15070231 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:15070231
20852 CHERRYLAND DR CUPERTINO CA 95014(359 20 03 1)
OWNER'S NAME: SUEJANE I-IAN
DATE ISSUED;10/29/2015
OWNER'S PHONE:408-568-0616 PHONE NO:
LJMSEDCONTRACTOR'SDECLARATION
BUILDING PERMIT INFO:
License Class Lic.#
Contractor Date —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:
I hereby affirm under penalty of perjury one of the following two declarations: CONSTRUCT NEW 2 STORY SFD(3777 S.F.)WITH
i. I have and will maintain a certificate of consent to self-insure for Worker's ATTACHED GARAGE(465 S.F.)AND NEW PORCH AREA(432
Compensation,as provided for by Section 3700 of the Labor Code,for the S.F.)
performance of the work for which this permit is issued. REV#1-CHANGE PILES FOUNDATION INTO RAISED FLOOR,
z. 1 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 SUBMIT S-2 FOUNDATION PLANS
permit is issued. ISSUED:5/2/2016
APPLICANT ERTIFI.ATION
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 Sq.Ft Floor Area: Valuation:$677000.00
and state laws relating to building construction,and hereby authorize
representatives of this city to enter upon the above mentioned property for
inspection purposes. (We)agree to save indemnify and keep harmless the 359 Number: Occupancy Type:
City of Cupertino against liabilities,judgments,costs,and expenses which 359 20 031
may accrue against said City in consequence of the granting of this permit.
Additionally,the applicant understands and will comply with all non-point
source regulations per the Cupertino Municipal Code,Section 9.18. PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Signature Date /5/2 201st 180 DAYS FROM LAST CALLED INSPECTION.
OWNER-BUJI DER DE LARATION 'i41
V
Issued by:ALEX VALLELUN A QA/ Y
I hereby affirm that I am exempt from the Contractor's License Law for one of the Date: 10/29/2015
following two reasons:
i. I,as owner of the property,or my employees with wages as their sole
compensation,will do the work,and the structure is not intended or offered for RE-ROOFS:
sale($cc.7044,Business&Professions Code) All roofs shall be inspected prior to any roofing material being installed.If a roof is
1,as owner of the property,am exclusively contracting with licensed installed without first obtaining an inspection,I agree to remove all new materials for
contractors to construct the project(See.7044,Business&Professions Code). inspection.
I hereby affirm under penalty of perjury one of the following three declarations: Signature ofApplicant:
i. I have and will maintain a Certificate of Consent to self--insure for Worker's Date: /2/2016
Compensation,as provided for by Section 3700 of the Labor Code,for the
Performance of the work for which this permit is issued. ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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. HAZARDOUS MATERIALS DISCLOSURE
y I certify that in the performance of the work for which this permit is issued,I I have read the hazardous materials requirements under Chapter 6.95 of the
shall not employ any person in any manner so as to become subject to the California Health&Safety Code,Sections Municipal
25533,and 25534. I will
maintain
Worker's Compensation laws of California. If,after making this certificate of Heal h&Safety Code,SecCupertino 9.12 and
ti n255 (a)should I store or handle rhazard ushe
exemption,I become subject to the Worker's Compensation provisions of the material. Additionally,should I use equipment or devices which emit hazardous
Labor Code,I must forthwith comply with such provisions or this permit shall air contaminants as defined by the Bay Area Air Quality Management District I
be deemed revoked. will maintain compliance with the Cupertino Municipal Code,Chapter 9,12 and
APPLICANT ANT FRTIFI ATION the Health&Safety Code,Sections 25505,25533,and 25534.
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 state laws 'Owner or-autkQdzed�gent:� y
relating to building construction,and hereby authorize representatives of this city Date:5/2/2016 —
to enter upon the above mentioned property for inspection purposes. (We)agree
to save indemnify and keep harmless the City of Cupertino against liabilities, I hereby affirm that there is a construction ending agency,for the performance
judgments,costs,and expenses which may accrue against said City in of work's for which this permit is issued(Sec.3097,Civ C.)
consequence of the granting of this permit. Additionally,the applicant understands Lender's Name
and will comply with all non-point source regulations per the Cupertino Municipal
Code,Section 9.18. Lender's Address
i
;Signa tire ARCHITECT'S DECLARATION
,✓� _ Date /2/ Y I understand my plans shall be used as public records.
