13120074FA
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10143 LOCKWOOD DR
CONTRACTOR: K C WU CONSTRUCTION
PERMIT NO: 13120074
OWNER'S NAME:
FREMONT, CA 94536
PHONE NO: (510)739-1365
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL
' ! Z
�r/
ADD 499 S.F. TO SFD, REMODEL (E) KITCHEN & BATH
License Cla—,B., 1 Lie. # b `�
(TOTAL 140 S.F.) & REPLACE WATER HEATER WITH (N)
<"7~ / `�3
C ��
TANKLESS
Contractor � Cpe l4 Date
REV # 1- REPLACE (E) SEWER LINE & ADD PROPERTY LINE
I hereby affirm that I am licensed under the provisions of Chapter 9
CLEANOUT PER CUPERTINO SANITARY - ISSUED 2/13/15
(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:
SANITARY
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
erformance of the work for which this permit is issued.
Sq. Ft Floor Area:
Valuation: $80000
I have and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 34214030.00
Occupancy Type:
Section 3700 of the Labor Code, for the performance of the work for which this
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 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
DAYS F CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
Led
costs, and expenses which may accrue against said City in consequence of the
by: Date: 3
granting of this permit. Additionally, the applicant understands and will comp)
with all non -point source regulations per the Cupertino Municipal Code, Se n
ROOFS:
9.18.
(-
_f �^ t
Signature Date J
r
All roofs shall be inspected prior to any roofing material being installed. If a roof is
any
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
❑ OWNER -BUILDER DECLARATION
Signature of Applicant: Date:
1 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
Section 3700 of the Labor Code, for the performance of the work for which this
the Health & Safety Code, Section505, 2 , and 25534.
Date
Owner or authorized agent:
permit is issued.
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
CONSTRUCTION LENDING AGENCY
Compensation laws of California. If, after making this certificate of exemption, I
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
:K
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10143 LOCKWOOD DR CONTRACTOR: Kc w6t
PERMIT NO: 13120074
NS 7 Z aC- vN
OWNER'S NAME:
PHONE NO:
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL
ADD 499 S.F. TO SFD, REMODEL (E) KITCHEN & BATH
/' _
License Class c 3 6 Lic. # 0'/ 04- -)L-]Q
(TOTAL 140 S.F.) & REPLACE WATER HEATER WITH (N)
-a _ n l �
"
TANKLESS
Contractor
I hereby .rm 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: $80000
have and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 34214030.00
Occupancy Type:
Section 3700 of the Labor Code, for the performance of the work for which this
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 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 ALL 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
y' Date:
granting of this permit. Additionally, the applicant understands and will comply
with all
�� Date - �l y
RE -ROOFS:
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
61
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)
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
1 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
for this
the Health & Safety Code, Sections 25505, 25533, and 25534. /!
Section 3700 of the Labor Code, for the performance of the work which
Owner or authorized
permit is issued.
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
CONSTRUCTION LENDING AGENCY
Compensation laws of California. If, after making this certificate of exemption, I
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
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10143 LOCKWOOD DR
CONTRACTOR: WONG PAKMAN AND
PERMIT NO: 13120074
WANG FEN-HUA TRUSTE
OWNER'S NAME:
CUPERTINO, CA 95014
PHONE NO:
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL E]
❑ LICENSED CONTRACTOR'S DECLARATION
ADD 499 S.F. TO SFD, REMODEL (E) KITCHEN & BATH
License Class Lic. #
(TOTAL 140 S.F.) & REPLACE WATER HEATER WITH (N)
TANKLESS
Contractor Date
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: $80000
I have and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 34214030.00
Occupancy Type:
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXPIRES IF C IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN S OF P T ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
1 ED INSPECTION.
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
(�
costs, and expenses which may accrue against said City in consequence of the
Date: 7
granting of this permit. Additionally, the applicant understands and will co
with all non -point source regulations per the Cupertino Municipal Code, S c ton
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.
fif 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)
, as owner of the property, am exclusively contracting with licensed contractors to
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
1 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 Cu ertino M 'cipal Code, Chapter 9.12 and
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
the Health & Safety Code, Sections 5,105 , a d 25534.
Owner or authorized agent: Date:
rmit is issued.
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
CONSTRUCTION LENDING AGENCY
Compensation laws of California. If, after making this certificate of exemption, I
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 re ulation er the Cupertino Municipal Code, Section
Licensed Professional
9.18.
