B-2016-1925 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMTT NO:B-2016-1925
18705 LOREE AVE CUPERTINO,CA 95014-3869(375 19 013) RUA-AME GROUP
INC
PALO ALTO,CA 94303
OWNER'S NAME: LIN CHEYU ET AL DATE ISSUED:07/18/2016
OWNER'S PHONE:832-859-1258 PHONE NO:(650)565-8899
LICENSED CONTRACTOR'S DE LARATION BUILDING PERMIT INFO:
License Class GENERAL BUILDING CONTRACTOR Lic.# 4271
Contractor HUA-AME GROUP INC Date 03/31/2017 X BLDG —ELECT —PLUMB
_
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH X RESIDENTIAL_COMMERCIAL
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
(N)ATTACHED TWO CAR GARAGE(535 SQ F'1;COVERED PORCH
I hereby affirm under penalty of perjury one of the following two declarations: (57 SQ FT);INSTALL NEW FRONT DOOR WITH SIDELIGHTS.
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.
s GI have and will maintain Worker's Compensation Insurance,as provided for by
III Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area:592 Valuation:$30000.00
APPLICANT CERTIFICATION
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 APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 375 19 013 Deferred Submittal(R-3),U(Private Gar/Ag Bldg)
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.
F
Signature/-
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/ Date 07/18/2016 Issued by:MEbt
Date:07/18/2016
OWNER-BUILDER DECLARATION `
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS:
following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
1. I,as owner of the property,or my employees with wages as their sole installed without first 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)
2. 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:07/18/2016
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
2. I 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
permit is issued. maintain compliance with the Cupertino Municipal.Code,Chapter 9.12 and the
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
shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous
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 r
be deemed revoked. Owner or authorized agent: _
APPLICANT CERTIFICATION Date:07/18/2016
1 certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance
relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.)
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
.Code,Section 9.18. 1 understand my plans shall be used as public records.
Licensed
Signature Date 07/18/2016 Professional
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION `
10300 TORRE AVENUE•CUPERTINO',CA 95014-3255
(408)777-3228 v FAX(408)777-3333-build ing0cupert
int�.or�C
QNEWCONSTRU�CTION ADDITION QALTERATIONITI Q REVISION/DEFERRED• ORIGINALPERMIT#
PROJECT ADDRESS 1 P Ca S L aT2 ~ t( APNN 3-7 Ts. l C1l _ pt3.
OWNER NAME J
PHONE��6[J EMAIL
STREET A16DIWS$ �- CITY,STATE,ZIP PAX
CONTACT NAMEPHONE PrMAIL
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L1 OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT El CONTRACTOR ❑CONTRACTOR AGENT )KORCHCTI;CT ❑ENGINLER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME T;TCFNSE NUMBER LICENSE TYPE BUS:LIC N
COMPANY NAME E-MAIL FAX
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DESCRIPTION OT WORK t
EXT.STRdG USE. - PROPOSED USE CON$TR TYPE H STORIES ...
OhhICE USh NLY
* � �-5-:.-•3 •� .,.00 P .DES'RB?.TI N .:5 .lT. .VALIJA'fIOf1 .
E+XisTG NEWFLOOR DEMC) TOTAL
AREA I bC7Uj AREA I b84� AREA NE'TAREA _ -.,..
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BATHROOM KITCHEN r OTHER t fl •:: ==`=`.. -
REMODEL AREA RFMODEL AREA � ItEMObEL AREA ..,
PORCH AREA DECK AREA TOTAL DECK/PO�RCCH AREA (I B AREA:CI DETACH
<ATTACH
g DWELLING UNITS: ISA SECOND UNIT YES SP.CONDSTORY - YES .r
]3lINCADDRI)? TO ADDMON7 RO •"'' `'' " _
PRE-APPLICATION Cl YES IF YES PROVIDE C011YOP PLANNER'S NAME- RECEtYED BY T YALUATI
PLNING APPLtJ NO PLANNING APPROVAlI.&TTRR 9 [} , ..
AN
By ivy signature below,I certify to each of the following: I am the property owner or aufhorized agent to act oil the property owner's behalf, I have read this
application and the.infonnatfo ]_terve 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 11.t' to bbl i g cGnstruction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent:,^ Date; S
SUPPLEMENTAL INFORMATION REQUIRE - PYdNCxECicrirE _.
_Now SFDorMultifamily dwellings: Apply for demolition permit for `I 1OVER;THE-COUNTER BUILDIAGPLA:,REVIEli-
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. 0 rxPREss 'IQ rc nNrnty�rt Ax�EviE v �
_Commercial Bldgs Provide a completed Hazardous Materials Disclosure O srnl\nAIZD t t.� aLlciiaxxs �rt Cv�te,
fonts if any Hazardous Materials are being used as part of this project, _ p FIRE DEPT .-.
Copy of PIanning Approval Letter or Meeting with Planning prior to
submlittal otBuilding Permit application. bIAJOR SAiiLTARY SEiiEIt>IISTRICT
:�;:r;'>ii;�[-_�;'���;�:_'sia_�'t':-_'::::_: :_te :_I�•::EM9ROI)IASENTAL`IITALTH=`�::'.;>-_:
Bldg4pp_�201 L doe revised 03116111
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FILE
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Phone: (408)319-7682
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Addres;: 721 . 18 fit. ssn 1cse
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August 18,2016
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Buildir g Division-City of Cupertino
Tel:40 077 28
Fax: 4 8. 77.3
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Subje t: 18705 Loree Avenu Cupertino 95014
To the ep
j Please consider this letter my certification that we have field verified the location of the
ConcreIie Foundation forms for the Front New House Addition(attached Garage)on the Subject
Property and found them to be completely within the Building-Setback Lines.
Please call me with any question_
Sincerely,
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JOHN t.MARSAU
NO.637$
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John Marsau
LicensedLand Surveyor
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DAVID PERNG,ARCHITECT
10268 Bandley Dr.#102
Cupertino,CA. 95014 FILE
Phone: (408) 996-7988; Fax: (408) 996-7809
To: City of Cupertino,
Building Department
' Building Inspector i
Date: `Sep.27, 2016 _
Job Site: 18 Loree Ave.
Reg,: Holdown retrofit observati
k
Dear Inspector, - '
Per Owner's request, I have gone to the site to observe the holdowns-installation on this
site on Sep. 26 and 27, 2016. There is one holdown near by the new entry porch&-
garage. Contractor does clean up the holes and uses the epoxy adhesive (set-xp). The
installation is proper and per approved drawings. ~�
If you have any question,please give me a call. Thank you!
David Perng, Architect
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