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14020106CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 14020106 10049IMPERIALAVE CUPERTINO CA 95014 (357 17 013) HOMEOWNER/BUILD ER OWNER'S NAME: LONG DING-GWO AND SHIRLEY L DATE ISSUED: 03/02/2015 OWNER'S PHONE: (510) 206-0590 PHONE NO; LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class Lic. # Contractor HOMEOWNER/BUILDER Date —BLDG —ELECT —PLUMB MECH RESIDENTIAL COMMERCIAL 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. JOB DESCRIPTION: CONSTRUCT SFDWL ON 2ND FLOOR OF MIXED USE I hereby affirm under penalty of perjury one of the following two declarations: BUILDING, 1853 LIVING, 440 GARAGE 1. I have and will maintain a certificate of consent to self -insure for Worker's REV #1 - CHANGE HALLWAY BATHROOM CONFIGURATION - Compensation, as provided for by Section 3700 of the Labor Code, for the ISSUED 10/17/2016 performance of the work for which this permit is issued, 2. I have and will maintain Worker's Compensation Insurance, as provided for by PERMIT EXT'D TO 12/9/2016 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTMCATION 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 02/18/15 3RD EXTENSION TILL 5/19/15 representatives of this city to enter upon the above mentioned property for 10/29/14 2ND EXTENSION TILL 2/19/15 inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which Sq. Ft Floor Area: Valuation: $300000.00 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. APN Number: Occupancy Type: 357 17 013 Signature Date 10/17/2016 PERMIT EXPIRES IF WORK IS NOT STARTED OVY'NFR_BUI DER DECLARATION WITHIN 180 DAYS OF PERMIT ISSUANCE OR I hereby affirm that I am exempt from the Contractor's License Law for one of the 180 DAYS FROM LAST CALLED INSPECTION. 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 Issued by: ABBY AYENDE sale (Sec.7044, Business & Professions Code) Date: 03/02/2015 it I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). RE -ROOTS: I hereby affirm under penalty of perjury one of the following three declarations: 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 t. I have and will maintain a Certificate of Consent to self -insure for Worker's inspection. f Compensation, as provided for by Section 3700 of the Labor Code, for the of the work for which this permit is issued. ,performance I have and will maintain Worker's Compensation Insurance, as provided for by Signature of Applicant; Section 3700 of the Labor Code, for the performance of the work for which this Date: 10/17/2016 permit is issued. . 3. I certify that in the performance of the work for which this permit is issued, I ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE exemption, I become subject to the Worker's Compensation provisions of the I have read the hazardous materials requirements under Chapter 6.95 of the Labor Code, I must forthwith comply with such provisions or this permit shall California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will be deemed revoked. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous APPLICANT CERTIFICATION material. Additionally, should I use equipment or devices which emit hazardous I certify that I have read this application and state that the above information is air contaminants as defined by the Bay Area Air Quality Management District correct. I agree to comply with all city and county ordinances and state laws will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and relating to building construction, and hereby authorize representatives of this city the Health & Safety Code, Sections 25505, 25533, and 25534. to enter upon the above mentioned property for inspection purposes. (We) agreej�, to save indemnify and keep harmless the City of Cupertino against liabilities, Owner or authorized agen judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands []ate: 10/17/2016' and will comply with all non -point source regulations per the Cupertino Municipal CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance Code, Section 9.18. of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Signature !/( Date 10/17/2016 Lender's Address V -co i CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 , FAX (408) 777-3333 • building(aD-cupertino.ong El NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI s.a-1 EVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS c 1 /] APN n 3 7 i g� C� L� OW'NERNAIAE PHONE Iy�C LatjG 771 6 o!qQ P vSC3� c C�ice{ ZMA'(,L> q STREETADDRESSI _ g ' A� CITY. STATE. ZIP (— � [ /' ( FAX 1 4C) 2- A\&5 ­ CONTACT NNAME9 OJ�EA�JV Pi_ I (� ` EMV'ed��3G�l9J i 03AFAX STREET:ADDRESS CITY, STATE IP OWNER ❑ OWINTER-BUIIAER 9 ON'NERAGENT ❑ CON -TRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMELICENSE �. NUMBER LICENSE TYPE BUS. LIC n NAME AME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE, ARCHITECT/ENGINEER NAA LICENSE NUMBER 111 Zt� BUS. LIC