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B-2016-2417CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2417 10349 DENISON AVE CUPERTINO, CA 95014-2428 (316 29 053) IHOME CONSTRUCTIONS INC LOS ALTOS, CA 94024 OWNER'S NAME: YANG TA-KUAN AND HUANG YUAN -CHI DATE ISSUED: 10/24/2016 OWNER'S PHONE: 650-741-8198 PHONE NO: (4Q8) 332-8958 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class f3 Lie. #966862 Contractor (HOME CONSTRUCTIONS INC Date 10/31/2017 X BLDG X ELECT X PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing X MECH X RESIDENTIAL — — COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: f ADDITION (1,041 SF); REMODEL (1,355 SF); (I) REAR AND FRONT I hereby affirm under penalty of perjury one of the following two declarations: COVERED PORCH (141 SF); (I) WATER HEATER; (I) FURNACE; i. I have and will maintain a certificate of consent to self -insure for Worker's UPGRADE ELECTRICAL PANEL TO 200 AMP. Compensation, as provided for by Section 3700 of the Labor Code, for the REV #1 - REVISE ROOF AND FRAMING PLAN - ISSUED 1/11/17 performance of the work for which this permit is issued. REV #2 - REVISE CEILING FRAMING IN GARAGE (446 SF) ISSUED 6q I have and will maintain Worker's Compensation Insurance, as provided for by 2/15/2017 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Floor Area: 1041 Valuation: $358900.00 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 APN Number: Occupancy Tyke: and state laws relating to building construction, and hereby authorize 316 29 053 Deferred Submrttal (R -3),R-3 (Custom) 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit.. Additionally, the applicant understands and will comply with all non -point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST (CALLED INSPECTION. Signature ff_l,(2ZLL8 /44�_ Date 02/15/2017 Issued by:�bl�A�ead� OWNER -BUILDER DEC IONi Date: 10/24/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the RE ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is 1. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for insp Iction. sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature ofApplicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 02/15/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1. 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. HAZARDOUS MATERIALS DISCLOSURE i. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will Section 3700 of the Labor Code, for the performance of the work for which this maintain compliance with the Cuper ' to Municipal Code, Chapter 9.12 and the permit is issued. s. I certify that in the performance of the work for which this permit issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous shall not employ any person in any manner so as to become subject to the t material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of Area will maintain compliance with the CupeIrtino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Sections '25505,25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall % be deemed revoked.',. -'Owner or authorized agent: C APPLICANT CERTIFICATION Date: 02/15/2017 1 certify that I have read this application and state that the above information is CONSTRUCTION LE Y correct. I agree to comply with all city and county ordinances and state laws 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.) relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal ARCHITECT'S'DECLARATION Code, Section 9.18. 