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15080193CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10101 ADRIANA AVE CONTRACTOR: BABEL CONSTRUCTION PERMIT NO: 15080193 OWNER'S NAME: ZHOU YUE AND YU JING 3939 ARDEN FARMS PL DATE ISSUED: 12/10/2015 OWNER'S PHONE: 4084643618 SAN JOSE, CA 95111 PHONE NO: (408) 561-7041 JOB DESCRIPTION: RESIDENTIAL, ❑ COMMERCIALE] LICENSED CONTRACTOR'S DECLARATION CONSTRUCT (N) ONE STORY SFD (3553 S.F.) FRONT _ License Class Lic. # } PORCH (156 S.F.) REAR COVERED PATIO (150 S.F) WITH ATTACHED GARAGE (441 S.F.) Contractor E C3LC� UY1 t Va Tl 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: 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 Valuation: $520000 performance of the work for which this permit is issued. Sq. Ft Floor Area: 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 APN Number: 32620028.00 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 180 DAYS FROM LAST CALLED INSPECTION. 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 Issued by: Ot Date: 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. Date. LZ RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is Signature / 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 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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) HAZARDOUS MATERIALS DISCLOSURE I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business &Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the Sections 25505, 25533, and 25534. I will California Health & Safety Code, with the Cupertino Municipal Code, Chapter 9.12 and the I hereby affirm under penalty of perjury one of the following three maintain compliance Health & Safety Code, Section 25532(a) should I store or handle hazardous declarations: 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 the Bay Area Air ni DistrictManagement uality Compensation, as provided for by Section 3700 of the Labor Code, for the ipal Code, Chapter. 12 and yip contaminants compliance with the Cupertino Muny performance of the work for which this permit is issued.the Health &Safety Code, Sections 2� 5 2 3, and 25534. I have and will maintain Worker's Compensation Insurance, as provided for by f 1 Date: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I Owner or authorized agent: ' I certify that in the performance of the work for which this permit is issued, shall not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker'sCompensation provisions of the Labor Code, I must affirm is tissued (Se3097, lending gen) for the performance of tiv hereby this forthwith comply with such provisions or this permit shall be deemed revoked. which permit Lender's Name, APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is and state laws relating correct. I agree to comply with all city and county ordinances to building construction, and hereby authorize representatives of this city to enter to save DECLARATION upon theabovementioned property for inspection purposes. (We) agree indemnify and keep harmless the City of Cupertino against liabilities, judgments, against said City in consequence of the ARCHITECT'S I understand my plans shall be used as public records. costs, and expenses which may accrue granting of this permit. Additionally, the applicant understands and will comply Professional with all non -point source regulations per the Cupertino Municipal Code, Section Licensed 9.18, Signature Date, _ - CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 LA (408) 777-3228• FAX (408) 777-3333 • building aOcuoertino.org CUPERTINO NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PRO"" W0 n APN OWNERNAME - PHOgNE £MAIL VO A - STREET ADDRESS CITY, S E P FAX el CONTACT NAME �A PHONE 0 E -MAS r P � c STREET ADDRESS t✓/ _ s b nCITY�ATE�ZIP� r c7 �? f`�'i FAX E OWNER E, OWNER -BUILDER E OW1dERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHITECT eENGDQEEK E DEVELOPER TENANT CONTRACTORNAME KTTCHEN. - OTHER, REMODEL AREA REMODEL AREA LICENSE NUMBER LICENSETYPE DECK AREA BUS. LTC # COMPANY NAME - - DETACHt ,�AT'fACiI. E-MAIL 26 FAX STREET ADDRESS # DWELLING UNITS: CITY, STATE, ZIP SECOND STORY ADDITION? DYES -8.Ti0 PHONE ARCI41TECTIENOLNEER NAME L 1s THE BLDG AN LICENSE NUMBER r PRE -APPLICATION LINES IF YES, PROVIDE COPY OF PLAITNINGAPPLr ,®3I0 PLANNING APPROVAL LETrER