14060002 CITY OF IC1UPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7575 SQUIREWOOD WAY CONTRACTOR:SHENG'S PERMIT NO: 14060002
CONSTRUCTION INC
OWNER'S NAME: LEE PERKINS AND MINGLUEN GRACE YUAN 10078 SANTA CLARA AVE DATE ISSUED:06/02/2014
OWNER'S PHONE: 4088078666 CUPERTINO,CA 95014 PHONE NO:(415)519-7874
LICENSED CONTRACTOR'S DECLARATIONJOB DESCRIPTION:RESIDENTIAL E] COMMERCIAL
i o ( � REMODEL(E) KITCHEN&2(E) BATHROOMS,ADD 19(N)
License Class 2 Lic.# RECESSED LIGHTS&REPLACE S WINDOWS& 1 SLIDING
GLS DOOR(WILL MEET EGRESS& BE TEMPERED
Contractor Date WHERE
1 hereby affirm that 1 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:
1 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
Jhravn
foance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$30000
je ad will maintain Worker's Compensation Insurance,as provided for by
ctio3700 of the Labor Code,for the performance of the work for which this APN Number:36227005.00 Occupancy Type:
irut 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 ������ Ili®���� ®� E ISSUANCE ®�
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 1 ED PECTION.
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 c ssu Date:
with all non-point source regulations per the Cupertino Municipal Cod , ion
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
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, 1 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 1
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 25505,255 3,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this — r
permit is issued. p Owner or authorized agen Dater '� ���
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
indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION
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
CONSTRUCTION PERMIT APPLICATION O�
02
COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION rl�
10300 TORRE AVENUE o CUPERTINO, CA 950143255 V
CUPERTINO (408)777-3228 o FAX(408)777-3333 o building()cupertin°.org
❑NEW CONSTRUCTION ❑ ADDmoN ❑X ALTERATION i Ti ❑ REVISION I DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS 7575 Squirewood Way I
APN# 362-27-005-00
OwNERNAME Lee F. Perkins and Grace Min luen Y
PH
408-807-8666 E-MAIL
g gryuan998@gmail.com
STREET ADDRESS CITY,STATE.ZIP FAX
7575 Squirewood Way Cupertrino,CA
CONTACT NAME Steven Chu PHONE 408 505-9985 E-MAIL stevencchu@hotmail.com
STREET ADDRESS 10615 John Way CITY,STATE,ZIP Cupertino,CA I
FAX
. ❑OWNER ❑ OWNER-BumDER ❑ owNER AGENT ❑ CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT 12ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME Sheng Yong. LICENSE NUMBER U LICENSE TYPE B BUS.LIC#
COMPANY NAM Sheng's Construction Inc. E-MAIL sheng.yyu@gmail.com FAX
STREET ADDRESS 10078 Santa Clara Ave CITY,STATE,21P Cupertino, CA PHONE
415 519-7874
ARCHTTECr/ENGINEER NAME LISE N
CENUMBER
Steven Chu C5m Hyl 6v BUS.LIC#
COMPANY NAME Steven Chu 8r Assoc E-MAIL stevencchu@hotmail.com FAX
STREET ADDRESS 10615 John Way CITY,STATE,ZIP Cupertino,CA PHONE 408 505 9985
DESCRIPTION OF WORK 1 Replace e)dsbn windowsAV
P 9 Ga/rn�e tc, S/I40(1 r)c 6S4 ato
2. Remodel existing bathrooms /p Q
3 Replace exir-finci kitchen cabinets nod appliances eo 62
4.Add recessed lights (�
EXISTING USE PROPOSED USE CONSTR TYPE #STORIES
SFD SF® V ONE USE TYPE OCC. SQ.FT. VALUATION(S)
EXISTG NEW FLOORDEMO TOTAL
AREA 1190 AREA 0 AREA 0 NET AREA 1190
BATHROOM KiTcRER OTHER
REMODEL AREA 100 REMODEL AREA 100 RIIKODFJ.AREA 0
PORCHAREA I DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA: DETACH
0 0 0 TrACH