1 understand my plans shall be used as public records. I Licensed ,Signature Date 02/15/2017 Professional ❑ NEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DiVr1J[a: 11S1,0N 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a1cupertino.org ❑ ADDITION ❑ALTERATION / TI 5 Bldgt4pp_2011.doc revised 06/21/11 i i REVISION EFERRED ORIGINAL PERMIT # PROJECT 2 L 2RES 1DQ1 p--' MIR. /w S° /g I O NA E -MAH. r STREET ADDRESS CITY, STATE, ZIP F AJ 11 i CJE CO ACT AME PHONE -MAIL STREET ADD S :V0:'Je CITY, STAT , ZIP Y h I ❑ OWNER ❑ OWNER-BUH,DER ❑ OWNERAGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT NTRA TO NAME LICE 'S�( R �G LICEN E TYPE BUS. LIC # CO AN�q,Y� NAME ®'"lam �X LAL- A5 E IL FAX I I A E� STREET ADDRESS CITY, STATE, ZIP HONE �'��l r v�—�3�0 T ARCHITECT/EN'GMER NAME LICENSE NUMBER BUS. LIC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE_ DESCRIPTION OF R%ORK y i.I M �, A / YGt W C� i i i EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($; EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA � BATHROOM KITCHEN OTHER .REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH i # Dl6'ELLING UNITS:IS A SECOND UNIT E] YES SECOND STORY E] YES - BEINGADDED? []NO ADDITION? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? ❑ NO RE D $Y: TOTAL VALUATION: 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 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 relating to b ' ding^ construction. I author} representatives of Cupertino to enter the above -identified property for inspection purposes. Signature ofApplicant/Agent / D SUPPLEVENTAL INFORMATIMIREQU i TYPE I I A cicx RoilTuvc siaP New SFD or Multifamily dwellings: Apply for demo/litnpermit forOVER TIt> COUIVTER uryDING rL�IvRESnEv4>existing building(s). Demolition permit is required prior tance of building 1 permit for new building. ❑ - EXPRESS PiA \NTNG PIAN REa IEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ •>;UBLIC �VQRKS form if any Hazardous Materials are being used as part of this project. Q LARGE ❑FIRE D> Pr Copy of Planning Approval Letter or Meeting with Planning prior to MnaoR, ❑ SANITARY SEWER niSTRICT submittal of Building Permit application. EIC IRONAIENTAL HEALTH -- - Bldgt4pp_2011.doc revised 06/21/11 i i CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2417 10349 DENISON AVE CUPERTINO,CA 95014-2428(316 29 053) HOME CONSTRUCTIONS INC LOS ALTOS,CA 94024 OWNER'S NAME: YANG TA-KUANAND HUANG YUAN-CHI DATE ISSUED:10/24/2016 OWNER'S PHONE:650-741-8198 PHONE NO:(408)332-8958 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class Lic.#966862 • Contractor IHOME CONSTRUCTIONS INC Date 10/31/2017 X BLDG X ELECT X PLUMB X MECH X 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: ADDITION(1,041 SF);REMODEL(1,355 SF);(N)REAR AND FRONT I hereby affirm under penalty of perjury one of the following two declarations: COVERED PORCH(141 SF);(N)WATER HEATER;(N)FURNACE; 1. I have and will maintain a certificate of consent to self-insure for Worker's UPGRADE ELECTRICAL PANEL TO 200 AMP. Compensation,as provided for by Section 3700 of the Labor Code,for the G REV#1-REVISE ROOF AND FRAMING PLAN-ISSUED 1/11/17 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. Sq.Ft Floor Area:1041 Valuation:$358900.00 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 316 29 053 Deferred Submittal(R-3),R-3(Custom) 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. 'WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature-//34-if ilk Date 01/11/2017 Issued by:MELISSA NAMES Date: 10/24/2016 OWNER-BUILDER DELL TION v I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:01/11/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. 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. HAZARD US MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safe Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with t e Cupertino Municipal Code,Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Se tion 25532(a)should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally,sho d I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance wi h the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safe Code,Sections 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized age t: APPLICANT CERTIFICATION Date:01/11/2017 v I certify that I have read this application and state that the above information is N - correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is:construction lending agency M.P.a performance relating to building construction,and hereby authorize representatives of this city of work's for which this per it is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands I TECT'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. SiSignature Date 01/11/2017 Licensed g Professional B.