It, COMPANY NAME �[n��a,,,s)� �E-MAIL +f FAX f STREET ADDRESS 3 "70 o�0 CITY, STATE, ZIP PHONE DESCRIPTION OF WORK A4 o 6 t F*-! -d- c Bw rah C6 Tt Ehl," EXISTING USE PROPOSED USE CONSTR. TYPE" STORIES. USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA ReiIODELAREA REN40DELAREA PORCH AREA DECK AREA TOTAL DECK: -TORCH AREA GARAGE AREA: ❑ DETACH ❑ ATTACH DIVELLIG UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BELNGADDED? ❑NNO ADDITION? ❑NO PRE-.APPLIC.ATIOIa'' ❑YES IFYES, .PROVIDE COPY OF IS THE BLDG ,N ❑YES RECENEDBX k. TOTAL VALUATION: PLANNr-\'G ADPL- ❑ NO. PLANTING APPROVAL LETTER EICHLER HOATE? ❑ NO By my signature below, I certify to each of the following: I Hill the property owner or authorized agent lo act on the property owner's behalf I have read this application and the information I have 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 relaf building con tfuction. I authorize representatives of Cupertino to enter the above, identifie pproperty for inspection purposes. . Date: 1 } 7/1C. Signature ofApplicant/Agent:� SUPPLEMENTAL INTFORMATION REQUIRED PL3� CHECF TIPS .a. � ROUTING'SLIPr_ NTew SFD or Multifamily dwellings: Apply for demolition permit for ❑ RE~�EiA — eXisting building s). Demolition is required prior to issuance of building OY ER THE COL"�3ER BU11 DbiNG PLA s .permit permit for new building. k E�PIiEss ❑ PLA �NINGPLA v RE\TE10' Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STA tDARD w l]; PLBLIC i ORIS - form if any Hazardous Materials are being used as part of this project. , ❑ LARGE I] `FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to AL4JOR SAitITAI2Y5EA�ERDISTRICT submittal of Buildina Pen -nit application: w z :>... I❑ EN4'IRONT3EI�TAliHEAi3i3 , BldgApp 2011.doc revised 06/21/11 CUPS T INO Building Department 1 REVIEWED FOR CODE. COMPLIANCE Reviewed By: EXHAUST FAN W1 BACKDRAFT DAMPER CAPACITY: 50 CFM INTERMITTENT OR 25 CFM CONTINUOUS TO VENT TO TH OUTSIDE RECESSED LED LIGHT FIXTURE AT CEILING WET AREA LOCATION WALL MOUNT LED LIGHT FIXTURE ALL LED LIGHT FIXTURES 1 LIGHTS SHALL COMPLY WITH 2013 CA ENERGY CODE SECTION 150(k) - PROVIDE 20 AMP DEDICATED BREAKER FOR BATHROOM 4 F BATHROOM FLOOR PLAN -cj-- 4- 1 s CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10049 IMPERIAL AVE CONTRACTOR: LONG DING-GWO AND PERMIT NO: 14020106 SHIRLEY L OWNER'S NAME: LONG DING-GWO AND SHIRLEY L 4921 PROCTOR AVE DATE ISSUED: 03/02/2015 OWNER'S PHONE: 5102060590 OAKLAND, CA 94618 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL E] CONSTRUCT SFDWL ON 2ND FLOOR OF MIXED USE License Class Lic. # BUILDING, 1853 LIVING, 440 GARAGE Contractor 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: 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. Sq. Ft Floor Area: Valuation: $300000 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: 35717013.00 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 180 DAYS OT 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 LED 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 Issued by: Date. granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section RE-ROOFS: 9.18. Signature Date 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 r inspection. �OWNER-BUILDER DECLARATION Signature of Applicant: Date: ;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, Bu iness & Professions Code) ?I fa owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE �onstruct 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. I 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(a) 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 performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, S". 25505, 25533, and 25534. Section 3700 of the Labor Code, for theerformance of the work for which this p ? O7wner or authorized agent: Date: it is issued. I c�fy that in the performance of the work for which this permit is issued, I shall oape/ t 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 Code, I I hereby affirm that there a construction lending agency for the performance of become subject to the Worker's Compensation provisions of the Labor must i t is issued (Sec. 3097, Civ C.) work's for which this permit 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. 0 �/``�'__ Signatute, Date CONSTRUCTION PERMIT APPLICATION -COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - building _cuperiino.ora CONSTRUCTION L_i ADDITION ❑ ALTERATION I TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # gRINGADDED? ❑NO PROME COPY OF PRE- PPLICATION OYES IF YES, VID ADDITION? ONO PR03EI ADORES . I A- P& j t-- I Icy L - �7 �I � APN # 3-67( 7 c13 IS THE BLDG AN ❑YES NO 1-PiiONE £ t�4AIL f Y�r C n E O J OWNER NAME / _ 5 io ?-0(.-0I�. 0 i -V W STRESf ADDRESS CITY, STATE, ZIP IQ t FAX its i ,,i lG- e �i EICHLERHOhiE9 13 CONTACT NAME PHONE l �A� ; q ` �'i? � �Ca � 3r.)(. L v'.