The URL can be used to link to this page

13060084 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18680 NEWSOM AVE CONTRACTOR:JM CONSTRUCTION PERMIT NO:13060084 OWNER'S NAME: HSUEH-CHIEN SUN 562 DIVISION ST DATE ISSUED:06/10/2013 OWNER'S PHONE: 4084838176 CAMPBELL,CA 95008 PHONE NO:(408)379-9852 13 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIALE] License Class_2e_>� Lie.#_7aQk50__ REPAIR ROOF FRAMING FROM FALLEN TREE DAMAGE, I LIKE Contractor ate_lot FOR LIKE,NO STRUCTURAL CHANGE/CONVENTIONAL I hereby affirm that I am licensed under the provisions of Chapter 9 FRAMING (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:$10000 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:37530003.00 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 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 FROM 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 Issued granting of this permit. Additio lly,the applicant understands and will comply with all non-point source regul ns per the Cupe i o Municipal Code,Section 9.18. I i RE-ROOFS: Siena'6re ate zkm 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: 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 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. 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 emif hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Are it Quality Management District I performance of the work for which this permit is issued. will maintain complia w h the Cuperti unicip ,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safe ode, e i s 25505 3,and 255 4 Safety Section 3700 of the Labor Code,for the performance of the work for which this A , affen r permit is issued. Owner or auth A .1............ - 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 FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 18680 NEWSOM AVE DATE: 06110/2013 REVIEWED BY: MELISSA APN: 375 30 003 BP#: � *VALUATION: $10,000Li *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration 1 Repair PRIMARY PENTAMATION 1 R3SFDREM USE: SFD or Duplex PERMIT TYPE: WORK REPAIR ROOF FRAMING FROM FALLEN TREE DAMAGE LIKE FOR LIKE. NO STRUCTURAL SCOPE CHANGE/CONVENTIONAL FRAMING 77 Xlech, Plan C,'hecA' k�hinib, Plan Check �t�c�. Nan Check _ F'<.>swif Fee: l'tc;r�la.1'erra7iT Ie:e; zai�€ect..F�errrtaa Fee: C31her,fecrh,Imp, Other Plurnb hasp. £?ttr�r f.;�tcae.Ins�s. Tech.Insp..Fee: MInwb, fhspi Fere_ Efec.Imp, Fee: NOTE.This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These ees are based on therelimina information available and are only an estimate Contact the De t or addn7 info. FEE ITEMS(Fee Resolution 11-053 Eff, 711112) FEE QTYIFEE MISC ITEMS Plan Check Fee: $0.00 88 s.f. Remodel,Other Suppl.PC Fee: (j) Reg. Q OT 0.0 hrs $0.00 $400.00 1REWESOTH PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee:. Reg. 0 OTQ (} hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (�ons1kvction /m, Admir,I.stF ative Fee: Work Without Permit? O Yes No $0.00 Advanced Planning<Fee: $0,00 Select a Non-Residential Building or Structure Travel1�ocuinenttation 'ee,s'. � Strom Motion Fee: 1BSEISMICR $1.00 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 ' + $2.00 $400.00 TOTAL i $402.00 Revised: 04129/2013 07/2a/2013 ll:a6 FA% 408 979 9857 JM CONSTRLTCTION �001 .. .�._.. _.__.,__.�_.�.._......._ I Buildinb nep�rtment � Ciry Of Cupertino I I U:300'1"oRe l�ve��ue ; ; Cupertin�i,CA 9�014-32�5 Telepliot�c: �Ub-777-3228 CUPERTI�10 Fax;408-777-3333 � CONTYtACTOR/SUSCONTRAC'�'OR LIST � -- JO�AUDR�SS: Q NEG�ISoM �V� PEItMrT# ._,30�00 S_� O WN GR'S N nM E: �/�U,�'iy C�/EN �'UN , Pl-�ON��f y4 S�,��J 9�9�5� � �.,_ _ GF..NERAL CONTRACTOR �' �/V5'7', T�USiNESS I.,ICLNSC# �-4 9SS � �_..._,.�. �_,._._.......... I _...,., �_...., �. .. ...,._.......__........ _ _..__�._ . AC)n1t:FSS: �(oZ �DI'1/iSio�✓ vrY. ��..._.. Cl1'Y/;GTPCVDE: �008 � "Ow•�nunicipal codc requires al) liuSinesSeS wOr�ipg in thC cih'4'U h��C ri City uf Cupertino busiuess license. i NO BU[LDiNG I�(�lA�, UR ��NAL OCCUn�1NCY INSPGCT[ON(S) W1LL BC SCFIEDULED UNTlI� TH� i GCNERAL CONTRACTOR AND ALL SU[iCONTRACTORS �[AVE OBTAINED r# C(TX U.�' CUPC[tT[NO SUSIN�,Sti I..I(:�NS�. i i 1 am not using any subcnntractars: ._-_...� _._._..-.._� . I Sinnature Date Plea��check applicablE�ubcbntracio►-s �nd complete the following inform�flon: _...._. .__,�_..-_._____.,_... _..,_. ..__.....-- _..�� ,__..��.,..,.:..,...._...�.......:........ ........ ..........._.,.�.�,___:m.�,_,.,.._....._...,....,.__,.._,_,... ✓ SU�3C'O�'"TYtACTOR �3115INESS NAME BUSI7�i�SS LICF_NSE # ; CA.bit�ets & Millwork C"c►t�ai�t ki�i.isl�i.��g� Eleclilcal .....� � ---.._ .....----- Gxcavation Fencing Flooring/Carpetin� I„i.no�cuan /Wood � Giass/Glazing � T }ieating Insulation T.,andsca��ing Latl�inb � M.asur�►y Pai.nting/Wa.11pa�er Pavin.� Plasterin�; Piunlbin� ..�._.�_,_„_..,.._�,�.,�._„�..,.�...,.,.,.�...._.�. �__.__._...__...__.._......___.� _ � Roofi.�� ,S'NDGlJD E/✓ DO�N� -----.--Z_�Z� 8� S�ptic T�inlc �i Slieer Metal S11eet Rock ~ ~�^ �� Tile � ' � �v��—�� -. „ __ ....w:_.�....,.. ._.............. _ ,... .... —._........_.._._....__..._..,..---._..,___,__�-..._,.. Owner/Cuntractor Si�pafure Duce