Loading...
12090254 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10271 JOHNSON AVE CONTRACTOR:CHANG WOO PERMIT NO: 12090254 CONSTRUCTION OWNER'S NAME: JASON PARK 3204 ARCHWOOD RD DATE ISSUED:02/15/2013 OWNER'S PHONE: 9168333581 SACRAMENTO,CA 95821 PHONE NO:(916)607-8420 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL ❑ CONSTRUCTION OF A ONE STORY 354 SQ FT MASTER License Class_ Lia# BEDROOM ADDITION; CONVERT BEDROOM 43 INTO(N) LAUNDRY ROOM; REMOVE AND REPLACE FURNACE. Contractor h(;t�q Date —�f l"'%(L REV#1-ADD(N)200 AMP PANEL&CHANGE WINDOW TO DOOR IN(N) 1 hereby affirm that 1 am licensed under the provisions of Chapter 9 MASTER BEDRM-ISSUED 2/14/14 (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: 1 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. Sq.Ft Floor Area: Valuation:$20000 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:37518030.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF P T ISSUANCE OR 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 2 LLED 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 ZLl granting of this permit. Additionally,the applicant understands and will comply Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. _......... RE-ROOFS: Signatu � 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 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 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) I,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 I 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 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 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 Coder Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized ent: Dates) permit is issued. 1 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,1 must 1 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION 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 regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10271 JOHNSON AVE CONTRACTOR:CHANG WOO PERMIT NO: 12090254 CONSTRUCTION OWNER'S NAME: JASON PARK 3204 ARCHWOOD RD DATE ISSUED:02/15/2013 OWNER'S PHONE: 9168333581 SACRAMENTO,CA 95821 PHONE NO:(916)607-8420 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIALE] License Class_ Lic.# �-�—�� 5 CONSTRUCTION OF A ONE STORY 354 SQ FT MASTER BEDROOM ADDITION;CONVERT BEDROOM#3 INTO(N) Contractor �� L[}CCS Date _,1.—/,�7—4-j LAUNDRY ROOM; REMOVE AND REPLACE FURNACE. 1 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. 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 performance of the work for which this permit is issued. Sq.Ft Floor Arca: Valuation:$20000 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:37518030.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 D OF PERMIT ISSUANCE OR 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 DAY O AST 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 granting of this permit. Additionally,the applicant understands and will comply Iss by Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Sign ture d 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 1 hereby affirm that 1 am exempt from the Contractor's License Law for one of Signature of Applicant: Date: 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). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I 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 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 I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,S4ctieus 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Owner or authorized a nt: Date 1 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,l 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 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 regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 ,J C U P E RTI N 4 (408) 777-3228• FAX(408) 777-3333• buildingOcupertino.org ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/Ti ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESSl V` APN# . ^ I� �! ( v OWNER NAME t O PHONE E-MAIL Nr OO O L� STREET ADDRESS O 11 sO ` CITY, STATE,ZIP FAX CONTACTNAMEPHONE E-MAIL�^err �0 06)(/4)W.W, N STREET ADDRESSyr, `/ /f ` CITY,STATE, ZIP ^ FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME C'(O�OL'l t^:y 6)D LICENSE MBER LICENSE TYPE BUS.LIC# Go 6JS to N o �7' COMPANY NAME �f E-MAIL FAX STREET ADDRESS / CITY,STATE,ZIP PHONE ARCHITECT/ENGINEER NAME t <,� LICENSE NUMBER BUS.LIC# JJ 1 "j C746 COMPANY NAMEt E-MAIL FAX STREET ADDRESS S� CV CITY,STATE,ZIP �^ Lle DESCRIPTION OF WORK . y,,� [�� W EXISTING USE PROPOSED USE CONSTR.TYPE #ST RIES �/ USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR '/DEMO V TOTAL 'yH� off AREA CJ AREA AREA NET AREA���� ;��ri• 7 e/V •/ � �� ` BATHROOM( KITCHEN OTHER REMODEL !w ! REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREATOTAL DECK/PORCH AREA GARAGE AREA: DETACH 411-, DtATTACH #DWELLING UNITS 7 IS A SECOND UNIT ❑YES SECOND STORY E]YES BEINGADDED? 110110 ADDITION? PRE-APPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY: - TOTAL VALUATION. PLANNING APPL# NO PLANNING APPROVAL LETTER EICHLER HOME? d�o�•�er'S 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 building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL ORMATION REQUIRED PLAN CHECK TYPE.. ROUTINGSLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER BUILDING PLAN REVIEW 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 DisclosureSTANDARD ❑ 'PUBLIC WORKS . form if any Hazardous Materials are being used as part of this project. 