�,rl� i 04o t� c � , � t�si✓T _ 1 � �� •2.; -v�,i CITY, STATE, ZIP FAX STREET ADDRESS i - ❑ OwNER ❑OWNER-BUnDER- OwNHRAGENT ❑ CONTRACTOR ❑CONTRACTORAGENT 13 ARCHITECT ❑ ENGINEER E3DEVELOPER ®TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # Multifamily dwellings: Apply for demolition permit for ovEliTicot?Ivrt.. COMPANY NAME. E-MAIL FAX existing "z permit for new building. STREET ADDRESS CTFY, STATE, ZIP PHONE form if any Hazardous Materials are being used as part of this project._NONE _ _ _ LICENSE NUMBER ARCHTrECT/ENG NAME _ g J j �CS7 E-MAIL COMPANY NAME , 7 FAX submittal STREET ADDRESS t""i c'�S. �ICI� CITY STATE ZIP PHONE DESCRA'TIONOFWORK EXISTINGUSE. - PROPOSED USE TYPE # STORIES Z USE TYPE OCC. SQ.FT. VALUATION ($) -7 e1rt K U5E LCONSTR. EXISTG NEW FLOOR DEMO TOTAL z AREA j AREA. f1 NET AREA LA v I /,3 186'3 AREA f 0 0® - REMODEL AREA REMODEL AREA AREA BATHROOM - KIFCHEN 4i; 14+0 _ I PORCHAREA DECK AREA TOTALDECKlPORCHAOEAREA: DETACH .ATTACH BldgApp 2011.doc revisea voiziii 1 gRINGADDED? ❑NO PROME COPY OF PRE- PPLICATION OYES IF YES, VID ADDITION? ONO IS THE BLDG AN ❑YES NO RECEIVEDY TOTAL VALUAIQTj1: PLANNINGAPPL# [INO PLANNINGAPPROo LETTER EICHLERHOhiE9 13 the following: I am the property owner or authorized agent to act on the property owner's behalf. lb read this By my signature below, I certify to each of is I have read the Description of Work and verify it is accurate_ I agree to comply with all applicable local application and the information I have provided correct ordinances and state laws relatiValwilding constgaction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. 4- Date % � Signature of Applicant/Agent SUPPLEMENTAL INFORMATION REQUIRED PL lei c rYPR OWN Multifamily dwellings: Apply for demolition permit for ovEliTicot?Ivrt.. New SFD or building(s). Demolition permit is required prior to issuance of building`��� existing "z permit for new building. Commercial Bldgs. Provide.a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project._NONE Copy of Planning Approval Letter or Meeting withPlanning prior to ao �� �rsTlara of Building Permit application. submittal BldgApp 2011.doc revisea voiziii 1 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 10049 imperial ave DATE: 02/1912014 REVIEWED BY: Mendez APN: BP#:���, *VALUATION: J$300,000-� xPERMIT TYPE: Building Permit R-3 (Custom) PLAN CHECK TYPE: New Construction PRIMARY USE: SFD or Duplex IR3PLNCK 2nd Unit? Yes E)No PENTAMATION PERMIT TYPE: 1 R3SFD WORK construct sfdwl on 2nd floor of mixed use building SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,111-B,IV,V-B 2,293 0$-2-,8-37--73-91-- IR3PLNCK $2,549.75 lR31NSP, $0.00 PME Plan Check: $0.00 Permit Fee: $2,549.75 Suppl. Insp. Fee:D Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 2,293 $2,837.39 1 $2,549.75 #new units NOTE: This estimate does not include fees due to other Departments (i.e. Planning, ruuuc works, Pire, 5anuary aewer "tstf t, Ouicuvt _,. _ r ,... ,. ,..7.....,.,7 ,. ,. sl.....,..,1�.,,..ic.nv.i iwfnvrvrntinn nvnitnh]n nNd /lYP nnlV an estlinate. Contact the Dept for addn'l into. utstriu, ecu . 1 hese ees a e UUJ— V/C ——....wu---- FEE ITEMS (Fee Resolution 11-053 Eff. 7/11132 FEE i' i--2un , Ph,,m! CPt(?{'i _ .... Elec. Man (,'hoelk Pt'r i;f F,>e 'I r llb. r'c°t m;l Fee. 1 kc. � erni F -e; A3c>c�s. 7 as,3.=r,-, { tt;e 171 rh Irrrt�. 01 ea -f lc;. lnv),. Llllli5l,�1111 TlhT, ib, 1€up1 Fee: �. l.le, IYi-sp. Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, ruuuc works, Pire, 5anuary aewer "tstf t, Ouicuvt _,. _ r ,... ,. ,..7.....,.,7 ,. ,. sl.....,..,1�.,,..ic.nv.i iwfnvrvrntinn nvnitnh]n nNd /lYP nnlV an estlinate. Contact the Dept for addn'l into. utstriu, ecu . 1 hese ees a e UUJ— V/C ——....wu---- FEE ITEMS (Fee Resolution 11-053 Eff. 7/11132 FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,837.39 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. Q OT LO.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $2,549.75 Suppl. Insp. Fee:D Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXR rl #new units 652.28 Work Without Permit? 0 Yes (E) No $0.00 Advanced Pla�� 1PLLONGR $321.02 Select a Non -Residential Building or Structure 0 /71=d:'el 19ovumeniaion Pee9'; Strong- Motion Fee: IBSEISMICR $30.00 Select an Administrative Item Bldg; Stds Commission Fee: IBCBSC $12.00 SUBTOTALS: -I $6,402.44E.00 TOTAL FEE:1 $6,402.44 Revised: 01/15/2014 r, �s OWNER -BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE CUPERTINO-, CA 95014-3255 (408) 777-3228 FAX (408) 777=3333 building fcr7.cupertino.ora CUPERTINO Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property Improvoments_Specified _at: , r We are providing you with an Owner -Builder Acknowledgment an6Information Verification Form to make you aware of - your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS: Please read and initial each statement below to signify you understand or verify this information.) 