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15020063-FP CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20202 JOSEPH CIR CONTRACTOR:TIM—TO BE PERMIT NO: 15020063 DEWC-FadINED OWNER'S NAME: WANG YIN AND ZHANG XIAOTING �'� t h DATE ISSUED:02/10/2015 OWNER'S PHONE: 4088396249 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL E] REMODEL(E)190.F.KITCHEN,NO STRUCTURAL; 162 SF License Class� �` Lic.#/���, S S TO BATHROOM TO INCLUDE M,E,P'S Contractor 9'Lj �'� R-J, I Date 2 I I-:� , ?10P< I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions ily� OOM FIREPLACE-ISSD OTC 2/19/2015 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 Cc pensation,as provided for by Section 3700 of the Labor Code,for the ormance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$65000 ave 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 APN Number:31624051.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that l 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 upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS CALLED INSPECTION. 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 Issued by: Date: with all non-poasource ' s er the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Date 2'f"l*�Z f? > 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, 1:1 ER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(x)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sec' ,255 ,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ONmMeAamthorizednagent: -� Date:G�"r9' Zd f 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 CONST/CTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Date CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 20202 joseph cit DATE: 02/19/2015 REVIEWED BY: Mendez APN: BP#: *VALUATION: Iso %PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY 2nd Unit? Yes No PENTAMATION SFD or Duplex OTC? 0 Yes 1 R3SFDREM USE: No PERMIT TYPE: WORK SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B.111-B,IV,V-B 0 $0.00 $0.00 TOTALS: 0 $0.00 $0.00 MECII,HOUItiY 0.Yes No `PLJMB,HOU1tI.Y Ye's;. Nor ELEC,HU>iTRLY 'Yes 'Q No. ;Meeh. Plan Check Plumb. Plan Check Elec..Plan(:'heck bfech. Permit Fee: Plumb.Penni!Flee: hl ec. Pei-Mir Pee: Other A/ech. Insp. Other Plumb Insp, Li Other Llec.Insp. Li Idcech.hq/). Fee: ['lamb. Insp. Fee: ZJec.Insp,Fee: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These,fees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS (Fee Resolution 11-053 E f.7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes Q)No $0.00 1 hours Plan Check,Hourly Suppl.PC Fee: ) Reg. 0 OT 0.0 hrs $0.00 $143.00 1STPLNCK PME Plan Check: $0.00 Permit Fee: Hourly Only? ®Yes (D No $0.00 Suppl. Insp. Feer Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: ,4dininistrative Fee: 0 Work Without Permit? ® Yes E) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential G Travel Documentation 1*ees: Building or Structure i Strong;Motion Fee: $0.00 1.0 hrs Inspections Bldg Stds Commission Fee: $0,001 $143.00 ISTINSP Inspection,Hourly SU�TOTAI Sc" $0.001 $286.00 TOTAL FEE`: $286.00 Revised: 02/1412015 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE,CUPERTINO, CA 95014-3255 B. CUPERTEI~IO (408)777-3228• FAX(408)777-3333 a buildina5cLioetno.org ❑NEW CONSTRUCTION ❑ ADDITION ❑•ALTERATION/TI REVISION/DEFERRED ORIGINAL PERMIT# 7 d .__ PROJECT ADDRESS f9 : S f APN R OWNER NAME A( �, e/1 .