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14100102-F
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21088 LAVINA CT CONSTR CT ON INC DER BROTHERS I PERMIT NO: 14100102 I OWNER'S NAME: KONG CONRAD TRUSTEE & ET AL 145301 INDUSTRIAL PL STE 4 1 DATE ISSUED: 01/14/2015 1 OWNER'SPITONE: 4088338896- - n FREMONT, CA 94538 1 PHONE NO: (5 -10) 573 -2 -141 - -1 LICENSED CONTRACTOR'S DECLARATION License Class _ Lic. # Contractor ZF1k+T/ FU X Datekb,y / /- 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 performance of the work for which this permit is issued. have and will maintain Worker's Compensation Insurance, as provided for by ection 3700 of the Labor Code, for the performance of the work for which this kpermit is issued. APPLICANT CERTIFICATION 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, 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. Date % // ❑ Z OWNER- BUILDER DECLARATION I hereby affirm that I 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) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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. 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 forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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, 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, Date JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL E] CONSTRUCT (N) 2 STORY 4,227 S.F. SFD W /ATTACHED 497 S.F. GARAGE & 310 S.F. PORCH AREA & 39S.F. DECK AREA Sq. Ft Floor Area: I Valuation: $450000 APN Number: 32608026.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS F CALLED INSPECTION. Issued by: Date: 1.1415 • / S / RE- ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, 1 agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sectio 505, 25533, and 25534. 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 Add ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERTINO - - -- IE NEW CONSTRUCTION c oms rRaic r i4oiv PFRmi r A PPt eeA 7i®t4 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building(cDcupertino.org ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION /DEFERRED t� 1� ORIGINAL PERMT # PROJECT ADDRESS aP 98 Lox I vi o,_ Co cot APN # 3a 6-- o8 - o a 6 OWNERNAME _Q �/ n g I III 1J_ .� i iq LLa PHONE �-08 - 033-(9876 E-MAIL Q0y\Y f &kk@ y0�o (q\ CoV� ��Ll STREET ADDRESS O(I A rp I / h 0 Y) CITY, STATE, ZIP Ste\ j oS e-1 C /� q ; 13 5 FAX CONTACT NAME A n elo-V � g ' �L11 t'1 r\ PHONE { �Q - Z`� _ cJ / 6 ?i E-MAIL a��2 �QY1q'Qrlll h17 is SbC�� ObGII,YJe STREET ADDRESS 501 Coneor�( brl've CITY, STATE ZIPML'VIIO C!` qT 0ZS F`JIJVSo 32I-5i8 Shepe aS 1 1 VQ{'`CJ ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ` `S l LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME I n h 'mot y---- I l LICENSE NUMBER C a / ( G Q am- O `i C) BUS. LIC # - - - - -- -- -- COMPANY NAME 'J� N � ft p _ . I Q ct r Tit lCN p 1 r E-MAIL /1 fil (�l>�j� �l (� Y1 i1 (°� S C �0 pill, {� 2� FAX 6 So 3 Z 1 -57S-2- ©Vl STREET ADDRESS 50a_ /j lRJ j y- Ve CITY, STATE, ZIP M,4� fourk CA V 0 2 S t PHONE 6 SO - 3ZI - 5 7e 2 DESCRIPTION OF WORK - ` hew Z st-ory sin le EXISTING USE t si(�Pir�`1lAL PROPOSED USE CONSTR QSi E �A W96,t."I"a�'?c _TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG AREA NEW FLOO-..'� _ AREA . [ � ,� t- DEM AREA I TOTAL - NET AREA' F 15 Gtr 00 a J BATHROOM REMODEL AREA UA KITCHEN OTHER TT REMODEL AREA Nj� REMODELAREA NA PORI'r�li AREA 31 osF DECK pAREA ,C 39 r TOTAL DECK/PORCH AREA 34-7 � GARAGE AREA: � DETACH L�.C�. SIT-, IT ATTACH 1ONDi # DWELLING UNTTS_ _ / - IS A SECOND UNIT []YES SEC STORY []YES .�f�l� BEINGADDED ?