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14110069Z� MY OF CUP ERUNO BUIDLWNG P ERMffT BUILDING ADDRESS: 10240 YOSHINO PL CONTRACTOR: ZHANG TIANHAO AND PERMIT NO: 14110069 LOU XUEMEI OWNER'S NAME: ZHANG TIANHAO AND LOU XUEMEI 10240 YOSHINO PL DATE ISSUED: 11/13/2014 OWNER'S PHONE: 4083184152 CUPERTINO, CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL KITCHEN REMODEL 110 SQ FT, REMODEL M.SUff ']E ADD License Class Lic. # WALK IN CLOSET Contractor Date REVISION 1: REMOVE AND REPLACE (5) WINDOWS. ISSUED 4/29/15 1 hereby affirm that 1 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. 1 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: $10000 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: 37503007.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is P ][gjyffT EXPIRES S I YORK RS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating �II�,�� 180 ���� ®� ]FIE��� ����A��E ®� 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 FROM ]LASS' CALLED UiS?ECTRON. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Issued �/f7 Date: granting of this permit. Additionally, the applicant understands and will comply by: if'!� 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, 1 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) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will 1 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 1 use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health &Safety Code, Section 05, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this �' Owner or authorized agen . 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, 1 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 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 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 I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source ulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature \ Date �S-casas fi CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT -BUILDING DIVISION 10300 TORRE AVENUE ^ CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 ^ FAX (408) 777-3333 ^ build ing(a-)cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION . ❑ ALTERATION / Ti REVISION / FERRED ORIGINAL PERMIT 4 PROJECT ADDRESS us�l v► L OWNER NAME PHONE � 40 1,'� E-MAIL 2 1 STREET ADDRESS'69111 V1 a P I FAX CITY, STATE, ZIPa evr q CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP FF ❑ O' NIER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT Cl- ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT COMRACTORNAMF yg�at�S�UL�1D� LICENSENiJ9nER_6� JI LICENSETYPE © BUS. LIC # COMPANY NAME Yb - lov) / W E-MAIL !n„ com 7 V mo'ti'f v r I FAX STREET ADDRESS �6 fl fAvle W CITY, STATE, ZIP UaZ PHONE 4b� 31 j� 12J, ARCHITECT/ENGIN'EFR NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONST& TYPE # STORIES USE TYPE OCC. SQ.FT, VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA - BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA:DETACH ❑ ATTACH # DWELLING UNITS: IS A SECOND UNrr ❑ YES SECOND STORY ❑ YES BEING ADDED? ❑ NO ADDrTION? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNINGAPPL. NO PLANNING APPROVAL LETTER ❑ IS THE BLDG AN ❑ YES EICHLERHONIE? NO ❑ k &$CEI VE r~ ] i. TOTAL ALUATION: k Iwo R� ^;'. idt ..0 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 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 buil g construction. I authorize representatives of Cupertino to enter the above -identified erty for ins ection purposes. Signature of Applicant/Agent: Uk Date: SUPPLEMENTAL TION REQUIRED PLACHECKT]PE� ��ROUTTNGSLIP�_ New SFD or Multifamilyd« elli s: 1 for demolition permit for PP Y P L i � E i BI NTR'T1VCOIRvTER % s f�'� 3o i BUII7)II\GPL REVIEW existing building(s). Demolition perm is required prior to issuance of building x rF x ? + permit for new building r-PE EXRS P '._ �ZaAINGELArREYEwY gpg mg, fv Commercial Bldgs: Provide a completed Hazardous Materials Disclosure g- D STANDARD 5PIaBv� LrcoRxs �y r ` _ form if any Hazardous Materials are being used as part of this project. meg`; 0� r426 � p2b, � � t _ Copy of Planning Approval Letter or Meeting with Planning prior to »❑ Mi1:r0Raa �E�,.i]C4SAI�'ITTT YER'ERDIS�'RICTxs, submittal of Building Permit application.1 G' wv.�:•.�r��;..�.._7- ��s5�u�,M..,,.a�.� w.....�.EI4'V,IRONMENTAL''HEATiTHmnr: � ?. B1dgApp_2011.doc revised 06/21/11 MY OF cCNIFIERTIDN® FMIN FEE IES TMA'II OR — BUIDLMNG DffVffSffGN 19 ADDRESS: 90240 Yoshino PI DATE: 04/29/2095 REVIIEWEIID BY: Sean Powl;, fi;r,>: APN: IBP#: 14110069 *VA LUATIION: 1$2,000 PIIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: od) ?.r•,'il ). PENTAMATIION 1 GENRES I PERMIT TYPE: WORK Revision 1: Remove and replace 5 windows. SCOPE Suppl. Insp. Feer Reg. C) OT NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc). These fees are based on the nreliminarv, information available and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 F.ff' 7//// 3) AJt ch. 111"'m Ch" A.{ vb. Aia 0"leek i`lec, Phar: ('hec l; C Powl;, fi;r,>: }Flit!!?t). P,!Iniri lste(. 