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12100017 CITY OF CUPERTINO BUILDING PERMIT BUILDING.ADDRESS: 18771 BARNHART AVE CONTRACTOR:CHUNG CHOY PERMIT NO: 12100017 OWNER'S NAME: CHUNG CHOY 3567 MAURICIA AVE DATE ISSUED:04/22/2013 ONVNER'S PHONE: 4086210067 SANTA CLARA,CA 95051 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIALE] License Class Lic.# CONSTRUCTION OF NEW SINGLE STORY,SINGLE FAMILY Contractor Date RESIDENCE(VACANT LOT),2821 SQFT,430 SQFT I hereby affirm that I am licensed under the provisions of Chapter 9 GARAGE,290 SQFT COVERED PORCH-SANITARY IS IN (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:37517056.00 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 WITHINt80DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enterupon the above mentioned property for inspection purposes. (We)agree to save 180 DAOM 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 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 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 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 I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 2550 ,,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this yr permit is issued. Owner or authorized age �/ ` 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,1 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 l 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. J Signature -- Date / CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18771 BARNHART AVE CONTRACTOR:CHUNG CHOY PERMIT NO: 12100017 OWNER'S NAME: CHUNG CHOY 3567 MAURICIA AVE DATE ISSUED:04/22/2013 OWNER'S PHONE: 4086210067 SANTA CLARA,CA 95051 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL License Class Lic.# CONSTRUCTION OF NEW SINGLE STORY,SINGLE FAMILY Contractor Date RESIDENCE(VACANT LOT),2821 SQFT,430 SQFT I hereby affirm that I am licensed under the provisions of Chapter 9 GARAGE,290 SQFT COVERED PORCH-SANITARY IS IN (commencing with Section 7000)of Division 3 of the Business&Professions DEFERRED SUBMITTAL#1-TRUSS CALCS-ISSUED 7/30/2013 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:37517056.00 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 DAY 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_DAYS ST 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 granting of this permit. Additionally,the applicant understands and will comp) a Date: U with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 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. t 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(Sec.7044, Business&Professions Code) �',Cc 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 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 Workers Compensation Insurance,as provided for by the Health&Safety Code,Sections 0 x35533,and 2,1V34. Section 3700 of the Labor Code,for the performance of the work for which this >15I permit is issued. Owner or authorized agent• a 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,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 ur regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. --L �L%� Signal / Date CONSTRUCTION PERMIT APPLICATION [a COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228• FAX(408) 777-3333•building(a)cupeltino.org ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERA�T^ION/TI ❑D REVIS /DEFERRORIGINAL PERMIT# PROJECT ADDRESSN ._ OWNER NAME `LL PHONE E-MAIL STREET ADDRESS CITY, STATE,ZIP FAX CONTACT NAME '��,u .�� PHONIfrf_p�� � 36J r �, E-MAIL STREET ADDRESS G CITY,STATE,ZIP f GY— FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMELICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME LMAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK (s �A rl�k,I S EXISTING USE PROPOSED USE CONSTR.TYPE 0STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODELAREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA 7;E7DECKfPORCH AREA GARAGE AREA: UDETACH []ATTACH b DWELLING UMTS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? ❑NO ADDITION? ❑NO PRE-APPLICATION []YES EF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED TOT ATION: PLANNING APPL H []NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO By my signature below,I certify to each of the-fo ng: I am the property owner or authorized ager#t ct on the property owner's behalf. I have read this application and the information I rovided is co ct. I have read the Description of Work and veri t is accurate. I agree to comply with all applicable local ordinances and state laws rela to. ding c on. I authorize representatives of Cupertino to enter the above-id ti/feed property for inspection purposes. d- - 1L /! Signature ofApplicand ent: Date: ` x !1 S PPLEMEN TAL'INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP New SFD o ultifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW existing