-ILS, 2.(4 - \ / Nstly . CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISIO ' B ::: 4 .as 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 ' CUPERTINO (408)777-3228•FAX(408)777-3333•buildings cupertino.orq 1p f ) I _l�V EI NEW CONSTRUCTION El ADDITION DI ALTERATION/TI IREVISION/DEFERRE I ORIGINAL PERMIT# PROJECT ADDRESS i .....>4... G ;Den �R tl l(IPJ APN#. OWNER NAMETpi - /'0 . 1 !1 i. .. PHONE 4I ' i; r -MAIL, nCt�t Gl i, ®fig GI�a ,l r3 I `Y d STREET ADDRESS CITY, STATE,ZIP ���F� •t WOi CA f0$ FAX CONTACT NAME / PHONE ' � STREET ADDRESS DIIIIMIIIIME ❑OWNER 0 OWNER-BUILDER ❑ OWNER AGENT g CONTRACTOR ❑CONTRACTOR AGENT I❑ ARCHITEC L 0 ENGINEER 0 DEVELOPER 0 TENANT CONTRACTOR NAME '•LICENSE LICEN 'E BUS.LIC# 1 -,� c '-ii 3-- COMPANY NAME ` g E- • L /y/3 O 9 FAX . 11111111 ST' 'T ADDRESS CITY,STATE,ZIP PHONE ..L0RE-z iN ` a Et a --r t N o .6,- "i '5---0 t Hca, 3 _,11,,,...r? ? ARCHITEC /ENGINEER NAMEBUS.LIC#, 71/7 '' 0 IBM MI= COMPANY NAME E-MAIL jj FAX ' ,, A 5S1C9C TSS 11 0 ‘2'' .12-- i,AIM STREET ADDRESS CITY,STATE,ZIP � PHONE ->-2:- g 1 ., 0 O . `/5 /V* v L '� 'P .A !'0 C ,4 ..g. . .. C408,4.4- I. A DESCRIPTION OF WORK / (irami'7 p/Ai,-- Mi. EXISTING USE PROPOSED USE CONSUL TYPE #STORIES TYPE ' OCC. SQ.FT. VALUATION($) ARNEWFLOOR DEMOTOTAL I- AREAEA AREA AREA NET AREA BATHROOM KITCHEN OTHER I-- REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTALDECK/PORCH AREA GARAGE AREA: ■DETACH I-- ❑ATTACH #DWELLING UNITS: IS GADDEUNTd' ❑NOS SECOND STORY 0 YES _ I -_ BEINGADDED? 0 N ADDITION? 0 N PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN 0 YES ' CEIVED BY: TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ONO l / ..62 '1 acv A By my signature below,I certify to each of the following: I am the property owner or authorized agent o act o r the pr•perty 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 relating to building construction. I authorize representatives of Cupertino to enter the above-id entified property for inspection purposes. Signature of Applicant/Agent: %,... R :,„„,-Ar„„*„... im Date: //'a I SUPPLEMENTAL INFORMA ION RE" IRED PLAN CHECK TYPE 1 ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OYER-THE-CouNTl x © BUILDING PLA y REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. 0 EXPRESS ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to 0 MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. 0 ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO BUILDING PERMIT 1 BUILDINGADDRESS: CONTRACTOR: PERMIT NO: B-2016-2417 10349 DENISON AVE CUPERTINO, CA 95014-2428 (316 29 053) ]HOME G CONSTRUCTIONS INC LOS ALTOS, CA 94024 OWNER'S NAME: YANG TA-KUAN AND HUANG YUAN -CHI DATE ISSUED: 10/24/2016 OWNER'S PHONE: 650441-8198 PHONE NO: (408) 332-8958 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. #966862 Contractor IHOME CONSTRUCTIONS INCDate 10/31/2017 X BLDG X ELECT X PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing X MECH X RESIDENTIAL _ COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: ADDITION (1,041 SF); REMODEL (1,355 SF); (N) REAR AND FRONT I hereby affirm under penalty of perjury one of the following two declarations: COVERED PORCH (141 SF); (I) WATER BEATER; (1) FURNACE; i. I have and will maintain a certificate of consent to self: insure for Worker's UPGRADE ELECTRICAL PANEL TO 200 AMP. 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 �,�_S.tion 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Floor Area: 1041 Valuation: $358900.00 APPLICANT CERTIFICATION 1 certify that I have read this applicationand state that the above APN Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 316 29 053 Deferred Submittal (R -3),R-3 (Custom) 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulatio s per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. 