The URL can be used to link to this page

B-2016-2072CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2072 10270 CALVERT DR CUPERTINO, CA 95014-3808 (375 18 019) AN KY CONSTRUCTION INC SAN JOSE, CA 951391 OWNER'S NAME: LEUNG HOI SAN OWNER'S PHONE: 408-.807-7971 LICENSED CONIRACTOR'S DECLARATION License Class B Lic. #840856 Contractor AN KY CONSTRUCTION INC Date 06/30/2018 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. 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. 2. I h 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. 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 pd will comply with all non -point source regulations perjpt; Cgtpertino> nicipal Code, Section 9.18. Date 11/30/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: i. 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) 2. 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Sec.7044, Business & Professions Code). hereby affirm under penalty of perjury one of the following three declarations: i. 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. 2. 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. 3. 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 1 certify that 1 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. Signature Date 11/30/2016 09/09/2016 NO: (408) 234-2673 BUILDING PERMIT INFO: X BLDG _ELECT PLUMB _ MECH X RESEQENTIAL _COMMERCIAL JOB DESCRIPTION: CONSTRUCT (1) SINGLE STORY HOME (2102 SQ FT); (l) GARAGE (424 SQ FT); (1) PORCH (61 SQ FT) DEF #1 - (11/10/16) TRUSS CALCS ISSUED 11/30/2016 Sq. Ft Floor Area: APN Number: Occupancy Type: 375 18 019 Deferred Submittal (R -3),R-3 (Custom),R-3 (Custom),U (Private Gar / Ag Bldg),U (Private Gar / Ag Bldg) PERMITEXPIRES IF WORK IS NOT STARTED WITHIN 180, DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: KIM DUNBAR RE -ROOFS: 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. Signature of Applicant: Date: 11/30/2016 s 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 mit hazardous air contaminants as defined by the Bay Area Air Quality Ma gement District I will maintain compliance with the Cupertino Municipal C e, Chapter 9.12 and the Health & Safety Code, Section O5, 25 ,and 25534. Owner or authorized agent:_ Date: 11 /30/2016 hereby affirm that there is a constructiofi lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans; shall be used as public records. Licensed CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2072 10270 CALVERT DR CUPERTINO, CA 95014-3808 (375 18 019) AN KY CONSTRUCTION INC . SAN JOSE, CA 95139 . OWNER'S NAME: LEUNG HOI SAN DATE ISSUED: 09/09/2016 OWNER'S PHONE: 408-807-7971 PHONE NO: (408) 234-2673 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. #A0256 Contractor AN KY CONSTRUCTION INC Date 06/30/2018 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: CONSTRUCT (1) SINGLE STORY HOME (2102 SQ FT); (N) GARAGE I hereby affirm under penalty of perjury one of the following two declarations: (424 SQ FT); (N) PORCH (61 SQ FT) 1. 1 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. 2 < . I h 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 / Sq. Ft Floor Area: 2526 Valuation: $350000.00 ` " permit is issued. 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 18 019 Deferred Submittal (R-3),R-3 (Custom),R-3 (Custom),U representatives of this city to enter upon the above mentioned property for (Private. Gar / Ag Bldg),U (Private Gar / Ag Bldg) 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. PERMIT EXPIRES IF WORK IS NOT STARTED Additionally, the applicant understands and w omply with all non-point ' WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the C e o Munic' at Code, Section 9.18. 180 DAYS FROM LAST CAL EDSP CTION Signature:",Date 09/09/2016' <- Issued by: MELI Date: 09/09/2016 I hereby affirm th/at I am exempt from the Contractor's License Law for one of the following two reasons: " 1. 1, as owner of the property, or my employees with wages as their sole All roofs shall be inspected prior to any roofing material being installe . f a roof is compensation, will do the work, and the structure is not intended or offered for installed without first obtaining an inspection, I agree to remove all new ma ' is for sale (Sec:7044, Business & Professions Code) inspection. z. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). Signature of Applicant: Date: 09/09/2016 I hereby affirm under penalty of perjury one of the following three declarations: 1. 1 have and will maintain a Certificate of Consent to self-insure for Worker's ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 2. 1 have and will maintain Worker's Compensation Insurance, as provided for by HAZARDOUS MATERIALS DISCLOSURE Section 3700 of the Labor Code, for the performance of the work for which this I have read the hazardous materials requirements under Chapter 6.95 of the permit is issued. California Health & Safety Code, Sections 25505, 25533, and 25534. I will 3. I certify that in the performance of the work for which this permit is issued, I maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the shall not employ any person in any manner so as to become subject to the should I store or handle hazardous Health &Safety Code, Section use material. Additionally, should I use equipment or devices which emit hazardous equipment Worker's Compensation laws of California. If, after making this certificate of air contaminants as defined by the Bay Area Air Quality Management District I exemption, I become subject to the Worker's Compensation provisions of the will maintain compliance with the CupertinoMunicipal Code hapter 9.12 and Labor Code, I must forthwith comply with such provisions or this permit shall the Health & Safety Code, Section 5, 25533, d 25534. be deemed revoked. APPLICANT CERTIFICATION Owner or authorized agent: I certify that I have read this application and state that the above information is ! ' Date: 09/09/2016U;M correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representativesofthis city CON TRUCT19(, AGENCY I hereby affirm that there is a construction le ding agency for the performance to enter upon the above mentioned property for inspection purposes. (We) agree of work's for which this permit is issued (Sec. 3097, Civ C.) to save indemnify and keep harmless the City of Cupertino against liabilities, tender's Name judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit, Additionally, the applicant understands Lender's Address and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Signature Date 09/09/2016 Licensed Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUSERT IN (408) 777-3228 + FAX (408) 777-3333 building(iDcupertino.org ti N'W CONSTR[ICTI0N ❑ ADDITION ❑ ALTERATION 1 TI ❑ REVISION ( DEFERRED ORIGINAL'PEItM1T PROJECT ADDRESS jV 7�IJ 4i �» APN# 1V1 l ONINER NAME ` 61,-� I- e �0 } /� PHONE 0TJ -7 11 E-MAIL STREET ADDRESS �'2� b (�+ r CITY, STATE, ZIP--_ FAX CONTACT NAME 1 `3/ l PHONE E-MAIL STREETADDRF.SS t � �•��V l� ! CITY, STATE, ZIP �� 4r�-� � '"C', FAX ❑ OWNER CI OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT 1-1 A1t.ITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACI'ORNAME .-r y}- LICENSE NUMBER LICENSE TYPE BUS, LIC # COMPANY NAME E-MAIL FAX :STREET ADDRESS CITY, STATE, ZIP PHONE - ARCHITECTMNOIKEER NAME -_ �XVI^.L�a�"1- LICE, S" NUMBER { j ut�G7�L - BUS. LIC COMPANY NAME E-MAJL -- YN — FAX W ^�-/ - STREET ADD.RI?SS � � ` rj %' ► fDtr� ` CITY, STATE, ZIP t✓ � IN � 4 - PHONE 00 gyp{'% -31 -7 DESCRIPTION 6F WORK EXISTING USE • PROPOSED USE TYPE #STORIES��_ USE - TYPE OCC, - "•`u`"` SQ.FT. - VALUATION ($} —. M. TG NL•W FLUD.R :DEMO TOTAL AREA 'AREA,+ �p AREA NETAREA BATHROOM - - - KITCHEN OTHER _ REMODELARfiA REMIODEL AREA REMODELAREA - PQHAREA BECK AREA TOTAL DECKlPORCH AREA pARAGE AREA; D AC1T - - - f, rACH `7 #DWELLING. ITS; ISASECONDUNIT ❑ Q ES SCCONDSTo - vvYES BEINGADDED? sj NO.. ADDITION? Q90 PRE -APPLICATION YES ErYES, PROVIDL•.CpPY OP-� PLANNINGAPPLti []NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YIIS EICHLERHONJEU 0 .]Z:E(,',L[ygD gY• _-"TbTAL VALUATION: By ury signature below, I certify to each of the following: I all, the property owner or authorized agent & act the perty owner's behalf, I have read tbis application and the information I have provided is correct I leave read the Description of TVork and verify it is accurate. I agree to comply with all applicable local ordinancesand state Laws relating to bu' d construction. I authorize representatives of (Aipertino to enter tale ubovvo--ideentifed property for inspection purposes. Signature of Applicant/Agent: _ Date: SUPPLEMENTAL INFORMATICIA4 REQUIRED < PLAn CHECKTYPE 77-77 R06'I7rG SLIP.