Loading...
13070152CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6657 CLIFFORD DR CONTRACTOR: DING'S CONSTRUCTION PERMIT NO: 13070152 OWNER'S NAME: KE LU AND ZHIYI HAN 4174 CRESTWOOD ST DATE ISSUED: 01 /I 7/2011 OWNER'S PHONE: 4088932567 FREMONT CA 94538 PRONE NO: 510- 676 -7853 ❑ LICENSED CONTRACTOR'S DECLARATION �7 BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class R/c taic. # 1 J/ Contractor D/aaS rV"5�'L/L Date r< / i `1- MECH RESIDENTIAL COMMERCIAL I hereby affirm th�Jat [ am licensed under the provisions of Chapter 9 JOB DESCRIPTION: CONSTRUCT A 498 SQ FT ADDITION WITH A 200 SQ PP (commencing with Section 7000) of Division 3 of the Business & Professions INTERIOR REMODEL. DEMOLITION OF EXISTING SHADE Code and that my license is in full force and effect. STRURE IN REAR YARD. STRUCTURE 1 4�e rctvf�rm under penalty of perjury one of the following two declarations: and'will maintain a certificate of consent to self - insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Sq. Ft Floor Area: Valuation: $88000 Section 3700 ofthc Labor Code, for the performance of the work for which this permit is issued. L n APPLICANT CERTIFICATION APN Number: 3692601 1.00 Occupancy Type: I c r tha 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 PERMIT EXPIRES IF WORK IS NOT STARTEI) indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE, OR =ranting of this permit. Additionally, the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Q l L ! Signature Date O oZ � � "�" Issued by: E� // N f^ T C Date: ❑ OWNER - BUILDER DECLARATION RE- ROOFS: I hereby affirm that 1 am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed. If a roof is the following two reasons: installed without first obtaining an inspection, I agree to remove all new materials far I, as owner of the property, or my employees with wages as their sole compensation, inspection. will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) Signature of Applicant: Date: 1. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044. Business & Professions Code). ALL ROOF COVERINGS TO BE CLASS "A" OR BF: CTER 1 hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self- insure for Worker's HAZARDOUS MATERIALS DISCLOSURE ! Compensation, as provided for by Section 3700 of the Labor Code, for the 1 have read the hazardous materials requirements under Chapter 6.95 of the performance ofthe work for which this permit is issued. California rnia health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain I have and will maintain Worker's Compensation insurance, as provided for by compliance with the Cupertino Municipal Code, Chapter 9.12 and the Ilealth & Section 3700 of the Labor Code, for the performance of the work for which this Safety Code, Section 25532(x) should 1 store or handle hazardous material. I Additionally, should 1 use equipment or devices which emit hazardous air permit is issued contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued, I shall maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health & Safety Code, Sections 25505, 25533, and 25534. Compensation laws ofCaliforma. If, after making this certificate ofexemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must Ow or a hor'zed agebt: —] /0�11-11 forthwith comply with such or this shall be deemed revoked. Date: ( provisions permit 1 APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 1 certily that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued (Sec. 3097, Civ C.) to building construction, and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, Lender's Address costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply ARCHITECT'S DECLARATION with all non -point source regulations per the Cupertino Municipal Code, Section 9 18. I understand my plans shall be used as public records Signature Date Licensed Professional _ I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 6657 CLIFFORD DR NONTRXCTOR: DING'S CONSTRUCTION PERMIT NO: 13070152 OWNER'S NAME: KE LU AND ZHIYI HAN OWNER'S PHONE: 4088932567 LICENSED CONTRACTOR'S DECLARATION License Class Liic. #�/��7u1Ut73t�L Contractor D G 1 ) t ��S'T at iTlVe 01 I herebv 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. 