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B-2016-2894CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2894 5986 SUTTON PARK PL CUPERTINO, CA 95014-3531 (375 35 027) KEN LIN CONSTRUCTION INC SAN JOSE, CA 95138 OWNER'S NAME: KAO WILLIAM W AND SHEN YUJUNG DATE ISSUED: 03/31/2017 OWNER'S PHONE: 408-517-9875 PHONE NO: (408) 872-2898 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class a Lic. #996087 Contractor KEN LIN CONSTRUCTION INC Date 08/31/2018 X BLDG —ELECT —PLUMB 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: FRONT ADDITION - (I) BEDRM, BATH & LAUNDRY (496 S.F.); I hereby affirm under penalty of perjury one of the following two declarations: REMODEL KITCHEN (125 S.F.); REMODEL MASTER & HALL BATHS 1. I have and will maintain a certificate of consent to self -insure for Worker's (118 S.F.); RECONFIGURE/REMODEL LIVING RM/FAMILY Compensation, as provided for by Section 3700 of the Labor Code, for the RM/MASTER BEDRM (463 S.F.) performance of the work for which this permit is issued. REV #1 - CHANGE KITCHEN LAYOUT - READJUST WINDOW, z. I have and will maintain Worker's Compensation Insurance, as provided for by REMOVE WALL PARTITION, ADD PANTRY; FAMILY ROOM - /+ All Section 3700 of the Labor Code, for the performance of the work for which this READJUST SLIDING DOOR - ISSUED 6/19/2017 7 permit is issued. APPLICANT CERTIFICATION Sq. Ft Floor Area: 496 Valuation: $250000.00 I certify that I have read this application and 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 375 35 027 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. Date 6/19/2017 Signature Issued by Abby Mende OWNER -BUILDER DECLARATION Date: 03/31/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of theF.>r ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is r. 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: 6/19/2017 I hereby affirm under penalty of perjury one of the following three declarations: r. I have and will maintain a Certificate of Consent to self -insure for Worker's ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 z. 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. I 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 exemption, I become subject to the Worker's Compensation provisions of the will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and Labor Code, I must forthwith comply with such provisions or this permit shall the Health &Safety Code, Sections 25505, 25533, and 25534. be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date: 6/19/2017 1 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 I hereby affirm that there is a construction lending agency for the 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. Signature Date 6/19/2017 Licensed Professional CONSTRUCTION PERMIT APPLICATIftp i�� COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 ' _' (408) 777-3228 •FAX (408) 777-3333 • building(a�cuoertino.org b0 � rZ? CUFERT[NO 1 3 y ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS ! > APN # OWNERNANM PHONE i E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX �rl vi CONTACT NAME PHONE r E-MAIL STREET ADDRESS CITY, STATE, ZIP ^ �a FAX Su -NA P = r , OWNER El OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER t 0 r� � LICENSE TYPE ^ BUS. LIC # v, l D COMPANY NAME ' eY' E-MAIL VOC, k✓ GL c� • �. v V FAX 1 STREET ADDRESS3 v` a ` CITY, STATE, ZIP L�� u S q C p PHONE ARCMTECT/ENGINEER NAME V � l ' LICENSE NUMBER l BUS. LIC # xv COMPANY NAME r"E-MAILr1 Xhi��,6 �k.FCOt , STREET ADDRESS CITY, STATE, ziP r PHONE DESCRIPTION OF WORK i V' r!f--)2 �p 'JGt.'' 5")rc' EXISTIN SE PROPOSED USE CONSTR, TYPE #sT S ` 3 USE TYPE OCC. SQ.FT. VALUATION (S) STG _ NEW FL80R Itmo TOTAL 1 AREA 1 / (JI (, AREA TBT AREA ) BATHROOM f� KITCHEN (v OTHER L REMODEL AREA I 7� REMODEL AREA REMODEL AREA 4& & PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: 0 DETACH ❑ ATTACH # DWEL.L UNITS`. IS A SECOND UNIT 9YES SECOND STORY []YES BEING ADDED? NO ADDITION? )gNO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES IVED BY _ TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER ROME? j �( NO - v By my signature below, I certify to each of the following: I am the property owner or authorized agent to act od the property owner's behalf. I have r ad 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..bu ing co truction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: l -V SUPPLEMENTAL INTO TION REQUIRED ; PLAN CHECK , <„ , d ; Iiovruvc'si . -� _ New SFD or Multifamily dwellings: Apply for demolition permit for3 ' ❑ OVER THE-COiNTER ❑ zBUII DIIQG YLANREVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. O REss ❑T ArT>rcpLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STAIlDARD ❑ PUBLIC woRxs . ': form if any Hazardous Materials are being used as part of this project. Q LAaGE ❑ 'FIiiEDEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to C] IKArox ❑ sAIQITARYSEV�ERDisTRICT submittal of Building Permit application. ❑. EN«onfltNTALHEALTH' BldgApp_2011.doc revised 06/21111 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: B-2016-2894 5986 SUTTON PARK PL CUPERTINO, CA 95014-3531 (375 35 027) KEN LIN CONSTRUCTION INC SAN JOSE, CA 95138 OWNER'S NAME: KAO WILLIAM W AND SHEN YUJUNG DATE ISSUED: 03/31/2017 OWNER'S PHONE: 408-517-9875 PHONE NO: (408) 872-2898 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B: C-27 Lic. #22_QD_$7 Contractor KEN LIN CONSTRUCTION INC Date 08/31/2018 X BLDG _ELECT _ PLUMB 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: FRONT ADDITION - (1) BEDRM, BATH & LAUNDRY (496 S.F.); I hereby affirm under penalty of perjury one of the following two declarations: REMODEL KITCHEN (125 S.F.); REMODEL MASTER & HALL BATHS n. I have and will maintain a certificate of consent to self -insure for Worker's (118 S.F.); RECONFIGURE/REMODEL LIVING RM/FAMILY Compensation, as provided for by Section 3700 of the Labor Code, for the RM/MASTER BEDRM (463 S.F.) 'performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by ,/2.1- rtSection 3700 of the Labor Code, for the performance of the work for which this Sq. Ft Floor Area: 496 Valuation: $250000.00 `r/,, spermitisissued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances 375 35 027 R-3 (Custom) 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 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 r /�{/iili� n 11� J / t ! Date 3131/2017 Issued by: AbbyAyende OWNER DECLARATION Date: 03/31/2017 -BUILDER I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is following two reasons: n. 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 (Sec.7044, Business & Professions Code). Date: 3/31/2017 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 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 maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the permit is issued. Health & Safety Code, Section 25532(a) should I store or handle hazardous s. I certify that in the performance of the work for which this permit is issued, I material. Additionally, should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the 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 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, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: ( _ APPLICANT CERTIFICATION Date: 3/31/2017 1 certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance correct. I agree to comply with all city and county ordinances and state laws 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, Lender's Address judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands ARCHITECT'S DECLARATION and will comply with all non -point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code, Section 