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15060099-DP7429 STANFORD PL 15060099 F/P XU TETE AND RUI SHI SCANNED BOX # 684 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7429 STANFORD PL CONTRACTOR:' PERMIT NO: 15060099 OWNER'S NAME: XU TETE AND RUI SHI DATE ISSUED: 07/09/2015 OWNER'S PHONE: 4087866574 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL TO CLEAR CODE ENFORCEMENT CASE: DEMO License Clas�, Lic. # le 6 UNPERMITTED �p�� Contracto 'd � ' �1/I � /Date j p 243 S.F. ADDITION & REMODEL (E) 93 S.F. KITCHEN 7sI (WORK DONE WITHOUT PERMITS) 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 Sq. Ft Floor Area: Valuation: $7000 performance of the work for which this permit is issued. E 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 APN Number: 35932034.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 D FROM LAST CALLED INSPECTIO . 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 Issued by: Date: with all non -point source regulations per the Cupertino Municipal Code, Section RE -ROOFS: 9.18. �r�yr 4 Signature al3 Date 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 inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 05,25 d..25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: z .. ate: 7 7 tt 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date V Ri CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7429 STANFORD PL CONTRACTORS XU TETE AND RUI SHI PERMIT NO: 15060099 OWNER'S NAME: XU TETE AND RUI SHI 7429 STANFORD PL DATE ISSUED: 07/09/2015 OWNER'S PHONE: 4087866574 CUPERTINO, CA 95014-5814 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL TO CLEAR CODE ENFORCEMENT CASE: DEMO License Class Lic. # UNPERMITTED 243 S.F. ADDITION & REMODEL (E) 93 S.F. KITCHEN Contractor Date (WORK DONE WITHOUT PERMITS) 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 Sq. Ft Floor Area: Valuation: $7000 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 APN Number: 35932034.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FR LED INSPECTION. 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 Date: L with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signature Date 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 inspection. OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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) . asowner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE onstruct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this `*0 5 Owner or authorized agent: Date: 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked, work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. x,7, % 4/��Date ` Signature C� CONSTRUCTION PERMIT APPLICATION CUPERTINO COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building )cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION 00 '�F5' KALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS / 7 APN # 2 5 47 _ � 2-_ e 34 OWNERNAME /+ T�� / 11 PHONE(,5 � 1)7&�f 4- E-MAIL 74 STREET ADDRESS CITY, STATE, ZIP \/sl ® FAX CONTACT NAME -Pe PHONE (Po3 3/ E-MAIL STREET ADDRESS 0q2 CITY, STATE, ZIP �i11/� . p A �❑ FAX ❑ OWNER ❑ OWNER -BUILDER/ OWNER AGENT El CONTRACTOR El CONTRACTOR AGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECTIENGINEER NAME ' /� ,1y] ( LICENSE NUMBER 5,e BUS. LIC # COMPANY NAME el, LJ� * S4a E MAIL , ^ FAX (✓� C , STREET ADDRESS A -- CITY, STATEVZIP �y f A ,/ � PHONE /`;w 3-31 , GB DESCRIPTION OF WORK / I i EXISTING US 3 PROPOSED USE CONSTR. _ TYPE j / —is # STORIES / " USE TYPE OCC. SQ.FT. VALUATION ($) AREAEXIST/ �® NEW' FLO AREA , ea AREA 24Y3! I DEMO TOTAL NET AREA /,'24 0 BATHROOM REMODEL AREA fPr KITCHEN REMODEL AREA ?30 OTHER REMODEL AREA PORCH AREA •y DECK AREA TOTAL DECKIPORRCH AREA GARAGE AREA: ❑ DETACH ATTACH 7 -7-7 -f #DWELLINGUNITS: IS A SECOND UNIT ❑YES BEING ADDED? SECONDSTO Y YES ADDITION? O X0 PRE -APPLICATION []YES IF YES, PROVIDE COPY OF PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? ❑ NO RE BY - TOTAL - +70 VALUATION: 0V By my signature below, I certify to each of the following: I am the property owner or auth ed agent rty owner's behalf. I have rea rs application and the information I have provided is correct. I have ead the Description of Work and I curate. I agree to comply with all applicable local ordinances and state laws relating to building con on. I orize r atives of Cupertino to enter the above -identified property for inspection purposes. Date: (611-VA< Signature of Applicant/Agent: SUPPLEMENTAL INFO TION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER THE.COUNTER ❑ BUILDING PLANREVIEYt' _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building ; permit for new building. ❑ EXPRESS PLANNING PLAN _ Commercial B(dgs: Provide a completed Hazardous Materials Disclosure = Q STANDARD ❑ ` PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. "0 LARGE- = ❑,:FIEiCDEPT. _ Copy of Planning Approval Letter or Meeting with Planning prior to MAJOR- ❑ SANtTARYSEWER DISTRICT submittal of Building Permit application. ❑- ENVIRONMENTALHEALTH B1dgApp 201 Ldoc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR -- BUILDING DIVISION imADDRESS: 7429 STANFORD PL DATE: 06/15/2015 REVIEWED BY: MELISSA APN: 359 32 034 BP#: "VALUATION: 1$7,000 %PERMIT TYPE: Building Permit PLAN CHECK TYP : Alteration / Repair PRIMARY SFD or Duplex USE: p PENTAMATION PERMIT TYPE: 1 R3SFDREM WORK I To Clear Code Enforcement Case: DEMO UNPERMITTED 243 S.F. ADDITION & REMODEL E 93 SCOPE S.F. KITCHEN (WORK DOME WITHOUT PERMITS) Mech. Plan Check Plumb. Plan Check Elea Plan Chc:ek Mech. Permit Fee: Plumb. Permit Fee: l;Iec. Permit Fee: Other Hech. Insp. Other Plumb Insp.Li Other Elec. Insp, Mech. Insp. Eee: Plumb. Insp. Tee: Elec. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (i. a Planning, Public Works, Fire, Sanitary Sewer District, School District. etc-). These fees are based on the nreliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 93 s.f. $645.00 Remodel, Kitchen (<=300 sf) IREMRESKIT Suppl. PC Fee: Q) Reg. 0 OT F070 1 hrs $0.00 PME Plan Check: $0.00 F243 I s.f. $431.00 Remodel, Other 1REMRESOTH Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administrative Fee: Q E) Work Without Permit? (F) Yes 0 No $1,076.00 Advanced Plannin Fee: $0.00 Select a Non -Residential Building or Structure Q i Trm,el Documentation Fees: Strong; Motion Fee: IBSEISMICR $0.91 Select an Administrative Item Bldg; Stds Commission Fee: IBCBSC $1.00 : . }:SUBTOTALS. $1, 077.91 $1, 076.00, _ TQAL .FEE w $2,153.91 Revised: 05/07/2015