buiIding(s). eTtltltition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part Of this project. ❑ LARGE ❑ FIRE DEPT _Copy of PIanning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH' BldgApp 2011.doc revised 06/21/11 l�t� J6.11M1,7` CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 (408) 777-3228• FAX (408) 777-3333• building(aDcupertino.org C PERTlNO / NEW CONSTRUCCTION ❑ ADDITION ❑ ALTERATION/Tl ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 1 �01Y V) \ o R APN tl/ �yy� OWNER NAME �Y 1 I/I•1 ��O'� C PHONE�j 1.13 6 y J �TTTE-MAIL O STREET ADDRESS / �(Ar[ C Cc v-P- CITY, STATE,ZIP,--­ 10 IP - N�� C10 V6 C'I � F� CONTACT NAMEI I a 'n PHO E / E-MAIL U O STREET ADDRESS CITY,STATE, ZIP�� ClG Ur rG � 4r-C FAX y j ❑OWNER ZJ 0WNER-BUILDFR ❑ OWNER AGENT ❑ CONTRAC-TOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME r ! - P LICENSE NUMBER LICENSE TYPE BUS.LIC N COMPANY NAME © E-MAIL FAX STREET ADDRESS '{ CITY,STATE,ZIP PHONE ARCHITECT/ENGINEER NAME 77 Q Q n yvvv111,' LICENSE NUMBER BUS.LIC# COMPANY NAMET 1 p S S E-MAL T n/f t I M per'Ek C � n� FAXG STREET ADDRESS pp N � CITY,STATE,ZIP r 1 r Qv L O PHONE,/},,Q 37 DESCRIPTION OF WORK I�r l I✓1 I^� v. G U G r9 rG G/3U EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION(S) 1%111v-�e �t=� 1/3 % EXISTG NEW FLOOR DEMO TOTAL �r� ^3 AREA /� AREA f,�� J AREA NET AREA�a.�( � I �.7 F rim ! ( V--' ✓ "�J BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA (/`,J/l �V/ 41340PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: UDETACH GO 7�36 ❑ATTACH #DWELLING UMTS: ISA SECOND UNIT []AYES SECOND STORY [:],YES CJ / BEING ADDED. 8NO ADDITION. ffNO PRE-APPLICATION ❑� I'YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED TOT VALUATION: PLANNING APPL# PLANNING APPROVAL LETTER EICHLER HOME? �JO ���^/ � Q Q 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 constLuction, I authori r entaC s of Cupertino to enter the above-iden Ked prop for inspection purposes. Signature of ApplicanUAgent: Date: // -, C) �' 2� / L-- SUPPLEMENTAL INFORMATI N 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 permit for new building- ❑ EXPRESS ,{PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD t PUBLIC 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 y MAJOR SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ElENVIRONMENTAL HEALTH BldgApp_2011.cloc revised 06/21/11 CITY OF CUPERTINO h �OQI �7 FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 18771 Barnhart Ave DATE: 10/02/2012 REVIEWED BY: Sean APN: BP#: IoZ10001'7 *VALUATION: $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 Construction of one story residence 2821 sq ft with attached garage 430 sq ft and covered porches SCOPE (290 sq ft). OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) 11-8,111-B,IV,V-B 3,541 $2,966.76 IR3PLNCK $3,067.19 IR3INSP TOTALS: 3,541 $2,966.76 $3,067.19 Alcc;ir Plan C'kec'4 Phumb.Plan( ,4r<:„ Plum Chcek Mech. Permit Fee. Plumb.Permit Fee: Elec. Permit Fee: Other Mech.Insp. Other Plumb Insp. Lj Other Elec.Insp. Ll I— iVech.Insp. Fee: Plumb. In-y. 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 addh7 info. FEE ITEMS (Fee Resolution)1-053 Elf.' 711/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,966.76 Select a Misc Bldg/Structure Suppl. PC Fee: Q Reg. O OT 0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $3,067.19 Suppl. Insp. Fee.S Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 #new Construction Tax: IBCONST A7? 1 units $595.41 Administrative Fee: 0 Work Without Permit? C) Yes (j) No $0.00 0 Advanced Planning Fee: IPLLONGR $460.33 Select a Non-Residential G Trcavl Documentalion Fees Building or Structure 0 Strong Motion Fee: IBSEISMICR $30.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $12.00 SUBTOTALS: $7,131.69 $0.00 TOTAL FEE: 1 $7,131.69 Revised: 07/01/2012 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CU P E RTI N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: IS771 OA RN H �?RT f-1 i PERMIT# ►,11 v OG 1 7 OWNER'S NAME: CH U tQ& C-H Q PHONE# 400 2- 006 GENERAL CONTRACTOR: 60K COV51 RqC T-toe ' BUSINESS LIC NSE# Ir SZ 3 4 0$7 ADDRESS: Cc 66K 1g:2 CITY/ZIPCODE: LU15p C(q gS`00 *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork J$�g Cd/)5j'f"i2.l�fC770A) $ Cement Finishing 614 k CDN 5-r- aC--n owl 3q097 Electrical 5� H K I ,j 9V-7 Excavation 34' 99 7 Fencing 13 H < Flooring /Caq?e&q 13 H i< 3 Y-9R 7 Li m/Wood 1$ H k 0 Le- 9-9 7 Glass /Glazing 6H {L ti ? q-$j1?--7 Heating j AA,-1 t+V AC, $ 7 1 8 Insulation (31`1 IC Cd/L/9T2Tro3 ;9, 7 Landscaping 34-53 I Lathing g ( {< GDA/5TQ UG-r10,4) 8 7 Masonry &11A- Painting/Wallpaper 13 H t<- 7 Paving -rA GONCe 6 7-iF- 3 L4- S-3 1 Plastering Plumbing L-0(-� A PL iii M 6 i A)e, 2- Roofing Roofing A K C.o IJ Q U c,f r p/JIJC:' Septic Tank /V Sheet Metal A.1 j4r Sheet Rock !3 H IL 3 LJ>99 7 ' t-'g Oz' C- ie'� i1 err/Contractor Signature