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13090207
CITY OF CUPERTINO BT,T)LDYNG PERMIT BUILDING ADDRESS: 10377 DENISON AVE CONTRACTOR:HOME GENERAL PERMIT NO: 13090207 CONTRACTORS OWNER'S NAME: HUR SONYA TRUSTEE 41498 TIMBER CREEK TER DATE ISSUED: 10125/2013 OWNER'S PHONE: 7143130545 FREMONT,CA 94539 PHONE NO:(5 10)709-8356 I� LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIAL License Class lb Lic. �J��� ADDITION 499SQFT,DECREASE PORCH 24SQFT, _" - I cq & DECREASE Contraetor '�,it�--_ \ Date tGAAGE 4I(RETAIN MIN 20X28 GARAGE), I hereby affirm that I am licensed under the provisions of Chapter 9 IUII "(commencing with Seetion 7000)of Division 3 of the Business&Professions ROX 50OF EXISTING HOUSE Cade and that my license is in full force and effect. �4SIONI hereby affirm under penalty of perjury one of the following two declara�i ISION#! SE ROOF FRAME,AND PATIO BEAM I have and will maintain a certificate of consent to self-insure fo' 4r' 14 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:$100000 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:31629051.00 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.l agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS 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 DAYS F AST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against Iiabilities,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 Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Q! _K 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, ❑ O\VNER-BUILDER DECLARATION I hereby affirm that I am exempt from clic Contractor's License Law for one of Signature of Applicant: Date: 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(See.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 1 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,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this _ rter_gr pulhorized agent: Dat . permit is issued ----.r.;�, —�—� 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,1 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.1 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. CONSTRUCTION PERMIT APPLICATION n COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION r�1� I 90300 TORRE AVENUE•CUPERTINO, CA 95014-3255 oo V CUP RT[NO (408)777-3228• FAX(408)777-3333•buildina(cDcuoertino.org I �"' ❑NEW CONSTRUCTION _,Ytfl ADDITION ❑ ALTERATION/TI REVISION/DEFERRED ORIGINAL PERMIT# PROIECrADDRESS -APN# •OWNERNAME �. ,,�+ - PHONE' ,` E-MAIL STREET ADDRESS 1N�f CITY,STATE,ZIP FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUDDER ❑ OWNFSIAGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENG24EER ❑ DEVELOPER ❑ TENANT CO CTORNAME LICENSE`�(�j5��,`� LICENSETYPr;,., BUS.LIC# COMPANYNAME E-MAIL FAX STR E , ADD 5_ _ CITY, TE,ZIP h-009 CA ' PHOT I c>! oo �. ARCHMCTIEN6INEEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS - CITY,STATE,ZIP PHONE DESCRIPTION OF WORK Y � JC�e Ck EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXLSTGNEW FLOOR DEMO - TOTAL AREA AREA AREA NETAREA BATHROOM KITCHEN OTHER' REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA I GARAGE AREA: 0 DETACH []ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEINGADDEV? F]NO 'ADDMON? []NO PRE-APPLICATION El YES IF YES,PROVIDE COPY OF 4S THE BLDG AN ❑YES TOTAL V PLANNINGAPPLO []NO PLANNING APPROVAL LETTER EICHLERHOME? ❑NO By my signature below,I certify to each of the following: I am the property owner or authorized agent to act o_—_—* owner's behalf. I have read this applieation and the information I have provided is correct. 1 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 a thorim representatives of Cupertino to enter the above-identified property for inspection purposes. Signature ofApplicant/Agent: Date: nt 7-7i�, l SUPPLEMENTAL INFORMATIO UIRED � s PIAN CHECIC,TYP.,E :, s..a. ,�,.. ROUTING'SLiP New SFD or Multifamily dwellings: Apply for demolition permit for r S OVER TH>rCOUtN'['ER r i v ISILDIIYGPLANREVIEW + .existing building(s). Demolition permit is required prior to issuance of building +` Lr s i permit for new building. ExrREss� ." Pxxirrs PLAN REVtEw , Commercial Bldgs: Provide a completed Hazardous Materials Disclosurei] $TANDAtU C] �II$LlcwoRxs: ^'1 form if any Hazardous Materials are being used as part of this project. �'� E K r 4 gg,,�a LARGES I e:�Ff�tFIIiElSF.P'�' �r _ Copy of Planning Approval Letter or Meeting with Planning prior to CI�zKArdxSAxrrAlt�?'sEIVERbisTluCr .. submittal Of Building Permit application. BIdgApp 201 Ldoc revised 06/21/11 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: O P �/Q� PERMIT# i'.J0 C)0'2,D OWNER'S NAME: Gjdh LA,— PHONE# -6),::)-7 7:;53 b GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: 4l-lam CITY/ZIPCODE: 'of Lf5>P *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: C" Icy/1��Q Sign re Date Please check applicable subcontractors and complete the following information: ✓ 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 y O er 1 Contractor Signature Date CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10377 DENISON AVE CONTRACTOR:HOME GENERAL PERMIT NO:13090207 CONTRACTORS OWNER'S NAME: HUR SONYA TRUSTEE 41498 TIMBER CREEK TER DATE ISSUED:10/25/2013 OWNER'S PHONE: 7143130545 FREMONT,CA 94539 PHONE NO:(510)709-8356 �r LICENSED t^ONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIAL IJ License Class_ Lic.4 $W 1s ADDITION 499SQFT,DECREASE PORCH 24SQFT, DECREASE Contractor ��� �j:�,a,+�,,;, Date d ' ''. �; >� GARAGE 40SQFT(RETAIN MIN 20X20 GARAGE), I hereby affirm that I am licensed nnder the provisions of Chapter 