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15120145-FP1 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19844 BAYWOOD DR CONTRACTOR: PERMIT NO: 15120145 OWNER'S NAME: YE HUANCHUN AND XU LI DATE ISSUED: 12/16/2015 OWNER'S PHONE: 4083141183 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:. RESIDENTIAL ❑, COMMERCIAL License Class 0'Z-Y�- INSTALL (N) PRE -FAB PATIO COVER AT REAR (220 SF) Lie. # Contractor C3Y�( Date /2S 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 Compensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $7320 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 APN Number: 31631015.00 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 1g0 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 FROM LAST 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 AU40kdr, Issued by: Date: granting of this permit. Additionally, the applicant understands and will comply with all non -point sourcer ulations per the Cupertino Municipal Code, Section 9.18. 6�� /, — RE -ROOFS: If is Signature Date 1 / /// All roofs shall be inspected prior to any roofing material being installed. a roof installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Date: Signature of Applicant: 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. 1 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 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 will maintain compliance with the Cuper " o Municipal e, Chapter 9.12 and 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 the Health &Safety Code, Sections 5533 nd 255 Owner or authorized agent: I v Date: %24 % 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 . CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I I I hereby affirm that there is a construction lending agency for the performance of become subject to the Worker's Compensation provisions of the Labor Code, must work's for which this permit is issued (Sec. 3097, Civ C.) forthwith comply with such provisions or this permit shall be deemed revoked, 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 CONSTRUCTION PERMIT APPLICATION _._:. -. ..... _ COMh/iUNl i `f DEVELO?i�4ENT'D_r�AR i MiENT • BUILDIi�G DIVISION 10300 TORRE AVENUE • CUPERT1h0, CA 95014-3255 (40$) 777-3228 • FAX (408) 777-3333 • buiidinoftuUertino.oro CUPERTiNO, NEW CONSTRUCTION ❑ ADDITION I l .i.rR_z: 70W 151.12 . f na M71 NT A T. T)TZ7? 1JT7 PROI-tCr ADDPF55 11q 9 hPtt G� Q} . ri01� Pdl/ T i y_ I-.tJ_4tZ STRE_r ADDRESS . G C1iY, STA Z' 4X moi' I t "�'-✓ ' �� .�/r. COhiACT N� v -� - ala _ >J S R / ITMq [t y- & p _ {p 01i*ncR �. OA'2�'P,-3TJS.D� ❑ Dk�•Zx kC�"t CO?.•t:.tCTOR ❑ C01.Ti.SCTOR?.GT°r ❑ ARCT�T.•'-CT ❑ �ICfi yR ❑ DEl•;:LO?3 ❑t i_ItiFh'T C01viRf CORY ANv t �- I L IGTSE R'[}i°�' I LICTYrH ( BUS. LIC K C01✓.PGI�'Yl�,��,rr. �`..)g�- _ ,`n�•• Ftd :•N=.II. �q /J ld /p I � i Pp/ �� J//� p�y�.m%✓it 6w" F t✓ � �p f J�'•� ,n "EP'C. � /f+L IP ..7.Y f. � C..-� 5ly��rycF., I € ✓ -°-" srMTADDRss / cry, sT'f' S rzoa tRC.�SSCTt= vG ham. p�gg FV LIC.rl^ I J ✓SER I - 13L'S. L, I _.. CO1 S .Aw RAN% B_MJ :L ) FF X i STREET E TJDPF SS CITY,STA, a; ZIP D.SC1iYiIOl,1OF WORK �/��G•- � c'7¢ "��(�j.}✓ ppm , EJaSTL';G USE I PROPCKBD USE I CONSTIt iY?� ( STORMS i USE I TYPE I OCC. I SQ.r'T. I VALUATION (i) r _TG LOORI DE1,40 TOTPS AREA 11\70 APzA T_TAREA - I I .- BArED00M Kt3C nT R vIODEL ARP..4 P-11,10 DEL AREA R"M iODEL AREA PORCH A_RtA DECK Ap.EA TOTAL DECY iPOR CH AREA fiR?A: 1. 1�_,0LAGS EDDETACIi D1N'ELLRgGUNIT S ISA. SECOND UNIT L3 YES SECOND STORY ❑YES BEING ADDED? ❑ o ( ADDMON? ONO ) PPEAIPPLICATiON ❑YES 7YS,PROVIDE COPY OF IS THE BLDGA.K E3 YES K._,C Iv •31- " -_ Y4LU.4Tl a. PLA.,11M\10 .PPLR ❑N0 P1,42NXTnGA.PP?0YA_LcT13R I EICHLERHO1,1z, E3 \,o jTjQS:L � By my sipature below, I cer<ij to each of the fell : I am the property owner or authoriz d ae : to act on the -o ,: ov-1er's be !lf I have read this application and the information I have provide o„ eet. Lha r >d t e escr poo l of S� ork and; ern7y ;t is accw e I z , e to comply ; ith all �Dplicable local ereinances and state laws relating to 1 tion. I _rhorize re -e en_ti; es of Cuper ina :o enter the abo`°e- as ed grope y for inspection, purposes. Si�_t1€tureof?pplicandAgent: �w Date: /I — SUPLEAr?>;TAL?�SOR�Z� Ors. I11R:ED-.�=..�0_LTLnORIp,._-_..,,-z yam:� N-,wSFD or.��ujr1=z..lily dN?eell+_^g,A-.Dply or demolitio-n a -flit=orc HT>w07 rrR BITISDL cYL3RRc..... existing buHinng(s). Demolition P --—,3L 13 requ-...d prior ,o .ssu ?ce of buildug g P,-:, * it, for new buiidiDg.Ss ss �4 ��L\GPL� PF4?EFi - 11 coercial 3ld�s; Pro; ide a co r_pleted _�Lz dons Materials Discios�re i� �A Pu>co�us n� — _ or -_r if P_ny Hazardous h4aterir?is art being used as part of this project. Approval Leer ?;�eoan� with PI n_.z to Copy or Planning or o prior �`S��a�Z c T - l submittal or Building Pe -=,t applicPtion. �••_..