Licensed
CONSTRUCTION PERMIT APPLICATION El 4 COMMUNI>T Y DEVELOPIJiENT DEPARTMENT-BUILDING DIVISION 10300 T ORRE AVENUE CUPERTINO', CA 05014-3255 IEV
(408)777-3228 FAX(408)777-3333.building(a.cupertino.org p j
CUPERTINO
NEW CONSTRUCTION ❑ ADDITION 0 ALTERATIONII/TI ❑ REVISIOiN/DEFERRED ORiGE\A _PERNITT
PROJECTADDRESS L I L.PNn
0Wrl TER 111A1✓E I PHONE E-h�L4IL
STREETADDRESS nCITY, TATE,ZIP I FAX
CONTACT NAME PHONE E-hQ41L
STREET ADDIS CITY,S to E,z �/ FAY
❑ OV ER
0R-BUILDER ❑ OAT-RAGENT ❑ CONTRACTOR 11 CONTRACTORAGENT El ARCHITECT 2 rGINEER ❑ DE%LLOPFR ❑ TENANT
CONTRACTOR NA1,1E I LICENSE NUN BER LICENSE TYPE BUS.LIC
COMPANY NAh4E I E-111AIL FAX
STREET ADDRESS CITY,STATE,ZIP I PHONE
ARCI ITECT;ENGL-ER NAh E � 7- LICENSE N1laFRC65 6� Bi S.LIC=
C0114PANYNAM EA/LSIL I FAX
Ott t�l L-�6, 6.c 6QrA- e <<e&- ,--
STR£ET` R SSI CITY,S 4TE,ZIP PHO.'\-
DESCRIPTION of WORK
ifo You'd
90- 1
EXISTING USE PROPOSED USE CONSTR.TYPE --.'STORIES
II
USE TYPE OCC. I SQ.FT. VALUATIOT\(K)
EXISTG. NEIV FLOOR I DEMO I TOTAL (- -
?AE_A AREA AREA N-T.A-P,EA
B A,>-ROOM KITCHEN OTHER
RELTODELAREA ( REMODEL AREA I REk,ODELARE.S
PORCH AREA DECK AREA TOT??DECKPORCH AREA GA-RAGE AREA: Lj DETACH
[-]ATTACH
l
DCvELUNG L?'-TTS: TS A SECOND UNIT ❑YES SECOSD STORY ❑S'ES
BEING':DDED? E]NO ADDITION' NO
rRE A-PPLiCATION ❑YES TF -S.PRO\'IDE COPY OF IS THE BLDG AN ❑`TES e RECE-I 'E $1 ` TO T_-^.L.V:a LUA_ION:
❑NO PLANNUN-G APPROVAL LETTER EICHLER.HOATE? ❑NO
By my.gra ure below,I certify to each of the followin2: I ani the property owner or authorized agent to act on the property owners behalf. I have read this
application and the innformation I have provided is correct. I have read the Description of"Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws elating to build* g constauction. uthorize representatives of CuperiiSlO to enter the above-identified property for inspection purposes.
Signature of applicant/.' ent: Date:
KWLEMENITAL INF0R1\ TIG N REQUIRED
Net�,SFD or niLl�i�zr75 Apply mi1 dwellings:s: A 1 for deo, r
.tion ei_iit for
-- -- ❑�OS`ER Ti'E COOTER i�t � HLILDI\G PL.-L\Rte\IES§ a�
CX,StiPQ building(S) Demoitio-i permnit IS required prior,0 issuance Ofbuilding
pe_1init for new building. Lj P•1�RESS;
_ CornmercialBidQs: Provide a completed Hazard,ous:Materials DISC10SurP JZST CD4RD PLELIC I§ORTtiD
10i_TI 11 ain,Hazardous Isla*cr.a1S are be-ing"SZQ c5 part,OT il'_1S project.
Copy of Planping Approval Letter oI .Meetintr ,_,.th Punning prior to S
L, i LAJOR � ;, i� S�\IT.I2]cEtO ER Dt�TR1CT
sLbmiftal of Building Peir,It application.
