The URL can be used to link to this page

13020104 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18965 TUGGLE AVE CONTRACTOR:CHEN'S CONSTRUCTION PERMIT NO: 13020104 COMPANY OWNER'S NAME: JUN SHEN 10349 LEOLA CT APT 1 DATE ISSUED:04/22/2013 OWNER'S PHONE: 4089662192 CUPERTINO,CA 95014 PHONE NO:(408)726-2956 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL L1 COMMERCIALE] License Class Lic.# C/(-,-Zi-r71 NEW TWO STORY SFD. 1934 SF OF LIVING SPACE,443 C SF GARAGE,71 SF COVERED PORCH,151 SF SECOND Contractor� �, N CQ�15T �,� , fZ.L FLOOR BALCONIES. 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. 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:$300000 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:37534003.00 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 WIT 80 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 D ROM LAST 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 Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature 14" Date (3All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,1 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 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(x)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 Code,Sections 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 agent: Date: I certify that in the performance of the work for which this permit is issued,l 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,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 1 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 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.I8. Signature Date 0 CONSTRUCTION PERMIT APPLICATION rte\ COMMUNITY DEVELOPMENT DEPARTMENT •BUILDING DIVISION / /lJ V 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333 •building(o-cupertino.org CUPERTINO \ ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS /_ � VI _ APN# OWNERNAME Rdagip ;(`^y1 , i SE� PHONE 4t-R 96G7iq�, E-MAIL STREET ADDRESS p �� Vr(vUy�/�� CITY,STATE,ZIP -t�j� FAX CONTACT NAME j;, � t PHONE LfVZS 8A_2' ''C) EMAILf��M1�`�}n/�tiJA'L, STREET ADDRESS rJ 14O ley��`� A, CITY,STATE,ZIP `Aye fL�P �t r+�A_ -7FAX ❑ OWNER ❑ OWNER-BUILDER I❑FO`WWNER\ AGENT !�❑V iCOONNTRACTOR ❑CONTRACTOR AGENT� lam( ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITECTJENGINEERNAME ^, I LICENSE NUMBER BUS.LIC H COMPANY NAME , E-MAIL ® FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK �K L)l�Iv L (r i' `w y 1 \J Z Sr OamC for r_- 3 F A EXISTING USE PROPOSED USE CONSTR TYPE 1 4 STORIES o ^'�'] +�.VA USE TYPE 2OCC. ?SQQ..FT. VALUATION(S) EXISTAREA NEW FLOOR DEMO D l �A 173 I / �A gi IV NET AAREA Li l�� BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH �15�-7 � tl,y ATTACH H DWELLING UNUS: IS A SECOND UNIT ❑YES SECOND DRY S BEING ADDED? NO ADDITION? NO PRE-APPLICATION 14 YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES �REC �Drq._, TOTAL Y LUATION: PLANNING APPL# NO PLANNING APPROVAL LETTER EICHLERHOME? 'TPNO l� CTO-7�By my signature below,I certify to each of the following: I am the property owTn"�er or aut the erty 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 te. I agree to comply with all applicable local ordinances and state laws relating to building construction. I author' representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: -, Date: e 0 SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP _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 111 permit for new building. ❑ EXPRESS PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 119 STANDARD PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE FIRE DEP `SWR �� _Copy of Planning Approval Letter or Meeting with Planning prior to E] MAJOR El SANITARY SE�G�:R DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH B1dgApp_2011.doc revised 06121111 CITY OF CUPERTINO j FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 18965 TUGGLE AVE DATE: 02/20/2013 REVIEWED BY: MELISSA APN: 375 34 003 BP#: C4-20/01V *VALUATION: 1$300,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY SFD or Duplex 2nd Unit? Yes No PENTAMATION 1 R3SFDW USE: PERMIT TYPE: WORK I NEW TWO STORY SFD. 1934 SF OF LIVING SPACE 443 SF GARAGE 71 SF SCOPE COVERED PORCH, 151 SF SECOND FLOOR BALCONIES. OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. sS. R-3 (Custom) II-B,111-B,IV,V-B 2,448 $2,755.70 IR3PLNCK $2,579.95 IR3INSP TOTALS: 2,448 $2,755.70 $2,579.95 . COI. 1 CIA Li; t'hurrb. f'�r;r Ciu��1 Elec.Plan Chuck Afech.Permit Fee: Plumb, Pe7mit Fre: Elec, Permit Pe<. Other>Lteeh.Insp Other Plumb Insp Other Elec. Insp. Ll Aleech, Hasp. Fee: Plumb. Insp.Fee: Elec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(Le.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 info. FEE ITEMS (Fee Resolution 11-053 a 711/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,755.70 Select a Misc Bldg/Structure Suppl. PC Fee: (F) Reg. C) OT 0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $2,579.95 Suppl. Insp. Fee-0 Reg. Q OT0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 #new Construction Tax: IB CONSTAXR 1 units $ .29 Administt-ative F(e: Work Without Permit? C) Yes E) No $0.00 G Advanced Planning Fee: IPLLONGR $318.24 Select a Non-Residential 0 Trcn,el Doctanentation Fees: Building or Structure i Strong Motion Fee: IBSEISMICR $30.