9 REMODEL (commencing with Section 7000)of Division 3 of the Business&Professions APPROX 500SQFT OF EXISTING HOUSE 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-itisnre 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:$100000 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:31629051.00 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 comity ordinances and state laws relating WITHIN 180 DAYS OF PE 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 LED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may aeerue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply u Date: C / with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. x RE-ROOFS: Signature Date! � All roofs shal I 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 I hereby affirm that I 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 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(See.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 maiutain 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 def ued 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,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this e permit is issued. Owner or authorized agent: Date: 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 snbject 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 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. CONSTRUCTION PERMIT APPLICATION 001 O COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 eta 6� CUPERTINO (408)777-3228• FAX(408)777-3333• buiIdinq(a7CUpertino.OTQ ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION//�DEFERRED�y/ORIGINAL PERMIT# PROJECT ADDRESS 1,311 _0.0, � )p APN# OWNER NAME D +C PHONE J r I _ ~D✓7 T E-MAIL STREET ADDRESS f p Z f7� sSd� tI CITY, STATE,ZIP / �Y rnO ' �� FAX f5 0-9 f 1--7/[QL CONTACT NAME /J�q Y I1yy� E MAIL �'f .G kq_ 1 G mo STREET ADDRESS CITY,STATE. ZIp_ FA." ' ❑OWNER ❑ OWNER-BUMDER �(OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ARCHTlE ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITECT/ENGINEER NAME 1, MY!r LICENSE NUMBER /� //Of Q BUS.LIC# oe�ens 0, COMPANY NAME E-MH. -]AFAX ' MiwISS IM- (Z tom-. STREET ADDRESS 9Lf3 Dore-1 V * CITY,STATE,ZIP PHONE y LM DESCPJPTION OF WO �^ �� AIA Zaa A 4 DG +» t G LJ krc3 GA-" -4— DI rz I ark G A aeJh U,0 l`l L P I EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES 1 r' USE TYPE OCC. SQ.FT. VALUATION(5) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODELAREA REMODELAREA REMODELAREA PORCH AREA DECKAREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? ❑NO ADDITION? El NO PRE-APPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN ElYES R CE D TOTAL VALUATION: PLANNING APPL# FlNO PLANNING APPROVAL LETTER EICHLER HOI%E? ❑NO o) O O O r+ By my signature below,I certify to each of the following: 1 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: �- SUPPLEMEN AL INFORWATIONREQUIR.ED PLANCHECKTYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for ❑. 0A'ER-T1IE=CdUNTER BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuancc of building permit for new building. % XPRE"SS PLANNING PLS REVIEMI Commercial Bldgs: Provide a completed Hazardous Materials Disclosure TANDARD 0" PUBLIC��oRxs 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 E ,MAJOR ❑, SANITARY SENVER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH B1dgApp_2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR— BUILDING DIVISION ADDRESS: 10377 denison ave DATE: 09126/2013 REVIEWED BY: APN: 316-29-51 ??? BP#: C' © 'VALUATION: 1$100,060 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY 2nd Unit? Yes No PENTAMATION USE: SFD or Duplex OTC? Q Yes E)No PERMIT TYPE: 1 R3SFDADD WORK addition 499 sq. ft decrease porch 24 sq ftdecrease garage 40 sg ft retain min 20x20 ara e SCOPE remodel approx 500 sq. feet of existing house. OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE 1D CONSTR. s.f. R-3 (Custom) I1-B,111-B,IV,V-B 500 $2,577.00 IR3PLNCK $1,617.00 IR3INSP TOTALS: 500 1 $2,577.00 $1,617.00 MECH,HOURLY Q Yes (F) No PLUMB,HOURLY Q Yes (j) No ELEC,HOURLY Q Yes Q No Mech. Plan Check Ph(mb.Plan Check Elec.Plan Check llleclr.Pernrit Fee Plumb, Permit Pee: Glec.Perntir Pee: Other Afecrh.Insp, Other Plumb Imp. 01her Elect.Insp. llech.Insp.Fe. Plumb, lns1r.Fee; Elec.Insp. Fee: NOTE:This estimate does not include fees due to other Departments(I.e.Planning,Public ;Forks,Fire,Sanitary Sewer District,School District,eta). Thesefees are based on(he prefintina information available and are on an estimate- Co►dact the De t or addn'I info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/13) FEE QTYIFEE MISC ITEMS Plan Check Fee: $2,577.00 DKIs.f. Remodel,Other Suppl.PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $488.00 IREMRESOTH PME Plan Check: $0.00 Permit Fee: $1,617.00 Suppl. Insp.Fee:Q Reg. Q OT 0,4 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: -FT $0.00 Construction Tax: Administrative Fee: Q Work Without Permit? Q Yes Q No $0,00 0 Advanced Planning Fee: 1PLLONGR $70.00 Select a Non-Residential Q Tremel Documentation Fees: Building or Structure Q i Strong Motion Fee: IBSEISMICR $10.00 Select an.Administrative Item Bldg Stds Commission Fee: IBCBSC $4.00 SUBTOTALS: $4,278.00 $488.00 TOTAL FEE: $4,766.00 Revised: 0 810 112 01 3 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: pj PERMIT# OWNER'S NAME: Qnn PHONE# GENERAL CONTRACTOR: QAIA BUSINESS LICENSE# ADDRESS: A) j CITY/ZIPCODE: 1` *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: ✓ 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 )o ISS �' 2 Ow ontractor Signature Date