B-2017-1285CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-1285
7525 NEWCASTLE DR CUPERTINO, CA 95014-5220 (366 17 068)
SUCCESSFUL
CONSTRUCTION INC
FREMONT, CA 94538
OWNER'S NAME: CHEN HUASONG ET AL
DATE ISSUED: 08/03/2017
OWNER'S PHONE: 408-805-0616
PHONE NO: (510) 552-0058
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class B Lic. #913612
Contractor SUCCESSFUL CONSTRUCTION INC Date 07/31/2018
X BLDG _ELECT _PLUMB
MECH X 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 & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
REMOVE BUTLER STATION IN FAMILY ROOM; REVISE LOCATION
I hereby affirm under penalty of perjury one of the following two declarations:
OF DOOR I POWDER ROOM
r: I have and will maintain a certificate of consent to self-insure for Worker's
Compensation, as providedfor 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 3400 of the Labor Code, for the performance of the work for which this
permit is issued.
Sq. Ft Floor Area:
Valuation: $3000.00
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
366 17 068
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 Cupertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 08/03/2017
Issued by: Kim Dunbar
Date: 08/03/2017
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
t. 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 (Scc.7044, Business & Professions Code)
z. I; as owner of the property, am exclusively contracting with licensed
Signature ofApplicant:
contractors to coristruct the project (Sec.7044, Business & Professions Code).
Date: 08/03/2017
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
z. 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
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 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.
Owner or authorized agent: r
APPLICANT CERTIFICATION
Date: 08/03/2017 /
I certify that I have read this application and state that the above information is
CONSTRUCTION ENDING 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 me ntioried'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.
1 understand my plans shall be used as public records.
Signature Date 08/03/2017
Licensed
Professional
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildingCcDcupertino.org'
CUPERTINO I
❑ NEW CONSTRUCTION [:1 ADDITION ❑ ALTERATION / TI El REVISION / DEIID- ORIGINAL IEN
PROJECT ADDRESS �1%Q��J!' `
APN #
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OWNER OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
LICENSE NUMBER
LICENSE TYPE
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DESCRIPTION OF WORK
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EXISTING USE
PROPOSED USE CONSTR-
TYPE
# STORIES
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USE
TYPE
OCC.
SQ.FT.
VALUATION ($)
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA TAREA
NET AREA
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: DETACH
❑ ATTACH
# DWELLING UNITS:`IS
A SECOND UNIT [-]YES
SECOND STORY ❑ YES
BEINGADDED? ❑NO
.ADDITION? ❑NO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER
EICHLER HOME? ❑ NO
"RE
By my signature below, I ceitify'to each of the following: I am the property owner or authorized age t to act on the property owner's behalf. I have read this
application and the informatidni j 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 t ilding cons ction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent 1fi'L�
e: 3
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SUPPLEMENT INFORMATION REQUIkElYPLAN
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720UTING SLIP
New SFD or Multifamily dwellings: Apply for demolition permit for
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❑
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existing building s). Demolition permit is required prior to issuance of building,
OVER THE COUNTER
BUILDING PLANREYIEW
permit for new building.
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EhPREssE
❑ PLANNII\G PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
;❑,
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®M sTANDAitD
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❑ PUBLIC WORKS
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form if any Hazardous Materials are being used as part of this project.
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4 ❑�t�.ARGE � .":
❑ FIRE�DEPT- � of � � �' m ..
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Copy of Planning Approval Letter or Meeting with Planning prior to
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❑ MAJOR `
❑� SANITARY SEWER DISTRICT .,T`
submittal of Building Permit application.
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HEALTH
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,❑ �'E1WiRONNiENTAI: , ..; ..s;
BldgApp_2011.doc revised N121/11
1. The structural observation of the owner design changes to remove the Butler counter
i'
and enclosure wall is acceptable per the existing truss roof design condition.
Should you have any questions or additional comments, please do not hesitate to call.
Sincerely,
ArchiRender.com
COPIES: Regina Kao
v'7
ARCHIRENDER.COM
Architecture . Planning
27 Country Club Dr Hayward, California 94542
FILE
Telephone 510-585 6445, Web: Archirender.com
E
Date: July 26, 2017
Re: House Remodel
7525 Newcastle Dr
Cupertino, CA
PLN No: N/A
To Whom It May Concern:
This letter is to inform you for the followings:
1. The structural observation of the owner design changes to remove the Butler counter
i'
and enclosure wall is acceptable per the existing truss roof design condition.
Should you have any questions or additional comments, please do not hesitate to call.
Sincerely,
ArchiRender.com
COPIES: Regina Kao