agency for the performance Date Signature D I hereby affirm that there is a construction of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name CITY OF CUPERTINO BUILDING PERMIT' BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15100060 19683 WHEATON DR CUPERTINO CA 95014 (316 28 009) LYNSTAR ENTERPRISES INC SAN JOSE, CA 95112 OWNER'S NAME: PHONE NO: (408) 280-1848 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. #563773 Contractor LYNSTAR ENTERPRISES INC Date 04/30/2017 _ BLDG —ELECT —PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing — MECH _ RESIDENTIAL _ COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: ADD 445 S.F. TO 1 ST FLR & 2NS STORY ADDITION OF I hereby affirm under penalty of perjury one of the following two declarations: 871 S.F. (1,316 S.F. TOTAL), ADD COVERED PORCH & 1. 1 have and will maintain a certificate of consent to self-insure for Worker's DECK W/TRELLIS (96 S.F.), COMPLETE REMODEL OF (E) Compensation, as provided for by Section 3700 of the Labor Code, for the 1,392 S.F. SFD, REPLACE (E) SIDING (1,276S.F.) & performance of the work for which this permit is issued. RE-ROOF (10 SQ'S), REPLACE 12 (E) WINDOWS/DOORS, ,_1.1\4 have and will maintain Worker's Compensation Insurance, as provided for by REPLACE HVAC & WATER HEATER, UPGRADE PANEL Zection 3700 of the Labor Code, for the performance of the work for which this :-`permit is issued. APPLICANT CERTIFICATION REV #1: REVISED FOUNDATION SYSTEM TO PIER AND GRADE I certify that I have read this application and state that the above BEAM - ISSUED 4/26/2016 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. Sq. Ft Floor Area: Valuation: $40(000.00 Additionally, the applicant unders ands and will comply with all non-point source regulate ns . C erti o Municipal Code, Section 9.18. APN Number: Occupancy Type: .Si nature - Date 4/26/2016 316 28 009 OWNER-BUILDER DECLARATION PERMIT EXPIRES IF WORK IS NOT STARTED I hereby affirm that I am exempt from the Contractor's License Law for one of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR following two reasons: i. I, as owner of the property, or my employees with wages as their sole 180 DAYS FROM LAST CALLED 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 Date: 01/15/2016 contractors to construct the project(Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: RE-ROOFS: 1. I have and will maintain a Certificate of Consent to self-insure for Worker's All roofs shall be inspected prior to any roofing material being installed. If a roof is Compensation, as provided for by Section 3700 of the Labor Code, for the installed without first obtaining an inspection, I agree to remove all new materials for performance of the work for which this permit is issued. inspection. 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 Signature of Applicant: permit is issued. Date: 4/26/2016 3. 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 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE be deemed revoked. I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will APPLICANT CERTIFICATION maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the I certify that I have read this application and state that the above information is Health & Safety Code, Section 25532(a) should I store or handle hazardous correct. I agree to comply with all city and county ordinances and state laws material. Additionally, should I use equipment or devices which emit hazardous relating to building construction, and hereby authorize representatives of this city air contaminants as defined by the Bay Area Air Quality Management District I to enter upon the above mentioned property for inspection purposes. (We) agree will maintain compliance with theupertino amici Code, Chapter 9.12 and to save indemnify and keep harmless the City of Cupertino against liabilities, the Health & Safety Code, ections 5 , 25534, and 25534. judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands (Owneror - _— — authorized ager and will comply with all non-point source regulations per the Cupertino Municipal -Date:-4/26/209 6--^ Code, Section 9.18. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance Signature Date 4/26/2016 of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name CITY OF CUPERTINO FEE ESTIMATOR BUILDING DIVISION ADDRESS: 19683 WEATON DR DATE: 10/07/2015 REVIEWED BY: MELISSA APN: 316 28 009 BP#: *VALUATIONS 1$400,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY USE: SFD or Duplex 2nd Unit? - Yes No OTC? ®Yes No PENTAMATION PERMIT TYPE: 1 R3SFDADD WORK ADD 445 S.F. TO 1 ST FLR & 2NS STORY ADDITION OF 871 S.F. (1,316 S.F. TOTAL),ADD SCOPE COVERED PORCH & DECK W/TRELLIS (96 S.F.), COMPLETE REMODEL OF (E) SFD (1,392 S.F.),© OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,111-B,IV,V-B 1,492 $2,757.15 IR3PLNCK $2,035.55 IR3INSP I TOTALS: I 1,492 $2,757.15 I _ $2,035.55 r NiEC , H(?VRIl e .- hofn-u-mB, mOURG f des .= a EL» ; Ht IIRL _ Ye To ldech. Plan Check Plumb. flan Check h7ece i lan Check A-1ec h' Permit I ee: 1'luml}. 1'er sa2if Fee: e: Elec. Permit trr?t It'ee: Other:bfiech.1eisp7E1__L_ other Pi2d17bAl—vp, OtherE'�lea Insp. Afech. hup, Fee: Plumb. Imp.Fee: Elec. Imp. Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, ete.. These ees are based on the preliminar information available and are only an estimate. Contact the De t or addn'l infix FEE ITEMS (Fee Resolution 11-033 Ef. 711113) FEE QTYIFEE MISC ITEMS Plan Check Fee: $2,757.15 1,392 s.f. Remodel, Other $4,888.00 IREMRES2 Suppl. PC Fee: e) Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $2,035.55 Supp/. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tex: rlchninistrativeFee: Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: IPLLONGR $208.88 Select a Non -Residential Building or Structure O Tr avel.d ocumenIation Fec,5°: Bldg Suds Commission Fee: I BSEISMICR $52.00 IBCBSC $16.00 TL: $5,069.58 $4,888.00 Select an Administrative Item $9,957.58 Revised: 10/01/2015