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11090183 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10613 GASCOIGNE DR CONTRACTOR:ZHU MEIDUO AND PERMIT NO: 11090183 HU HONGQI ONVNER'S NAME: ZHU MEIDUO AND HU HONGQI 10613 GASCOIGNE DR DATE ISSUED:04/02/2012 I 0131NER'S PHONE: 4087253692 CUPERTINO, CA 95014 PHONE No: i i ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# Iw F NISCH RESIDENTIAL COMMERCIAL Contractor Date JOB DESCRIPTION: NEW SiNGLE FAMILY DWELLING(2322SQF"I') I hereby affirm that I am licensed under the provisions of Chapter 9 W/ATTACHED (commencing with Section 7000)of Division 3 of the Business&Professions GARAGE(427SQFT)&DECK(36SQFT)-SANITARY IS Code and that my license is in full force and effect. SUNNYVALE'S JURISDICTION. 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 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 APN Number:37528014.00 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 by: � rz Date: ° granting of this permit. Additionally,the applicant understands and will comply 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. ONVNER-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(See.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 Arca Air Quality illanagement District I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and performance of the work for which this permit is issued. and 25534,25533 Sections 25505 Code t f Health&Safety aey , , , r I have and will maintain Worker's Compensation Insurance,as provided for by the Section 3700 of the Labor Code,for the performance of the work for which this 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 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 source regulations per the Cupertino Municipal Code,Section Licensed Professional i 9.18. r Signature ; �f 6 Date I i CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10613 gascoigne dr. DATE: 099/26/2011 REVIEWED BY: bob s. APN: t�BP#: /a�a� VALUATION: 1$300,000 ! y'PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction i TI PRIMARY SFD or Duplex 2nd Unit? Yes No pERMIAMAEN 1 R3SFDW USE: WORK construct new 1 story sfd. SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,111-B,IV,V-B 2,7c,95 $2,758.37 IR3PLNCK $2,659.26 IR3INSP i TOTALS: 2,795 $2,758.37 $2,659.26 E1_L_ t f NOTE. This estimate does not include fees due to other Depts(i.e.Public Works,Sanitmy Sewer District,School District,etc.). These,fees are based on the preliminary in ormation available and are only an estimate. Contact the De t or addn'1 in o. FEE ITEMS (Fee Resohrtioil 11-053 Eff, 7/11111 FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,758.37 Select a Misc Bldg/Structure I Suppl.PC Fee: E) Reg. 0 OT 0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $2,659.26 Suppl.Insp.Feer Reg. 0 OT0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Constr.Tax: IBCONST, 1 #newunits $579.61 Work Without Permit? Q Yes 0 No $0.00 Advanced Planning Fee: PLLONGRNGR $363.35 Select a Non-Residential 0 _ Building or Structure 0 Strom.Motion Fee: 1BSEISMICR $30.00 Select an Administrative Item BldcJ Stds Commission Fee: 1BCBSC $12.00 SUBTOTALS: $6,402.59 $0.00 TOTAL FEE: $6,402.59 Revised: 09/02/2011 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 LJ (408)777-3228- FAX(408)777-3333-building0cupertino.org CUPERTINO DNSWC_ONSTRUCTION ❑ ADDITION ❑ ALTERATION TI El REVISION DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS AIN# 0 C,( ;�7 6,-AS7C/01[6f�,�— �tr OWNERNAME PHONE 7 E-MAIL STREET ADDRESS &A cc�,,c v\f 0 CITY, STATE,ZIP FAX 0 IrCh q 1�0 q PHONE " F(ZA14–L -0&*40-&,C)t� CONTACT NAME p 0 rZ S7C,,Z)o 4 E STREET ADDRESS (2_ CITY,STATE,�,*Lft-rc C-A FAX El OWNER El OWNER-BUILDER ❑ OWNER AGENT 11 CONTRACTOR El CONTRACTOR AGENT V/AICHITECT 13 ENGINEER 11 DEVELOPER 11 TENANT CONTRACTOR NAME,— LICENSE NUMBER 7 LICENSE TYPE BUS.LIC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITECTIENG11,4EERNAIME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK C,01� T(IA;C-'V f-Y&1,,J EXISTING USE PROPOSED USE I CONST TYPE STORIES T N 'I USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG AREA ARFLOOR DEMO TOTALry AREA rz EA -7 NETAREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH ARE � GARAGE AREA: DETACH 1_�C 4?Q ATTACH #DWELLING UNITS: IS A SECOND UNIT []YES SECOND STORY []YES BEING ADDED? WO ADDITION? ;KNO PRE-APPLICATION YES IF YES,PROVIDE COPY OF IS THE BLDG AN RECEIVED BY: AL VALUATION: PLANNING APPL# pj�NO PLANNING APPROVAL LETTER EICHLER HOME? I e!Nos , I /1_�J' I s,�UC,U-T By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the prpperty 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 conction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. 1, Signature ofApplicant/Agent; Date: tzz; i"� SUPPLEMENTAL I INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for El OVER-THE-COUNTER DING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ETPLA10ING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure _STANIARI E—PUBLIC WORKS fo_rm if any Hazardous Materials are being used as part of this project. 1:1 LARGE 3_10RE bFPT Copy of lanning Approval Letter Or Meeting with Planning prior to El MAJOR ETSANITutY SEWER DISTRICT submittal of Building Permit application. [I—ENVITIONMENTAL HEALTH, BldgApp�2 011.doc revised 06/21/11 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 j C U P E RT!N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: ® o p PERMIT# /Q 67 1,5 OWNER'S NAME: — PHONE# - — 7.2 a GENERAL CONTRACTOR: J06RUA BUSINESS LICENSE# ADDRESS: 10613 -4S c)jqjyf XKel&M"` ,CITY/ZIPCODE: 0/ *Our municipal code requires all businesses worldng in the citylo have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) 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: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing ; h o� 3�6 - 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 i ner/Contractor Signatu Date