- ^New SFD"or Multifalrlily dwellings: Apply for demolition peri -nit for OVER THE Conn r$R-BUILDING P) An 12) l IEiV existinghuilding(s). Demolitipn permit is required prior to issuance of building permit for new building. ❑ :> xPRrss.. ...:•_ PLAA%Ii�G PliaN RCVtEYy -Commercial Bldgs: Pmvide a completed Hazardous Materials Disclosure ..Jl.'. .::0 . STANDARD:..PUBLIC 11.'01RIL5 " Ton Poon if atiy Hazardous Materials are being used as part of this project. p LAxGr FIRE DEPT.. Copy of Planning Approval Letter or Meeting with Planning prior to �.:?al? ❑ SANITARY SEWER nISTIiICT suUlnittal ofBuilding Permit application. .. - - 'EhyIROi\MFNTALHEAETH BldgA,gp_2011.doc revised 0612.1/11 • PURPOSE UTILITY RELEASE REQUEST FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 buildingftcupertino org For residential single family or duplex construction, there are cases where gas and electric utilities are requested to be released prior to the issuance of the certificate of occupancy. Upon approval from the building inspector, the City of Cupertino is allowing both utilities to be released prior to the final sign -off of the building. INSTRUCTIONS 1. Download this form at: lit42://Www.cuertino.org/index.aspx?i)age=297. 2. Complete the form and obtain signatures from both the owner of the property and the primary contractor. 3. Fax, E -Mail, Mail or hand deliver the original signed form to: City of Cupertino Building Division Attn: Utility Release Request Form 408-777-3228 office 10300 Torre Ave. 408-777-3333 fax Cupertino, CA 95014 buildin acupertino org 4 Schedule a Gas Meter Release inspection (#403) and/or Electric Meter Release in (#404). Please note, a Gas Test inspection (#506) is required prior to or at the same time of the Gas Meter Release inspection. BUILDING INFORMATION (Please complete the following information): APN B-2016-2072 7 BLDG PERMIT#: 375 18 019 DATE: 7-29-2016 SITE 10270 Calvert Drive, Cupertino, CA 95014 ADDRESS: OWNER'S NAME: Hoi San (Michael) Leung PHONE #: 408 807-7971 FAX #: MAILING ADDRESS (if different from site address): CONTRACTOR: Hung Tu PHONE # 408 234-2673 FAX #: CONTACT: Hung Tu PHONE #: 408 234-2673 FAX M I request the City to release my utilities prior to obtaining a final inspection approval for the building. I fully understand the occupants of the building cannot move into the residence until they receive all of the required final sign -offs and the City has issued a certificate of occuoancv for the buildina. Ho San (Michael) Leung 7/2812016 Owner: .................. ; ................... ..... ............................. Print:..... ......... ......................................Date .......................... Contractor:...... - Hung Tu 7/22..... ......... ......... ._._.........Print:.... ................................................................ Date:.......8!.........016 ............. UtilityReleaseForm 2011.doc revised 08109111 CUPERTINO CONTRACTOR [SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax. 408-777-3333 JOB ADDRESS102 ,7(2 LM 1APERMIT # "�0 OWNER'S NAME _ PHONE # 0 2-3 GENERAL CONTRACTOR. f.0 ��/ Tl f BUSINESS LICENSE # Q ADDRESS CITY/ZIPCODE !�o"o e . *Our municipal code requires aill businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors. Signature Please check applicable subcontractors and complete the following information: Date V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical A Al X ® 1 Q i Rj C, T1 1 C- t Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating C� Insulation !u ,�m P6U/Aziml _ e' C? Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing 4 Al 1.4 CW� ! e ! � N &020_32-7 Roofing Septic Tank �Q Sheet Metal i Sheet Rock A 114 DR& 1 A 6 , Tile Signature M/1 r R 7 3ate 0 0