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B-2016-3057 • • CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-3057 885 BETLIN AVE CUPERTINO,CA 95014-4546(369 27 028) OMEGA CONSTRUCTION • SAN JOSE,CA 95117 OWNER'S NAME: CHIANG MIKE AND LIN HSIANG-HSIU DATE ISSUED:05/19/2017 OWNER'S PHONE: PHONE NO:(408)605-8113 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic.#586016 Contractor OMEGA CONSTRUCTION.Date 01/31/2018 X BLDG YX ELECT _PLUMB MECH Y 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 Sr Professions Code and that my license is in full force and effect. JOB DESCRIPTION: ONE STORY ADDITION(FRONT/SIDE);ENCLOSE(E)PATIO(53 I hereby affirm under penalty of perjury one of the following two declarations: S.F.);ADD(N)FULL BATH&EXTEND(E)LIVING RM(341 S.F.) . 1. I have and will maintain a certificate of consent to self-insure for Worker's (TOTAL ADDITION 394 S.F.);(N)COVERED PORCH(60 S.F.); Compensation,as provided for by Section 3700 of the Labor Code,for the REV#1-REVISE LOCATION OF FAMILY ROOM CEILING BEAM- •erformance of the work for which this permit is issued.. ISSUED 7/31/2017 A I :ve and will maintain Worker's Copensation Insurance,as provided for byV#2-UPGRADE PANEL(200 AMP)-8/28/2017 Sec'on 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area:394 Valuation:$150000.00 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 369 27 028 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. WITHIN 180 DAYS OF PERMIT ISSUANCE OR' Additionally,the applicant understands and will comply with all non-point • source regulations per the,Cu. -• • Municisal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. t"" • ature al Date 8/28/2017 Issued by:AbbyAyende ,70.� Date:05/19/2017 • OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the • RE-ROOFS: • following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. 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:8/28/2017 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 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 eniit hazardous 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 Co • 'Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sectio, • 505 _: ,,,*,' . Labor Code,I must forthwith comply with such provisions or this permit shall r,f Alm. • be deemed revoked. 0 ie.- authorized a•- : • APPLICANT CERTIFICATION i"i"i'':8/28/2017 Wr I 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. I understand my plans shall be used as public records. Licensed Signature Date 8/28/2017 Professional CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: "VALUATION: $0 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition • PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1 REAP i WORK SCOPE 1 . a a 3f E t } :t lec°r=. Pion Check I I 1'lasr,?b.Plot Check I I Elec.Plan Check 0.0 hrs $0.00 Vech.Pa;•mft Pee: Plumb I' rrala Pee: Elec.Permit Fee: I EPERMIT -1 Oi/.er?Iech. hut, Other Plionb incio. II Other Elec.Insp. 0.0 hrs $56.00 Alec:'d.Insp...'e': ?iamb.103p.1` t. Fi c. /73T 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 preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 16-031 Eff. 7/1/16) FEE QTY/FEE M'ISC ITEMS Plan Check Fee: $0.00 200 amps Electrical Suppl.PC Feer ® Reg. 0 OT 0.0 hrs $0.00 .. LEC2oo Services PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee() Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 s . . ;. $56.00 Construction struction My: tta's tance Fee: X1..4], a 0 Work Without Permit? 