1 t°r,ri;f 1V,' Suppl. PC Fee: E) Reg. C) OT int' 1EJ Elc imp, �EllOther $0.00 od) ?.r•,'il ). ()/heY c, �.12C1l. l%dSti, /'r'2: t'r' wibI fam P",': L"(ee. 1N,<(L I-ee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc). These fees are based on the nreliminarv, information available and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 F.ff' 7//// 3) FEE QTY/FEE Iy ESC ITEMS Plan Check Fee: $0.00 5 # Window / Sliding Glass Door $431.00 I WINREP Replacement Suppl. PC Fee: E) Reg. C) OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. C) OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 %.`o1 ?S'lructio1 ?JCI\':EJ Adir," 1;51ralhv �`uC'; 0 Work Without Permit? 0 Yes E) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure I'avc l 1),n(;urrzerttallz;r� .F`c e.�'. Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 ' a IITAC FEE. $432.50 Revised: 04/01/2015 Q.L. 14 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10240 YOSHINO PL CONTRACTOR: ZHANG TIANHAO AND PERMIT NO: 14110069 LOU XUEMEI OWNER'S NAME: ZHANG TIANHAO AND LOU XUEMEI 10240 YOSHINO PL DATE ISSUED: 11/13/2014 OWNER'S PHONE: 4083184152 CUPERTINO, CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL KITCHEN REMODEL 110 SQ FT, REMODEL M.SUITE ADD License Class Lie. # WALK 1N CLOSET Contractor Date 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: $10000 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 APN Number: 37503007.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT jE S ORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating W�Td fl�®� ®�, PERMIT �������� ®� 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 ]SAYS F ]L 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 Issued by: Date: J 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. 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 1 am exempt from the Contraetor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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) 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. I will 1 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 1 store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District 1 performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 2,5f]13, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: 11/1 3 I� 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 ARCHPFEC"F'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 I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source re ulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date r L/ 3 J 4 CONSTRUCTION PERMIT APPLICATION U, ED COMMUNITY DEVELOPMENT DEPARTMENT ^ BUILDING DIVISION \� 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 �\ (408) 777-3228 • FAX (408) 777-3333 ^ buildinq�cupertino.org \ ❑ NEW CONSTRUCTION ❑ ADDITION & ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS e APN# OWNER NAME /j�1 ^� 2& U( PHO � & �/ ``+Jf�� !��}� E-MAIL ryp�m hO�I / W E 01 CITY, STATE, ZIP FAX STREET ADDRESS 1� o ® CONTACT NAME A� p�D� ]�, /,'��I �:J-MAIL PHONE(40)`Q 1�/ /94 STREET ADDRESS / I � � CITY, STATE, ZIP �% % FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER 7 LICENSE TYPE BUS. LIC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAMEyn F LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL IfiW, apt / y FAX STREET ADDRESS I 119 � �I � m �9 I� CITY, STATE, ZIP /� ^_ PHONE DESCRIPTION OF WORK nA dOV EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM REMODEL AREA KITCHEN OTHER REMODEL AREA OD� MODEL AREA] ® �� PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT [I YES SECONDSTORY []YES BEING ADDED? []NO ADDITION? 1:] NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY;. ;' T VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO ` 1 0o0 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 have pr ided 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 buil din ction. thorize representatives of Cupertino to enter the above- identi ed propety for inspection purposes. p I � Signature ofApplicant/Agent: Date: SUPPLEMENTAL FO D 'PLAN CHECK TYPE ROUTINGSIAP Q ovER-couNTER �. i IEw ❑ ",Bup Dlric 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 . „ - rr�, 0 PLANNING PLAN REVIEW 6 „ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD" ❑ 'FUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑. LARGE' , FIRE DEPT' _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑� SANITARY SEWER DISTRICT, Submittal Of Building Permit application. ❑„ ENVIRONMENTAL HEALTH' B/dgApp_2011.doc revised 06/21/11 IM-M FEE ESTIMATOR — BUILDING DIVISION CITY OF cCUP EIi�' INO .y ADDRESS: 10240 yoshino dr DATE: 11/12/2014 REVIEWED BY: sean lfcclr Permit fce• APN: BP#: *VALUATION: 1$10,000 *PERMIT TYPE: Building Permit PIAN CHECK TYPE: Alteration / Repair PRIMARY USE: SFD or Duplex p/7urrh. fusp. Fee: PENTAMATION PERMIT TYPE: 1 R3SFDREM FWORK kitchen remodel 110 s ftremodel m.suite add walk in closet $0.00 = s.f. $431.00 NOTE: This estimate does not includejees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the Dreliminary information available and are only an estimate. Contact the Dent for addn'l info. EEE ITEMS (Fee Resolution 11-033 Eff: 7/1113) 1fek-h. Plan Ch, Phn„h. r'Iew Clio :', rii lfcclr Permit fce• d'luimb. Permit Fe'.. 