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $12.00 SUBTOTALS: $6,325.18 $0.00 TOTAL FEE: 1 $6,325.18 Revised: 01/01/2013 Building Department LI City Of Cupertino ig V 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C O P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: , j PERMIT# r O /0 OWNER'S NAME: JVLn k*n PHONE# GENERAL CONTRAC OR:(:t 't C) - 4LC 0BUSINESS LICENSE# ql ADDRESS: ,' �`� de - CITY/ZIPCODE: Cjt *Our municip l code re wires all businesses workin in the city to have a City of Cupo busi ess 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: A�. r/ SUBCONTRACTOR BUSINESS NAME BUSI SS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Flooring / Carpeting Linoleum/ Wood Glass/Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing �- Roofing Septic Tank Sheet Metal Sheet Rock Tile *71 Owner/do ntractor Signature Date 1 GREEN SIGNATURE DECLARATIONS Project Name: SHEN' Project Address: 18965 TUOESIDENCE LE AVENUE one lus Project Descriptio NEW 2,3 SF TWO STORIES HOME _ SECTION 1 - DESIGN VERIFICATION Complete all lines of Section 1 —"Design Verification"and submit the completed checklist(Columns 1 and 2)with the plans and building permit application to the Building Department. The owner and design professional responsible for compliance with CalGreen Standards have revised the plans and certify that the items checked above are hereby incorporated into the project plans and will be implemented into the project in accordance with the requirements set forth in the 2010 California Green Building Standards Code as adopted by the City of Cupertino. Owner's Signature Date RICKY JUN SHEN Owner's Name (Please Print) Design Professional's Signature Date FRANK LINH HO Dsi rolessi I's Name (Pleas 02/18/2013 Si nature of License Professional responsible for CalGreen compliance Date FRANK LINH HO 408.892.5020 Name of License Professional responsible for CalGreen compliance(Please Print) Phone FRANKLHO@YAHOO.COM Email Address for License Professional responsible for CalGreen compliance SECTION 2 - IMPLEMENTATION VERIFICATION Complete, sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was construr4ed in accordance with this Green Building Checklist and in accordance with the requirements of the 2010 Califordireen_13uildin dards Code as adopted by the City of Cupertino. 03/04/2014 Si nature of License Professional responsible for CalGreen compliance Date FRANK LINH HO 408.892.5020 Name of License Professional responsible for CalGreen compliance(Please Print) Phone FRANKLHO@YAHOO.COM Email Address for License Professional responsible for CalGreen compliance Page 5 of 5 CalGreen_2010.doc revised 08/27/// PUBLIC WORKS CONFIRMATION FORM Public Works Department 10300 Torre Avenue (408) 777-3354 / Fax (408)777-3333 Cupertino, CA 95014 publicworks@cupertino.org L U P E RT I N O I http://www.cupertino.org/publicworks A Public Works confirmation form, if required, must be completed prior to project submittal to the Planning Department. The fee for the confirmation is $263.00. If a Building Permit Application is submitted within one year of the sign-off date at the bottom,the confirmation fee will be applied towards the Public Works Building Permit fee. The purpose of this confirmation is to identify preliminary Public Works issues, which may adversely affect the application. Please submit this form, the fee, and a copy of the site plan to the Public Works Department for review. The Public Works Department can be reached at (408) 777-3354. she 2o0 '/ Project Address: �UVL Email Address: Applicant Name: ./1 SA�4 Phone No: *** For Public Works Department Use Only *** PW Confirmation Required ($263) PW Confirmation Not Required Addition: Single Family Dwelling Flood Zone: Requirements: ❑ Dedicate Right-of-way (road): T�lq ElEasement(streetlight): Offsite improvements re wired (circled) sidewa cur r, cur r z rivewa pavement,street ligh s et ee -1, 'x* v `I V'�"� ❑ Registered civil engineer requil•ed to YeWggn grading plans or imp �`rovement plans Clearly show all utility lines from the house/project site to the street(electric,electric panel, gas,water, sewer). Indicate as new (N) or existing (E) ❑ Underground all overhead utility service to new house or new electric panel '*ND Show onsite drainage on site plan with direction and slope percentage /❑ Include relevant City Standard notes and Details on plans ncroachment permit r Development Agreement -_ [IStreamside Permit V� �7 1 bb J\ lC. C &L77PC-� ❑ Soils letter/report `C �(RA �- ✓ Submit preliminary title report and Quitclaim underground water rights Comments -DYFV�T ON — 5lT __," AQ15' }� 7 �. ��,►�J d !� 07 � Signature Title Date Sheet 4 of 4 App2012-13.doc revised6128/1.2 HAZARDOUS MATERIALS CHECKLIST COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333• building(cDcupertino.org PURPOSE To minimize possible delays that would result for the Fire Department plan review, please complete the following checklist to determine if an additional level of Hazardous Materials plan review will be required. MARK `YES' IF THE PROPOSED SCOPE OF WORK INCLUDE ANY OF THE FOLLOWING? PLEASE MARK YOUR ANSWER WITH AN `X' IN THE YES OR NO BOX ON THE SIDE YES NO BELOW. 1. Use, dispensing, mixing or storage of flammable or combustible liquids or gases, hazardous materials, etc. 2. Battery back-up rooms or racks. 3. Propane tanks. 4. Gasoline stations with underground tanks. 5. Installation or replacement above ground or underground storage of liquid petroleum products, liquefied petroleum gases, compressed natural gas, explosives or other regulated hazardous materials. 6. Gas rooms for dentist, doctors or veterinarians. 7. Generators with back-up diesel or other fuels. x 8. Large refrigeration systems. 9. Fuel cell systems. 10. Commercial pool systems. 11. Chemical Storage areas. 12. Flammable liquid storage. 13. Compressed Gases. 14. Dry cleaners. 15. Print Shops. 16. Auto Repair and Auto Body Shops. 17. Research and Development. For any additional information regarding this checklist, please contact Hazardous Materials Specialist, Santa Clara County Fire Department, at (408) 378-4010. Has Ma[ 2011.doc revised 03/07/11