'Signature ' i` Date 10/24/2016 Issued by: Abby Ay ende / OWNER -BUILDER DEC Date: 10/24/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS- F ROOFS:following followingtwo reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is 1. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Scc.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature ofApplicant: contractors to construct the project (See.7044, Business & Professions Code). Date: 10/24/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1. 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. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 3. 1 certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally, should I use equipment or devices which emit hazardous Worker's Compensation laws of California. If, after making this certificate of air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the ' the Health & Safety Code, Sections 25505, 25533 25534. Labor Code, I must forthwith comply with such provisions or this permit shall /� iJ be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION t Date: 10/24/2016 I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct. I agree to comply with all city and county ordinances and state laws 1 hereby affirm that there is a construction lending agency forhe performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 10/24/2016 Professional CUPERTINO 1 I 1 VMV ('nI TQTDT7f1'r7n1,T CONSTRUCTION PEP PPLI ATION COMMUNITY DEVELOPMENT DEPP' 3 AIENT * BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (409) 777-3333 • bui_ lding0cl,ARestino,ora rt/-',,," xr n — ---- - u nnva,3iVlvrLr,5+�1CR4G1J VYU ANALFbK.MATA rrtOJFC`i-ADURE5S 7 ^� -d i1 4 aFP "" — OWNER NAMr PHONE / y-' _ E-MAIL to 't{fisn r�}4vooC S'i'It&H'rADI)RESS��� ` of. 45b QCONTACT CrrY; gTATT,fPqq J� FAX NAME PHONE E-MAIL f STREETADbp.ESS CITY, STATE TP FAX OWNER l OWNLR-BUL.DtR OWNFRAGENT CONTRACTOR ❑CONTRACTORAGENT VAlkCRITBCT FNG11*1FFR ❑ DEVELOPER El TENANT CONTRACTOR NAMEVJR . � l LICENSE U ER LICENS TYPE RUS, 1.,1C+1 PANIYNAME E-MAIL. } FAX sTR�� r•,r,-,TADDRESS C � CITY, STAT P7E p ARC'I nTE /ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E -MAST. FAx 5'rREET ADDRESS CITY, STATE, LIP PHONE DEWRIPTION Or WORK 111XISTJN0 Use PROPOSED USE CONSTR. TYPE N 5TOIZIF-5 J USP: TYFE occ. 77 I SQ -FT. VALUATION (g) r,N]STO NrW PLOOR 1713MO .1RIA � AREA AREA TOTAL NET AREA I'1.1'rI i a 0 0 M KITCHEN OTHER - - REMODELARE.A l RRMODFI; AReA t ,, u,F'MOAEI,AREA l f6&TACH ' l P PORCTi AREA r1r.OK ARTA TOTAL DFCK1PORCi•I ARF- C,ARAOF,. AREA,: TTA C.'i '.DWELLING1JNtx5: "SECQNIRS-- l TSA SECOND UNIT ❑YEs 6F,rNy ADDED)? ONO ADDITION? []NO 15 TTIE BLDG.AN 1:1 YRS EICHLERROME? [Np RF_CEI V$D 13Y: TOTAL VALUATION: PItE.APPLICATiON Q YF,.S IP YES. PROvIOE S.()PY OF PLANINQAPPI,# NO PLANNING APPROVALT,ETTFR By my signature below, I certify to each of the Following: I am r properly owner or authorized agent to act on the property owner's behalf i have read this upplivation and the information 1 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 relating to lsui[dtn comtriActlori. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applican2aI Date: -JL4 SUPPLEMENTAL INFORMATION REQUIRED ]PLAN CXT9CK TVFF a ROUTING e4TA ❑ OVER_TEW CIDUNTETt © 91JILVIATG REVIEW New SFD or Multifamily dwellings; Avoly for demolition permit for existing building(s). Demolition permit is required prior to issuance of building YUAN permit for new building, ❑ F'xPR1ESS ❑ PLANfTINr, PLAN REVTEw _ Commercial Bldgs: Provide. a completed HaZardm Mhterials Disclosure ElSTANDARD ❑ PUBLIC WORKS Farm if any i-Iazar out Materials are being used as part of this project. ❑ LARcE ❑ FIRE AFFT Copy of Planning Approval Letter or Meeting with Planning prior to .Ublvlittal of I3uildit)g Permit application. ❑ IVAJ�' ❑ SANITARY SEWER Dr$TRTCT EN V JA0,NMUNTAL'R E A.LTH R(�,�Ap/9_,�t711.s�oc r-evir�d !16121/,(1 r' CAPEX ENGINEERING INC. PO BOX 14198, FREMONT, CA 94539 Tel: (510) 668-1815 Fax: (510) 490-8690 Building Department City of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3232 Subject: Dear Sir: Project No. 10739 November 15, 2016 Proposed One -Story