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07090128 - PUB=ile Edit Actions Details Links Favorites Help Certificate Type CO - CERTIFICATE OF OCCUP Certificate Number _ Permit ' Property Zoning Applicant ' Contractor " Defined Fields Location Information Address 10092 B IAN CHI WAY City /State/Zip CUPERTINO CA 95014 APN 35907019.00 j Unit 11-kmer Entity Information Owner Name " CUPERTINO COMMUNITY SIN HOUG DI Use Default Address Home -10092 BIANCHI WAY +� City /State/Zip [CUPERTINO J 'CA 95014 Permit Details 6 Permit Information LMFDWL -REM —� Permit Number " 07090128 _. �0 V/N N Status ` J Applied Value " Master Number SQUARE FT. Notes 1 0! Project - -- -- - _ - Apply Date' 09/20/2007 Iffl- Operator patg Permit Issue Date 12/11/2007 Ownership Operator patg Certificate Issued 04/18/2008 -- Operator suew� Certificate Type CO - CERTIFICATE OF OCCUP Certificate Number _ Permit ' Property Zoning Applicant ' Contractor " Defined Fields Location Information Address 10092 B IAN CHI WAY City /State/Zip CUPERTINO CA 95014 APN 35907019.00 j Unit 11-kmer Entity Information Owner Name " CUPERTINO COMMUNITY SIN HOUG DI Use Default Address Home -10092 BIANCHI WAY +� City /State/Zip [CUPERTINO J 'CA 95014 Permit Details Permit Type " LMFDWL -REM —� 'DO NOT USE Usage Class " �0 V/N N OFFICES V N N DONT USE Applied Value " 150000 SQUARE FT. 295 Calculated Value 51844 �I US C -404 Type 434 C ALT: RESIDENTIAL — s Permit Form " AUTOPERM -PERMIT Ownership 1 Private Project Size i _ -- 'ermit issued 12111/2007 Inter permit status Purpose /S pecial Conditions - -- – – - - - - -- (CONSTRUCTING COMMUNITY ROOM PORCH AT EXISTING AP COMPLEX- FILMED 2011 Add Default T v '" OK Back 14-4 Contractors Wees 4 Plan Reviews La Inspections 16 Print Permit Adjustments 11-i Holds Copy Permit lQ Close Permit Overrides Supplemental Fields lirl Notes �i Attachments Ovp ad Z IUi' Z uu�Z i nyU t�y< i00 02 Z C H W f1. Q az U wF OU � CL ►F-i V7 U �r CITY OF CUPERTINO BUILDING DIVISION PERMIT ..., ., BUILDING ADDRESS: PERMIT NO. 10092 BIANCHI WAY PORTRAIT HOMES INC 07090128 OWNER'S NAME: PERMIT ISSUE DATE CUPERTINO COMMUNITY HOUSING 265 N JOY ST 12/11/2007 PHONE] T SANITARY NO. CONTROL NO. (510)577 -0294 ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Chapter 9 fob Description 1 hereby affirm that I am licensed under provisions of (commencing with Section 7000) of Division3oftheBusinesssandProfcssionsCode ,andmylicenseis CONSTRUCTING COMMUNITY ROOM & PORCH AT EXISTING in full force and effect- License q2 Class Lic.+r 645297 7 Contractor r " Ju fVL APT . COMPLEX. Date ARCHITECTS DECLARATION I understand my plans shall be used as public records Licensed Professional OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the ' following mason. (Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, impme, demolish, or repair any suuctum prim to its issuance, also requires the applicant for such permit to file a signed statement he is licensed to the of the Commuira license Law (Chapter 9 Sq. Ft. Floor Area Valuation that pursuant provisions (commencing with Section 7000) of Division 3 of the Business and Professions Code) or _. $150000 that he is exempt therefrom and the basis for the alleged exemption. Any violation of Number 07 0 Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not mote than five hundred dollars (5500). 