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10060001 - PUB 1 1 14110 , l l lel Illi I I I l 1,LL-7j 11 1111O1I It I Lr x a O Q -4 Ell H m Pv m ' a Q w U N tl7 pOC a � co N 0 � J 00 CE I pZa a q co ' LO a x « w Z H 'D to a H H W H J coN O •U '� U F W W 0 p Z CDC) \ a O F: a PG m A CrY V c LO W F P Lo C7 C. U W Co l7 W M Q 0 w y o z m to 00 W mLO C7 ZD 2- p C'V �- CD - J _ U 3 Pt Z * r j r ^ O U W CL x� Q- E E i ;J Q ip Lo ... ��I C U L -i U Q ZD 4 U i.� CD o,CL CL o ^l I iv io 4 xo � ui � ! O y m g 1w a� `o o w 0ZD`o 0 CD CL OL OL OL LLJ dlli I�� E n I Lu �o Ncm ffL >i �! q � ! '' � ,CL ii - J LU 0 1 nM 0 C=. ¢ , 7 �� . � u � C o � �� o o W �' w '�, o JI CD ,t 1 1 1 C LL- J ❑7 m W p .> Oo UM � CD t vco r Cn - Q - -' o M 0 0 f --E' o Q -0 Q} 4) ,^ [ x Cl x x (D m a V (U 3 a O rn y ;, E x� �- Zm 5, t y ? w o -C to 0 v CD <, �_ v Q y 6 7 y x Q Q E y —'' E r a� y a O" o Lo v 3 o N a .1. W I v 'D .O a Q} Q`} .Ol •0? W W ZD Q co U Z) CL O W •_ L LL w Lo M w g w U U U 01 IL � � d El L V CL LL CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10284 S STELLING RD CONTRACTOR:LISA WONG PERMIT NO: 10060001 OWNER'S NAME: LISA WONG 10284 S STELLING RD DATE ISSUED:06/01/2010 OWNER'S PHONE: 4083290062 CUPERTINO CA,CA 950I4 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lie.# MECH RESIDENTIAL r— COMMERCIAL Contractor Date I hereby affirm that I am licensed under the'provisions of Chapter 9 JOB DESCRIPTION: REMODEL KITCHEN(132SQ)&MASTER (commencing with Section 7000)of Division 3 of the Business&Professions BATH(110SQ);NON-STRUCTURAL 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. 1 have and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:535000 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:35913094.00 Occupancy Type: APPLICANT CERTIFICATION I certify that l have read 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 construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. 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. Issued by: Date: Signature Date OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am pt f the Contractor's License Law for one of installed without first obtaining an inspection,l agree to remove all new materials for the following two reasons: inspection. 1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure i5 not Intended or offered for sale(See.7044, Signature of Applicant: Date: Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Cofle,For the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. _1V&0 compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air permit is issued. 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 1 certify that in the performance of the work for which this permit is issued,l shall Health&Safety Code,Sections 25505,25533,and 25534. 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,l Owp&or authgrjzec,ggg{rt: I w become subject to the Worker's Compensation provisions of the Labor Code,I must �� `1r1 Date: forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION l hereby affirm that there is a construction lending agency for the perfonnance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.l agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Signature Date I �( 0 Licensed Professional � � `. CITY OF CUPERTINO ADDITION/REMODEL CUPERTIN0 FEE SCHEDULE APN# Date: 1-)9 t:5 q L�, �,,tne j .2 -10 Is a 2nd unit being added? Yes ❑ No ® If es, please fill out the permit application for 2nd unit. Building"+ddress: 102-6"+ S. << r cict esu i� Mailing Address (if different from building address): Owner's Name: Phone.# LlwoyoC�$� 2 -oo 2- Contractor: Contractor: Phone#: Fax#: Cupertino Business License: State Contractor License#: Contact: n Phone#: e+b II �- 4 OC ex awk.2 �•e U Fax#: 469 ?,Z-4b4 Landscape Ordinance Compliance: Landscape area in sq. ft. (includes all irrigated areas): N-A If 2,500 sq.ft. or less, compliance with the Landscape Water-Efficiency Checklist is required. If more than 2,500 sq. ft., a complete Landscape Project Submittal is required. Compliance Method: ❑ Plant Type ❑ Water Budget Building Permit Info: Bldg. ❑, Elect. 0--- Plumb. Q--`" Mech. [Q-- Hillside ❑ Job Description: Addition-What is being added?(Be Specific): What is being remodeled (not including addition)? Remodel Includes Re-Roof: Yes ❑ No If yes list number of squares Remodel Includes Structural: Yes ❑ No R Do you have the pre-application planning approval? Yes ❑ No If yes, please provide a copy of your planning approval letter. Planners name: Square Footage: Addition: Porch: Deck: Garage: Detached Attached �lasi�r Remodel: Kitchen 132, Bath 110 s4 4Other Type of Construction (Usage Class): Occupancy Type: I-A, I-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B [ Valuation: 1&_35t Please check this box if the project is a Project Size: Express Standard ❑ Large ❑ Major❑ second-story addition ❑ 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. C5_ Revised 05/18/10 CITY OF CUPERTINO �' ADDITON/REMODEL f CUPERTINO FEE SCHEDULE ' Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft ADDITIONS 1R3SFDADD 1PLLONGRNGR Long Range PL Plannin /Residential 1R31NSP Dwellings Inspections B 1R3PLNCK Dwellings plan check B 1R3REPINSP Dwellings Repeat B Ins ection 1R3REPPLNC Dwellings Repeat Plan B Check 1R3HINSP Dwellings Hillside B inspection 1R3HPLNCK Dwellings Hillside plan B check 1R3HREINSP Dwellings Hillside B' . _ Repeat Ins ection 1R3HREPLNC Dwellings Hillside B Repeat Plan Check IR3ALTINSP Dwellings Alternate B Materials Inspection 1R3ALTPLNC Dwellings Alternate B Materials Plan Check 1PCESS Cesspool P 1PPRSEVVG Ea. Private Sewage P Disposal System 1 PRSEWER S ewers P 1BPSPRI.NK Lawn Sprinkler/Backflow P 1BPWSVCS Main Water Service P f 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE SeismicResidential B 1REROC►FRES Residential Re-roof Each B 100 SF