0 Yes ® No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential @ 1 a o •.e: ITRAVDOC $56.00 Building or Structure 0 Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 4 SUBTOTALS k $153.00 $56.00 TOTALFEE $209.00 • Revised: 08/23/2017 .0 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: B-2016-3057 885 BETLIN AVE CUPERTINO, CA 95014.4546 (369 27 028) OMEGA CONSTRUCTION SAN JOSE, CA 95117 OWNER'S NAME: 'CHIANG MIKE AND LIN HSIANG-HSN DATE ISSUED: 05/19/2017 OWNER'S PHONE: 408-876-0210 PHONE NO: (408) 605-8113 LICENSED CONTRACTOR'S DECLARATION' BUILDING PERMIT INFO: License Class B Lic. #588016 Contractor OMEGA CONSTRUCTION Date 01/31/2018 X BLDG _ELECT _PLUMB MECH X RESIDENTLIL 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: ONE STORY ADDITION (FRONT/SIDE); ENCLOSE (E) PATIO (53 I hereby affirm under penalty of perjury one of the following two declarations: S.F.); ADD (N) FULL BATH & EXTEND (E) LIVING RM (341 S.F.) t. I have and will maintain a certificate of consent to self -insure for Worker's (TOTAL ADDITION 394 S.F.); (I) COVERED PORCH (60 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. REV #1 - REVkSE Lff ATION OF FAMILY ROOM CEILING BEAM ._ T� '� I UI7r have GG Jb I and will maintain Worker's Compensation Insurance, as provided for by ection 3700 of the Labor Code, for the performance of the work for which this permit Sq. Ft Floor Area: 394 Valuation: $150000.00 is issued. 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 APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 369 27 028 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 -nicipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. ig r! e Date 7/31/2017 Issued by: Abby Ayende OWNER -BUILDER DECLARATION Date: 05/19/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS: following two reasons: All roofs shall be inspected prior to any'roofmg material being installed. If a roof is i. 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 ofApplicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 01 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 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 contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificateair 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. , x , er or authorized agent: . APPLICANT CERTIFICATION Date: 7/31/2017 I certify that I have read this application and state that the above information is CONSTRUCTIONLE INGAGE 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. I understand my plans shall be used as public records. Signature Date 7/31/2017 Licensed Professional CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333• btiildino(I)cupertino.orcl ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ®VISION / EFERRED ORIGINAL PERMIT # 16 d PR07ECTADDRESSggs-3ej//m 'nn APN 8—�// _kS3 -7 OWNER NAME �) , L PHONE 1 �, E-MAIL l / �Ud1A 'ice 'r --0-)4o 11AAAW STREET ADDRESS l CITY, • STATE, ZIP FAX e CONTACT NAME r ; , I PHONE / E-MAIL LQ /�^^ STREET ADDRESS CITY, STATE, ZIP �CLfit q FAX ❑ OWNER ❑ ONTIER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTI? ACTOR AGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER FTSFTYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGHIEER NAME 46" / _ Za; LICENSE NUMBER ` /, _ BUS. LTC # COMPANY NAME dl , j� _ (/(/�/ n/ /{ j- E-MAIL �L�r'al j� �^ FAX STREET ADDRESS ©S� ,W(, .+ CITY, STATE, ZIPS PHONE DESCRIPTION OF WORK (•l 7V "2l% ' Ilq, he -am EXISTING USE PROPOSED USE CONSTR. TYPE 1 # STORIES USE TYPE OCC. SQ.FT: VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET�AREA BATHROOM - KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH ARE I GARAGE AREA: EIDFTACH []ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? []NO ADDITION? []NO PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF IS THE BLDG AN ElYES RECEIVED BY TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO' a iie e...: e By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on tfie 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 c nstruction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: '�b-91 SUPPLEMENTAL INFORMATION REQUIRED' PLAN;CHECK:GYP , _ New SFD or Multifamily dwellings: Apply for demolition permit for # }zc © OVER TFiE COLTI�TER ❑ BTI1T bING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑_' E1tPREgr4ss� PANNIG rtiaNlzEv>E)v _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosuretl &Tf1ND 1Rp ❑rrlaLICwoRI.s ua form if any Hazardous Materials are being used as part of this project. LARGE s © FIRED$PT ' M _ Copy ofPlanning Approval Letter or Meeting with Planning prior to submittal of Building Permit application, ©, MAIOR' ©sANI�cS> wDRkt sTRtGT f .. .:�„zs, ' s ,,.