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14110037-DCer This Certificate is issued purses at the time of issuance, the requirements of this code and and division c Building Permit Number(s): Address of Building: Portion of Building: Use: Single Family Dwelling Floor Area: 586 S.F. Type of Construction: V -B Current Property Owner: Current Owner Address: Final Inspection By: Final Inspection Date: *SPECIAL STIPULATIONS OR A 1 nrp is Building Code certifying that ,d for compliance with the )nstruction for the occupancy is classified. Issuance Date(s): 01 -21 -2015 PORCH (55 S.F.) Load: SFD CUPERTINO APPLICATION FOR CERTIFICATE OF OCCUPANCY OR CERTIFICATE OF COMPLETION x 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 • building (ftupertino.ora COMPLETE A SEPARATE APPLICATION FOR EACH BUILDING: „ PR JECT ADD APN # DATE OWNE AME PHON -- ��� E -MA Yl ^ STREET ADD SS CITY, S ATE, ZIP \ A� -� CONTRAC OR NAME ` PHONE�t E -MAIL STREET DRES c CITY, SAZ -3 � 3 -� MAIL CERTIFICATE TO: LIST ALL BUILDING PERMITS ISSUED FOR PROJECT: OCCUPANCY DATA: PERMIT NUMBER SUBMIT DATE ISSUE DATE DATE FINALED INSPECTOR SCOPE - 2 3 3 4 OCCUPANCY DATA: BUILDING DATA: # STORIES BELOW GRADE USE OCCUPANCY TYPE FLOOR AREA OCCUPANT LOAD 1 2 3 4 BUILDING DATA: # STORIES BELOW GRADE # STORIES ABOVE GRADE OVERALL FLOOR AREA MAX OCCUPANT LOAD FIRE SPRINKLERS REQUIRED ES OR NO FIRE SPRINKLERS PROVIDED ES OR NO # PARKING REQUIRED # STANDARD /COMPACT PARKING PROVIDED # ACCESSIBLE PARKING PROVIDED NOTE: ATTACH A COPY OF THE SIGNED INSPECTION CARD TO THIS APPLICATION. Q - OFFICE USE ONLY (To be completed by inspector of record) - Z5rhuIA1- J I it U LA I WIN J UK l:U114 1J111U1N J: CofO Application. doc revised 05107112 CITY OF CUPERTINO BUIL..DING PERMIT INSPECTION CARD BUILDING ADDRESS: 44+2 TILSON AVE CONTRACTOR: TITAN GENERAL PERMIT NO: 14110037 i, P (y CONSTRUCTION OWNER'S NAME: HSU TRACY TRUSTEE 46509 MISSION BLVD STE 118 DATE ISSUED: 01/21/2015 OWNER'S PHONE: 4084645030 - FREMONT, CA 94539 PHONE NO: (408) 883 -8668 INSPECTIONS (., w„ :DATE ,., a; 4 ,..r , INSPEGTOIt FOUNDATION/PIERS/H D.S. (J � BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH UFER GROUND F� RESIDENTIAL COMMERCIAL PAD /SET BACK -CERT r r JOB DESCRIPTION: DETACHED SECOND DWELLING UNIT (586 SQ FT) ; COVERED - PORCH (55 SQ FT). GARAGE SLABS/PREGUNITE UNDERGROUND PLUMBING UNDERFLOOR PLUMBING UNDERFLOOR MECHANICAL i�NOERrLOOR ELECTRICAL WILDLAND URBAN INTERFACE FIRE AREA ERN UNDERFLOOR FRAMING VENT TO ARRANGE INSPECTION UNDERFLOOR INSULATION _ 1 Call 777 -3228 between 7:30 am and 3:30 pm Monday through Friday, at least 24 hours kLACE No OV.E,11A � . s1[GNEn before required inspection. Job address and Permit Numbers are needed when ROOF SHEATHING I requesting an inspection. ROUGH PLUMBING L r�- CUPERTINO SANITARY DISTRICT 1 "UBS & SHOWER PAN is Closed circuit video inspection of property line cleanout, point of connection ROUGH MECHANICAL and street lateral required prior to passing FINAL CITY PLUMBING INSPECTION. Call the District (408- 253 -7071) for an appointment. BOUGH ELECTRICAUPOOL BOND FRAMING /STAIRS /E. EGRESS 2n. -4 NO BUILDING FINALS INSPECTIONS UNTIL ALL REQUIRED - - BUSINESS LICENSES ARE OBTAINED 1NSULATIONi'VENTILATION _1 t� covER =N w +ORx.uvT1L AovE xAS BEENs D ��l PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAVS OF PERMIT EXTERIOR SHEAR /HOLD DOWN __. ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. INIMRIOR SHEAR /HOLD DOWN f � IMPORTANT 4I tFL'TROCK!SHEETROCK SHEAR � � i ,( w When a permit has expired, a charge totaling one -half the fees to obtain a new permit LXTERIOR LATH /V SCREED -7— � j ZT must be paid in order to reactivate the permit. If a permit has been expired for more INTERIOR LATH than one year, a charge totaling the full fees to obtain a new permit must be paid _ to reactivate the permit. JO TAPE OR PLASTER UNTiL ABOV,F HAS BEEN'SIGN'ED SCRATCH COAT Q NOTES- ER/WATER iF � r C .._. l J M -T- aAR/vIF.CHQ L.EC "T ABOVE CE1L :I ECTRIC METER RELEASE VECIAIL S INSPECTIONS Inspector: _ Date: G: \S 7ES7'/Ie4ETER RELEASE � p -_ W� - RE ROOF INSPECTIONS GR76LE - PUSUC WORKS ` 3 l -r �q PRE- INSPECTION: Inspector: — Date: PIRF - CALI (403) i73 4010 ! / TEAR -OFF: Inspector: Date: PLANN,NG ( OT) 77 - 3308 PLYWOOD: Inspector: Date: _ SANITARY (408) 253-7071 ELECT TRICAL BATTENS: Inspector: _ Date: IN PROGRESS: Inspector: Date: — -- MECHANICAL — PLUMBING FINAL: Inspector: Date:. t. HANDICAP NOTE: OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR INSPECTION. ENERGY * OCCUPANCY OF SCALDING NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY _ INSPECTOR BUILDING, ` C� 1-7-16 CLk i TTC ATE )F OCCUPANCY f I ` Bahl, 0' CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 1904ilTiLSON AVE CONTRACTOR: TITAN GENERAL PERMIT NO: 14110037 CONSTRUCTION OWNER'S NAME: HSU TRACY TRUSTEE 146509 MISSION BLVD STE 118 1 DATE ISSUED: 01/21/2015 OWNER'S PHONE: 4084645030 1 FREMONT, CA 94539 1 PHONE NO: (408) 883 -8668 ❑ LICENSED CONTRACTOR'S DECLARATION License Class__ Lic. Contractor " �(% �ch'71>oCpate M4.-. 1 hereby affirm that 1 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. 1 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 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that 1 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 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. n Signature Date ❑ 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) 1, 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 malting this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, 1 must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I 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. Date JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL ❑ DETACHED SECOND DWELLING UNIT (586 SQ FT); COVERED PORCH (55 SQ FT), Sq. Ft Floor Area: I Valuation: $90000 APN Number: 375 09 006 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by:, _ rll Z447� Date: 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 hIealth & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: � � -= — Date: Z/ CONSTRUCTION LENDING AGENCY 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 Ad ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Profess CITY OF CUPERTINO BUILDING PERMIT I 1 BUILDING ADDRESS: 19048 TILSON AVE I CON TRACTOR TITAN GENERAL I PERMIT NO: 14110037 OWNER'S NAME: HSU TRACY TRUSTEE 146509 MISSION BLVD STE 118 1 DATE ISSUED: 01/21/2015 OWNER'S PHONE: 4084645030 1 FREMONT, CA 94539 1 PHONE NO: (408) 883 -8668 ❑ LICENSED CONTRACTOR'S jDE�CQLARATION License Class Lic. # Contractor l�id� /�er✓..� (rem Srt;,� Date 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: 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. 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 permit is issued. APPLICANT CERTIFICATION II certify that I have read this application and state that the above information is .meet. 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 sour ulations per the Cupertino Municipal Code, Section 9.18. Signature /--- Date 21 ❑ 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) 1, 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 ofthe 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. Signature. Date JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ DETACHED SECOND DWELLING UNIT (586 SQ FT); COVERED PORCH (55 SQ FT). REVISION #I: ADD(3)WINDOWS. Sq. Ft Floor Area: I Valuation: $90000 APN Number: 37509006.19048 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Date: 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 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 t 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 Cup umcipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533 and 25534. Owner or authorized agent: �� Date: 7Z,rL.