2-1 X 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner - Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 2 0 D dX 2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. 3. 1 understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial -risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. QL Lt4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. �LZ I understand if l employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. Z6.1 understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. gclyo O7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 8. 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for td" any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. OwnerBuilderForm 2010.doc revised 04/14/10 �iL9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321=CSLB (2752) or www,.cslb.ca.gov for more information about licensed. contractors. ��41 O..,Iam aware.of and consent to an Owner -Builder building permit applied for in my name, and understand that I am1he party legally andfinancially-responsible for proposed construction activity at the site address listed above. �V_111._ I agree that, as the party legally and financiallYy responsible for this proposed construction activitY,I will abide by all applicable Laws and rrequirements that goer-n.Owner-Builders .as well :as employers. - 12 1 agree to.notify,the.issuer -of this, .f6rm.immediately of any.additions,.deletions, or.changes to any.of the information l •have provided on this:form:. Licensed contractors are'regulated,:by laws designed to protect.the public. --If -, .-., you..contr..act,with someone°who does not'have"a'.license, the Contractors'.State License Board maybe Unable to assist -You With -any financial loss. you.maY sustain:as.a resultof a. complaint. Your only remedy against unlicensed Contractors,may be•in civil :court. Itis also.--important,for=_you to: -understand that if an unlicensed Contractor or employee of that individual or -firm is injured while working on your property, you may be held liable for damages. If you obtain a'permit as Owner=Builder and wish to -hire Contractors, you, will -be -responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance. coverage., CONSTRUCTION LENDING AGENCY (DIRECTIONS: Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's drivers license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owners si nat re. Property Owner's Signature: K - Date: -----------------------------------------------------------------------------------------------------------------------=-------------------- (NOTE: ------------------(NOTE: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project c1 rpt C Scope of Construction Project (or Description of Work):l i 1 Project Location or Address: f Name of Authorized Agent: f I (' `Af Tel No y Address of Authorized Agent: Out q f 5,5 �C � C ��� �u���� �� d f �i� � c/ I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the property owners drivers license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature:C. Date: OwneYBuilderForm 2010doc revised 04/14/10 C.UPERTINO OWNER -BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO. CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 - building(cDcupertino:ord Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SITE ADDRESS ;.- APN .3,5`7-- f -0t BP# 14 �© -OWNER NAME OWNER ADDRESS DESCRIPTION OF WORK: = al l U � L -O We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a. building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS: Please read and initial each statement below to signify you understand or verify this information.) 21 x_1.1 understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner - Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. 1, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed..person. and.his or her employees while working on my property, My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my (,insurance coverage for injuries to workers on my property. zTJ 2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. e 3. 1 understand as an Owner -Builder' I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 0Iunderstand Contractors are required by law to be licensed and bonded in California and to list their license L numbers on permits and contracts. 0 q 1P M,5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be Considered an "employer" under state and federal law. QV6.1 understand if l am considered an "employer" under state and federal law, 1 must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk.g. C? U47. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 0 8. 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. OwnerBuilderForm 2010.doc revised 04/14/10 29. 1 understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca;gov for more information about licensed contractors. X10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that am the party legally and financially responsible .for proposed construction activity at the site address listed above. 