B-2017-0758CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
21316 RUMFORD DR CUPERTINO, CA 95014-1334 (326 41 018)
OWNER'S NAME: MURAI TOM TADAYOSHI AND ROBERTA CHIN ET AL
OWNER'S PHONE: 408-499-0445
LICENSED CONTRACTOR'S DECLARATION
License Class B Lie. #949588
Contractor B Y U CONSTRUCTION INC Date 07/31/2018
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
CONTRACTOR: PERMIT NO: B-2017-0758
BYU
CONSTRUCTION INC
DALY CITY, CA 94015
DATE ISSUED: 08/01/2017
PHONE NO: (415) 725-7844
BUILDING PERMIT INFO:
X BLDG —ELECT —PLUMB
MECH X RESIDENTIAL COMMERCIAL
JOB DESCRIPTION:
FIRST FLOOR ADDITION OF GUEST BATHROOM, BATHROOM AND
LAUNDRY ROOM (347 S.F.)
Compensation, as provided for by Section 3700 of the Labor Code, for the
0 otmance of the work for which this permit is issued.
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: 347 Valuation: $75000.00
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 buildings construction, and hereby authorize
representatives of this city to enter'updn the above Mentioned property for
inspection purposes. (We) agree;to save indemnify and keep harmless the
City of Cupertino against liabi61es,1judgments, 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 erthe Cupertino Municipal Code, Section 9.18.
hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
t. I, as owner of the;propert}l 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 8i 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:
t. 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.
z. 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.
3. 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, Imust forthwith comply with such provisions or this permit shall
be deemed revoked.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all �cityand 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 anon-point!source regulations per the Cupertino Municipal
Code, Section 9.18.
Signature Date
APN Number: Occupancy Type:
32641 018 R-3 (Custom)
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
by: JASMINE ARCHBOLD
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining aq inspection, I agree to remove all new materials for
�J inspection.
"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 Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or authorized agent:
Date:
CONSTRUCTION LENDING AGENCY
I 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
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 7-77-3228 • FAX (408) 777-3333 • bulldin-g@cupertino.orq
❑ NEW CONSTRUCTION 2 ADDITION ❑ ALTERATION/Ti ❑ REVISION /DEFERRED ORIGINAL PE+RMrf N
PROJECT ADDRESS n �V O �D ID � 7APN
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STREET ADDRESS
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❑ OIVNER ❑ OWMR-BUUMER ❑ OWNER AGENT LJ CONTRACTOR ❑ CONTRACTOR AGENT *K ARCHITECT ❑ ENGINEER ❑ DEV=PER ❑ TENANT
CONTRACTOR NAME
LICENSE NUMBER
LICENSE TYPE
BUS. LIC #
COMPANY NAME
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-477-2147
DESCRIPTION Or WORK
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EXISTING USE
PROPOSED USE CONSTR.
TYPE
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AREA 7,x'7
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TOTAL
NE'r AREA
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BATHROOM
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OTHER
REMODELAREA
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PORCHAREA DECKAREA
TOTAL DECK/PORCIIAREA
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#DWEW,INGUNITS:
ISA SECOND UNIT []YES
SECONDSTORY YES
,
DEINGADDED? WO
ADDITION? Wo
PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF
79 THE BLDG AN E] YES
RECEIVED BY:
TO VALVATION;
PLANMNG APFL # []NO PLANNING APPROVAL LETTER
EICHLER HOME? Q NO
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By my Signature below, I certify to each of the following: I am the property owner or authorized agent to act on a property owner's behalf. I have read this
application and the information I'bave 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 inspectionpurposes.
Signature of Applicant/Agent: 2rDate: 15 1'Z 17
SUPPLEMENTAL INFORMATION REQUIRED
`
C.HECIC
PIAN TYPE
RovT G SLIP
❑ OVER-THE-CQI
❑ BUILDINGW VIEW
New SFD or. Multifamily, dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
INTER
AN
permit for new building.
❑ EXPRESS
El PLANNING PLAN VIEW
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
El STANDARD
❑. PUB is WORK$
form if any Hazardous Materials are being used as part of flus project.
❑ LARGE
❑ FIRE DEPT
Copy of Planning Approval Letter' or Meeting with Planning prior to
_
submittal of Building Permit application.
❑ NIAJi)R
❑ $ANITARY'SEWER DISTRICT
❑ ENVIRONMENTAL HEALTH
B1dgApp_2011,doe rev ed 06121/11
017 —07,c:
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•
F. R.STRATHDEE ARC HI TECT
ciciv
DESIGN AND DEVELOPME-NT
SEPTEMBER 26, 2017
CITY OF CUPERTINO
BUILDING DEPARTMENT
RE: Ou MURAI RESIDENCE
21316 RUMFORD DRIVE
CUPERTINO, CA 95014 •
To WHOM IT MAY CONCERN:
BECAUSE OF THE MINIMAL LOADING, IT IS ACCEPTABLE TO INSTALL A
DIAGONAL BRACE RUNNING DOWN FROM EACH SIDE OF THE RIDGE AT
ROUGHLY A 45 DEGREE ANGLE TO THE TOP OF THE SHEARWALL. THIS
WOULD BE IN LIEU OF RUNNING THE SHEARWALL UP THROUGH-THE /147P5C
TO THE BOTTOM OF THE ROOF FRAMING.
CLIPS SHOULD BE INSTALLED WHERE THE BRACES MEET THE TOP OF THE
SHEARWALL.
SINCERELY,
FREDERICK R. STRATHDEE
ARCHITECT
FRS ELS
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