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15020040CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10477 MERRIMAN RD CONTRACTOR: CHUA FAM PERMIT NO: 15020040 PARTNERSHIP NO.2 OWNER'S NAME: CHUA FAM PARTNERSHIP NO.2 375 OLIVE ST DATE ISSUED: 02/06/2015 OWNER'S PHONE: 4084062485 MENLO PARK, CA 94025 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL REMODEL (2) BATHROOMS (80 SQ FT); KITCHEN (300 SQ License Class Lic. # FT); DECREASE SIZE OF (2)WINDOWS AND REMOVE AND REPLACE (10) WINDOWS TO MEET EGRESS IN Contractor Date BEDROOMS; 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 Sq. Ft Floor Area: Valuation: $48000 performance of the work for which this permit is issued. 1 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: 34229055.10477 Occupancy Type: permit is issued. APPLICANT CERTIFICATION P 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 OF PERMIT 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 F ST 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 )—/4 It granting of this permit. Additionally, the applicant understands and will comply Issued by: Date. 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. 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 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 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(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 l use equipment or devices which emit hazardous rnpensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the ay a Air Quality Management District I erformance of the work for which this permit is issued. will maintain compliance with t C rt' pal Code, Chapter 9.I2 and have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, See o s 50 , 25533, d 25534. ection 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date permit is issued. 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-po ou a regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature / Date 446— I I CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building c-ocuoertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION /TI ❑ REVISION / DEFERRED ORIGINAL PERMIT 4 PROJECT ADDRESS ©4 11 MazimbrAl 2>- APN SS" U OWNER NAME 'Thg- L PHONE j��-j s�Z E-MAIL k1 STREET ADDRESS 375 CIT , ESTATE, ZIP FAX CONTACT NAMEQW�A3S t"' -'bV ��- PHONE'�06—A� J E -AIL Dy(fiAlFe-& S' M STREET ADDRESS - CITY, STATE, ZIP 74 C r FAX -409 - 2-43-1944, oft+NER OWNER -BUILDER ❑ OVINER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGMER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC d COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC k COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ESCRIPTION OF WORK -e - S i td rS T I -l+ aj D 2 E 1 o&W I. ................... e if llll Li L Uj -rO I )W EXISTING USE PROPOSED USE CONSTR. TYPE k STOkMS USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOORDEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA6O REl` DE1E��A L REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: LJ DETACH ❑ ATTACH 9 DWELLING UMTS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? El NO ADDITION? ❑NO ALOF PLAt.".7NGAPPPRE-APPLICATIOX ❑YES NO PAt.'NB�GAVPPROVCOPY ❑ LETTER IS THE: BLDG AN E]CHLERHOt. E? ❑NO ❑ FuV Q'P.'iFS{„TOT rwal V}1ANION: 1 Y . ^ • ,"111 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 ha pr d 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 t 'b i in ction. I authorize representatives of Cupertino to enter the above -id e tifi`ed property for inspection purposes. 1J Signature of Applicant/Agent: Date: SUPPLEMENTA�i INFORMiATION REQUIRED rf ; x cis r�%`y�ti?pi7rzhG'srrx'�'°` „x: New SFD or Multifamily dwellings: Apply for demolition permit for existing buildings . Demolition permit is required prior to issuance of building for new building. permit Commercial Bldgs: Provide a completed Hazardous Materials Disclosure _ form if any Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with submittal of Building Permit application. Planning prior to J G T1 R SEDC 177T$TRtC1 BldgApp_201 1. doc revised 06/21/11 CITY OF CUPERTINO FM_7 FEE ESTIMATOR - BUILDING DIVISION 1AADDRESS: 10477 merriman rd DATE: 02/06/2015 REVIEWED BY: Mendez Plan Check Fee: APN: BP#:/ 5 ()-a coo 4�C) VALUATION: 1$48,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or DuplexPENTAMATION USE: PME Plan Check: PERMIT TYPE: 1 R3SFDREM WORK remodel 2 bathrooms 80 sq ft); kitchen 300 sq ft)m decrease size of (2)windows and remove and SCOPE replace (10) windows to meet egress in bedrooms; install (4) led lights in hallway NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School 1)ic1rirt otr ) Thoco fooc oro hncod nn tho nroliminary infnrmatinn avadahlo and aro nnly an o.ctimnlo_ Cnnlarl tho Dent for aldn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 80 s.f. Remodel, Bath (<=300 so $645.00 IREMRESBAT Suppl. PC Fee: 1E) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00300 s.f. Remodel, Kitchen (<=300 so $645.00 IREMRESKIT Permit Fee: Hourly Only? 0 Yes Q No $0.00 Suppl. Insp, Fee,0 Reg. Q OT 0.0 hrs $0.00 12 # Window / Sliding Glass Door $574.00 I WINREP Replacement PME Unit Fee: $0.00 PME Permit Fee: $48.00 ® # Electrical $72.00 IBREMFIXT Fixtures, Lighting ( c n"o rn fi(n (rr.t- Administrative Fee: (ADMIN $45.00 C) (F) Work Without Permit? © Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential 0 Building or Structure 0 Travel Documentation Fee: ITRAVDOC $48.00 Strong Motion Fee: IBSEISMICR $6.24 = hrs Inspections $143.00 ISTINSP Inspection, Hourly Bldg Stds Commission Fee: IBCBSC $2.00 TJ�T(J'ILi ' $149.24 $ 2,079.00 TOJALEs` $2,228.24 Revised: 01/06/2015 f Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 L U P E RT I' N D Telephone: 408-777-3228 Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: ryi OWNER'S NAME: - PERMIT # /502OD4-0 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 CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: r / Signature Date Please check applicable subcontractors and complete the following information: ✓ 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 / Contjr4fftor Signature CVPERTI'NO OWNER -BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingCcDcupertino.org 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: S T SS &,,h4,,,Y1 BP# IPA, OWNER E OWNT DDR SS j DESCRIPTION OF WORK:C CAUA%Q� jzy��t)QowS ` Le 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.) oa—K- . 