1 hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self - insure for Worker's . ompensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City ofCupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence ofthe granting ofthis permit. Additionally, the applicant understands and will comp) with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. W-2Signature Date _ ❑ OWNER - BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (See.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self - insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. 4174 CRESTWOOD ST 4 DATE ISSUED: 01/17/2014 FREMONT, CA 94538 j PHONE NO: (510) 676 -7853 JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL 0 CONSTRUCT A 498 SQ FT ADDITION WITH A 200 SQ FT INTERIOR REMODEL. DEMOLITION OF EXISTING SHADE STRUCTURE IN REAR YARD. REVISION #1: REMOVE FRONT DORMER AND (2) BAY WINDOWS ON RIGHT ELEVATION.RE -ROOF (E) 14 SQ'S - ISSUED 10/14/14 Sq. Ft Floor Area: j Valuation: $88000 APN Number: 3692601 1.00 1 Occupancy Type: 1 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR �rlsL'E INSPECTION. d b Date: RE- ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should 1 store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sectigns 25550/5,�2555y3�3, air d 25534. Owner or authorized agent: �' Date: �6 ` CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Profess Kw CONSTRUCTION PERMIT (APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT1*_Vl18 l ,._ , 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 ' (408) 777 -3228 • FAX (408) 777 -3333 • building(@cupertino.org CUPERTINO ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI REVISION / EFERRED ORIGINAL PERMIT # v 3c) —o i PROJECT ADDRESS �/� ♦ / [� _ L _ s� i O J! OWNER NAME I PHONE �j E -MAIL STREET ADDRESS c. AJ ,/A�� CITY, STATE, ZIP FAX CONTACT NAME PHONE E -MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME i LICENSE NUMBER LICENSE TYPE BUS. LTC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP UQ E t� ARCHITECT/ENGrNEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK _ ✓ 12 4:5z P6 e "4rr 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 # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY E]YES BEING ADDED? E]NO ADDITION? []NO PRE - APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVE Y:. TOTAL V TI PLANNTNGAPPL# ONO PLANNING APPROVAL LETTER EICHLERHONIE? NO By my signature below, I certify to each of the following: 1 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 building constr ction. I authorize representatives of Cupertino to enter the above - identified property for inspection purposes. v SignatureofApplicant/Agent: Date: r7 SUPPLEMENTAL INFORMATION REQUIRED PLANCHECKTYPE � �.' -� —ROUTINGS, iP .- i>GOUNTER New SFD or Multifamily dwellings: Apply for demolition permit for _ existing building(s)- Demolition permit is required prior to issuance of building ovER su>LDmG Pt AN.R EVIEW permit for new building. ©.' EaPRESS` PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑'� °sTANnn�, ❑. puBLlCwoiucs form if any Hazardous Materials are being used as part of this project. ❑ ❑ LARGE,' PIREDEPT`.- _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑>+IAroa ❑ snNITARY submittal of Building Permit application. sEwERDISTRICT ❑ ;ENVIRON114ENTAI HEALTA BIdgApp_2011.doc revised 06121111 5Z CUPERTINO 'V CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 O'+ (408) 777 -3228 • FAX (408) 777 -3333 • building(DGUpertino.org U NEW CONSTRUCTION LN ADDITION U ALTERATION / TI U REVISION / DEFERRED ORIGINAL PERMIT # PROTECT ADDRESS 6/'5-7 , IVY- , APN # ^ 7-4, -3 6 OVVNERNAME I t 14A ZH P O�� .. —Z i6 E -MAIL STREET ADDRESS / OCC. /� CITY, STATE, ZIP EXISTG AREA NEW FLOOR AREA I& � CONTACT NAME TOTAL NET ARE4q PHONL5,1 O D E-MAIL / �+ STREET ADDRESS I j�7 I ^ N G., KITCHEN I OTHER � REMODEL AREA REMODEL AREA CITY, STATE, ZIP , p�( FAX ❑ OWNER ❑ OWNER - BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME —rD j/ j'1 LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ODETACH E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP ❑ ATTACH PHONE ARCFHTECT/ENGINEER NAME ^ u ,4 LICENSE NUMBER i O C•/ # DWELLING UNrfS: BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS 06 t er BEING ADDED? NO CITY, STATE, ZIP �,,. PHONE DESCRIPTION OF WORK _ �, r A _ / / / / ♦ _ / EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES I USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG AREA NEW FLOOR AREA I& � DEMO AREA TOTAL NET ARE4q V r , BATHROOM REMODEL AREA KITCHEN I OTHER � REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ODETACH ❑ ATTACH # DWELLING UNrfS: IS A SECOND UNIT ❑ YES SECOND STORY OYES BEING ADDED? NO ADDITION? [J NO PRE - APPLICATION OYES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑YES AEC TOTAL VALUATION. PLANNING APPL # ONO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I 14ve 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 construcitton'Jauthorize, ntatives of Cupertino o to enter the above - identified property for inspection purposes. n Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATIOX REQUIRED rl+tTETYPE RoitiNG &�P Cis ccl tTrR Q BUILDING PLAN i2Ei IOW New SFD or Multifamily dwellings: Appl for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. 0 ExrRRM Q PLA' NNNGPL" 1xEVIE'VV _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure rod NAARD' 1 �7 PV 1, WORKS form if any Hazardous Materials are being used as part of this project. d LARGE Pig- E im"T _ Copy of Planning Approval Letter or Meeting with Planning prior to MA3QR ❑ SA1ri1TAR'VSER'RRI7ISTRI�" submittal of Building Permit application. © EPiVIRONMENTAL IIPAT T'H`- B1dgApp_2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 6657 CLIFFORD DR DATE: 10/14/2014 REVIEWED BY: MELISSA APN: 369 26 011 BP #: 13070152 `VALUATION: Iso PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: Plan Check, Hourly ISTPLNCK PENTAMATION 1GENRES PERMIT TYPE: WORK REV # 1 -REMOVE FRONT DORMER & 2 BAY WINDOWS AT RIGHT ELEVATION. RE -ROOF E SCOPE 14 SQ'S TO MATCH ADDITION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Cff.' " 1.13) FEE QTY /FEE MISC ITEMS Plan Check Fee: Hourly Only? ® Yes Q No $0.00 2 hours $286.00 Plan Check, Hourly ISTPLNCK Suppl. PC Fee: (2) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 1,400 s.f. $238.00 Re -roof InEROOFnEs Permit Fee: $0.00 Suppl. Insp. Fee-Q) Reg. 0 OT F-01 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 F-T- 0 Work Without Permit? 0 Yes (D No $0.00 Advanced Plannin Fee: $0.00 -7 Select a Non - Residential 1 Building or Structure E) Stron�Z Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $Q.00 $524.00 TOTAL FEE: $524.00 Revised: 08/20/2014 FEW CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION i9iADDRESS: 6657 CLIFFORD DR DATE: 0712412013 REVIEWED BY: MELISSA PC FEE ID APN: 369 26 011 BP #: r' Spy. *VALUATION: 1$88,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: 2nd Unit? Yes .' No OTC. 0 Yes (F) No PENTAMATION 1 R3SFDADD PERMIT TYPE: WORK 498 SQ FT ADDITION TO CREATE 3 N BEDROOMS & 1 N BATHROOM. REMODEL 170 SQ FT SCOPE TO RECONFIGURE (E) FAMILY RM & (E) BDRM OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA 01) . PC FEES PC FEE ID BP FEES BP FEE ID R -3 (Custom) II- B,111- B,IV,V -B 498 $1,579.00 IADDPLCK $1,284.00 IADDINSP PME Plan Check: $0.00 Permit Fee: $1,284.00 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 498 $1,579.00 $1,284.00 LEC, HOURLY'! HOURLY, M i ®Yes Q Na (' .. ..�L, E17- El iFJtf'i .i `. .. i z'c; CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014 -3255 Telephone: 408 - 777 -3228 Fax: 408 - 777 -3333 JOB ADDRESS: PERMIT #_/ r� OWNER'S NAME: PHONE # GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: CITY /ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CU RTINO BUSINESS LICENSE. o20 i I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: Owner / Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date