3 5 9 1 9-.TJl! ❑ 1, as owner of the property, or my employees with wages as their sole compensation, Required Inspections will do the work and the structure is not intended or offered for sale (See. 7044, Business and Professions Code The Contractor's License Law does not apply to an owner of - property who builds or improves thereon, and who does such wort himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to convect the project (Sec. 7044, Business and Professions Code:) The Contractor's Li. tense Law does not apply to an owner of property who builds or improves thereon, and, who contracts for such projects with a contracwr(s) licensed pursuant to the Contractor's License Law. ❑ lam exempt under Sec. . B & P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations. ❑ I have and will maintain a Certificate of Consent to self -insure for Workers Compen- sation, 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 required by Section 3 00 of the Labor Code, for the performance of the work for which this permit is Issued. ' My Worker's Compensation insurance carrier and Policy number am: '7 Carrier. 57NIT- L, � - Policy No.: �7 CERTIFICATE OF EXEMPTIO?i FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed If the permit Is forone hundred dollars ($100) or less) 1 certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the Workers Compensation . Laws of California. Dale Applicant . . _ NO'nCE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C) Lenders Name Lenders Address 1 certify that I have mad this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building convection, 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 in any way accrue against said City in consequence of the granting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date SOUR R ULATIONS. Re -roofs Type of Roof ��- I' -- Y-14 Sig azure of ApplioanUContracmr Date HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code. Chapter 9.17, and the Health and Safety Code, Section 25s32(a)? ❑ Yes ()�No 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 Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality.Managcment all new materials for inspection. District? ❑ Yes No I have mad the hazardous materials requiremcns under Chapter 6.95 of the Califor- nia Health & Safety Code, Sections 25505, 75533 and 25534.1 understand that if the building does not cu sly have a tenant, that it is my responsibility to notify the occupant of the require.,.. mustbemetlid ttf issuanncceOfaC atifteamofOccupancy. Signature of Applicant Date A] I roof coverings to be Class "B" or better ' Owner or authorized agent Date A CITY OF CUPEkTINO CITY OF CUPERTINO PERMIT APPLICATION FORM 0-709 0/,:;Z? APN # .3 571 _ G ;� ^ d/f i D 0 Date: V,47- Building Address: Mailing Address (if different from building address): Owner's Name: l -6u5/,u6 FV12 Phone #: 4 S6, 3 S-6 74 Z Contractor: License #: �i7L/f�T l�Drc�3, /NZ- Contact: Phone: 576 ss ajy6 Cupertino Business License #: �6 G/ruaf3S Fax: C� /d) 6�P �6 oZ Building Permit Info: Bldg ❑ Elect ❑ Plumb ❑ Mech ❑ Job Description: c4)ub772 u e ri lu 6 Gdxte -t"mry XvDm-c f ,-44 C'r czn Z ),7 fi C Residential 9 Commercial ❑ Sq.Ft. Floor Area: Ku�I TY n'`' c aex� Pc, Sq.Ft.: (36 SF. Cost of Project: jei$0", owe Occupanc Group: Type of Construction: Please check this box if the project is a BBOILER5 second-story addition: ❑ Project Size: Standard ❑ Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to IM Btu MECHANICAL BBOILER4 Boiler > 1 M to 1.75 M Btu MECHANICAL BBOILER5 Boiler > 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax — Resi/Mobile BUILDING BELEC 1000 Elec 600V <= l OOOA ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING I of 3 CITY OF CUPEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777 -3228 Fax (408) 777 -3333 Building Department JOB ADDRESS:/ ,90 ,� Z I f�� l �-►4 PERMIT # OWNER'S NAME:Cy zi h no ,� • v., ¢ t , Ole4 tFHONE # sr� o 0 7 l GENERAL CONTRACTOR: metre,. , FAX # S`l O 5`-7 7 7 9 2 (o I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 1,W � W ,7-0 Ow er /Contractor Signature 1 bate 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 1,W � W ,7-0 Ow er /Contractor Signature 1 bate