9.18. Licensed Signature Date 3/31/2017 Professional ❑ I,TECONSTRUCTION CONSTRUCTION PERM" . " �LICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 - B (408) 777-3228 • FAX (408) 77T-3333 - build! np(a-)CUpert ino.org L co Zat�, �J ADDITION ❑ .kuERATio / TI ❑ REVISION / DEA D ORIGINAL PERNUT if PROJECT Alll)RESS ' S APN�� ONWER NAME ^ / � �_ nPHONE L2a, . E-MAIL ` 1 S l (1 Y W�t1 y�^• O � STMT ADDRESS I 1/1 ry 1 CITY, STATE,' /� th ? r� /'� FAX J �UV t 1 CO?dTACT NAME.l { �J PHONE i E-MAiL } V� LA�l71 WY'n ' t I�� C t1J Piyl�j% , A\ -- �C STREET ADDRESS CITY, STATE, ZIP A Y/t ORTER ❑ OWNTER-BUMDER ❑ ONWER AGENT ❑ CONTRACTOR ❑ CONVRACTOR AGENT ❑ ARcrmECT ❑ nmmEER ❑ DEVELOPER ❑ TENANT CONITR-ACTORNAMEn C i lE� L ti�" LIC EitTSEN'[JVBER qof 0 LICENSETYPE s^ US, LIC 9 q COMPANY NAMEvcLt & t3�1 F MAIL STREET ADDRESS / \ �, e CITY, STATE, �► � rte— � �"���-9 _ a ARCHI7LCFILIdGJNEER J TAN9E • LICENSE ATUMBER BUS. LIC 132 -1. --- COMPANY NAME p7"Y`Qi n Y�F1� E-A4AIL I �� �v�A 7FAX S{"1��3"`��i STREET ADDRESS p L � , (f „/ CITY, STATE, ZIP ` C` PHOT�E � DESCRIPTION OF WORK W nmV lbw�il' 1 lvtvv e w a - X1,4. NV�) AA.t. ,.�_._,.. _�-6 EXISTWO USE • - PROPOSED USE, COIJSTR. TYPE .-STUS1. USE TYPE OCC. SQ.FT. VALUATION {S) AREAr J NAREA L DAREA ! V NLT AREA > BATHROOM iREN40DELAR.- i KITCHEty OTHER } y REMOD—^—r-1l �REF,10DELAREA %f �K — ----_ — F0RCHAREA� I 'DECKAREA TOTALDECKIPORCUAREA GARAGE ARL.,. CH �hTTACH DWrIl.ING UNITS: ISA SECOND L -NIT ❑ YES SECOND sTOItY ❑ YES BEING ADDED? 1K. 0 ADDITION? WO PR-E•,4PPLIC.ATION° ❑YES IF YES, PROVIDE COPY OF IS THE BLDG AN �-' ��ILECEiVED. _��;==`i�;X�:=` TOTAL \'ALUATIUN: `•'ti-'- PLAN'N`WGAPPL4 [:]\10 PLAA'NINGAPPROVALLETTER EICBLERH011IM O "� _."�;' ,- `', _---___ By my signature below, I certify to each of the fo]Iowing t I am the property oxmer or authorized agent to act on er[y owner's beha f. 1 have read this application and the information I have provided is c 'ect. I have read the Description of Work and verify i late. I agree to comply with all applicable local ordinances and state latus relating to bu5iding cons tion. I authorize representatives of Cupertino to enter the above -identified p ppity forinspectionpurposes. : Date: l7 Signature of Applicant/Agent: SUPPLEMENTAL INFORMATION REQUIRED (y�Te wNWi [T =N — 'PL•�.1`�13ECICTI - - l:f n« ..4•_4 :' — — �'7ir�vai - .,�:.;.:;=_:p.::=.:>>.•:-..., ....... .. ,. _-�:,..-:.-.._. ' .Ts:�,� '' '<•' Now ' alnil � dwellings: Apply for demolition ermit for 1\ex SFA or� p exisi' abuildino s. Dernition permit is required prior to issuance of building r. ---- errnit for new building. "'I]•. SS+�'�'iV ��`�'�<:_�� V'�"�� x�_r.IZE -PLA?�1L.GPL� IEl!"��`�+'-z-i' Fide a com leted Hazardous Materials Disclosure Commercial Bldags. Pro! p ,•_, S._,_ ,_.;-_,,.•_ .,. - form if any Hazardous AdaterialS are being used as part of this project. . ❑ > IREDEPT Copy OPlamrfriApprolal Letter drMeeting with Plannin Prior to '�'���-5.!iW1TAitY-SEti'FItDISTR`IC3h"�'-�� t. submittal ofBuildinc� Pennita application. °=�*r. psi:- --- - a:= -- - _= - - ��>;-_=:��u - - . -`.:zcT'�+;-•_>> _-:..»-� -- -- - =.. rte. - - us_�•� �Y`:-� �- ��:=� '�t:2;�-.-�5^�.—•�. r>-M:�-�-=G`z';� Bldglpp_2011.doc revised 06121/11 ,.- I j�Kr E NN Engineering Services 5.—?-H7 036- • P6- • 22528 Poppy Drive - 1� Cupertino,CA 95014 cT�Ji 6 g 408-873-7972 17141 6/28/2017 Cityrof Cupertino 10300 Torre Ave. Cupertino, CA 95014 Re: 5980 Sutton Park PI., Cupertino, CA 95014 Dear Sir/Madam: This is to, certify that I have performed the Hold Downs Epoxy inspection at the above address. Based upon my personal observation, it is my judgment that epoxy installations were performed in accordance to the approved plans and manufacturer's recommendations. Regards, r s.ESS/ , 49- •I iiike, C 58134 70 zp.6/30/2018 lik% OF,OA��Fo. Nhu Nguyen ,