1!1111. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner Builders as well as employers, ,12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information i have provided on this form.. Licensed contractors are regulated bylaws designed to protect,the public. If you contract with someone who does not have --a license, .the Contractors' State License Board may be unable to assist you with any financial loss you may sustain asa result of a complaint. Your only remedy against unlicensed Contractors maybe in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on yaur property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will -be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS: Please complete the following construction lending agency information.) hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: 0 Lender Address: Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note; A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the propeqy owner's si nat re. Property Owner's Signature: hate: --------------------------------------------------------------------------------------------------------------------------------------------- (NOTE: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. yw � r � Scope of Construction Project (or Description of Work): I __.._ Project Location or Address: too `{ 9 141 �"YL-Cay— Name of Authorized Agent: 13 PJ Tel No s- f Address of Authorized Agent: Lr ��� C %"� cif C j' I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the property owner's driver's license, form notarization, orother verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. 1 Property Owner's Signature: [ ._. Date: 2--/ OwnerBuiderForm 2010.doc revised 04/14/10 CUPERTINO Building Department CITY OF CUPERTINO 10300 TORRE AVENUE e 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: June 02, 2015 RE: New/Change of Address APN #357-17-013 Please note the following address change: 10049 Imperial Ave has been demolished and a mixed use building is being built. The addresses will be as follows: 10043 & 10045 Imperial Ave Offices 10047 Imperial Ave Medical Office 10049 Imperial Ave (2nd Flr) Residential The new address will take effect 30 days from the date of this letter. See attached map. 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 t a Fri t 1i 21711-': o k• F �� E t R1' al{ 0075 eN.a��■ o 21730,4;' , 1 vAl _ — ' QUl ,i g Ca. cn Ii"d e I i L 76 6= J6822 r� 1 wdo 9 In 4iff M.u X11` kir11 �r Cupertino Union School District. 1.0271 10301 Vista Drive, Cupertino, CA 95014 Tel (408) 252-3000 • Fax (408) 865-0326 Developer Impact Fee Compliance The Cupertino Union School District has adopted Resolution Nos. 1403 and 1404, imposing developer impact fee pursuant to Government Code 53080. Building Permit Request The City of (` t.f; ;= f f has received a request for a Building Permit described as follows: Residential Development Project 11-Commercial/industrial Development Project Name of Developer: Project Address:r�1 Description: Square Footage: �£ = Lot/Parcel #: `? ;r ,� ;•f �, / j:% Permit #: _ A Date: >j. By: �fi . City Authorized Representative Square footage will be verified by the city prior to issuance of a building permit; fees may be adjusted accordingly. Important Notice: Cupertino Union _School District _gives..no. credit for -total dem.o.lition,.of.existing square. footage area, which. makes.._ Way for new construction as mandated in the Government Code Sections 53080, 53080.6 and 65995. SCHOOL DISTRICT DEVELOPER IMPACT FEE CERTIFICATE OF COMPLIANCE The authorized representative of the Cupertino Union School District has reviewed the City of t`"y 10P k.1 ';7-.I lit:f:J Building Permit Request described above and hereby certifies that the developer or authorized representative has �- met the requirements of the District's Developer Impact Fee requirements. Dated:' - - By: m. Authorized Representative Cupertino Union School District V 'i s` Certificate not valid without District seal, initial, and date. Facilities Planning - White City- Yellow Fee: $ >f tl Check No.: Requestor - Pink Accounting - Gold FREMONT UNION HIGH SCHOOL DISTRICT` X89 WEST MEW AVENUE sUNNYVALE, GALIFQI•tNiK 64087 408-522-2200 Developer Impact Fee Compliance Building permits will not be issued without a completed Certificate of Compliance Building Permit Application The City of (A' +t , ] ^ has received a request fora Building Permit described as follows: New Residential Development _ Residential Addition (501) sq. ft. or more _ Commercial Development Name of Owner / Developer: r,)l r -S L C- rZ,f t r , Project Address: t(.!