— CONSTRUCTION LENDING AGENCY 1 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 Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional XUPERTINO 'I NEW CONSTRUCTION /y //ao3 7 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building(tupertino.orc ❑ ADDITION ❑ ALTERATION I TI ❑ REVISION I DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 1 1 M [�2- rS o N�� APN # = /% D q — OWNER NAME T � � EM IL U STREET ADDRESS 2 Z .. i_- %� 0. CITY, S TE, ZIP / FAX CONTACT NAME PHO E- MfIILr 1 O 6 —" s t.t.. STREET ADDRESS '1 3 p �„ , _ / _ ja G A4 -GENT (❑ CITY, ATE, ZI •� ^ CA ' -o `ENN- FAX OWNER ❑ OWNER -- BUILDER ❑:OWNER A CONTRACTOR ❑ CONTRACTOR AGENT ❑ ❑ GINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMB LICENSE TYPE BUS. LIC # �_ COMPANY NAME E -MAIL FAX STREET ADDRESS id CITY, STATE, ZIP PHONE 4 -. 4i ARCHITECT /ENGiNEEIZNQC E ` LICENSE NUMBER /. r BUS. LIIC # G �M' // h (�_ 1 O COMPANY NAME H 10-C, f�15 tt� s E -MAIL h FAX —¢ • socr` r�, ec�i o o STREET ADDRESS �Z O �� Y� �� CITY, STATE, P HONE Q� Gd// DESCRIPTION OF WORK Q ✓�,�r' / Q�Gf� �5 �D. T EXISTSE PROI'OSF��S� CONSTR. TYPE # STORES USE TYPE OCC. SQ.FT. VALUATION L (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA � ie/ AREA NET AREA 1�" 23; BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA; EIDETACH []ATTACH # DWELLING UNITS: IS A SECOND ONTT KYEs SECOND STORY [_1 YES 1 BEING ADDED? NO ADDITION? E] NO PRE - APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED,B e , TOT L VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I N4 read this application and the information I have provided ' correct. I have read the escription of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to b Id" onstruction. I author resentatives of Cupertino to enter the above- identi ed property for inspection purposes. Signature of Applicant/Agent: Date: t (1611,21 SUPPLEMENT INFORMATIO UIRED Q " ° = PLAN CHECK T YPE OUTIN0 I a •� & R SLIP New SFD or Multifamily dwellings: Apply for demolition permit for °0 OVER existing building(s). Demolition permit is required prior to issuance of building TAE COUNTERBUH DING PiAN REVIEW permit for new building. 0 ExPRESSI' LANNTNGPLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as of this E sTANDARn a 1, ruaLrewoxxs�J.� part project. Copy Planning Approval Letter Meeting ��"4+,1i9 a '�"''I'? .g LS7�� ` wg n'+4 of or with Planning prior to submittal of Building Permit application. t -s."w, yi MAJOR + sM a r x I � ,, � � � �� ). r a I SANITARY SEWER DISTRICT -Ya � s � � � � � � � � �.�v �,� L'J'V NVIRONM NTAliIiEALTA :` r,' B1dgApp_2011.doc revised 06 /21/11 6 7,1� • CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300TORRE AVENUE • CUPERTINO, CA 95Q WSION (408) 777 -3228 • FAX (408) 777 -3333 • buildingQcuoertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI X1 REVISION / DEFERRED ORIGINAL PERMIT # 14 0 00 3 '� PROJECT ADDRESS `S APN'. OWNERNAA2E j 1'� SCJ PH` -T`'b �� E-MAIL I _ �rQ<G _ { \5 t" GL�C70, STREET ADDRESS �D P CITY, S TE, ZJI�P �t 1 VLZ K (fA9 � 1 � FAX ' CONTACT NAME PHONE rGz {'f S E -MAIL STREET ADDRESS CITY, STATE, ZIP _ ,7 C FAX Q i 2� ►/ 4� .W ',R ❑ OWNER- BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT � CONTRACTORNAME r LICE,s,ENUMBER LICENSE TYPE BUS. LIC# COMPANY NAME - L EMAIL FAX STREET ADDRESS `+S, 5C� /vl 51 �u Q J VA 5i 211 R CITY, STATE, ZIP C � 4Qe — 3 6,6 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION (S) IDS TG NEW FLOOR DEMO TOTAL AREA AREA AREA NETAREA- BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE .AREA: DETACH []ATTACH I # DWELLHQG UNITS: IS A SECOA'D UNIT YES SECOND STORY ❑ YES BEINGADDED? EINO ADDITION? [-]NO PRE - APPLICATION ❑YES IF YES, PROVIDE COPY OF PLANN'INGAPPL# ❑NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLERHOME? ❑NO RF EI By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property ov<mer's behalf. I have read this application and the information I have provided is correct. I have read the D scription of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building c struction. I authorize r e tatives of Cupertino to enter the above - identified property for inspection purposes, Signature ofApplicant/Agent: Date: r- SUPPLEMENTA ORMATION D a a•P sI� CHEC]{1YPE, ' New SFD or Multifamily ciNvellings: Apply fo, demolition permit for OF ER THE COTJI�TER BUILDING existing building(s). Demolition permit is required prior to issuance of building Kc-i z k ARL PLAN REVIEW permit for new building• z� Exr.R'ESS4"�I �� x�•* �.. '�PLA1'11II�U rLANREVtEw . Commercial Bldgs: Provide a completed Hazardous Materials Disclosure AxD PITBLTCRORKS� form if any Hazardous Materials are being used as part of this project. �q..4- LARGE© z � ? I•RE DEFT ,� �, ; _ Copy of Planning Approval Letter or Meeting with Planning prior to rfl'�AxrzARsvlsrxrcr -tea submittal of Building Permit application. M�R� Bld,App_2011.doc revised 06/21/11 ED jo FM-7, CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION 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 Preliminary information available and are only an estimate Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11 -053 UL. 7/1/13) ADDRESS: 19048 Tilson Ave DATE: 05/21/2015 REVIEWED BY: Sean ;Lleeh. Perruil Fee APN: BP #: 'VALUATION: Iso PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: Numb,. hasp. hec � PENTAMATION 1GENRE PERMIT TYPE: WORK Revision #1: Add 3 windows. SCOPE Suppl. Insp. Fee.-(F) Reg. 0 OT 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 Preliminary information available and are only an estimate Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11 -053 UL. 7/1/13) i9e <:7�. 1'i:arr Check i'llialh. ,hire (.'heck Elec..Plan Chcwck ;Lleeh. Perruil Fee Plumb. Pe:-rnil Fee: F;le:c Permit Fee: Other �t1ec °dt. /rap. n7t:er Flur,�2h 1nsp. Lj Ohher Vec. Insp. 'i"Ieclz h Fr. Fee: Numb,. hasp. hec � �7ec. Ins '). Ei e: 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 Preliminary information available and are only an estimate Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11 -053 UL. 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes (F) No $0.00 0 hours Plan Check, Hourly $143.00 ISTPLNCK Suppl. PC Fee: (F) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee.-(F) Reg. 0 OT p.p hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Adinim"I tratf ve? 'Fee: 0 Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential 0 Building or Structure 0 Travel Doculnerl"aliorl Tees: Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 ;�, � . SUBTOTALS; $0.00 $143.00 TOTAL FEE: $143.00 Revised: 05/07/2015 CITY OF CUPERTINO r .. FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 190 Tilson Ave i9xi, TYPE OF CONSTR. DATE: 11/06/2014 REVIEWED BY: Sean ; APN: BP #: 7Vle! 901--1 - VALUATION: $90,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY SFD or Duplex 2nd Unit? USE: G Yes - No PENTAMATION 1 R3SFD2ND PERMIT TYPE: WORK Construct a detached second dwelling unit 586 s ft with covered porch 55 s ft . SCOPE Permit Fee: 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 641 $2,654.00 1R3PLNCK $1,666.00 IR31,VSP $0.00 PME Plan Check: $0.00 Permit Fee: $1,666.00 Suppl. Insp. Fee:•' Reg. Q OT p,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: TOTALS: 641 $2,654.00 $1,666.00 1 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 nreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Elf 7/1113) v;',<ct!. Plap,i i.. %i c'L'! /'ltalN%. P"10 Cl7eC% Fli'[:. 