#DWELLING UNITS: LSA SECOND UNIT ❑YES SECOND STORY YES
ONE BEINGADDED, [ANO ADDr1ON9
INO
PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES EIV TOTAL VALUATION:
PLANNING APPL# ('NO PLANNING APPROVAL[ETIER EICHLER HOME? rYNO
$30,000.00
By my signature below,I certify to each of the following: I am the properly owner or errt on the rty owner's behalf. I have read this
application and the information I have provided is correct. 1 have read the Description of Work and ve urate. I agree to comply with all applicable local
ordinances and state laws relating to build nstruction. I authorize representatives of Cupertino to enter the Zipentifjpd property for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPL.EMENTAL`INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP
New SFD or Multifamily dwellings: Apply for demolition permit for yER-THE-COUNTER ❑ BUILDING PLAN REVIEW
existing bt lding(s). Demolition permit is required prior to issuance of building
permit for new building. 1 ❑ 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 Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
B1dgApp_201 Ldoc revised 06/21/11
CET Y OF CUP ERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 7575 SQUIREWOOD WAY DATE: 0610212014 REVIEWED BY: MELISSA
APN: 362 27 005 BP#: zqa -VALIDATION: $30,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Repair
PRIMARY SFD or Duplex PENTAMATION
USE: pPERMIT TYPE: 1 GENRES
0RR1K REMODEL E KITCHEN & 2 E BATHROOMS ADD 19 N RECESSED LIGHTS & REPLACE 8
SCOPE WINDOWS & 1 SLIDING GLS DOOR (WILL MEET EGRESS & BE TEMPERED WHERE RE'QRD BYB2
Nlv;7[/'ie(1, NIIMI). Plcu1 Chi rl Elec.Plan Check 0.0 hrs $0.00
1,,;h N .jjj it�rr Pla,tl>. Purenii Fre: Elec.Permit Fee: IEPERMIT
Other Phunb Other Elec.Insp. [E hrs $47.00
Pkofff, IvNp. Fe c, l lec. Insp. Hec:
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works, Fire,Sanitary Sewer District,School
District,etc. . These.Lees are based on the relimina information available and are onL an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 11-053 E(f 711;13) FEE QTY/FEE I+ ISC IT]EI+a9[S
Plan Check Fee: $0.00 = # Window/Sliding Glass Door
Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 $557.00 IWINREP Replacement
PME Plan Check: $0.00 = s.f. Remodel, Kitchen(<=300 sf)
Permit Fee: $0.00 $626.00 1 IREMRESKIT
Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 = s.f. Remodel, Bath (<=300 sf)
PME Unit Fee: $0.00 $626.00 IR..,IAT
PME Permit Fee: $47.00 19 # Electrical
,.�,)1A.r r.r,/!.M ?itW: $70.00 IRREMFI,IT Fixtures,Lighting
Administrative Fee: (ADMIN $44.00 0
Work Without Permit? ® Yes (D No $0.00 E)
Advanced Planning Fee: $0.00 Select a Non-Residential Q
Travel Documentation Fee: ITRA VDOC $47.00 _�] Building or Structure 0
d
Strong Motion Fee: IBSEISMICR $3.00 Select an Administrative Item
Bldg Stds Commission Fee: 18CBSC $2.00
SUBTOTALS: $143.001$1,879.00 TOTAL]FEE: 1 $2,022.00
Revised: 04/01/2014
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
CON7RACTOR/ SUBCONTRACTOR UST
JOB ADDRESS: ' W cp PERMIT# 000
OWNER'S NAME: ;� PHONE# — &"
GE]VERAL CONTRACTOR: . ���� ,r BUSINESS LICE]VSE#
ADDRESS: CITY/ZIPCODE: ri o i
*Our municipal code requires all businesses working in the city t® have a City®f Coupe nn® lousiness license.
NO BUILDING ]FINAL OR ]FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUIPlERTINO
BUSINESS LICENSE.
I am not nosing any subcontractors: L2 y 12, IM
1
Signature hate
PEease check appllicabEe subcontractors and compllete the following information:
V 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
Owner/Contractor Signature Date