14040088CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10438 N STELLING RD
CONTRACTOR: JOSHUA
PERMIT NO: 14040088
CONSTRUCTION & REMODELING
OWNER'S NAME: HONGQI HU
10613 GASCOIGNE DR
DATE ISSUED: 06/30/2014
OWNER'S PHONE: 4087253692
CUPERTINO, CA 95014
PHONE NO: (408) 725-3692
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL 0
CONSTRUCT (N) ATTACHED SECONDARY UNIT (525 S.F.)
License Class__ _ Lic. #_,4t 02, 6(MAIN
HOUSE BP # 14040087) (DEMO PERMIT #
' 6 (fie /
Contractor t fu � Date
14060104)
I hereby affirm that I am JicenCd un er the pr visions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
Sq. Ft Floor Area:
Valuation: $50000
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
APN Number: 32630096.00
Occupancy Type:
ermit is issued.
APPLICANT CERTIFICATION
1 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 F�ERMIT 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
YS FR CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of Ibis permit. Additionally, the applicant understands and will comp y
- -
Issue ate:
•..- ----- D
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
RE -ROOFS:
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
inspection.
I� 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 %vork, 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
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 25532(x) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self -insure for Worker's
material. Additionally, should I use equipment or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as defined by the flay ,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, Sections 25505, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
�,A�,"^ — /
Owner or authorized agent:�f�/ Date:
permit is issued.
7
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If, after making this certificate of exemption, I
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I must
I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such Provisions or this permit shall be deemed revoked.
work's for which this permit is issued (Sec. 3097, Civ C.)
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
1 understand my plans shall be used as public records.
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
9.18.
Signature Date
CUPERTINO
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(cDcupertino.org
® NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION/ DEFERRED ORIGINAL PEP.NIIT #
PROJECT ADDRESS 10438 STELLING ROAD
APN'# 326-30-096
OWNERNAME HONGQI HU
PHONE 408.725.3692
E-MAIL
STREET ADDRESS 10613 GASCOIGNE DR
CITY, STATE, ZIP CUPERTINO CA 95014
FAX
CONTACT NAME FRANK L. HO
PHONE 408.892.5020
E-MAIL FRANKLHO@yahoo.com
STREET ADDRESS 12480 Saratoga Avenue
CITY, STATE, zip Saratoga, CA 95070 --
F, x
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ® ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME TBD
LICENSE NUMBER
LICENSE TYPE
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
ARCHITECT/ENGINEERNAME FRANK HO
LICENSE NUMBER C29889
BUS. LIC#
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS 12480 SARATOGA AVE
CITY, STATE, ZIP Saratoga CA 95070
PHONE 408.892.5020
DESCRIPTION OF WORK New' 1secondary unit with 1 bedroom and 1
bath room. Also include 2 cars garage. Total living area is- S"2-57Total garage is f
EXISTING USE
PROPOSED USE CONSTR
TYPE
#STORIES
SFR
SFR
VB
2 USE TYPE
OCC.
SQ.FT.
VALUATION (S)
EXISTDEMO
AREAL
AR FFLOOR arj2
%
AREA 1,246
TOT
NET AREA
0
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: DETACH
4
�t !`/
® ATTACH
# DWELLING UNITS:
IS A SECOND UNIT ® YES
SECOND STORY R) YES
IBEING
ADDED? NO
ADDITION? ❑NO
PRE -APPLICATION 91 YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ TOTAL VALUATION:
PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER
EICHLER HOME?�� CIO
wa
By my Signature below, I certify to each of the following: I am the property owner or author o ct 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 Wo verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I author 'we r presentatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Dat
SUPPLEMENTAL WFORMAPON REQUIRED
PLAN CHECK TYPE
ROUTING SLIP
❑ OVER-THE-COUNTER
❑ BUILDING PLAN REVIEW
New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
❑ EXPRESS
❑ PLANNING PLAT 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
1771
El
Submittal of Building Permit application.
MAJOR
SANITARY SEVER DISTRICT
❑ ENVIRONMENTAL HEALTH
BIdgApp_201 1. doc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
OCCUPANCY TYPE:
ADDRESS: 10438 N STELLING RD
DATE: 04/15/2014
REVIEWED BY: MELISSA
PC FEE ID
APN: 326 30 096 BP#:
'VALUATION: 1$50,000
PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY
SFD or Duplex
USE:
2nd Unit? G Yes 0 No
PENTAMATION
PERMIT TYPE: 1R3SFD2ND
WORK
CONSTRUCT N ATTACHED SECONDARY UNIT 525 S.F.
SCOPE
PME Plan Check:
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
525
$2,577.00
1R3PLNCK
$1,617.00
IR3INSP
$0.00
PME Plan Check:
$0.00
Permit Fee:
$1,617.00
Suppl. Insp. Fee:Q Reg.
Q OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
TOTALS:
525
$2,577.00
$1,617.00
NOTE: This estimate does not include fees due to other Departments ('tie. Planning, Public Works, Fire, Sanitary Sewer District, School
Dictrict_ -Yr) Thoco fooc ore haced nn the nroliminary ininrmalinn availahlo and oro nnly an oetimato_ Contact the Dent fnr addn'l info.
FEE ITEMS (Fee Resolution 11-053 Ef: 7,1/13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,577.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: E) Reg. 0 OT
1 0.0
1 hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$1,617.00
Suppl. Insp. Fee:Q Reg.
Q OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: IBCONSTAXR1
# new
units
$659.99
G
Work Without Permit? Yes t) No
$0.00
Advanced Ptanning Fee:
IPLLONGR
$73.50
Select a Non -Residential
Building or Structure
0
Strong, Motion Fee:
IBSEISWCR
$5.00
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$2.00
SUBTOTALS:
1 $4,934.49
$0.00
TOTAL FEE:
7 $4,934.49
Revised: 04/01/2014