1 /ar.; Cr,;ecA. nk>.cl, i'c' -r %r, if <e;: P ?rrmlr. 1'ca'rr.rt lire: 1.lr.'c. pen;iarVee: oth,, Insp. Oittcr PFa rrh ins'k. Utfrar' f'lcc`. Ir l�a. El Su 1. PC Fee: Re OT pp � g• � 0.0 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 nreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Elf 7/1113) FEE QTY /FEE MISC ITEMS Plan Check Fee: $2,654.00 Select a Misc Bldg /Structure or Element of a Building Su 1. PC Fee: Re OT pp � g• � 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,666.00 Suppl. Insp. Fee:•' Reg. Q OT p,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXR 1 # new un;ts $667.73 Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: IPLLONGR $89.74 Select a Non - Residential Building or Structure 0 7ioo c:l Dt3ewricniatiorr Fues. Strong Motion Fee: IBSEISMICR $11.70 Select an Administrative Item Bldg; Stds Commission Fee: IBCBSC $4.00 SUBTOTALS: $5,093.171 $0.00 TOTAL FEE: $5,093.17 Revised: 10/01/2014 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 ADDRESS: l I bL� vA&e PERMIT # I 1-Z- vib;� OWNER'S NAME: PHONE # O C7 GENERAL CONTRACTOR: USINESS LICENSE # ADDRESS: CITY /ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) 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 54-ntch -vw (-.,e (. 5-() Cement Finishing r0K 5 MCfi z+4 -30 Electrical, Excavation U YI T,-41 C -3 /-+ 4-3 Fencing 1.�� tk I't,� Flooring / Carpeting 3 hb 5'��j,LG��`(g -vt Co Z Linoleum / Wood 0 5+1'il Glass / Glazingd C-Ft 2 Ztk Heating Insulation Landscaping j -�41 G Lathing ' , . '7— Masonry c �'3 b Painting / Wallpaper tnA C Paving Plastering C 3 Plumbing a� g Roofing �7 Septic Tank A Sheet Metal Sheet Rock 3C� Tile Owner / ontractor Signature Date I 3 A CUPERTINO Building Department CITY OF CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 TELEPHONE: (408) 777 -3228 • FAX: (408) 777 -7606 OFFICIAL NOTIFICATION OF NEW /ADDRESS CHANGE TO: All Agencies FROM: City of Cupertino DATE: April 16, 2015 RE: New/ Change of Address APN #375 -09 -006 Please note the following address change: 19042 Tilson Ave has been demolished and 2 new houses are being built. 19042 Tilson will remain with the main house and 19048 will be the new address for the detached 2nd unit. See attached map. The new address will take effect 30 days from the date of this letter. Please update your records accordingly. If you have any questions, please call me at (408) 777 -3246. Sincerely, Susan Winslow Administrative Clerk Cupertino Building Dept 408 - 777 -3246 or suew @cupertino.org om' t-1096V0 'O[�aviaED 'aAV NOS-M Z4061 lV9DN2CIIS9'd(13SOdO'dcl C I N %WMI N$3331110 � R t-m-m-m-egany ro/I W f I Aw ............... 4�4 FW U ... ..... 1:0010 .......... NEW 1121* .. . .... .... ZZU.", 1.: 1. lucllclm . . ..... . ..... MlUi MI 1.: .12-11 M IN P V -H .. . . ..... . ... I N E H f I 4�4 NEW I ,— . JAMES C. CHEN, C.E., S.E. 2881 Meridian Ave., #118 SAN JOSE, CA 95124 (408) 622 - 8251 JOB NO. 1404 SHEET NO. 1 OF 2> C. RECEIVFD DESIGN J. DATE 9/25/14 MAY 2 2 2095 BY REV. 1 12/2/14 REV. 2 1/9/15 REV. 3 5/21/15 STRUCTURAL CALCULATIONS PROPOSED RESIDENCE CuPER-remn Building D8179r"nt MAY SECOND REVIEWED FOR GORE COMPLIANCE Reviewed By: UNIT REVISION #J,-..