/\/ A []NO ADDITION? N^ ❑NO PRE - APPLICATION lErYES IF YES, PROVIDMY OF IS THE BLDG AN ❑YES - TO V TION: PLANNING APPL # ❑ NO PLANNING APP LETTER R-aoIq -I Rlvl-aol4 -t, Z EICHLER HOME? �7^ a O By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on 'IS_ 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 building construction. I authorize representatives of Cupertino to enter the above - identified property for inspection purposes. Signature of Applicant/Agent:�� /1/j - Date: la-- M —N SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER - THE - COUNTER ❑ BUILDING PLAN REVIEW 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 REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD El PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH F"M CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION 19 ADDRESS: 21088 LAVINA CT DATE: 10/16/2014 REVIEWED BY: MELISSA PC FEE ID APN: 326 08 026 BP #: / *VALUATION: 1$450,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY SFD or Duplex USE: 2nd Unit? Yes 0 No PENTAMATION I R3SFD PERMIT TYPE: WORK CONSTRUCT N 2 STORY 4227 S.F. SFD W /ATTACHED 497 S.F. GARAGE & 310 S.F. PORCH SCOPE AREA & 39S.F. DECK AREA OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R -3 (Custom) II- B,III- B,IV,V -B 4,576 $3,319.38 IR3PLNCK $3,854.58 IR3INSP U (Private Gar /Ag Bldg) II- B,111- B,IV,V -B 497 $0.00 IUIPLNCK $1,290.00 1UIINSP PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONsmR 1 #new units $667.63 i161117irlish -alive Fee: 0 G) Work Without Permit? 0 Yes Q No $0.00 TOTALS: 5,073 $3,319.38 Truvel Docuinenlalion fees: $5,144.58 Strong Motion Fee: IBSEISMICR NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Worlcs, Fire, Sanitary Server District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11 -053 EfT 711113) Alech. Plan Check 1'h:rrxh. Plan Check T Elec. flan Check mech. Permit Fee Plumb, Permit Fee: Ish:c. Perrnir Fee: Onccr ;llec•h, Imp. 01her Plumb Ins?. Ocher Elec. I17sp. E1__L_ llech. hrsp. P*ee: 1'lurub. hfsp. Face: Elec. Irish, P'ee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Worlcs, Fire, Sanitary Server District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11 -053 EfT 711113) FEE QTY /FEE MISC ITEMS Plan Check Fee: $3,319.38 Select a Misc Bldg/Structure or Element of a Building i Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $5,144.58 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONsmR 1 #new units $667.63 i161117irlish -alive Fee: 0 G) Work Without Permit? 0 Yes Q No $0.00 Advanced Planning Fee: IPLLONGR $710.22 Select a Non - Residential Building or Structure 0 i Truvel Docuinenlalion fees: Strong Motion Fee: IBSEISMICR $58.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $18.00 SUBTOTALS: $9,918.31 $0.00 TOTAL FEE: 1 $9,918.31 Revised: 08/20/2014 Building Department City Of Cupertino .10300 Torre Avenue -- Cupertino, CA 95014 -3255 Telephone: 408 - 777 -3228 C U P E RTI N O Fax: 408 -777 -3333 CONTRACTOR/ SUBCONTRACTOR LYS JOB ADDRESS:27088 & 21092 Lavina Court, Cupertino CA 95014 pE(tlyUf, # 141400102, 1 100103, & 14110123 OWNER'S NAME:Conrad Kong PHONE #408- 833 -8898 GENERAL CONTRACTOR- Snyder Brothers Construction Inc. BIJSMJsSS LICENSE 435875 - c ADDRESS:45301 Industrial Place Suite # 4 CITY/WCODE:945381 QA 'Our municipal code requires all businesses working in the city to have a City of Caper NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WIIA, Bli✓ $ GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED BUSINESS LICENSE. I am not using. any subcontractors: — Signature Please check applicable subcontractors and complete the following information: ✓ SUBCONTRACTOR BUSINESS NAME Cabinets & Millwork Snyder Brothers Construction Inc Cement Finishing Snyder Brothers Construction Inc / Electrical Snyder Brothers Construction Inc Excavation Snyder Brothers Construction Inc Fencing Steve Wong Landscape y _ Flooring / Carpetiiig Snyder Brothers Construction Inc Linoleum / Wood Snyder Brothers Construction Inc Glass / Glazing Snyder Brothers Construction Inc Heating Reliable Air Insulation IX McCoy Insulation Landscaping Steve Wong Landscape Lathing ~� N/A Masonry N/A Painting / Wallpaper Snyder Brothers Construction Inc Paving Steve Wong Landscape Plastering N/A Plumbing Villa Plumbing Roofing 6 Pacific Roofing Septic Tank NIA Sheet Metal Reliable Air Sheet Rock Snyder Brothers Construction Inc Tile Snyder Brothers Construction Inc Owner / Contractor Signature soon /z000a no business llcensK 14FOULED UNTIL THE CITY OF CUPERTINO .Date NESS LICENSE It 35875 3( 35875 35875 35875 35875 35875 35875 receipt 0100005685 AU0ADD9FC51 F 35875 .eceipt 0100005688 APOACCB387 BB 'eceipt 0100005685 35875 35875 1 -1 -016 Date ft r�9 >K Vu 1 1„U�M1 - n, n, n- I - . .. - SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITYDEVELOPMENT -DEPARTMENT. BUILDING DIVISION CULP.EERRTIINNO 