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14070004 CITY OF CU PETE TINO BUILDING PERMIT BUILDING ADDRESS: 20163 SOMERSET DR CONTRACTOR:ROY CHEUNG'S PERMIT NO: 14070004 CONSTRUCTION COMPANY OWNER'S NAME: CALVIN CHEUNG 3616 CARICK PLACE WAY DATE ISSUED:07/02/2014 OW 'S PHONE: 4084312496 SAN JOSE,CA 95121 PHONE NO:(408)489-5988 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL 0 q z REPLACE 7 (E)WINDOWS,SAME SIZE &LOCATIONS License Class„ eLic.# So 1�J EXCEPT FOR 2 BEDROOM WINDOW TO BE LOWERED TO E.v� ��Date Z Contractor MEETEGRESS(NO STRUCTURAL) 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:$3500 t 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:36930007.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 certify that I have read this application and state that the above information is PERMIT EXPIRES IFF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 1�®���� ®� PERMIT 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 180 DAYS 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 U 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,1 agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION 1 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) 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. 1 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 1 store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 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 e 505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this —2_1 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 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,I 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 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 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 V CONSTRUCTION PERMIT APPLICATION a COMMUNITY DEVELOPMENT.DEPARTMENT• BUILDING DIVISION D 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228• FAX(408)— 7-3333• buildingcDcupertino.orq \"\ ❑NEW CONSTRUCTION ❑ ADDITION ALTER4TION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT PROJECT ADDRESS�_0 0(0 50H U 5 C i 3�R. APN 0 � � _ -3O ® D OWNERNAME C40W CIfEu PHONE ( -MAIL STREET ADDRESSJ ®v c7 I CITY, STATE,ZIP FAX CONTACT NAME ✓4W PHONE E-MAIL STREET ADDRESS CITY,STATE, ZIP FAX ❑ o A NER 13D13owNER.BUDER OWNER AGENT M CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGWEER ❑ DEVELOPER ❑ TENANT COTTrRACTOR NAME o y (f d,�,r„�/ I LICENSE NUMBER(�� LICENSEeI O BUS.LIC R COMPANY NAM �` // �'! E-MAIL �C/ FAX ko -cam s �nrs GT�o� kCA c' ra-4 STREET ADDRESS CITY,STATE,ZIP PHO S d CA-TR 2J ,«c ARCHITECTIENGINEER NAME LICENSE NUMBER BUS.LIc k COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK fN'G�cQ®w EXISTING USE PROPOSED USE CONSTR TYPE R STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMOTOTAL AREA AREA AREA NErAREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: Ej DETACH ❑ATTACH R D"ATLLING UNITS: ISA SECOND UNrr ❑YES SECOND STORY ❑YES BEING ADDED? [3NO ADDITION? []NO -- -PRE-APPLIGA-TION-[-YES -IF-]ES,P.ROVIDE.COPY-OF -IS THE BLDG AN F1 YES 5 1 4k ;. TOTAL VALUATION: PLANI,gNGAPPLK []NO PLAI.R.gNGAPPROV.ALLETTER EICHLERHOME? Y! - ` } By my signature below,I certify to each of the following: I am the property owner or authorized agen o a n the property owmer's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and ve ' It is accurate. I agree to comply with all applicable local ordinances and state laws relating to building cons tion. I ut rize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: t1' SUPPLEMENTAL INFORMA ON REQUI - New SFD or Multifamily dwellings: Apply for demolition permit for "� x SE— "1 r ]ER TFLE COUnTER L BUIL-Dl1GPLd�REVSEW existing building(s). Demolition permit is required prior to issuance of building 1 � a ORR permit for new building• *I] FaPRE3S sa ,E �g I v �4I ANNIIGPLA1i RES IESS� t ` f ��µell K` �.�, yak's 4 bb \�.a 7+.m,�a '7�rwrr,. 4--'�y'S'y _Commercial Bldgs: Provide acompleted Hazardous Materials Disclosure 1]� ST.1�T.DARDk'� � � puBLICwGRhS+ * � form if any Hazardous Materials are being used as part of this project 7,ARGE x _Copy of Planning Approval Letter or Meeting with Planning prior to '� �� submittal of Building Permit application. �AI.IT'aR]s NtTi D_ISTRIC-"- � V.H BldgApp_2011.doc revised 06/21/11 CITY OF cCUP Ell8TINO FEE ESTIMATOR— BUILDING DIVISION ADDRESS: 20163 SOMERSET DR DATE: 07/02/2014 REVIEWED BY: MELISSA APN: 369 30 007 BP#: bo *VALUATION: $3,500 [FPTR::M::1T TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION USE: pPERMIT TYPE: 1GENRES� WORK REPLACE 7 E WINDOWS SAME SIZE & LOCATIONS EXCEPT FOR 2 BEDROOM WINDOW TO SCOPE BE LOWERED TO MEET EGRESS (NO STRUCTURAL) I' ( '•. I'hu,uh_ Pfnr,i Y,rr 1, 1.7ec'. Nan Check t.', P,•,,i,; r F-al"I Pcrrnir I,e f7ec 1'ermir f'ee El 04",1,""v-,7j)//I". El _L_ ofher L/ce. 1.1'. L_J , I h 1�I liril,trl`, P 'p. 1,v' Nec 177s'v, NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works, Fire,Sanitary Sewer District,School District,etc. . TheseLees are based on the relimina information available and are only an estimate. Contact the Dept for addn'l in o. IFEE ITEMS (Fee Resolution 11-053 ECJ' 7/1113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Window/Sliding Glass Door Supp]. PC Fee: ) Reg. 0 OT 0.0 hrs $0.00 $418.00 IWINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:(D Reg. Q OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 n,�rr t,ctior Kix: Work Without Permit? 0 Yes E) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential G Building or Structure 0 Strong Motion Fee: lBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $418.00 TOTALFEE: $419.50 Revised: 07/01/2014 . . - ,.. . _ . . � - � ate.- ' � .� � � , - _ . , _ 3 .. . . . . � t . - . .. r .. .� - _ - .. .. � .. �• . . ' .., - '- •' .. "f i':.'. .' � • ted � � _ � : . _ - . . ; • � � . . q . .. .. ,: .. . . • : . . , . I i ... � - � , - . . L. Y �la :-,. :., . ! t � . .. I - :, • � .. .. .. - .. ., P •� - . 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