`r. to Parcel # Square Footage: �7 �._- Descriptions -- Permit I Plan Check. # Date:. By City Building Inspector Square `footage verified by the city prior to issuance of a building permit; fees may be adjusted accordingly. Feeder Elementary District SCHOOL DISTRICT DEVELOPER IMPACT FEE CERTIFICATE OF COMPLIANCE The authorized representative of the Fremont Union High .School District has reviewed the City of�f�s+.tizjl,� Building Permit Request described above and hereby certifies that the. developer or authorized representative has met tate requirements of the District's. Developer Impact Fee requirements. Dated;? By: •—�a Fremont Union High School District Authorized Representative '-4fY Gediflpate: not valid without `,bisfitct.8e I -Initial, and.Dato ' a53 rl s�' Distribution: Facilities Planning — White City -- Yellow Dev. Impact Fee :Compliance (Rev. 11122105) Fee $ i )-q -6110 Requestor — Pink Accounting — Gold [92108 —1000] DISTRICT MANAGER -ENGINEER MARK THOMAS & COMPANY, INC. RICHARD K. TANAKA DISTRICT COUNSEL ATKINSON • FARASYN, LLP. MARC HYNES February 18, 2015 Building Department 10300 Torre Ave. Cupertino, CA 950143202 20863 STEVENS CREEK BOULEVARD, SUITE 100 CUPERTINO, CALIFORNIA 95014,2154 (408) 253.7863 PHONE ® (408) 253.5173 FAX www. cup ertinosonitorydistrict. org F L SUIng 1.1moing Permits BOARD OF DIRECTORS ANGELA S. CHEN JOHN M. GATT'O STEVE C. ANDREWS WILLIAM A. BOSWORTH PATRICK S. KWOK File: CSD -#15-044 City of Cupertino Subject: 2 -Story SFDWL/Medical Offices (3393sf lst/1853sf 2nd) — Approved Name: Shirley and Ding Long Residence Address: 10049 Imperial Avenue, Cupertino APN: 357-17-013 Permit No. 14020106 and 14020107 .. The Cup- crtino Sanitary District has reviewed -the plans for the mbject project: Sanitary sewer is available, see conditions / requirements below. The following Conditions/Requirements are made: • Install new property line cleanout. Property line cleanout must be within 5 feet of the property line. Cleanout shall be the same diameter as the street portion of the service lateral. Gravity lateral is 4" diameter minimum. (O. C 4101) • Closed-circuit 'Video of the new property line cleanout, point of connection and District lateral is required prior to clearance for City of Cupertino Final Inspection. Owner to call District at least 48 hours prior to video inspection to schedule a District Inspector. District to provide Building Department with written notification upon completion of inspection. (0. C. 5104) SUPPLYING SANITARY SEWERAGE SERVICES FOR: CITY OF CUPERTINO, PORTIONS OF THE CITIES OF SARATOGA, SUNNYVALE, LDS Atios AND SURROUNDING UNINCORPORATED AREAS Page 2 Subject: 2- Story SFDWL/Medical Offices (3 3 93 sf 1st/1853sf 2nd)—Approved Name: Shirley and Ding Long Residence Address: 10049 Imperial Avenue, Cupertino APN: 357-17-013 Permit No. 14020106 and 14020107 Other: All photographic processing fluids and chemicals shall be containerized for "off-site" disposal. Storm water from surface or roof drains, other general surface runoff water or condensate from any residential HVAC equipment shall not be discharged to the sanitary sewer. All conditions, requirements and recommendations are to be completed at the (owner/developer)'s expense. Yours very truly, MARK THOMAS & COMPANY, INC. District Manager -Engineer IWC Richard K. Tf aka If you have any questions or need additional information, please call Thanh Nguyen at 408- 253-7071. U:%Adminisu•ationlCorrespoizdence - GenerakLetters120151Leuer � 15-044 Cupertino Building Department 140201 D7_SFDW L 10049 Imperial Avenue—Sub 2_Approved 2-18-15.dor SUPPLYING SANITARY SEWERAGE SERVICES FOR: CITY OF CUPERTINO, PORTIONS OF THE CITIES OF SARATOGA, SUNNYVALE, LOS ALTOS AND SURROUNDING UNINCORPORATED AREAS FIRE DEPARTMENT VT1R U `;4 SANTA CLARA COUNTY 14700 Winchester Blvd., Los Gatos, CA 95032-1818 (408) 378-4010 • (408) 378-9342 (fax) • www.sccfd.org PLAN REVIEW COMMENTS Plans and Scol2e of Review: PLAN REVIEW No. 14 0436 BLDG 14020106 PERMIT No. This project shall comply with the following: 1. The 2013 California Building /Fire Codes {CBC / CFC), as adopted by the City of Cupertino. The scope of this improvement project includes the following: Construct single family dwelling residence on the 2nd floor of a mixed use building. The single family dwelling residence will have 1,853 s.f. living area on the 2nd floor and 440 s.f. residential garage on the 1st floor. Plans are approved, subject to comments that follow. Plan Review Comments: Comment #1 The building shall be provided with an automatic fire extinguishing system in accordance with the City of Cupertino Municipal Code, section 903.2. Sprinkler control valves shall be located to allow control of the sprinkler riser from outside the building. Submit shop drawings (3 sets) and a permit application to the Fire Prevention Division for review and approval before installing the system. Call :(408) 378-4010 for more information. NOTE: The 1st story of this mixed use building will be of commercial use, requiring a fire sprinkler system in accordance with NFPA 