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. 61$�2. I ur.derstand 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. I 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. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. (, . 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. (: I 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. 6P. I 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. I 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 04/14110 kAal 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. 0. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the site address listed above. 11. 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. 2. 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 by laws 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 as a result of a complaint. Your only remedy against unlicensed Contractors may be 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 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 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 Property owner's si(mature. Property Owner's Signature: ( M '4/1 ,_ (/ V-` � GM0e4,6q MV I KI Date: ) J®.JU41 !I.-1t� I ---- -- -- - - ----- -------------- - - - - --- ---- --- --- --- (NOTE: The following Authorization Form is required to be co pleted 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. , Scope of Construction Project (or Description of Work): Krre,� p 54-& 64/e, -T> , lop5 styes , 4)� i��"� Project Location or Address:01_, �— Name of Authorized Agent: Address of Authorized Ager 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 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. JeProperty Owner's Signature: .._, ate: fGV OwnerBuilderForm 2010.doc revised 04/14/10 SCOPE OF WORK for 3 bdrm unit at: 10477 Merriman Rd., Cupertino, CA 1. Replace cabinets, countertops sink and faucet at Kitchen including: c) Infill 4'x 4' opening with 2x ceiling joists hung on Simpson LUS24 joist hangers and patch ceiling flush with sheetrock to match existing. d) Tap off <E> 1" gas line over <E> FAU closet and add +/-18 LF OF 1/z" inch gas line for <N> Gas slide in range. e) New cabinets, granite countertops, sink, faucet. 2. At hall bath Replace vanity cabinets, sink and faucet. Replace toilet with <N> 1.28 gl/ flush unit. 3. At master bath: a) Remove window above vanity and infill with Int. and Ext. finishes to match <E>, over 2x framing within <E> ro opening. b) Replace toilet with <N> 1.28 gl/ flush unit. 4. Electrical including: a) Relocate 3 outlets and one switch; utilize <E> 220V circuit to install 1 dedicated 120v 20 amp outlet for microwave and add separate circuit for kitchen counter outlets; and add 1 ea. 3 way switch to gen. lighting for convenience (<E> gen lighting switch is adjacent sink.) b) Replace 3 ea. 4' recessed fluorescent lights with 4 new (<N>) 6" LED Recessed can lights; add 6 fluorescent under cabinet lights with separate switch.at kitchen. c) relocate lite j -box for new vanity fixture from ceiling to wall +/- 83" AFF and Add lea 6" LED can light and Panasonic "Whisperquiet "bath exhaust fan with new switch. Fan to be ducted to exterior with 4" ducting from factory backdraft damper at master bath. d) At Dining rm, add 1 switch and one 120v outlet for <N> Plug in 12v. LED cove strip lighting. S. Replace old aluminum single pane windows with new Milgard white vinyl dual glazed, Low -E windows as follows: a) 2 -18" x +/_ 108" (rake top) fixed windows. (Living Rm) b) 1-144"x60" XOX slider (Living Rm) c) 2 -48" x 60" xo slider (Bedrms 1 & 2) *Meets Egress d) 1-96" x 60" xo slider (Master bedrm) *Meets Egress e) 1 -72" x 80" XO patio sliding door (Fam Rm). **Tempered f) 1 -72" x 48" xo slider (Fam Rm) g) 1- 48" x 36" xo slider (Kitchen) h) 2- 40" x 48" xo slider (Dining Rm) i) 1 -40"x48" fixed (Dining Rm) Note: Repair stucco around openings as required with 2 layers Grd. D paper, (lapping 2+"), expanded metal lath lapping existing stucco wire and 3 ct stucco repair. 6. New Laminate flooring and 3-1/4" base in hall, Kitchen, dining and family rms. 7. Paint interior complete. NOTES: 1. Each bedroom shall have a window that meets Egress and Rescue requirements per 2013 CRC Section R310, 2013 CBC Section 1029 and 3407.including minimum net clear opening width of 20" and height of 24" and Min. net clear opening of 5.7 sq ft. 2. Smoke detectors shall be installed in each of the 3 bedrooms and 1 in the hallway adjacent to these sleeping rooms. 3. One CO detector shall be placed in the hallway adjacent to these sleeping rooms. 4. No bearing walls will be removed for this project, nor will any walls be relocated. S. Existing Tub and shower enclosures are to remain without alteration. 6. Except in kitchen and baths all receptacles and circuits are <E> to remain as is. 77 o/�ttz�tn ' U�t NGJt ?171 Gl f f Q) sn7 o �o 3 W�3a _ o