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13080080
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18644 LOREE AVE =NTRACTOR: N y PJ IN ERMIT NO: 13080080 OWNER'S NAME: TED SUL AND AMY CHENG DATE ISSUED: 10/14/2013 OWNER'S PHONE: 4085296109 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIALE] License Class Lic.4 71L i 472 SQ FT OF ADDITION TO INCLUDE M.SUITE,CLOSET �!� rr�� AND BATHROOM,REMODEL KITCHEN AND ENTRY Contractor rTYILO+tH J Date^ V WAY, I hereby affirm that I am licensed under the provisions of Chapter 9 INSTALL TANKLESS WATER HEATER (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in frill 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 performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$75000 e, 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:37525070.00 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 + RMIT 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 L 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 Date: y /3 with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. ,t r+.; l.. /2 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,l agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Lawfor 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) 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 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 Workcr'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 Arca 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,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: 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,1 CONSTRUCTION LENDING AGENCV become subject to the Worker's Compensation provisions of the Labor Code,I 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.1 agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this eity 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 1 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 Z COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 /�§ CUPERTINO (408)777-3228• FAX(408)777-3333•building0cupertino.org `V ❑NEW CONSTRUCTION i2f ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 9c 4,f 167 7APN# -,)75r 2S-020 OWNER NAME Rut PHO —52- C 9^ W MAI G45\ *r 1 _, [, STREET ADDRESS n �O CI , ATE �b�� FAX !l lJ �U CONTACT NAME � � PHONE STREETADDRESS Ti.Z:?-� 1; \N%R,4�t CITY,STATE,ZIP �t4 ^ FAX ❑owNER ❑ OWNER-BUILDER ❑ owNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ARCHITECT ❑ENGRXER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCHCCECTIENGINEERNAME (tj�ly Cs LICENSE NUMBER G �2r-� BUS.LIC# COMPANY NAME CItUW (�jl /� uE-MAI . CC�Jn_,,�-�`^ `n FAX AX 2� �+A/- ` CI ,STATE,ZIP PHONE DESCRIPTION OF WORK D EXISTING USE PROPOSED USE CONSTIL TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA�0 AREA t 5,Z() AREA NETAREA BATHROOM KITCHEN OTHER RFMODELAREA REMODEL AREA I AEMODELAAIA PORCHARF.A DECK AREA TOTALDECKIPORCHAREA GARAGEAREA: DETACH ❑ TTACH ft DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY []YES BEINGADDED? 'GiNO ADDITIONS? ;WO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEI ED 13 T TAL VALUATION: PLANNING APPL ff � PLANNING APPROVAL LETTER EICHLER HOME?(;SPO � 'JLC 00O, r� By my signature below,I certify to each of the fo wing: I am the property owner or authorized gont to act on the property owner's behalf. I have mad this V V application and the information I have p vide rrect. I have read the Description of Work verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to bu I 'ng o ction. 1 authorize representatives of Cupertino to enter the above- en fled property for inspection purposes. Signature of Applicant/Ag ent: Date: I ` � SUPPLEMENTAL INFORMATION RE UIRED PLAN CIIECK TYPE ROUTING SLIP _New SP'D or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-C UNTER ❑ D NG PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. -XPRrSS LANNH[G PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD PUBL C 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 ❑ AtAaoR ANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH 8ldgApp_1011.doc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 18644 LOREE AVE DATE: 08/1212013 REVIEWED BY: Mendez APN: BP#: VALUATION: 1$75,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY 2nd Unit? Yes • No PENTAMATION SFD or Duplex OTC? ©Yes 1 R3SFDADD USE: ©No PERMIT TYPE: WORK 1472 SQ FT OF ADDITION TO INCLUDE M.SUITE CLOSET AND BATHROOM REMODEL KITCHEN SCOPE I AND ENTRY WAY, INSTALL TANKLESS WATER HEATER OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE 1D CONSTR. s.f. R-3 (Custom) II-B,III-B,IV,V-B 472 N72415—Y,-Q7, ADDPLCK $1,284.00 JADDINSP TOTALS: 472 $1,579.00 $1,284.00 MECH,HOURLY Yes O No PLUMB,HOURLY Q Yes Q No ELEC,HOURLY Q Yes Q No Nfech.Plan Check Plumb,Plan Check 0.0 hrs $0.00 Elec. Plan Check Afech. Perniir Fee: Plumb.Permit Fee: 1PPERAET tree.Pennir Fee: OrheA1cch.Insp. Other Plumb Insp. 0.0 hrs $47.00 Ocher flee.Insp, ,Ucch. Insp.Fee: Phuub. hnsp.Fee: Elec.Insp.Fee: NOTE:This esdinate does not include fees dire to other Departments(Le-Planning,Public Works,Fire,Sanitary Sewer District,School District,em). These ees are based on the prefitninarV information available and are only an estirrrate- Contact the De t or addn'1 Info. FEE ITEMS (Fee Resohition 11-053 E f 7/1/122 FEE QTYIFEE MISC ITEMS Plan Check Fee: $1,579.00 60 s.f. Remodel,Other Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $418.00 IREMRESOTH PME Plan Check: $0.00 = # Plumbing Permit Fee: $1,284.00 $28.00 1PRWHERTR Water Heater Suppl. Insp. Fee.0 Reg, OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: -T-T $47.00 Construction Tax.- Administrative ax:Administrative Fee: Q Work Without Permit? ® Yes Q No $0.00 G Advanced Planning Fee: 1PLLONGR $66.08 Select a Non-Residential G Travel Documentation Fee: ITRA VD0C $47.00 Building or Structure Stron.g Motion Fee: 1BSEISMICR $7.50 Select an Administrative Item Bldg,Stds Commission Fee: 1BCBSC $3.001 1 SUBTOTALS: $3,033.581 $446.00 TOTAL FEE: I $�W-58 Revised: 07/0112013 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 950I4-3255 Telephone: 408-777-3228 C U P E RTI N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: /S b 1,o,'c— Ave, PERMIT# (10 '34>090 OWNER'S NAME: A-,,A C-kcX PHONE# '1 7-5 o G GENERAL CONTRACTOR: Ji, ,J, D,,,,.r Cotes BUSINESS LICENSE# ADDRESS: 1151Y9 Ljh,j.% j)i- (�nca, �YS z( CITY/ZIPCODE: C'-f�•tw,� �Ya--r *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/GIazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Ow ontractor Signature Date