13. Comment #2 On the "Section A --A" on sheet A4.0, the floor between "Commercial areas/spaces on the 1st floor" and the "Single family dwelling residence on the 2nd floor" is noted as "1 hr fire rated", as required under CBC #508.4 & Table 508.4. Indicate on drawings the corresponding "Item No." under CBC Table 721.1(3), or "UL File no." from UL Fire Resistance Directory, or "GA File no." from Gypsum Association Fire Resistive Design Manual that will be followed for construction of the indicated 1 hr floor system assembly". City PLANS SPECS NEW CUP M ❑ 0 RMDL AS ❑ ® OCCUPANCY B/R -3 CONST. TYPE V -B AppllcarotNams DATE Design Group 3/5/2014 PAGE 1 OF 2 SEC/FLOOR 2 Story AREA 2,293 s. E. LOAD PROJECT DESCRIPTION Residential Construction PROJECT TYPE OR SYSTEM New Structure NAME OF PROJECT MIXED USE & RESIDENTIAL LOCATION 10049 Imperial Av Cupertino TABULAR FIRE FLOW REDUCTION FOR FIRE SPRINKLERS REQUIRED FIRE FLOW @ 20 PSI BY Gilery 1 11O'brien, Organized as the Santa Clara County Central Fire Protection District Serving Santa Clara County and the communities of Campbell, Cupertino, Los Altos, Los Altos Hills, Los Gatos, Monte Sereno, and Saratoga 0,LARA Oo FIRE DEPARTMENT WIT"D U �,4 SANTA CLARK COUNTY 14700 Winchester Blvd., Los Gatos, CA 95032.1818 (408) 378-4010 • (408) 378-9342 (fax) * www.sccfd.org PLAN REVIEW No. 14 0436 BLDG 14020106 PLAN REVIEW COMMENTS PERMIT No. Comment #3 On sheet E-1.0, a "Furnace" will be installed under the exterior exit stair. Then, the space under the exterior stair shall be completely enclosed in 1 -hr fire--resistance-rated construction in accordance with CBC #1009.9.3. Indicate this on drawings. Comment #4 On sheet A-2.0, at the "Residence Garage" among column lines 1 & 2 and B & C, there is note stating: "When fire walls are required, the fire wall construction shall be completed immediately after the building is sufficiently weather protected at the location of the wall. CITY OF PALO ALTO 16.04.210". On the note indicated please remove "CITY OF PALO ALTO" and instead put "CITY OF CUPERTINO". Provide also the applicable code section from the "City of Cupertino Municipal Code". Comment #5 Approved numbers or addresses shall be placed on all new and existing buildings in such a position as to be plainly visible and legible from the street or road fronting the property. Said numbers shall :contrast with their background. tCFC/ 505.1] This review shall not be construed to be an approval of a violation of the provisions of the California Building or Fire Code or of other laws or regulations of the jurisdiction. CNy PLANS SPECS NEW RMDL AS I CUP ® ❑ N ❑ 19 OCCUPANCY BIR -3 CONST, TYPE V -B ApplinantName DATE Design Group 3/5/2014 PAGE 2 OF 2 SEC/FLOOR 2 Story AREA 2,293 s.f. LOAD PROJECT DESCRIPTION Residential Construction PROJECT TYPE OR SYSTEM New Structure NAME OF PROJECT MIXED USE & RESIDENTIAL LOCATION 10049 Imperial Av Cupertino TABULAR FIRE FLOW REDUCTION FOR FIRE SPRINKLERS REQUIRED FIRE FLOW @ 20 PSI BY O'brien, Gilery Organized as the Santa Clara County Central Fire Protection District Serving Santa Clara County and the communities of Campbell, Cupertino, Los Altos, Los Altos Hills, Los Gatos, Monte Sereno, and Saratoga July 31, 2014 Building Department City of Cupertino 10300 Torre Ave. Cupertino, CA 95014 Attn: Sue Winslow Re: Building Permit #14020106 T M Brown Consulting Real Estate Development 10491 Scenic Blvd. Cupertino, CA 95014 r l� Please provide an extension of time to reply to Pian Check for the above referenced Building Permit application. Reasons for the request are as follows: 1- The Civil Engineer of record, Nordic Engineering, ceased operation in April and I have had difficulty in acquiring corrected plans as requested. 2- The Architect of record, SC Designs, has encountered staffing problems..and has not been fully responsive to my repeated requests for corrected drawings. 3- 1 have encountered issues with the ownership of the adjacent property owner who is required to sign a permit application as requested by Planning (Comment #1). raj Be assured that I am diligently trying to comply with all plan check requests and will resubmit as early as possible. Thank you for your consideration. Terry M. Brown (408) 691-3007 tbrown10400 2att.net CI`T'Y OF CUPERTINO ITEM 1 OF 2 PERMIT RECEIPT OPERATOR: sinew COPY it . 1 Sec: Twp: Rng: Sub: B1k: Lot: APN ......... 35717013.00 DATE ISSUED.......: 08/01/2014 RECEIPT #.........: BS000024182 REFERENCE ID it 14020106 SITE ADDRESS .....: 10049 IMPERIAL AVE SUBDIVISION ...... CITY CUPERTINO IMPACT AREA ...... OWNER ............: LONG DING-GWO AND SHIRLEY L ADDRESS 4921 PROCTOR AVE CITY/STATE/ZIP ...: OAKLAND, CA 94618 RECEIVED FROM ....: TERRY BROWN CONTRACTOR .......: TBD - TO BE DETERMINED LIC It 00096 COMPANY TBD - TO BE DETERMINED ADDRESS CITY/STATF/?lP TELEPHONE ........ FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW SAL 1ADMIN HOURS 1..00 45.00 0.00 45.00 - 0.00 1BCBSC VALUATION 300,000.00 12.00 0.00 0.00 12.00 1BCONSTAXR FLAT RA'T'E 1.00 652.28 0.00 0.00 652.28 1BSEISMICR VALUA'T'ION 300,000.00 30.00 0.00 0.00 30.00 1PLLONGR SQUARE FEET 2,293.00 321.02 0.00 0.00 321..02 1R3INSP SQUARE FEET 2,293.00 2549.75 0.00 0.00 2549.15 1R3PLNCK SQUARE FEET 2,293.00 2837.39 2837.39 0.00 0.00 TOTAL PERMIT ----------- 6447.44 ---------- 2837.39 ---------- ----------.._.. 45.00 3565.05 T M Brown Consulting Real Estate DeMopnicnl 10491 Scenic Blvd. Cupertino, CA 95014 July 31, 2014 Building Department City of Cupertino 10300 Torre Ave. Cupertino, CA 95014 Attn: Sue Winslow Re: Building Permit #14020107 C/ lyod-olp,�, Please provide an extension of time to reply to Plan Check for the above referenced Building Permit application. Reasons for the request are as follows: 1- The Civil Engineer of record, Nordic Engineering, ceased operation in April and I have had difficulty in acquiring corrected plans as requested. 2- The Architect of record, SC Designs, has encountered staffing problems and has not been fully responsive to my repeated requests for corrected drawings. 3- 1 have encountered issues with the ownership of the adjacent property owner who is required to sign a permit application as requested by Planning (Comment #1). Be assured that I am diligently trying to comply with all plan check requests and will resubmit as early as possible. Thank you for your consideration. Terry M. Brown October 29, 2014 A"�/ ,0 Please provide an additional extension for completing the plans for this permit. The / substitute Civil Engineer underwent emergency open-heart surgery on October 21st and will not be able to resume work for 6 weeks per his doctor's orders. Consequently we cannot respond to the plan check dated October 28, 2014. Thank you. (408)691-3007 �tbrown 10400( mIt.net ITEM 2 OF 2 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp; Rng: Sub: Blk: Lot: APN ........: 35717013.00 DATE ISSUED.......: 10/29/2014 RECEIPT #.........: BS000025112 REFERENCE ID # 14020107 SITE ADDRESS .....: 10049 IMPERIAL AVE SUBDIVISION ...... CITY .............. CUPERTINO IMPACT AREA ...... OPERATOR: suety COPY # : 1 OWNER LONG DING-GWO AND SHIRLEY L ADDRESS ..........: 4921 PROCTOR AVE CITY/STATE/ZIP OAKLAND, CA 94618 RECEIVED FROM TERRY BROWN CONTRACTOR .......: TBD - TO BE DETERMINED LIC # 00096 COMPANY ..........: TBD - TO BE DETERMINED ADDRESS ........... CITY/STATE/ZIP ... TELEPHONE ........ FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAIL 1ADMIN HOURS 2.00 90.00 45.00 45.00 0.00 1BCBSC VALUATION 180,000.00 8.00 0.00 0.00 8.00 1BCONSTAX FLAT RATE 11540.00 4358.20 0.00 0.00 4358.20 1BMINSP FLAT RATE 500.00 1042.00 0.00 0.00 1042.00 1BMPLNCK FLAT RATE 500.00 6092.00 6092.00 0.00 0.00 1BOINSP FLAT RATE 1,040.00 1832.74 0.00 0.00 1832,74 1BOPLNCK FLAT RATE 1,040.00 5.809.38 5809.38 0.00 0.00 lBSEISMICO VALUATION 180,000.00 37.80 0.00 0.00 37.80 1PLLONGC SQUARE FEET 1,540.00 431.20 0.00 0.00 431.20 TOTAL PERMIT 19701.32 11946.38 45.00 7709.94 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER CREDIT CARD 90.00 VISA PRMT EXT FEE TOTAL RECEIPT --------------- : 90.00 T M Brown Consulting Real Estate Development 10491 Scenic Blvd. Cupertino, CA 95014 February 17, 2014 Building Department City of Cupertino 10300 Torre Ave. Cupertino, CA 95014 Attn: Sue Winslow Re: Building Permit #14020106 Please provide an extension of time to reply to Plan Check for the above referenced Building Permit application. Reasons for the request are as follows: The Architect of record, SC Designs, continues to have problems and has not been fully responsive to my repeated requests for corrected drawings. Be assured that I am diligently trying to comply with all plan check requests and will have compliant plans as early as possible. Indeed, I plan to resubmit plans on February 18, 2015 and have been in discussions with the various departments and made additional revisions at their request. Thank you for your consideration, Terry M. Brown /1iioR��r�n�d��f (408)691-3007 thrown10400 a att,net Duerson Construction, Inc. 15559 Union Ave #240 Los Gatos, CA 95032. Re: Permit number 14020106. 10049 Imperial Ave. Date: 6/9/16 To whore it may concern, Due to a few architectural corrections the time between inspections has lapsed. Please Un expire so I can continue the building process. Thank you, 0 Colin Duerson. President T M Brown Consulting Real Estate Development 10491 Scenic Blvd. Cupertino, CA 95014 June 29, 017 To: City of Cupertino Building Department From: Terry M. Brown Re: Building Permit # 140206 /n) 21 t Please extend the above referenced building permit. We have been unable to complete due to difficulties surrounding the acquisition of easements from our neighbor to the North. The attorneys are working on itl /o C) �O�aq�7 (408)691-3007 tbrownl04OO@att.net