Signature Date f%
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
OCCUPANCY TYPE:
ADDRESS: 10143 LOCKWOOD DR
DATE: 12/09/2013
REVIEWED BY: MELISSA
PC FEE ID
APN: 342 14 030
BP#: 1o7bd -7
-VALUATION:
$80,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Addition
PRIMARY SFD or Duplex
USE:
2nd Unit? • Yes No
OTC. 0 Yes ONo
PENTAMATION 1 R3SFDADD
PERMIT TYPE:
WORK
ADD 499 S.F. TO SFD REMODEL E KITCHEN & BATH TOTAL 140 S.F. & REPLACE WATER
SCOPE
HEATER WITH (N) TANKLESS
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.L
PC FEES
PC FEE ID
BP FEES
BP FEE ID
R-3 (Custom)
II-B,111-B,IV,V-B
499
$1,579.00
IADDPLCK
$1,284.00
1ADDINSP
like hall, (cc:
$0.00F$28.00
#
Plumbing
IPRwHEATR Water Heater
Permit Fee:
$1,284.00
Suppl. Insp. Fee -0 Reg. 0 OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$47.00
T__=
TOTALS:
499
$1,579.00
$1,284.00
MECH, HOURLY 0 Yes 0 No
PLUMB, HOURLY 0 Yes 0 No
ELEC, HOURLY 0 Yes 0 No
MISC ITEMS
Plumb. Plan Check 0.0 1 hrs $0.00
/-/tcc- t'%cry Chcck
$1,579.00
Plumb. Permit Fee: 1PPERMIT
Other Plumb Insp. 0.0 hrs $47.00
Uih' ,' /'1' bm"',
hrs
$0.00
like hall, (cc:
$0.00F$28.00
#
Plumbing
IPRwHEATR Water Heater
NOTE: This estimate does not include fees due to other Departments (Ge. riannmg, ruouc rrvrns, . err, �u.«<u•y ,�rv�• �-•�•• ��••��-
1'' t'on available and are onlyan estimate. Contact the Dept or addn'1 into.
District, etc). These Lees are based on the re tmtna
FEE ITEMS (Fee Resolution 11-053 E(f: 711;'13)
to orma i
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$1,579.00
=s.£
$418.00
Remodel, Other
1REMRESOTH
Suppl. PC Fee: 0 Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00F$28.00
#
Plumbing
IPRwHEATR Water Heater
Permit Fee:
$1,284.00
Suppl. Insp. Fee -0 Reg. 0 OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$47.00
T__=
< "onsiruction Tax:
Idininistrativc 1 ire:
0
Work Without Permit? 0 Yes 0 No
$0.00
Advanced Plannin& Fee: IPLLONGR
$69.86
Select a Non -Residential
Building or Structure
0
D,
Travel Documentation Fee: ITRAVDOC
$47.00
Strong Motion Fee: 1BSEISMICR
$8.00
Select an Administrative Item
1
Bids Stds Commission Fee: IBCBSC
$4.001
SUBTOTALS:
$3,038.861
$446.00
TOTAL FEE:
$3,484.86
Revised: 10i0ii20i3
CITY OF CUPERTINO
I�Y`_Yl/JI FFF. FCTIMATOR — WILDING DIVISION
APPLIANCE/ EQUIP TYPE
10143 LOCKWOOD DR
DATE: 02/13/2015
REVIEWED BY: MELISSA
IQADDRESS:
APN: 34214 030
BP#: 13120074
`VALUATION: Iso
*PERMIT TYPE: Plumbing Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY SFD or Duplex
p
#
PENTAMATION 1 RPSS
PERMIT TYPE:
USE:
Permit Fee:
Sh l
WORK
REV # 1 - REPLACE E SEWER LINE & ADD PROPERTY LINE CLEANOUT PER CUPERTINO
SCOPE
SANITARY - ISSUED 2/13/15
APPLIANCE/ EQUIP TYPE
FEE ID
Plumb. Plan Check 0.0 hrs $0.00
QTY
UNITS
BP FEES
Rec. Pennir Fee:
Sewer, Sanitary
1 PRSEWER
� )i/wr lilec. Insp.
E3
1
#
$25
Permit Fee:
Sh l
Suppl. Insp Feta
PME Unit Fee:
$25.00
PME Permit Fee:
$48.00
—I
L
Administrative Fee: 1ADMIN
$45.00
-
$0.00
TOTALS:
i
Travel Documentation Fee: ITRA VDOC
$25.00
Strong Motion Fee:
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer Dtstrict, c 00
I_ _ L ---,J .L_ vn;mhte and are nnty an PwimatP. Contact the Dent for addn'l info.
uis[ncy e[a ineae ee� u•e uu�au v • - --- are
FEE ITEMS (Fee Resolution 11-053 Ejf 7/1/131
FEE
Plumb. Plan Check 0.0 hrs $0.00
'.lec. P/on Check
/tech, P
Plumb. Permit Fee: IPPERMIT
Rec. Pennir Fee:
Other Alech. Insp.
Other Plumb Insp. 0.0 hrs L $48.00
� )i/wr lilec. Insp.
E3
,kfech. Insp. Fee:
PME Plan Check:
$0.00
Permit Fee:
Sh l
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer Dtstrict, c 00
I_ _ L ---,J .L_ vn;mhte and are nnty an PwimatP. Contact the Dent for addn'l info.
uis[ncy e[a ineae ee� u•e uu�au v • - --- are
FEE ITEMS (Fee Resolution 11-053 Ejf 7/1/131
FEE
QTY/FEE
----
MISC ITEMS
Plan Check Fee:
,Suppl. PC' Fee
PME Plan Check:
$0.00
Permit Fee:
Suppl. Insp Feta
PME Unit Fee:
$25.00
PME Permit Fee:
$48.00
construction Tax:
Administrative Fee: 1ADMIN
$45.00
Work Without Permit? C) Yes E) No
$0.00
idr(nu•f d Planning (ices
i
Travel Documentation Fee: ITRA VDOC
$48.00
Strong Motion Fee:
$0.00
Select an Administrative Item
—L
Bldg Stds Commission Fee:
$0.00
SUBTOTALS:
$166.00
$0.00 TOTAL FEE:
$166.00
Revised: 01/06/2015
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