1"”. Orhir lir<•h his",L] O/her P/urrrh frAf)L� hysp. d h h, MV). hee: p/7urrh. fusp. Fee: ! eC: 1 NOTE: This estimate does not includejees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the Dreliminary information available and are only an estimate. Contact the Dent for addn'l info. EEE ITEMS (Fee Resolution 11-033 Eff: 7/1113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. $645.00 Remodel, Kitchen (<=300 sf) 1REMRESKIT Suppl. PC Fee: Q Reg. 0 OT Q.Q hrs $0.00 PME Plan Check: $0.00 = s.f. $431.00 Remodel, Other 1REMRESOTH Permit Fee: $0.00 Suppl. Insp. Fee:(D Reg. Q OT Q Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C onsn'uction Tocr: Adinini.�trwive Feer: Work Without Permit? 0 Yes E) No $0.00 Advanced Planning; Fee: $0.00 Select a Non -Residential Building or Structure 0 z, Truwc�l I)neurn�>>zlcxtiurr I c es: Strong Motion Fee.: I BSEISMICR $1.30 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS- $2.30 $1,076.00 T®TAIL IEEE: $1,078.30 Revised: 10101/2014 CUPERTINO COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building aQcupertino.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: SITE ADDRESS 10440 os�Vlo L APN BP# OWNER NAME �`� j 4eyA6 Lo OWNER ADDRESS DESCRIPTION OF WORK: to C / 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.) 't• 1. 1 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. 1, 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. _�' L, 2. 1 understand 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. ­�',L' 3. 1 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. ,, L 4. 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. )(L' 6.1 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. L 7.1 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. T( L. 8. 1 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 04/14/10 -0- 9. 1 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.csib.ca.gov for more information about licensed contractors. `kL 10. 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. �Al 11. I 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. )�J_ 12. 1 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 veft the property owner's signature. Property Owner's Signature: Date: i J lgz -------------------------------------------------------------------------------------------------------------------------------------------- (NOTE: The following Authorization Form is required to be completed 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): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No 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 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 signature. Property Owner's Signature: Date: OwnerBuilderForm 2010.doc revised 04/14/10 CUI'N��T NO COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION CITY HALL 10300 TORRE AVENUE ^ CUPERTINO, CA 95014-3255 (408) 777-3228 ^ FAX (408) 777-3333 SCOPE OF WORKe Kitchen and Bathroom Remodel. Project shall comply with the 2013 California Building (Base code 2012 IBC), 2013 Residential (2012 IRC), Plumbing (2012 UPC), Mechanical (2012 UMC), Electrical (2011 NEC), Fire (2012 IFC) and Energy Codes (2008 Building Energy Efficiency Standards) Energy code mandatory lighting measures: 1. All permanently installed high efficacy luminaires shall be switched separately from low efficacy luminaires. (150(k)(7)) 2. Permanently installed lighting in Kitchens shall be high efficacy luminaires. Up to 50% of the wattage of permanently installed lighting in kitchens may be in lights that are not high efficacy. (150(k)(8)) 3. Permanently installed luminaires in bathrooms, garages, laundry rooms and utility rooms shall be high efficacy luminaires OR are controlled by an occupant sensor(s) certified to comply with Section 119 that does not turn on automatically or have an always on option. (150(k)(10)) Plumbing plan Quotes: 4. Water closets shall have an average water consumption of not more than 1.28 gallons per flush. (CPC 403.2) 5. Showerheads shall have a maximum flow rate of 2.0 gallons per minute measured at 80 psi and must comply with CALGreen. (CPC 408.2) 6. Kitchen faucets shall have a maximum flow rate not to exceed 1.8 gallons per minute at 60 psi. (CPC 403.6) 7. Residential lavatory faucets shall have a maximum flow rate not to exceed 1.5 gallons per minute at 60 psi. (CPC 403.7) 8. Shower compartments, regardless of shape, shall have a minimum finished interior of 1024 square inches and shall also be capable of encompassing a 30 inch circle. These clearances shall be maintained up to a height of 70 inches above shower drain. (CPC 408.6) 9. Shower compartments and walls above bathtubs with installed shower heads shall be finished with a smooth, nonabsorbent surface to a height not less than 72 inches (6 ft). (CRC R307.2) 10. The maximum hot water temperature discharging from the bathtub, shower and whirlpool bathtub filler shall be limited to 120 degrees Fahrenheit. The water heater thermostat shall not be considered a control for meeting this provision. (CPC 408.3 & 409.4) 11. A 30 -inch clear width for water closet compartment and 24 inch clearance in front of water closet. (CPC 402.5)