Bldg. p�_d017.doc ret=,:ed C6/?1/11
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20852 CHERRYLAND DR CONTRACTOR:CHERRYLAND LLC PERMIT NO: 15070231
OWNER'S NAME: CHERRYLAND LLC 20846 DUNBAR DR DATE ISSUED: 10/29/2015
OWNER'S PHONE: 4084645030 CUPERTINO,CA 95014-2958 PHONE NO:
® LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL
CONSTRUCT NEW 2 STORY SFD(3777 S.F.)WITH
ATTACHED GARAGE(465 S.F.)AND NEW PORCH AREA(432
License Class Lia# S.F.)
Contractor Date
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: Sq.Ft Floor Area'. Valuation:$677000
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. APN Number:35420031.20852 Occupancy Type:
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. PERMIT!EXPIRES IF WORK IS NOT STARTED
APPLICANT CERTIFICATIONWITHIN 180 DAYS OF PERMIT ISSUANCE OR
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 180 D S FROM LAST CALLED INS C ION.
to building construction,and hereby authorize representatives of this city to enter / y t
upon the above mentioned property for inspection purposes. (We)agree to save Issued by:
1.4L-� L� Date:
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. RE-ROOFS:
All roofs shall be inspected prior to any roofing material being installed.If a roof is
Date
Signature installed without first obtaining an inspection,I agree to remove all new materials for
r inspection.
[ l OWNER-BUILDER DECLARATION Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
the following two reasons:
1. 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 HAZARDOUS MATERIALS DISCLOSURE
sale(Sec.7044,Business&Professions Code)
property,am exclusive) contracting with licensed contractors to I have read the hazardous materials requirements under Chapter 6.95 of the
2. I,as owner of theY g California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
construct the project(Sec.7044,Business&Professions Code). compliance with Ithe Cupertino Municipal Code,Chapter 9.12 and the Health
Safety Code,Section 25532(a)should I store or handle hazardous material.
I hereby affirm under penalty of perjury one of the following three declarations: Additionally,should I use equipment or devices which emit hazardous air
1. I have and will maintain a Certificate of Consent to self-insure for Worker's contaminants as idefined by the Bay Area Air Quality Management District I will
Compensation,as provided for by Section 3700 of the Labor Code,for the maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
performance of the work for which this permit is issued. Health&Safety Code,Sections 25505,25533,and 25534.
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 Owner or authorizgent: Date:--�r �
permit is issued. -77
3. I certify that in the performance of the work for which this permit is issued,I shall CONSTRUCTION LENDING AGENCY
' 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 I hereby affirm that there is a construction lending agency for the performance of work's
become subject to the Worker's Compensation provisions of the Labor Code,I for which this permit is issued(Sec.3097,Civ C.)
must forthwith comply with such provisions or this permit shall be deemed Lender's Name
revoked. Lender's Address
APPLICANT CERTIFICATION ARCHITECT'S DECLARATION
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 I understand my plans shall be used as public records.
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Licensed Professional
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 C ��
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTIc4ENT BUILDING DIVISION
10300 TORRE AVENUE CUPERTINO,CA 95014-3255 9
CU'I? EtTit�I4 (408)777-3228 FAX(408)777-3333. building(a)cupertino.orq
NEW CONSTRUCTION ❑ ADDITION ❑ ALTER:ATION I TI ❑ REVISION/DEFERRED ORIGINAL PERMIT T
PRorErr ADDRESS t:3L�t-;Y 1-i ��6 t 6 APN R
OWNERNht�t PHONE_
Ift f`� Gni w I 4o b--' 4' —'jv3 0
STREET ADDRESS CITY, STATE,ZIP FAX
CONTACT !! PHONE E-h3AIL/�
NAME
STREET ADDRESSCITY,STATE,ZIP FAX
2 a- Ai t ? Uf
OR\-R owN R-BUILDER ❑ m ERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT 11-ARCHE-CT ENGa'-ER ❑ DEVELOPER ❑TENANT
CONTRACTORNAME LICENSEN IdBER I LIC£NSETYPE I BUS.LIC
C01d.PANY NAME E-MAIL � FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
ARCrzTiE r1ENGINE'r-R NAME LI CENSE NUMB ER
BUS.LIC.