�❑.�,EN�'IRONMENTAISAEALTI-��.�� BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-3057 885 BETLIN AVE CUPERTINO, CA 95014-4546 (369 27 028) OMEGA CONSTRUCTION SAN JOSE, CA 95117 OWNER'S NAME: CHIANG MIKE AND LIN HSIANG-HSN I I DATE ISSUED: 05/19/2017 1 OWNER'S PHONE: 408-876-0210 1 I PHONE NO: (408) 605-8113 III Lai DIC1.1 DI 1KIK811ganme"I of I ... ., License Class a Lic. #58601 ti Contractor OMEGA CONSTRUCTION Date 01/31/2018 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. BUILDING PERMIT INFO: X BLDG —ELECT —PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: ONE STORY ADDITION (FRONT/SIDE); ENCLOSE (E) PATIO (53 I hereby affirm under penalty of perjury one of the following two declarations: S.F.); ADD (N) FULL BATH & EXTEND (E) LIVING RM (341 S.F.) t. I have and will maintain a certificate of consent to self -insure for Worker's (TOTAL ADDITION 394 S.F.); (I) COVERED PORCH (60 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. 2. I have and will maintain Worker's Compensation Insurance, as provided for by ction 3700 of the Labor Code, for the performance of the work for which this pe it, issued. 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 5/19/2017 OWNER -BUILDER DECLARATION 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) 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). Sq. Ft Floor Area: 394 1 Valuation: $150000.00 "N Number: Occupancy Type: 369 27 028 R-3 (Custom) PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Abby Avende Date: 05/19/2017 RF 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: 5/19/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER r. 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. Signature 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 Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: 47 Date: 5/19/2017 CONSTRUCTION LENDING A I hereby affirm that there is a construction lending agency for a performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address I understand my plans shall be used as public records Licensed Date 5/19/2017 Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAY (408) 777-3333 ' buildino(acuoertin000rc� GUPERTfIlO g ?.Dl� _ ❑ NEW CON STRUCT)ON ❑ ADDITION ❑ A1TERATI01\1 / TI ❑ REVISION / DEFERRED ORIGINAL PERh4TT PROJECT ADDRESS � t3 — 0 1� f .4 10 P-7 PPIO?E lL>NJYl L, h�(s�l ^^ STREETADDRESS CITY, STATS, ZIP ( FAX CONTACT KUB E �~ �PHO*rE E•AkIL \ ���i� R3 ® tioyc rc/uS(\ sTREEr.anDRFss _ CITY, STATE, ZIP G FPA .' ❑ ONS a ❑ O\lR •3LTLTJER 130 kaxrr 13 coNmR CTOR ❑ CONURACTOR AGENT ❑ !RCBr-4tCT ❑ ENGINTER ❑ DE\rEtAPER ❑ TENAXT CONTRACTOR NAI k �/ LICENSE TYPE U BUS,LJCt ��1 j J j CC;hQ N NAAF j� E-Mt.IL FAX STREETADDRESS 1 /� `V t \v C17Y, STATE, ZIP T(!�e 1%I� f noNe. ARMITECTrNGLNEER>;- ME L10E.NISE?.!,IB`ER BUS,LIC 0 COWAN'YNAIME E-bWL FAX STREET ADDRESS —� i C)TY, STATE, 7IP ` I PHONE DE:SCP.ffTTON'OFWOPJC "I�� ,"� y� 111 � ��_-� �c niL �+iV�. 12202 - - ,x \ -I-�-r-4f --4 �c _ L`f1 0 'r F.XIS PIG L'SE PRO? SED e'. CONSTR. I -M k STORIES v V I USE ilPfi OCC. SQ.FT. VALUATION (S) EX1ST6 . _ ?.'EW FL 0 I DEMO TOTI1 AREAi'!( t � APS RE.4 A'ET AREA j2�5.r V (Z 3 BAT,h�Tj.0..OM KrTCNEN OThER I R-MAODEL AREA RE440DE1 EMODEL AREA wo I J r'ORCI'.AP.EAECA K '•TOT.tLDECK ORCHFREA GARhGEAREk: D_LFACH 3 .rrA LV0..{Ti TACH Ai DR'ELLNG U.\7TS: 15 A SECOND UNIT (] lis SECOSD STORY ❑ YES i BENGAXI) 7 ( w0 ADDITION? EVW .. - •-tet ;;i '+ru: ' •y LUATION' ?:L\/6 as ; �r PRE :tPPLICATION ❑ 1T5 IF 1'cS, PROVIDE COPT OF IS THE BLDG .h.\ ❑ T r�){r�OS PL.4.\NLG.4°?L# PLi�.-T'I'GAPJ'ROVALLETTER EICHLERHO.MV ,��'� 4 r �a TFUN By mIU signature below, I certify to each of the follo\\ ine: I am the property OWner or authorized agent to act on the property ovmer's behalf. I have read this application and the 'information I have provided is correct. 