BUS: LTC # a below, I certify to each of the following: I am the property owner or authori ed agent to act on the properly owner's behalf. I have read this I agree to comply with all applicable local By my signature application and the information I have proVidc4 is correct. I have read the Description of -Work and verify it is accurate. to enter the above-,�pidentified prop for inspection purposes. ordinances and state laws relating to buildi nstruction. I authorize representatives of Cupertino 7i f es -7 - Date: ., ., ,,.a E-MAIL . _ rA a• FAX STREET ADD ; DESCRIPTION OF ZIP USE TYPE I OCC. SQ.FT. VALUATION (S) , o-- - 1. - EXISTG FLOOR. AREA C AREAS DEMO ® AREA f !..� TOTAL NET AREA 3 t BATHROOM. REMODEL AREA• KTTCHEN. - OTHER, REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: �p - - DETACHt ,�AT'fACiI. 26 # DWELLING UNITS: ISA SECOND UNIT ❑YES BEING ADDED? [2.vo SECOND STORY ADDITION? DYES -8.Ti0 0,09 1s THE BLDG AN TOTAL VALUATION: PRE -APPLICATION LINES IF YES, PROVIDE COPY OF PLAITNINGAPPLr ,®3I0 PLANNING APPROVAL LETrER EICHLERHOME? a below, I certify to each of the following: I am the property owner or authori ed agent to act on the properly owner's behalf. I have read this I agree to comply with all applicable local By my signature application and the information I have proVidc4 is correct. I have read the Description of -Work and verify it is accurate. to enter the above-,�pidentified prop for inspection purposes. ordinances and state laws relating to buildi nstruction. I authorize representatives of Cupertino 7i f es -7 - Date: Signature of Applicant/Agent: _ New SFD or Multifamily &N ellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. Bldgtfpp 2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR -BUILDING DIVISION . ADDRESS: 10101 Adriana Ave DATE: 08/27/2015 REVIEWED BY: PAUL APN: 326 20 028 BP# *VALUATION: $520,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY SFD or Duplex 2nd Unit? 0 Yes No I PENTAMATION 1 R3SFDW USE: PERMIT TYPE: i WORK Construct N one story SFD 3550 S.f. Front Porch 113 S.f. Rear Covered Patio 150 S.f. with SCOPE Attached Garage (462 S.f.) OCCUPANCY TYPE: ,Jec, . Plan ("Aleck 11nmb. flan t"heck 17ec. TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,111-B,IV,V-B 4,275 $3,296.19 ld3PLNCK $3,671.79 1R31NSP Permit Fee: $3,671_.79 $0.00 Suppl. Insp. Fee -.0 Reg. 0 OT 0.0 hrs PME Unit Fee: $0.00 $0.00 PME Permit Fee: Construction Tax: IBCONSTAXR 1 #new units TOTALS: 4,275 $3,296.19 • Select allon-Residential Building or Structure Select an Administrative Item $8,340.06 $3,671.79 $0.00 Plan t'lzcck Atech Permil l gee: t'i711R/I pl. RI t I er: .l..si.,'. Tact fltrf 1'8e: 0111.r;:Uccla..titspF "! _L_ Other I't.,ntr�t.11asn> Other lee. friss afE°c°;a. I;nt Fee: Ptxrrnh. 1rsh. /'"e>: k7ec. Imp. Fee: ?Vf)TTi • Thie nctisr ato dnvc not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.. These fees are based on the reliminar in tion available and are only an estimate. contact me Lea ur uuurc FEE ITEMS (Fee Resolution] 1-053 E . 711113) Plan Check Fee: FEE QTY/FEEE MISC ITEMS $3,296.19 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: � Reg. OT 0.0 hrs PME Plan Check: $0.00 $0.00 Permit Fee: $3,671_.79 $0.00 Suppl. Insp. Fee -.0 Reg. 0 OT 0.0 hrs PME Unit Fee: $0.00 $0.00 PME Permit Fee: Construction Tax: IBCONSTAXR 1 #new units $684.98 $0.00OTALTE • Select allon-Residential Building or Structure Select an Administrative Item $8,340.06 .F�f771'11(i?IbiP°C.7(13 £? 1'�£'t': Work Without Permit? 07es No $0.00 Advanced Planning Fee: I PLLONGR TNi;�ti-4:'llirit'trtr�t�t'tttftto#t �'C�e�:S: $598.50 $67.60 Strong Motion Fee: IBSEISMICR Bldg Stds Commission Fee: IBCBSC $21.00 $8,340.06 TBTETAS, Revised: 07/02/2015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15080193 10101 ADRIANA AVE CUPERTINO CA 95014 (326 20 028) KEVIN DONG 3939 ARDEN FARMS PL SAN JOSE, CA 95111 OWNER'S NAME: ZHOU YUE AND YU JING DATE ISSUED: 12/10/2015 OWNER'S PHONE: (408) 891-8059 PHONE NO: 408-891-8059 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class U Lic. #965419 Contractor KEVIN DONG Date 05/31/2016 —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: CONSTRUCT (N) ONE STORY SFD (3553 S.F.) FRONT PORCH (156 I hereby affirm under penalty of perjury one of the following two declarations: S.F.) REAR COVERED PATIO (150 S.F.) WITH ATTACHED GARAGE 1. I have and will maintain a certificate of consent to self-insure for Worker's (441 S.F.) Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. REVISION #1: ADD STONE VENEER TO FRONT OF RESIDENCE- I have and will maintain Worker's Compensation Insurance, as provided for by ISSUED 4/25/2017 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $520000.00 APPLICANT CERTIFICATION I 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 ordinances 326 20 028 326 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature �i , (/ r'�/ /� i Date Issued by: Legacy DECLARATION Date: 12/10/2015 OWNER-BUILDER I hereby affirm that I am exempt from the Contractor's License Law for one of the RF.-ROOFS: All roofs shall be inspected prior to any roofmg material being installed. If a roof is following two reasons: 1. I, as owner of the property, or my employees with wages as their sole installed without fust obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sec.7044, Business & Professions Code) z. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE z. 1 have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the permit is issued. 3. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Sections 25505, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: !&,6 a �L) APPLICANT CERTIFICATION Date: � I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance correct. I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued (Sec. 3097, Civ C.) 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 Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Code, Section 9.18. Licensed Signature Date Professional CUPERTINO CONSTRUCTION PERMIT APPLICATIONnn SI COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING dI�V� 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a)cupertino.orci 15080 50a0 I ? 3 ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS ) Q f 0( /� J ri n a a v e r IN # 326-2o.-018 26-2_©ZQ OWNER NAME ``` n Y L •7 PHONE 6 5o - /( qu "1I 7m_mL i n9 ya W uC (09 Ala; STREET ADDRESS 3 Li me ri cit Ct CITY, STATE, ZIP S u JI�`� y l Q q (�A % !(�(} FAX CONTACT NAME PHONE ��✓_ (' r 2 j 9 3 _1 El -MAIL j y Lk� U * (j I a j [ - Cil V�1 J �l �I �J STREET ADDRESS -1 -7 3 LI ffV_'r1% C k Gt CITY, STATE, ZIP SLAV, V1 lo' e' CA NOV FAX DOWNER ❑ OWNER-BUB.DE , ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANI CONTRACTOR NAME Do�9 LICENSE NUMBER 9654-(? LICENSE TYPE B BUS. IICE: /�KQV�n COMPANY NAME /�7rhrand- Nest Cvxst�'ov\ `0 E-MAIL FAX STREET ADDRESS `La C h es+ a drl\�� CITY, STATE, ZIP S , CA Q L� V �, / PHONE 40$ V ARCHITECT/ENGINEER NAME j �e s Le L i u, v v LICENSE NUMBER C` 6 0 k 7 Q BUS. LIC # COMPANY NAME E-MAIL w n s `e � 1 a j o oo • �,n m FAX STREET ADDRESS 7 4 / ` i a rJ A%,� le i 5 ,tl'{e 0 U J, ' I CITY, STATED, ZIPI ' 11 T`fla , cA q C' 1 J t� 3 _ 1 Q PHONE 40Q - Q 73-18 Q 7 0 DESCRIPTION OF WORK ' Revise _tke &XtCrna,( urrd Wail r►'I S�ucGo 'Cu 5`%ne EXISTING USE PROPOSED USE CONST& TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA BATHROOM REMODEL AREA KITCHEN REMODEL AREA OTHER REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES BEING ADDED? []NO SECOND STORY []YES ADDITION? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES I EICHLER HOME? ❑ NO RECEIVED�BY: - TOTAL By my signature below, I certify to each of the following: I am the property owner 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 local ordinances and state laws relating to buildin construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: q/ 151 6 SUPPLEMENTAL INFORMATION REQUIRED _ 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. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. PLAN CHECK TYPE ROUTING SLIP OVER-THE-COUNTER ❑ EXPRESS El STANDARD ❑ LARGE ❑ MAJOR BUILDING PLAN REVIEW LANNING PLAN REVIEW PUBLIC WORKS ❑ FIRE DEPT ❑ SANITARY SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: �1 Adl/0 fla A ✓ PERMIT # I_F2go/ / OWNER'S NAME: 7 h m,, Ji"P "')j V„ PHONE # 41h9 Z9/ Q4 -r GENERAL CONTRACTOR: r BUSINESS LICENSE # ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OB AINED A CITY OF CUPERTINO BUSINESS LICENSE. LQ�-, � 51 I am not using any subcontractors: Ir Signature Date Please check applicable subcontractors and complete the following information: Owner / Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date