h t 242-S ---
C.ON.PANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP I PHOFIE
DESCRIPTION OF WORK -
t�1/U�ls11, 0 —
- f
ESISTINGUSE PROPOSED USE I C0 E r STORIES USE TYPE I OCC. I SQ.FT. I VALUATION(S)
EXISTG NEW FLOOR DEMO TOTAL e
AREA I AREA -1
BATHROOM
I AREA h'EI'AREA �ifI. I. l 1� �''
BATHROO vt KITCHENOTrD R e! I
REMODEL AREA RnM01) AREA
° RE11:ODEL AREA
PORCFIAREA DECKARF.A TOTALDECKlPORCHA.REA GARAGE AREA: - DETACH
4'12-z. 4-� ,
�DP.ELLINGUNITS: IS A SECOND UNIT ❑1'ES SECOND TORY O
BEING ADDED? �r-I I�0 ADD1TIOn°
PP E-APPLICATION �i ES IF 1-S,PROVIDE COPY OFF I IS THE BLDG AN []YES
I VALUATION:
(� x TOT.
AL
NO PLANIQn�GAPP?.OVALLt"TTER EICHLERHOME? , .'0 ~=" .��K - ;, ;
X06
By my signature belmv,I certify to each of the following: I am the property ovmer or authorized agent to act on the property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable Iocal
ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Aeent: Date
gig IIYoticsLTP _,
SUPPLEMEN L Il\IFORh2ATION REQUIRED I
Mol
_ _ �
New SFD or Multifamily dwellings: Apply for demolition permit for ❑�o�ri r_GoUh�TE2?� �$ME EGPL��rlxEv�r�
existing building s). Demolition permit is required prior to issuance of building - t
Ek'PS,ESs -, L a4- �-
permit for new building. T
fl PCIELSCF oZxs ,
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure �s - A-001 A
H
form if any azardous Materials are being used as part of this project. � D _
_r'�'
_Copy of Planning Approval Letter or Meeting with Planning prior toflAaoR� � �s .rrARYs3x�Is�xtcr
x
submittal of Building Permit application.
Bldgflpp_2011.doc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 20852 CHERRYLAND RD(LOT 3) DATE: 07/31/2016 REVIEWED BY: PAUL
APN: 359 20 031 BP#: *VALUATION: 1$677,000
VI ERMII TYPE: Building Permit PLAN CHECK TYPE: New Construction
PRIMARY SFD or Duplex 2nd Unit? Yes No PENTAMATION 1 R3SFDW
USE: PERMIT TYPE: a
WORK Construct new 2 sto SFD 3777 S.Q with attached Gara a 465 S.f. and New Porch Area 432 SJ.)
SCOPE
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.f.
R-3 (Custom) 11-8,111-B,IV,V-B 4,674 $3,327.11 JR3PLNCKI $3,915.51 1R31NSP
TOTALS: 4,674 $3,327.11 $3,915.51
Ileelz .Pkr z Check 1"'U zt;. P/an C Tice""- E'lec. Plan Clieck.
iFeE?z. Per,rz<Fee: 1'1irinf=.Perrzur.t'ee Elec.Perurztl acc:
Other A-2 h t'sp, other-I'lumb I ixp. �1th i },lec. 111sp.
Me(.ta. 11,sst). f`ae: Plum!;:InspFt-,,e: Elec. Insp. 1-ee,
NOTE: This estimate does not include fees due to other Departments(ie.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . These ees are based on the preliminar information available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 11-053 E . 711113 FEE QTY/FEE MISC ITEMS
Plan Check Fee: $3,327.11 Select a Misc Bldg/Structure
Suppl.PC Fee: (j) Reg. OT F676 hrs $0.00 or Element of a Building
PME Plan Check: $0.00
Permit Fee: $3,915.51
Suppl. Insp.Feer Reg. 0 OT 170701hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Construction Tax: IBCONSTAXR Fi #new $684.98
f Lltl1tYId,SYP°ETILi'£'Fee: O
Work Without Permit? 0 Yes (F) No $0.00
Advanced.Planning Fee: 1PLLONGR $654.36 / Select a Non-Residential E
Building or Structure
lf;,t'i:'l��(JC:lfl"Yt('YrlltltC317 �t?c'.5: �
Strong Motion Fee: 1BSEISMICR $88.01 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $28.00
SI7BTQ►TAI�S* $8,697.97 $0.00 = TflTtL FES:° $8,697.97
Revised: 07/02/2015