Addition at 10349 Denison Ave. Cupertino, CA SPECIAL INSPECTION FINAL AFFIDAVIT FOR DOWELS INSTALLATION WITH EPDXY CAPEX ENGINEERING INC., has provided testing and special inspection services at the subject site in accordance with section 1704A of the California Building Code (2013 Edition) as listed below: (1) Inspection of #4 x 6" min, embedment; dowels installation W/Epoxy for connecting new and existing concrete footings at specific locations. (2) The drilled hole for receiving dowels installation with Epoxy were cleaned of dust and debris and adequate in depth to embed into existing concrete. Personnel under the general supervision of a registered Civil Engineer performed this inspection. Based on the inspections performed and upon our substantiate reports that the inspected work was performed, to the best of our knowledge, in conformance with the approved plans and specifications and the applicable workmanship provisions of the California Building Code. Sincerely, C/APEX ENGINEERING INC., Gary su, P.E Principal ac E1 jp Y 4 CAPEX ENGINEERING INC. PO BOX 14198, FREMONT, CA 94539 Tel: (510) 668-1815 Fax: (510) 490-8690 Building Department City of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3232 Proposed One -Story Addition at 10349 Denison Ave. Cupertino, CA SITE DEMOLITION AND BUILDING PAD GRADING OBSERVATION REPORT Subject: Dear Sir: r Project No. 10739 November 15, 2016 CAPEX ENGINEERING INC., has provided observation service for site demolition, primary and final grading of building pad. On the basis of our observation and testing, we concluded building pad, compaction operation was performed in general accordance with recommendation of soil report and compacted to a minimum of 90% relative compaction. If you have any questions, please contact our office at your convenience. Sincerely, CAPEXINEERING INC., Gary/Hsu, P.E Principal CAPER ENGINEERING INC PO BOX 14198, FREMONT, CA 94539 Tel: (510) 668-1815 Fax: (510) 490-8690 Building Department City of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3232 Subject: Proposed One -Story Addition at Dear Sir: F L Project No. 10739 November 15, 2016 10349 Denison Ave. Cupertino, CA FOOTING EXCAVATION (GRADE BEAMS & SPREAD FOOTINGS) AND PREPARATION OBSERVATION REPORT CAPEX ENGINEERING INC., has provided inspection service for footing excavation and preparation. Footing depth and width were excavated adequate in accordance with approved foundation plan and specifications. The exposed soil conditions of excavated foundation are beyond design bearing capacity and acceptable. Any questions, please call our office at your convenience. Sincerely, C PEX GINEERING INC., Gary su, P.E Principal NO, CC W mum Ni CTI., ENGINEERING, INC. P. -0. BOX 12468, PLEA ANTON CA 94588-2468 October 20, 2016 City of Cupertino — Building Division 10300 Torre Avenue, Cupertino; CA 95014 Re: Construction Staking at 10349 Denison Avenue, Cupertino CA 95014 This letter is to confirm in writing that CTL Engineering, Inc. has checked the foundation staking for the remodeling work at the subject site. The foundation staking have been placed with the plans approved by the City horizontally. The following are the setback checks: Front Setback: 20.00' Calculated Actual Setback: 20.00'. Left Side Setback: 6.00' Calculated Actual Setback: 6.00'. Right Side Setback: 9.00' Calculated Actual Setback: 9.00'. Rear Setback: 20.00' Calculated Actual Setback: 24.0' +/ Note: All horizontal dimensions are given to the nearest 0.05 feet. If you have any questions, please contact me at 925 998-6301. Sincerely; H. P. Tang, PE Attachments I -41) x X S 89* 17, 001, xw x x 101,6700 FT INTERSECT N - 69*17'00" W 7475 A --7 = ._uv ff b FT C->- 00 S 89*17'00" W 101,6700 FT 33-0 RP'OFFSET I RP5 OFFSET gP6 OFf 5Q7OFFSET 2-T 2 OFFS[ OFF', L 4.0(.b ¢4—"tI F I L '55 Insulation Crtific t Nv,inierand Rreet W Cite C, ztP Subdivision Lot Number ROOF Material Thickness (inches) CEILING Batt or Blanket Type EIBERt SI ASS Thickness finches) -- Loose l i(I l e EIBERGi ASS Contractor's