1 have read the Desription of N�,ork and verify it is accurate. I agr ea to comply with all applicable local ordinances and state laws relating to buildingcors *Eon; I autlto 'ze re resentatives of Cupertino to enter the above•identified rOp r for inspection purposes. SignaturaofApplicznt/Agent: `11 Date: SUPPLEME-gTAL NFORMATIO, p U TYP 4tCH t:� u,.; ,r:.EC .G�7rt{' r+i•.4iiF .Fl`r —lt ; tr {� .:Y�r is1.4f'�L:L�ki� �yc"�j-'P,S-�',4�a•: - ; 'FSH K34c aKrE:�X ❑ l• yew SFD or Mjltifalivily dwellings: Apply ,or demolition permit for t is required prior to iance ofbuilding CXlsunaQ bL11di775)• ennorl �B Dlltioerinissu t. a( .. �6 0� ER Thi Ct)L'iTER * 64 Vit+ :� "— �+'t' �� i n. .� �. .��� .. _,;� :.�,. ,,.:�.��� -� BUII D] \C PL4N R£3TE1\a int nti•Lr BMX ' E,,{ l' -� ate.. �`:�.,n :�;. stye{. ,r:. r..,-,; errrit for new building.�,r ,ty �(-� r•- 1] ElPRESS r � 4 s,5�' •(.�,.r�x�,vs ❑� R�i Ev1-1 B1 Provide a ccnlpleted I'azardo_c Materials Di-closure -D`Coll;ne;cia! �rP4L3AT\\INT� s\7'1 i'4i�' 4X PL�> ICt�oRI s �c: _- . fonn if any Hazardous Materials are be -in. -us --d as part of this project, ❑ x ❑i Co of Planning A roval Letter or Meeting with Planning rior to L4fiCE c, ¢a r r `: r `tom r 5��a FIfiESDEPT # s a ux _ submittal of Bui)ding Permit applicatiott. ❑Y i�TOR" - ¢ €fit } �ES- \IT4R1 SEti\xveg SCT , 'fir s w 7 s ,ter. . ,�J,.cr ylF,t wzLy-. w ,, {fi ,3,�. �; ••'`❑ IRO r,% NT UEEAL4HIZ r:§ B1dg9pp_2011.doc revised 06/71111 p I ,.a, F-7 1: 1 RONG CHANG USA CORPORATION P_RT IT4 2050 Concourse Drive, #50, San Jose,CA 95131 ' A Phone: (408)892-7680 Fax: (408)321-9987 OP ARCHITECTURAL PROJECT DEVELOPMENT o PLANNING o MANAGEMENT City of Cupertino, California Building & Safety Division Re: Epoxy Holdown Installation Inspection 885 Betlin Ave Cupertino, CA 95014 Aug 25th,2017 Dear Sir or Madam: This letter is to confirm that I gone to the job site on Aug 24th, 2017,10 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: • 4 Epoxy HDU2 holdowns installed with 5/8" diameter anchorage bolt with minimum 12" ember depth, Simpson SET-XP structural epoxy-tie anchoring adhesive used. If you have any questions regarding the above,please contact me at(408) 321-9988 Sincerely; c. ,‘S SD ARC,y/))c SY—CHE Al /006111 * 4111 . DATE ��Q' �' OF Cp�F°� Sy-Cheng Tsai,Architect i6 3i7 0,11-17 a/- Lz,,r-IN l T SQUARE CONSULTING GROUP,Inc. 2050 COncouse Drive,#50 u �K� San 95131 , Phone: (400)3%l-9988 _______ _________________________________________________ Fax: (408)321-9987 �'� xnco/rsoToxxL PROJECT DEVELOPMENT ~ PLANNING �----------- ^ aw^nempm` Date Nov 27, 2017 Building CITY OF CUPERTINO 10300 TORRE AVENUE,CUPERTINO,CA 95014-3255 TELEPHONE.(408)777-3228 " FAX. (408)777-3333 Aftn. Inspector Re F' Conditisn m—�+c Single Family House Re`mleling At 885 Betlin Avenue Project#- #m-2016-3057(A*N#3@9 27 028) To Whom it may concern. | a0the Architect ofRecord for the above referenced p j � e��� Thio /� erserves aaa clarification of the field changes or clarification listed below, 1 Because we did not replace the furnace on the project, only extend some air ducts to new living room, since we did not change the furnace, this project doea not need to preform a HERS inspection as noted. 2. During the construction we found that there is an existing clear-out within the property line, since the construction did not extend the new sewer line to the front yard but connect to existing sewer line in the existing crawspace As the Architect of record I would like to delete the note"install new clean-out within 5' feet of the property line" on the floor plan. Please feel free to contact us at 408 321 9988, if you have any questions about these changes. Thanks Sincerely; - 111.0 C214\VI Rem Sy-Cheng Tsai, A\rc;12re...,,,,___§„,i-'ogl:471 T Square Consulting Group, Inc. 885 betiinave Cupertino marificationn