13120200CITY OF tCUP Elft' INO BUILDING PERMIT
MIT
BUILDING ADDRESS: 7558 TIPTOE LN I CON TR CT ON INCTBUILD I PERMIT NO: 13120200
OWNER'S NAME: YANG CHIANG-YUAN AND TE -TURN 11732 143RD AVE 1 DATE ISSUED: 12/23/2013 1
OWNER'S PHONE: 6502799059 1 SAN LEANDRO, CA 94578 j PHONE NO: (510) 388-5099 1
❑ LICENSED CONTRACTOR'S DECLARATION
License ClassLic. # 10 g 4
Contract S+_ Date
I hereby affirm that Iam iccnscd der 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
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 1 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.
Signature
Date Jz- 13
❑ OWNER -BUILDER DECLARATION
1 hereby affirm that 1 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 (Sec.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.
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
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.
Signature Date
BUILDING PERMIT INFO: BLDG I— ELECT r PLUMB f—
MECII r- RESIDENTIAL r— COMMERCIAL FL
JOB DESCRIPTION: HOUSE DEMO 1,639 SQFT.
Sq. Ft Floor Area: I Valuation: $7000
APN Number: 35932048.00 1 Occupancy Type:
PERMIT IEXPRR ES IF WORK IS NOT STARTED
WITHIN 180 DAMS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST
�CALLED RIS SP ECTRON.
Issued by: Date: /,-_? y3 - y
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 App
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
1 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 I store or handle hazardous material.
Additionally, should 1 use equipment or devices which emit hazardous 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 the
Health & Safety Code, Sections 25505, 25533, and 25534.
O r or authorized agent:
Date:
C NSTRUCTION LENDING AGENCY
1 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
CUPERTINO
COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION
10300 TORRE AVENUE o CUPERTINO, CA 95014-3255
(408) 777-3228 o FAX (408) 777-3333 ^ buildingCo cupertino.orq
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PROTECT ADDRESS �%�C Q �%"� �y rj f , ,
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APN #
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9-17
OWNER NAME
PHONE �j
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STREET ADDRESS
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CITY, STATE, ZIPZ
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CONTACT NAMEPHONE
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E-MAIL
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STREET ADDRESS/(
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CITY, STATE, ZIP
FAX
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❑ OWNER ❑ OWN R -BUILDER ❑ OWNER AGENT OCCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME .
LICENSE NUMBER �J Cj L
'Y
LICENSE TYPE
BUS. LIC #S
1S
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS t t/z
A
CITY, STATE, ZIP
is
PHONE
DESCRIPTION OF WORK
RESIDENTIAL
# DWELLING
OFFICE
USE ONLY
FLOOR AREA
UNITS (�
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OCC
TYPE
SO. FT.
VALUATION
COMMERCIAL
FLOOR AREA
TYPE OF CONSTRUCTION y /
# STORIES D
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VM
(YO
AQMD JOB NUMBER
11'�
RECEIVED BY, • - .-.
T TAL VALUATION:
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By any signature below, I certify to each of the folio ing: I am the property owner or authorized agent to act on the property owner's behalf. I ha r this
application and the information I have provided is coiTect. I have read the Description of Work and verify it is accurate. I agree to comply with all app icable local
ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent:62 Date:
SUPPLEMENTAL fNFOR'MXTJON!CVREfP`kIOR TO ISSUANCE OF DEMOLITION PERMIT
OFFICE USE ONLY
PLAN CHECK TVPE
Provide Job Number from Bay Area Air Quality Management District www.baagmd.or; @ 415-749-4762.
EXPRESS.
Provide three copies (Residential) or six copies (Commerical) of a site plan showing protection for any trees 10"
in diameter or more at 3' above grade.
STANDARD
/
x9 Provide letter from PG&E (408-725-3325) stating all gas and electric has been disconnected.
LARGE
El mAaOR
Provide a letter of inspection, tests, and abatement of any Hazardous Materials. Letter to be initiated by person(s)
certified in asbestos, mercury and/or hazardous material examination.
Planning Dept clearance to verify building is not considered an historical landmark. Allow 10 business days.
Provide letter of clearance of all vermin from a licensed pest control contractor.
,,-f Applicant shall call the Public Works Department at 408-777-3104 and schedule a "habitable dwelling" inspection.
rovide signed Debris Bin and Recyclable Materials form.
DemoApp_2013.doc revised 02113113
y
CI'T'Y OF CUP EllBTINO 10)
FEE ESTIMATOR - BUILDING DRVESEON
ImADDRESS:
7558 TIPTOE LN
DATE: 12/23/2013
REVIEWED BY: SEAN
,
i£'('h. I :rel t>�di F'eL'.
APN:
BP#: (xj
*VALUATION: 1$7,000
kP1ER1VIIIIII TYPE: Demolition Permit
PLAN CHECK 7')'I'F:
PRIMARY SFD or Duplex
USE:
=PERMIT
P]ENTAMATIION 1SFDWL-DEM
TYPE:
WORK
DEMOLISH RESIDENCE 1190 SQ FT AND ATTACHED GARAGE 449 SQ FT
SCOPE
Suppl. Insp.tFee:Q Reg. Q OT
FEE IID FFR AREA
s.f
1DEMORES 1,639
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.). These fees are based on the Dreliminary information available and are onlv an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution 11-053 ff. 7/1/13)
h. A.l1t {.,,-igC;}'
Numb. Piai1 {,ile:A.
!IPC. �1t13J
,
i£'('h. I :rel t>�di F'eL'.
Pltrmn. 1'="r,1riY %C':':
F; I', ?
ifl, /:."11mb
"I"s"'.
Afe, r. Test , l e:
Phon?,..I11ap. FCC
Eiec. l;rs;^..lee:
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.). These fees are based on the Dreliminary information available and are onlv an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution 11-053 ff. 7/1/13)
FEE
QTY/FEE
MIISC ITEMS
Piun Claec'k F*C(';
Sr1I'l,11, PC
Permit Fee:
$557.00
Suppl. Insp.tFee:Q Reg. Q OT
p,p
hrs
$0.00
PSE r n(t fee:
Construction ./a0":
ry
.d i "Ivel Documentation 176VS:
Strong Motion Fee: IBSEISMICR
$0.70
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$558.70
$0.00
TOTAL FEE:
$558.70
Revised: 10/01/2013
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
(CON7RA(C70R / SUB CON7RAcC7®IIS LEST
JOB ADDRESS: 7 -z-�
PERMIT #
OWNER'S NAME: g,�-
PHONE #
GENERAL CONTRACTOR:[
BUSINESS LICENSE #
ADDRESS:
IPCODE:
*Our m unicipAl code requires all businesses working in the city td ha+ -2 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 CITE' OF CUIPIERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Sa a (Date
]Please check applicable subcontractors and cor nplete the f6 lowing information:
V
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