minimsminirnum installed weightfft= Brand Maine Therrrmat Resistance stance f RA"aloe) Brand Name —JOHNS I`tA `d YTI I F Thermal Resistance (R -Value) Brand Name —JOHNS_ kTANVILLE Minirnuen thickness Manufacturer's installed weight per square f€acct to achieve,-,,,,. ....... ..Thermal Resistance (f2-N'aluc) EXTERIOR WALL Material FIBERfi SS Thickness (inches) RAISED FLOOR Material Thickness (inches) SLAP FLOOR Material — Thickness (inches) Width. (inches) FOUNDATION WALL Material Thickness finches) _ inches Brand Name JOHNS M 'ti ff' i I - Therarmal Resistance (R -Value) - _. Brand _\pante JOHNS MANYll-LF Thermal Resistance (R. -Value) J :Brand Name Thermal. (Resistance (R -value) Brand Name Thermal Resistance (R -Value) Declaration I hereh} certifv that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency ,Standards for new residential buildings contained in Title 24 of the California Administrative Code. C,, ra!Contractor(Eimden Si�mna:,are and Title Ponzini Insulation, Inc. S " ICa —nm"a natur rid Title POSED J 1Y 2G?5 License Mimbar Date 635993 License -Numbtr Date Feb. 20, 2017 To: Building Inspector City of Cupertino 10300 Torre Ave. Cupertino, CA 95014 (Re: Final framingnspection 10349 Deniso Ave. Cup i 0) , C Cupertino., C 95014 FILE Dear Building Inspector, I have a final review the framing work at the job site of 10349 Denison Ave. on Feb. 20, 2017. 1 found the -final framing works comply with approved plans. Should you have question, please contact me at 408-446-8418. Sincerely, Mikn, Architect H M C. ss H.M.C. ociates, LLP 12280 Saratoga -Sunnyvale Rd. #20 Saratoga, CA 95070 San Juan Bautista, CA 95045 Contractor's License #635993 Office: 831-623-2212 Fax: 831-623-4704 Insulation Certificate ,10349 DENISON AVE CUPERTINO Numb& and Strees City County SuRivislan Lot Rumber Ceiling Batt or Blanket Type- F13ERGLASS Thickness (inches). 1211 Spray Foam Type: Loose Fill Type. Installed weight/fl:2- Description of Installation Brand Name- John's Manville Thermal Resistance (R -value)- 38 Brand Dame: Minimum Thickness (inches) - Thermal Resistance (R -value): Exterior Wall Material: FIBERGLASS Brand Name: John's Manviliq Thickness (inches): 3.5" Thermal Resistance (11 -value): is Raised Floor Material. FIBERGLASS 6.5" Thickness (inches): Brand Name: John's Manville Thermal Resistance (R -value)- 19 �rYYYYrYYIY .. Declaration: I hereby certify that the above insulation was installed in the building at the above location in conformance with the currrent Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Administrative Code, Genef-373—ntraFtor ulrderl gignature Ponzini Insulation, Inc. SuW--Co-6tractoF 9sulFtlon installer) M Cchae�& P&n4,.C*v ignature Ocense Number ate 635993 ricense Number 3/6/2017 Date CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 103.00 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: 1,034 ; De PERMIT # OWNER'S NAME: (/►'`j6P/Lr, rokyll PHONE' # 9S-0 - % —,?/ � GENERAL CONTRACTOR: Co y,,fi`, BUSINESS LICENSE # ADDRESS:/ �j �, ' / CITY/ZIPCODE: !��icl G' your 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 Date Please check applicable subcontractors and complete the following. information: ✓ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork r if►�l/ C��p�„Q!� %7 / 1 ✓ Cement Finishing Com- u , p,J Electrical e Excavation CSN C �,vr Fencing " Flooring / Carpeting Gt, �:(G&✓> Linoleum / Wood Glass / Glazing Heating 1) w Gc—, 66 6 Insulation = 2 '� , l�S� e,7 c , (� v c �Dl off, Landscaping A1 Qh ds-g Lathing eo - 4P 31 Masonry %? aL/ /.4/ 2 � Painting./ Wallpaper V14iLCA 'CdA/S'j%UL /"c&/ 34La �-O ZC/ Paving of ,, S cap >> 3 3 � �a Plastering o Plumbing Roofing 1Z �� bC) / Septic Tank Sheet Metal v � � VO c)& Sheet Rock Co .