� 19042 TILSON AVENUE CUPERTINO, - CA 95014 Off, NO. 2262 .,. JAMES C. CHEN, C.E., S.E. JOB NO. P_ O. BOX 20302 SHEET NO. 2 OF Z SAN JOSE, CA 95160 DESIGN (408) 622 - 8251 DATE LOAD COMBINATIONS FOR ALLOWABLE STRESS DESIGN: FORMULA 8 GOVERNS, REV. 3 5/21/1° (0.6 - 0.14SDs) D + 0.7 p QE +H p := 1.3 H =0 SDs:= 1.124 SHEAR WALL AT LINE 21: FIRST FLOOR: L:= (6 + 7) -ft Vr := 0.7- p- (3460.0.5) -Ibf ROOF Diaph , X - Dir. Vr = 1.57 x 103lbf Vr hl := 9 -ft V:= — L OM:= (Vr- hl) -6 —ft L ll z' RM := (0.6 - 0.14- SDs) -�20- 8 + 15.9J 6 -Ibf -ft 2 2 OM - RM T := T = 877.521bf (6 - 0.5) -ft V = 121.1 lbf ft USE TYPE A WALL ( Allow. = 340#/ft) USE SIMP STHD14/ STHD14RJ ( Al low. = 3,500 # ) SHEAR WALL AT LINE 22: FIRST FLOOR: L:= (9 + 11) -ft Vr := 0.7- p- (3460.0.5) -Ibf ROOF Diaph , X - Dir. Vr = 1.57 x 1031bf hl := 9 -ft V:= Vr L OM:= (Vr- hl) -9 —ft L l z RM := (0.6 – 0.14 -SDs) -(20.2 + 15.9 I. 2 .lbf -ft OM – RM J T := T = 296.661bf (9 – 0.5)-ft V = 78.72 lbf ft USE TYPE A WALL (Allow. = 340 # /ft) USE SIMP STHD141 STHD14RJ ( Allow. = 3,500 # ) �tsu Project Name: Project Address: Project Descri EN SIGNATURE DECLARATIONS 10oo37 19048 TilsoVAve., Cupertino, CA 95014 Detach,ed'Second Dwelling Unit J - 7 -/X C)�, & SECTION 1 - DESIGN VERIFICATION Complete all lines of Section 1 —"Design Verification" and submit the completed checklist (Columns 1 and 2) with the plans and building permit application to the Building Department. The owner and design professional responsible for compliance with CalGreen Standards have revised the plans and certify that the items checked above are hereby incorporated into the project plans and will be implemented into the project in accordance with the requirements set forth in the 2010 California Green Building Standards Code as adopted by the City of Cupertino. Z�z Owner's Signature Date Tracy Hsu Owner's Name (Please Print) Design Profe sional's Signature Date Design Professional's Name (Please Print) H. Mike Chen Signature of responsible for CalGreen compliance Name of License Professional responsible for CalGreen compliance (Please Print) H. Mike Chen Email Address for License Professional responsible for CalGreen compliance hmikechen @gmail.com SECTION 2 - IMPLEMENTATION VERIFICATION ZZ Date 408 - 4468418 Phone Complete, sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2010 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License WofessMhal responsible for CalGreen compliance H. Mike Chen Name of License Professional responsible for CalGreen compliance (Please Pdnt) hmikechen @gmail.com Email Address for License Professional responsible for CalGreen compliance �V51 Date 408 - 4468418 Phone Page 5 of 5 CalGreen_2010.doc revised 08127111 CUPERTINO 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 • building ()cupertino.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: http : / /www.cupertino.org /index.aspx ?page =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 building2cupertino.org 4. Schedule a Gas Meter Release inspection ( #403) and /or Electric Meter Release inspection ( #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 BLDG PERMIT #: DATE: SITE �0�� ADDRESS: I,ISC��1 OWNER'S NAME: n6cA PHONE #: FAX #: b 4- 16 �03 0 MAILING ADDRESS (if di rent fr m site CONTRACTOR. PHONE #: uu FAX #. v CONTACT: PHONE #: k3 V&t CO UlA FAX #: 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 occupancy for the building. sic Io i��.5 Owner: ............................. ................ ... ............... .........Pring............ ..... ........ .... ............................... ........Date:........... //...... Contractor :.......... ........... Pring........... ..( ......... ...................... Date A.." .(w.. -15 ..... UtilityReleaseForm 2011.doc revised 08109111