� 'vweT� PHONE W9 'F 3 `7 O 2 T,3E-MAIL STREET ADDRESS TEZIP , LD FAX Agy L� S p ?1Q d E-MAIL PHOo5C TCONTACT NAMEZZ/; FAX CITY,STATE, ZI� � P/J ✓n - - 11 OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT �NTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME �L f�t� LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME �f� /J� E-MAIL /J FAX STREET ADDRESS CITY,STATE,ZIP ✓C_�/J, j AritaPHONE/5f„ 75G 3 7v ARCHITECT/ENGINEER NAJAE !T L LICENSE NUMBER �L �{V BUS.LIIC 9 COMPANY NAME E-NIHIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: EIDETACH ❑ATTACH I DWELLING UNRS: IS A SECOND UNIT YES SECOND STORY YES BEINGADDED? No ADDITION? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF I IS THE BLDG AN ❑YES RECEIVED BY �� TOTAL V. ATIO : PLANNING APPL# ❑NO PLANA*DNG APPROVAL LETI-ER EICHLER HOME? ❑NO �:. �;; " �- -' _t'.. -`a._ By my signature below,I certify to each of the folio gr–'I a—t�e property owner or authorized agent to act on 0wner'S behalf. I have read this application and the information I have provi Is correct._I haveread the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildings ti� thorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: ~` Date: SUPPLEMENTAL INFORM ON REQUIREDNli ROUTINRSLIP New SFD or Multifamily dwellings: Apply for demolition permit forgi s� OVER THECOUi\TER s ❑ BUILbI�GPLANREVSEW r existing building s). Demolition permit is required prior to issuance of building permit for new building. Cl`EaPxEss flrrLAt,.rxorLfu.REVIE�i _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure Ct STpl\DARD ❑'rIBLICwoRics 4 AI- form if any Hazardous Materials are being used as part of this project. LARGES i n ❑ FIRE DEPT a Copy of Planning Approval Letter or Meeting With Planning prior to s t k ` 114ASOR 0, ANTfARYSELiE)ibISTRICT submittal of Building Permit application. L3 EI\A'IRO "w�,yy t .,a.....`? �� :�"z.t+.._..,�'°',-� ' I�TIVIENTAL I�E.4L'');•�'�.,;�a. B1dgApp_2011.doc revised 06/21/11 -- CONSTRUCTION PERMIT APPLICATION b�� COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION n U 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 /bL (408)777-3228• FAX(408)777-3333• building(L_)cupetno.org _ CUPERTINQ ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI. ❑ REVISION/DEFERRED ORIGINAL PERMIT 4 PROJECT ADDRESS 2C� ��y )^S LS�J� J APN 4 �r /) :2z4 �r 1 OWNER NAME' 1 1 / Lj 0/I �l(�V I PHO/1.'W6) ��cJ 6rz qcF E-MAIL _ /� �( FJ�- STREET ADDRESS ©� ^�_�yi) /� CITY, STATE,ZIP /J�� J / 9�Q / , FAX CONTACT NAME /V7zCf�Y V PHONE/ o ��� ��G E-MAILL�J20(��'��nJ✓L!'IJi�t�— STREET ADDRESS /� .q �,L CITY,STATE, ZIP,' �=/OFAX 11ONR.'ER ❑ O,;ANER-BUILDER- -❑-OWNTERAGENT CONTRACTOR . ❑COISIRACTORAGEtrr- ❑ ARCHITECTS ❑ENGINEER ,❑ DEVELOPER, 11-TENANT CONTRACTOR NAME LICENSE NUA4BER LICENSE T BUS.LIC moi/,a )a,5 5 Qu 67 z iso/5;57 COMPANY NAME -5 E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP j�/� y��p/ PHONE/Z 3 791 NE ARCHITECT/ENGIERNAME !�L LYLG� v� LICENSENUMBER r BUS.LICC9 J!0 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP / I PHONE DESCRIPTION OF WORK ✓ l2L�rr v P cr�-- /�l.�-��r7 EXISTING USE PROPOSED USE CONSTR.TYPE 4 STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL pQ AREA AREA AREA NET AREA BATHROOM / KITCHEN OTFIER REMODEL AREA 16 z REMODEL AREA tcf 0 REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: El DETACH E21AATTACH 4''DWELLDdG UNUTS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BErNGADDED? C1'NO ADDITION? ,RNO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES .'RECEIVED - �� {; TO VALU.4T10N; PLANNING APPL 9 ❑NO PL42.XTIGAPPROVAL LETTER EICHLERHOME? ❑NO - ,p0 By Iny signature beloNv,I certify to each of the following: I am the property owner or authorized agen roperty oNvner's behalf. I have read this application and the information I have provided is cornea— e 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 nict on. uthorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: 2^ ZO S SUPPLEMENTAL INFO TION REQUIRED -a LP c> cicri t <7L ROIIxii�csLrr,_„_� . New SFD or Multifamily dw,ellinQs: Apply for demolition permit for 0\ER T3 COUnTER BUJLbI G PL .REVlip .