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 - FAX (408) 777 -3333 o building aOcupertino,ora r Permit No. i L4 I. _ckj Address 9I 01 Lc'V'"h Celt # of AIarms Smoke: % Carbon Monoxide:3 PERMIT CANNOT BE 1!INALED AND CONTLETED UNTIL THIS CERTIFICATE HAS BEEN Si` C AND HEPLME D TO TIiE.:13UILDING DIVISIOi�i PURPOSE This affidavit is a self - certification for the installation of all requixed Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314,2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single- family and mufti- family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and /or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s)_ X X On eveEX level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel- burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section 8314 and CBC Sections 9072.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above - referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. 1 have read and agree to Comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: 6ii t/ e, n Signature ......................... ...... Date: 1-:-1. Contractor Name: S„ d W 13-I %w 1 G1 4A-", // �� b �a -1 (, Signature .... ....... ................... ..................... �# ...,,., ....,................... .... ... Date: ......,............ LP_" Smoke and COjorm.doc revised 03118114 Roan /Ron aC�Ii YW4 wucc.ni otnz /zi /in WATER - CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CUPBRTINO 10300TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 -.FAX (408) 777 -3333 • building �cupertino.ora Owner Name C-0-ALP, A t9 k- oN C Permit No. I y I' a ci 1. V _L_ Address 2 /a 424 `a VI'-A- C(. 6e 1P e. r 41�-A o 7.y-01 S-- 1, is your real property a registered historical site? ❑ 'Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. ❑ No Go to Question 2. 2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its plumbing, installation of water- conserving plumbing fixtures is not technically feasible? Q Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form, D No Go to Question 3. 3. Is water service permanently disconnected for your building? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 0 No Go to Question 4. 4. is your real property built and available for use or occupancy on or before January 1, 19947 ❑ No My real properly is built and available for use or occupancyga Januai ], 1994. .ter Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. ❑ Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. Please check ONE of the following: ❑ My property is a single-family residential real property. See Civil Code Section 110I A. On and after January 1, 2014, building alterations or improvements shall require all non - compliant plumbing fixtures to be replaced with water - conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non- compliant plumbing fixtures shall be replaced with 'water- conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). Q My property is a multifamily residential real, property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water - conserving plumbing fixtures. On or before January 1, 2019, all non - compliant plumbing fixtures shall be replaced with water - conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). O My property is a commercial real property. See Civil Code Section 1 101.5. On and after January 1, 2014, specified building alterations or improvements shall-require non- compliant plumbing fixtures to be replaced with water - conserving plumbing fixtures. On or before January 1, 2019, all non - compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). I, as the owner or owner's agent of this property, certify under penalty of perjury that non - compliant plumbing fixtures will be replaced prior to date specified above with water - conserving plumbing, fixtures in accordance with Civil Code Sections 1101.1 through 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and that the water - conserving plumbing fixtures comply with the requirements as indicated in the table on the following rage. I owner or owner Agent's Signature: r Date: i y- i G Upon completing and it to the Building Division in order to final your building permit. SB907 2015.doc revised 08126115 Rnnn /bnnn5 vuJ wucc•ni 01 ()7171 /in