B-2016-3298CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: I PERMIT NO: B-2016-3298
10356 MENHART LN CUPERTINO, CA 95014-3631 (375 16 015) CNE CONSTRUCTION
INCORPORATION
SAN JOSE, CA 95130
I OWNER'S NAME: XIONGWEIRUAAND MENGZHAOHUI I IDATE ISSUED: 05/15/2017 1
OWNER'S PHONE: 408-334-1376 I I PHONE NO: (408) 726-2956
License Class B Lic. #1Q1=
Contractor CNE CONSTRUCTION INCORPORATION Date 03/31/2018
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.
hereby affirm under penalty of perjury one of the following two declarations:
1. I have and will maintain a certificate of consent to self -insure for Worker's
BUILDING PERMIT INFO:
BLDG —ELECT —PLUMB
MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
ONE STORY SFD (1,783 S,R); ATTACHED GARAGE (449 S.F.);
,H (29 S.F.)
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. Sq. Ft Floor Area: 2232 Valuation: $500000.00
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.
Date 5/15/2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
1. I, 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)
z. I, 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:
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.
2. 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.
s. 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.
Date 5/15/2017
APN Number: Occupancy Type:
375 16 015 R-3 (Custom),R-3 (Custom),U (Private Gar / Ag Bldg),U
(Private Gar / Ag Bldg)
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Abby yende
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: 5/15/2017
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. I 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 I 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 Cuperti Municipal Code, Chapter 9.12 and
the Health & Safety Code, a 'o s 25505, 25533, and 25534.
Owner or authorized agent:
bate: 5/15/2017 '
CONSTRUCYTION TENDING AGENCY
I hereby affirm that there is akonstruction 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
Professional
CUPERTINO
LLJ I` W C1E ONSTRI
CONSTRUCTION PERMIT 'APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTIN,✓4$4 .A 95014-3255
(401i8)) 777-3228 • FAX (408).777.3333 ® dinp(c cupertino.orp
ADDITION TE PION / F a2EVISION / DEFERRED ORTGTNAT. PERMIT #
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❑ ATTACH
# DWELLING UNUS:
ISASECOND UNTT E] YES
SECONDSTORY []YES
BEINGADDED? FIND
ADDITION? []NO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER
IS THE BLDG AN ❑ YES
EICHLER HOME? ❑ NO
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By my Signature below, I certify to each of the following: I am the property owner or authorized agen to act oA 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 construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
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Signature of Applicant/Agent: Date: �/ ZC Zk
SUPPLEMENTAL INFORMATION REQUIRED
PLAN CHECK TYPE
ROUTING SLIP
❑ 0VER-THIS-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 PLAN 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.
[j LARGE
❑ FIRE DEPT
_ Copy of Planning Approval Letter or Meeting with Planning prior to
11 MAJOR
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submittal Of Building Permit application.
❑ ENVIRONMENTAL HEALTH
BldgApp 2011.doc revised 06121111
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RONG CHANG USA CORPORATION P�`�
.w , ` 2050 Concourse Drive, #50, San Jose,CA 95131
1 Phone: (408)892-7680 Fax: (408)321-9987
ARCHITECTURAL PROJECT DEVELOPMENT m PLANNING a MANAGEMENT
City of Cupertino, California
Building& Safety Division
Re: Structural Revision
10356 Menhart Ln
Cupertino, CA
September 12th,2017
Dear Sir or Madam:
This letter is to confirm that I have,checked the job site condition and allowed the following
change:
1. One epoxy holdown with minimum 12"ember depth at line-1, max uplift force 961 lbs.
2. Two epoxy holdown with minimum 12" ember depth at line-2, max uplift force 1743Ibs.
If you have any questions regarding the above, please contact me at(408) 321-9988.
Sincerely;
G'SED ARcTF`
n2A
IlirSY-CHEN SAI
vian ,
DATE &
OF CA1a�°
Sy-Cheng Tsai,Architect:
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m BONG CHANE USA CORPORATION f 3"fl( If
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2050 Concourse Drive, #50, San Jose,CA 95131 I�p`�I
Phone: (408)892-7680 Fax: (408)321-9987 CJI J
ARCHITECTURAL PROJECT DEVELOPMENT PLANNING s MANAGEMENT
City of Cupertino, California
Building& Safety Division
Re: Structural Revision
10356 Menhart Ln
Cupertino, CA
September 11th, 2017
Dear Sir or Madam:
This letter is to confirm that I gone to the job site on September 11th, 2017,to do structural field
observation, it is my professional judgment that the overall structural work was performed in
accordance with industry standard practices, and was based on approved plan and specifications.
The following items have been inspected:
• Roof and Floor framing
• Shear wall nailing and holdown
If you have any questions regarding the above, please contact me at(408) 321-9988
Sincerely;
Gti�
,‘•5 C'6',),ARCy/TF
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SY—CHE SA1
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Sy-Cheng Tsai,Architect
f UTILITY RELEASE REQUEST FORM
t�� COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CU PE RTI NO
(408)777-3228• FAX(408)777-3333•buildinq(a.cupertino.org
PURPOSE
For residential single family or duplex construction, there are cases where gas and electric utilities are
requested to be released prior to the issuance of the certificate of occupancy. Upon approval from the
building inspector,the City of Cupertino is allowing both utilities to be released prior to the final sign-off of
the building.
INSTRUCTIONS
1. Download this form at: http://www.cupertino.org/index.aspx?page=297.
2. Complete the form and obtain signatures from both the owner of the property and the primary contractor.
3. Fax, E-Mail, Mail or hand deliver the original signed form to:
City of Cupertino
Building Division
Attn: Utility Release Request Form 408-777-3228 office
10300 Torre Ave. 408•.777-3333 fax
Cupertino, CA 95014 building@cupertino.org
4. Schedule a Gas Meter Release inspection(#403) and/or Electric Meter Release inspection(#404). Please
note, a Gas Test inspection (#506) is required prior to or at the same time of the Gas Meter Release
inspection.
BUILDING INFORMATION (Please complete the following information):
APN x)15_ �.' BLDG PERMIT#: DATE: / ?,,i 7
SITE f
ADDRESS: /7 c 7 l�y e%U�)ICE La's r GpertLtC. ---
OWNEITSNAME: r, 'PHONE#: 4c8 -3 jL� /?7�'/ moi$-Ss6--4u37
( '�tt �'G2 (-211004cA, �jf: `� FAX N
�7
MAILING ADDRESS (if efferent from site address): J
CONTRACTOR: —r PHONE#:
J FAX#: 4'1 — i
CONTACT: / PHONE#:
-{• F 35( -- Y-1 ttki:.,v, G L n FAX#:
I request the City to release my utilities prior to obtaining a final inspection approval for the building. I fully understand the occupants of
the building cannot move into the residence until they receive all of the required final sign-offs and the City has issued a certificate of
occupancy for the buildi . (AAA
// II
Owner: Print:....1/VfA,N Date 1 ( � Lc'j
/Print: ..�I7..I.2.?'°•7
Contractor: f
UtilityReleaseForm_2011.doc revised 08/09/11