� n o f " Tile--� -0 �Y ✓ Owner / CoiffrActor Signa re Date Mi4 Prn CERTIFICATE OF VERIFICATION �17 7 CF3R-MCH-20-H Duct Leakage Diagnostic Test /P-agEP"C Project Name: Yang Reside ce Enforcement Agency: City of Permit Number: B2016-2417 Cupertino Dwelling Address: 10349 Denison Ave City: Cupertino Zip Code: 95014 A.System Information 01 Space Conditioning System Identification or Name System 1 02 Space Conditioning System Location or Area Served Whole house 03 Building Type from CF-1R Single family 04 Verified Low Leakage Ducts in Conditioned Space No,credit is not taken (VLLDCS)Credit from CF1R? 05 Verified Low Leakage Air Handling Unit(VLLAHU)Credit No,credit is not taken from CF1R? 06 Duct System compliance Category New MCH-20a-Completely,New Duct System , 13 0 •B. Duct Leakage Diagnostic Test 01 Condenser Nominal Cooling Capacity(ton) 4 02 Heating Capacity(kBtu/h) 78 03 Conditioned Floor Area served by this HVAC system(ft2) 2396 04 Duct Leakage Test Condition Test final 05 Duct Leakage Test Method Total leakage 06 Leakage Factor 0.06 07 Air.Handling Unit Airflow(AHUAirflow) Determination Heating system method Method 08 Measured AHUAirflow This field or section is not applicable 09 Calculated Target Allowable Duct Leakage(cfm) 102 10 Actual duct leakage rate from leakage test measurement 97 (cfm) 11 Compliance Statement System passes leakage test Registration Number:216-N0283586A-M2000002A-M20A Registration Date/Time: 2017-08-10 12:19:36 HERS Provider:CaICERTS CA Building Energy Efficiency Standards Report Version:2013 Rev 1.008 Report Generated:2017-08-08 22:09:27 2013 Residential Compliance Schema Version:2013.1.007 �{LN4 ,t• Y1's'f'. CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 2 of 3) B. Duct Leakage Diagnostic Test 12 Notes C.Additional Requirements for Compliance 01 System was tested in its normal operation condition. No temporary taping allowed. Outside air(OA)duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage 02 testing.OA ducts used for Central Fan Integrated(CFI) Indoor Air Quality ventilation systems,or Central Fan Ventilation Cooling Systems,that utilize dampers that open only when OA is required and automatically close when OA is not required, may configure the OA damper to the closed position during duct leakage testing. 03 All supply and return register boots were sealed to the drywall. 04 Building cavities were not used as plenums or platform returns in lieu of ducts. 05 If cloth backed tape was used it was covered with Mastic and draw bands. 06 All connection points between the air handler and the supply and return plenums are completely sealed. Visual Inspection at Final Construction Stage(applicable,if system was tested at rough in) After installing the interior finishingwall and°verifyingthat the above rough in tests was completed,the following procedure must be performed :, ,;. £Y €, r 07 For all supply and return registers;verify that thd.spaces between the register boot-and the interior finishing-wall are properly sealed. 08 If the house rough-in duct leakage test was conducted without an air handler installed,inspect the connection points between the air handler and the supply and return plenums to verify that the connection points are properly sealed. 09 Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used. 10 Verification Status Pass 11 Correction Notes for this table The responsible persons signature on this compliance document affirms that all applicable requirements in this table have been met unless otherwise noted in the Verification Status and the Corrections Notes in this table. D. Determination of HERS Verification Compliance All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order for this Certificate of Verification as a whole to be determined to be in compliance. 01 Complies:All specified verification protocol requirements on this document are met. Registration Number:216-N0283586A-M2000002A-M20A Registration Date/Time: 2017-08-10 12:19:36 HERS Provider:CaICERTS CA Building Energy Efficiency Standards Report Version:2013 Rev 1.008 Report Generated:2017-08-08 22:09:27 2013 Residential Compliance Schema Version:2013.1.007 CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 3 of 3) Documentation Author's Declaration Statement • 1. I certify that this Certificate of Verification documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Minxuan Liu /it.4a 2/fi fi Company: Date Signed: Bay Area Energy Consultants 2017-08-10 12:19:36 Address: CEA/HERS Certification Identification(if applicable): 1181 Sundown Ln CC2006550 City/State/Zip: Phone: San Jose CA 95127 408-883-3865 Responsible Person's Declaration statement I certify the following under penalty.,,of perjury,under the laws of the State of California: 1. The information provided on this Certificate of Verification is true and correct. 