�-_- �'�` ;,rte '�t-Y � `} �+' �„ -�• j�.�� „s �`�.� �•.,.>��k...��NZ:TRO7a"A<�3SE�. HS4LT�i�._: : i3lagrp�_20.11.doc revised 06/21i11 CITY OF CUPERTINO Ww FF.F. F.IRTIMATOR — RITILDING DIVISION ADDRESS: 19844 Baywood Dr DATE: 12/1612016, REVIEWED BY: Phuong Suppl. PC Fee: @ Reg. 0 OT 0.0 PME Plan Check: APN: 316 31 015 BP#: *VALUATION: 1$7,320 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY USE: SFD or Duplex I PENTAMATION 1R3SFDADD PERMIT TYPE: A WORK I Install (n) pre -fab patio cover at rear (220 SF) SCOPE Work Without Permit? C) Yes Q) No Advanced Ptanning-Eggi NOTE. This estimate does not F-1 I due to other Departments (i.e. Planning, FEE ITEMS (Fee Resolution 11-1153 tff 7/7113) Plan Check Fee: Suppl. PC Fee: @ Reg. 0 OT 0.0 PME Plan Check: hrq Permit Fee: Suppl. Insp. Fee -.(a) Reg. 0 OT:�hrs PME Unit Fee: PME Permit Fee: Work Without Permit? C) Yes Q) No Advanced Ptanning-Eggi Strong Motion Fee: I BSFISMICR Bldg Stds Commission Fee: IBCBSC FEE $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Iwo Pe� ,mii 1, irks, Fire, Sanitary Sewer District, School table ana are onty an eulrrutt QTY/FEE MISC ITEMS 220 s.f. Patio Cover / Sun Room $716.00IpAT1omET4 I Metal' 1 $0.95 $1.00 $1.95 $716.00 Select a Non -Residential G Building or Structure 0 Select an Administrative Item $717.95 Revised: 10/01/2015 SMOKE f CARBON MONOXIDE ALARMS won OWNER CERTIFICATE OF COMPLIANCE go 22 -,s COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION (3.&—r CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 ' (408) 777-3228 ^ FAX (408) 777-3333 • building Cg)cupertino.org r� � 0 .% Permit No.. fi,ddrom / e A1/4) o � Y 9 of Alarms Smoke: r'1 Cai+mn h4n;Aj PERMIT CANNOT BE FINALED ANTI COMPLETED UNTIL THIS CERTIFICATE WkS BEEN aLQUE) ANI),},;, UfBar D TO THE BUILDING DIVISION PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On every level of a dwelling unit including basements X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel-buming appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. i nave read and agree to compiy with the terms, andconditions of this statement Owner (or Owner Agan@'s) Name: signature............../.� ?.Z A Contractor Name: Sinature,......_.......................................................... Lj%#...................................... Daie: Smoke and CO forna, doc remised 0311'8/14 OWNER CERTIFICATE OF COMPLIANCELizi !` COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION FILE CUPEi TINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 -�_- 22 (408) 777-3228 - FAX (408) 777-3333 • building(a)cupertino.oro 1 Owner Name L i X kk Permit No. Sj 2 D1 t7f Address 1 `3 iii f 861VtA 14 )tel ) r 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of fonn C/No Go to Question 2. 2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its plumbing, installation of water -conserving plumbing fixtures is not technically feasible? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. — / Skip the rest of the form and sign bottom of form. L�' No Go to Question 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 'P/No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ No My real property is built and available for use or occupancy after January 1, 1994. -- // Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. N es My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 110 1. 1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. Plept check ONE of the following: y property is a single-family residential real property. See Civil Code Section 1101.4. On and after January I, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non- compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ My property is a multifamily residential real propetty. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. O'n or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water - conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). ❑ My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). 1, as the owner or owner's agent of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1 10'1.8, the cur -rent California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and that the water -conserving plumbing fixtures comply with the requirements as indicated in the table on the following page. _ Owner or Owner Agent's Signature3' ' —Date:_ Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit. SB407 2015.doc revised 08/26/15 M, v 70 Z-0 Nn Pk`Ir� ,a �� PLAT N ECKED BY D DEPT C PE TINO cv IIV It� VE LLI u UL. LL w