0 LARGE ❑ FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to El MAJOR SANITARY SEWER DISTRICT submittal of Building Permit application. ENVIRONMENTAL HEALTH Bldg,9pp_2011.doc revised 06/21/11 • P CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISIO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUpERTINO (408)777-3228• FAX(408)777-3333•building(ftupertino.org ❑NEW CONSTRUCTION ❑ ADDITION ❑ALTERATION/TI REVISION/DEFERRED ORIGINAL PERMIT# 12 PROJECT ADDRESS /P-9 I APN# OWNER NAMEPHONE E-MAIL , �' .5,m LLr STREET ADDRESS CITY,STATE,ZIP FAX CONTACT NAME n i�lPHONEY,/ E-MAIL 1 f C �r STREET ADDRESS CITY,STATE,ZIP 07 � Ad s 4)V ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMEC4 h^`a� _ LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZI PHONE AilMiSh HV k ARCHITECT/ENGINEER NAME . LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK tel` ems.. EXISTING USE PROPOSED USE CONSTR.TYPE #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 AREA GARAGE AREA: DETACH []ATTACH #DWELLINGUNrIS: IS ASECOND UNIT []YESSECONDSTORY []YES BEING ADDED? []NO3 ADDrr10N? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO �„ '` ' �`'�- �a„ By my signature below,I certify to each of the following: I am the property owner or authorized agent t property owner's be a ead this application and the information I have provided is correct. I have read the Description of Work and veri it is accurate. I agree to comply with all applicable local ordinances and state laws rel g to m ing construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature ofApplicant/Age t: - Date: SUPPLEMENTAL INF ION REQUIRED €„Pr�ai�`carclTYrE. ,, 4 kna,,', OiinvLir,3� F _New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER THE COUNTERS LTJ[[AIN$PLAN REVi�W - existing building(s). Demolition permit is required prior to issuance of building permit for new building. o ❑ ExPREss �� a� PNNINY ANREi'iEW € F ; _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ sTANDART) ' form if any Hazardous Materials are being used as part of this project. ❑ xG _ ft Copy of Planning Approval Letter or Meeting with Planning prior to ❑ M 4d(1I{ ° , t AN Y S $DI& RICT� submittal of Building Permit application. � 7 t U ❑�,ENYIR NMENTIIEALTg B1dgApp 201 Ldoc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ILI ADDRESS: 10271 JOHNSON AVE DATE: 02/14/2014 REVIEWED BY: MELISSA APN: 375 18 030 BP#: 12090254 'VALUATION: Iso PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1 GENRES USE: PERMIT TYPE: WORK I RF-V-# 1 - ADD N 200 AMP PANEL & CHANGE WINDOW TO DOOR IN N MASTER BEDRM - SCOPE 2/14/14 Elec.Plan Check 0.0 1 hrs $0.00 Elec.Permit Fee: IEPERMIT 07— Other Elec. Insp. 0.0 hrs $47.00 Ll —I-- NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 in o. FEE ITEMS ('Fee Resolution 11-053 Ef' 77,,If'13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? ()Yes (F) No $0.00 1 hours Plan Check, Hourly Suppl. PC Fee: (F) Reg. OT 0,0 hrs $0.00 $139.00 ISTPLNCK PME Plan Check: $0.00 200 1 amps Electrical Permit Fee: $0.00 $47.00 IBELEC200 Services Suppl. Insp. Feer Reg. OT ro.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $47.00 Administrative Fee: IADM/N 00 Q Work Without Permit? 0 Yes (F) No $0.00 —� Advanced Planning Fee: $0.00 Select a Non-Residential G Travel Documentation Fee: ITRA VDOC Building or Structure 0 Strong Motion Fee: $0.00 Select an Administrative Item B1d4 Stds Commission Fee: $0.00 SUBTOTALS: $138.001 $186.00 TOTAL FEE: r $324.00 Revised: 01/15/2014 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10271 Johnson Ave DATE: 09/28/2012 REVIEWED BY: Sean APN: BP#: 'VALUATION: 1$20,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY 2nd Unit? Yes • No PENTAMATION USE: SFD or Duplex OTC? 0 Yes No PERMIT TYPE: 1 R3SFDADD WORK Construct a 354 sq ft one story addition. SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,111-B,IV,V-B 354 $1,512.00 IADDPLCK $1,230.00 IADDINSP TOTALS: 1 354 1 $1,512.00 $1,230.00 Mbdit 100t ® Yes. J'No ePL TMR fi©URLY ® Yes NO ELEC HOURLY ® YesO,N 1 _ _ . C_T_ ' ElCrit ?<<'_', lwp Li NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). Theseees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef. 7,/1/11� FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,512.00 Select a Misc Bldg/Structure Suppl. PC Fee: Q Reg. () OTp.p hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $1,230.00 Suppl. Insp.Fee:E) Reg. Q OT F0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 ( (iiZS'lf'?!t71Ut7 7c!,i": FCC. 0 Work Without Permit? C) Yes E) No $0.00 E) Advanced Planning Fee: IPLLONGR $46.02 Select a Non-Residential 0 71-a"vl IDocn1;,1crra a1b)1,1 1`ecs: Building or Structure Strom Motion Fee: IBSEISMICR $2.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBtOTALS $2,791.021 $0.00 TOTAL FEES $2,791.02 Revised: 07/01/2012 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 ELI Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: a„�7 / �,A�W56V AV PERMIT# /JO?"-6-44 OWNER'S NAME: tPHONE # / - --35 3/ GENERAL CONTRACTOR: G'ff BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/ Carpeting Linoleum/Wood Glass /Glazing Heating Insulation Landscaping Lathing Masonry Painting /Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile r—/Contractor Signature Date