2. I am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification(responsible rater). 3., The installed features,materials,components,manufactured devices,or system performance diagnostic results that require HERS verification identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2,RA3,and the requirements specified on the Certificate of Compliance for the building approved by the enforcement agency. 4. The information reported on applicable sections of the Certificate(s)of Installation(CF2R)signed and,subp tte'd':by the persons)responsible for the construction or installation conforms to the requirements'specified!on the Certificate(s),*Compliance(CEM.),approved by the enforcement'agency. 5. I will ensure that a registered copy.,of this Certificate of Verification shall be posted or made available with the building permit(s), ued issfs'r the building,and made available to the..enforcement agency for all applicable inspections un I derstand-that a registered;copy of=this',Certi„ficate of Verification is required to be included with the documentation the builder provides to the building owner at occupancy " '"' Builder Or Installer Information As Shown On"The Certificatez-Of Installation Company Name(Installing Subcontractor,General Contractor,or Builder/Owner): IHOMECONSTRUCTIONS INC Responsible Builder or Installer Name: CSLB License: HUEI-H WANG HUNG HERS Provider Data Registry Information Sample Group Number(if applicable): Dwelling Test Status in Sample Group(if applicable) Tested HERS Rater Information HERS Rater Company Name: Bay Area Energy Consultants Responsible Rater Name: Responsible Rater Signature: Minxuan Liu /Gfeetweadt<er Responsible Rater Certification Number w/this HERS Provider: Date Signed: CC2006550 2017-08-10 12:19:36 Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document,and in no way implies Registration Provider responsibility for the accuracy of the information. • Registration Number:216-N0283586A-M2000002A-M20A Registration Date/Time: 2017-08-10 12:19:36 HERS Provider:CaICERTS CA Building Energy Efficiency Standards Report Version:2013 Rev 1.008 Report Generated:2017-08-08 22:09:27 2013 Residential Compliance ' Schema Version:2013.1.007 -010 r6 - 02'�L7 CALGREEN SIGNATURE DECLARATIONS YangResidence c Project Name: =" Project Address: 10349 Denison Ave. F,-17--17 Q�G Project Description: Room expansion and remodeling of exist. house 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 2013 California Green Building Standards Code as adopted by the City of Cupertino. 07/27/2016 • Owner's Signature Date Vincent Yang Owner's Name (Please Print) 71107/27/2016 Design Professional's Signature Date H. Mike Chen Design Professional's Name (Please Print) 7y 07/27/2016 - Signature of License Professional responsible for CalGreen compliance Date H. Mike Chen 408-446-8418 Name of License Professional responsible for CalGreen compliance(Please Print) Phone hmikechen@gmail.com Email Address for License Professional responsible for CalGreen compliance SECTION 2 — IMPLEMENTATION VERIFICATION 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 2013 California Green Building Standards Code as adopted by the City of Cupertino. 7/1-1-4 �_�411 08/09/2017 Signature of License Professional:responsible for CalGreen compliance Date H. Mike Chen 408-446-8418 Name of License Professional responsible for CalGreen compliance(Please Print) Phone hmikechen@gmail.com Email Address for License Professional responsible for CalGreen compliance Page 5 of 5 CalGreen_2014.doc revised 01/15/14