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09080312 - PUBFile Edit Actions Details Links Favorites Help Permit Information Permit Number " 09080312 _'A. Status " ++ Master Number Notes JZ Project �— Apply Date " 08/24/2009 Operator patg Permit Issue Date 09/18/2009 Operator SylviaM Certificate Issued 12/16/2009 Operator iP LM Certificate Type Certificate Number Permit " i Property li Zoning ! Applicant Contractor " Defined Fields Permit Details Permit Type " 1R3SFDADD ®� I Lactation Inf, jrrnation Address " 22065 CLEARWOOD CT City/State/Zip CUPERTINO APN 32618028.00 Unit --� - ------ ----- CA 95014 0;:mer Entity Information Owner Name " YUANNONG XUE Use Default ❑ Address Home - 22065 CLEARWOOD CT v City/State/Zip CUPERTINO CA 95014 SINGLE FAMILY DWELLING ADDITIO Usage Class " 11/111 B, IIAIt B, IV -HT V-B NEW — Applied Value " 35000 SQUARE FT. 224 Calculated Value !, 0 US C-404 Type 434 ADD: RESIDENTIAL ----- --- -- Permit Form " yAUTOPERM -PERMIT v Ownership _ 1 Private Project Site EXPRESS -EXPRESS v Permit issued 0911812009 Enter permit status Purpose/SpecialConditions ------ ADD 1 BEDROOM(224SQ)6 NEW ROOF WITHOUT CHANGING (E STRUCTURE; RE-ROOF(23SQ) FILMED- 2011 E—OAdd Default T v U�O 0 K Back In Contractors l Fees Plan Reviews J lA Inspections 0 Print Permit 10-:Adjustmergs l Syr Holds l Copy Permit Q Close Permit l 1, Overrides l Supplemental Fields Notes i Attachments I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 22065 CLEARWOOD CT I CONT R C NED BD - TO BE I PERMIT NO: 09080312 I OWNER'S NAME: YUANNONG XUE I I DATE ISSUED: 09/18/2009 I OWNER'S PHONE: 4082196020 1 , I PHONE NO: I ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. # Contractor Date 1 hereby affirm that 1 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. 1 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 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 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is corre,:t. 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 BUILDING PERMIT INFO: BLDC ELECT PLUMB I- f- r- I- MECH RESIDENTIAL COMMERCIAL JOB DESCRIPTION: ADD 1 BEDROOM(224SQ)& NEW ROOF WITHOUT CHANGING (E) STRUCTURE; YES TO RE-ROOF(23SQ)& YES TO STRUCTURE Sq. Ft Floor Area: I Valuation: $35000 APN Number: 32618028.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued Date: RE -ROOFS: 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 1 hereby affirm that 1 am exempt from the Contractor's License Law for one of 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) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 1 hereby affirm under'penalty of perjury one of the following three declarations: l 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. I have and will maintain Worker's Compensation Insurance, as provided for by Sect,,on 3700 of the Labor Code, for the performance of the work for which this 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 become subject to the Worker's Compensation provisions of the Labor Code, I must fcrth with comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 1 certify that I have read this application and state that the above information is corre:,t. 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 s, rce regulations per the Cupertino Municipal Code, Section 9.18. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code. Chapter 9.12 and the Health & Safety Code, Section 25532(a) should 1 store or handle hazardous material. Additionally, should 1 use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 505, 25533, and 25534. Owner or authorized agent: f Date:_;OO 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 C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional Date ' Oq 0 0�s tz-- ;rev_:. CITY OF CUPEQ:1NO CITY OF CUPERTINO ADDITION/REMODEL PERMIT APPLICATION FORM APN # �; 2 & - % c? " 10Z Y 'I' - b C-::, Date: '? - 2 ¢ _ D Is a 2" unit being added? Yes ❑ No If yes, please fill out the permit application for 2"d unit. Building Address: 2 2 aG S G"L�A- fe woav co �,e Mailing Address (if different from building address): Owner's Name: Phone # Y,1,4Nn/oA(67 Xt,14_5 zip-��2,0 Contractor: Phone #: Fax #: Contractor License #: Cupertino Business License #: Contact: 4-v G� �� Phone #: 4-Ug Fax #: Building Permit Info: Bldg. [q Elect. ©� Plumb. ❑ Mech. [3---' Hillside ❑ Job Description: Addition -What is being added?(Be Specific): / /3" )e0oM - r/0"/ What is being remodeled (not including addition)? NE tv, R00F 1.6 A//j-"&I'T /N,�;i X� 7�e61 e7Zr,e p& Remodel Includes Re -Roof. Yes [� No ❑ If yes list number of squares 'Z 3 - Remodel Includes Structural: Yes [f No ❑ Do you have the pre -application planning approval? Yes ❑ No [�r' If yes, please provide a copy of your planning approval letter. Planners name: Square Footage: Addition: 77-,7t Porch: Deck: Garage: Detached Attached Remodel: Kitchen Bath Other gEkae Type of Construction (Usage Class): Occupancy Type: I -A, I -B ❑ II/III/V-A ❑ II/III B, IV -HT, V-B [/ R 3 Valuation: � 3 S 96) 0 Please check this box if the project is a Z second -story addition ❑ Project Size: Express Standard ❑ Large ❑ Major ❑ Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, Green Building Points Achieved: include in plan set & the sheet index. ***For Office Use Only*** Over -the -Counter ❑ Revised 07/06/09 CITY OF CUPEIkTINO CITY OF CUPERTINO ADDITION/REMODEL FEE SCHEDULE Quantity Sq Ft Fee ID Fee Description Fee Group Permit Type ADDITIONS 1R3SFDADD 22- 1 PLLONGRNGR Long Range Planning/Residential PL 2,� K 1 R31NSP Dwellings Inspections B 2..2 1 R3PLNCK Dwellings plan check B 1R3REPINSP Dwellings Repeat Inspection B 1R3REPPLNC Dwellings Repeat Plan Check B 1R3HINSP Dwellings Hillside inspection B 1 R3HPLNCK Dwellings Hillside plan check B 1 R3HREINSP Dwellings Hillside Repeat Inspection B 1 R3HREPLNC Dwellings Hillside Repeat Plan Check B 1 R3ALTINSP Dwellings Alternate Materials Inspection B 1 R3ALTPLNC Dwellings Alternate Materials Plan Check B 1 PCESS Cesspool P 1 PPRSEWG Ea. Private Sewage Disposal S stem P 1 PRSEWER Sewers P 1BPSPRINK Lawn Sprinkler/Backflow P 1 BPWSVCS Main Water Service P r j 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICRE SeismicResidential B n ,( 1REROOFRES Residential Re -roof Each 100 SF B CITY OF CUPERTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: Z � GGu�r PERMIT�����lZ OWNER'S NAME: 49 MD PHONE # GENERAL CONTRACTOR: _;- A �� FAX # I am not using any subcontractors: g ^ 2� " 9 Signature Date Please check avvlicable subcontractors and comvlete the followine 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 '4 `? - o � Owner/Contractor Signature Date