�-- r . existing bulldmg(s). Demolition permit Is required prior to Issuance of buildi _ r �y Y permit for new building. FO Q E11�32ES$ a r` 4 „ LPLAIiIINGPL41�REyIER' , _Commercial Bldgs:. Provide a completed Hazardous Materials Disclosure STDARD �^ fl PUBLIGWORKS form if any Hazardous Materials are being used as part of this project. ; t Copy of Planning Approval Letter or Meeting With Planning prior toz q 314ATOR 40kSANtITAR1SERERDISTRICT ”' submittal of Building Permit application. B14APp 2011.doc revised 06/21/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20202 JOSEPH CIR CONTRACTOR:TT..ae—:nra� PERMIT NO:15020063 �'7�ux,rnrED OWNER'S NAME: WANG YIN AND ZHANG XIAOTING DATE ISSUED:02/10/2015 O ER'S PHONE: 4088396249 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL REMODEL(E)190.F.KITCHEN,NO STRUCTURAL; 162 SF License Class /9 Lic.# ?©,'SS 7 TO BATHROOM TO INCLUDE M,E,P'S Contractor Date 2 • r C7 `Zo r$i 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 Co enation, s provided for by Section 3700 of the Labor Code,for the p rmance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$65000 ave 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 APN Number:31624051.00 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 upon the above mentioned property for inspection purposes. (We)agree to save 180 DA AST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the ��f•�S' granting of this permit. onally,the applicant understands and will comply Issued by: Date: with all non-Po source regulat ns per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Si tuc Date 2'gyp G6� r 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. ❑ NER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,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 HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous 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 Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the C" Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance_,as provided for by the Health&Safety Code,Sections 33,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this .. 2-/o. .: >-- permit is issued. orize�lt,agent Date. 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 CON UCT ON LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 20202 joseph cir DATE: 02/10/2015 REVIEWED BY: Mendez APN: BP#: -VALUATION: 1$65,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Repair PRIMARY SFD or Duplex PENTAMATION USE: PERMIT TYPE: 1R3SFDREM WORK REMODEL E 1905. KITCHEN NO STRUCTURAL; 162 sf to bathroom to include m e 's SCOPE f Mech. Plan Check Plumb. flan Check Plec.Plan Check Llech. Permil Ece: Plumb. Permit Fee: h"lec. Permit Fee: Other Hech, Imp. Other Plumb Insp. Other Elec.Insp. Lj A"Iech. Insp. 1"ee: Phunb. hisp. Tec:: Llec.Imp.Fee: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,eta). Theseees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 in o. FEE ITEMS(Fee Resolution 11-053 Eff' 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = S.f. Remodel,Kitchen(<=300 sf) Suppl.PC Fee: Q) Reg. 0 OT 0.0 hrs $0.00 $645.00 1PEMRESK1T PME Plan Check: $0.00 = SX. Remodel,Bath(<=300 sf) Permit Fee: $0.00 $645.00 IREMPESBAT Suppl. Insp.Fee:Q Reg. Q OT= hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax-: Administrative Fee: Q Work Without Permit? 0 Yes (F) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential 0 'Travel Documenlatif.m Fees: Building or Structure i Strong Motion.Fee: IBSEISMICR $8.45 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $3.00 x`SUBTOTAs $11.45 $1,290.00 TOTAL FEE: $1,301.45 Revised: 01/06/2015