11060168CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10284 S STELLING RD
CONTRACTOR: LISA WONG
PERMIT NO: 11060168
OWNER'S
CUPERTINO, CA 95014
PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION
r f"
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic. #
MECH r RESIDENTIAL r COMMERCIAL
Contractor Date
I hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: CONSTRUCT DETACHED 518 SQ FT SECONDARY
(commencing with Section 7000) of Division 3 of the Business & Professions
(GRANNY)
UNIT
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
performance of the work for which this permit is issued.
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
Sq. Ft Floor Area:
Valuation: $80000
permit is issued.
APPLICANT CERTIFICATION
APN Number: 35913094.00
Occupancy Type:
1 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,
PERMIT EXPIRES IF WORK IS NOT STARTED
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non -point source regulations per the Cupertino Municipal Code, Section
180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature Date
Issued _ ��— Dateif'!J f
ER-BUILDER DECLARATION
�fflrm
I ham exempt from the Contractor's License Law for one of
RE -ROOFS:
the following two reasons:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
1, as owner of the property, or my employees with wages as their sole compensation,
installed without first obtaining an inspection, I agree to remove all new materials for
will do the work, and the structure is not intended or offered for sale (Sec.7044,
inspection.
Business & Professions Code)
1, as owner of the property, am exclusively contracting with licensed contractors to
Signature of Applicant: Date:
construcjlthe project (Sec.7044, Business & Professions Code).
I hereb ffirm under penalty of perjury one of the following three
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
declarations:
1 have and will maintain a Certificate of Consent to self -insure for Worker's
HAZARDOUS MATERIALS DISCLOSURE
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have read the hazardous materials requirements under Chapter 6.95 of the
l have and will maintain Worker's Compensation Insurance, as provided for by
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
Section 3700 of the Labor Code, for the performance of the work for which this
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
permit is issued.
Additionally, should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued, I shall
contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Compensation laws of California. If, after making this certificate of exemption, I
Health & Safety Code, Sections 25505, 25533, and 25534.
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
Owner
� -^ Date:
APPLICANT CERTIFICATION
CONSTRUCTION LENDING AGENCY
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
I hereby affirm that there is a construction lending agency for the performance ofwork's
to building construction, and hereby authorize representatives of this city to enter
for which this permit is issued (Sec. 3097, Civ C.)
upon the above mentioned property for inspection purposes. (We) agree to save
Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
Lender's Address
granting of this permit.
Municipal Code, Section
9.18.
Signature Date U2-
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
�CITY OF CUPERTINO
WN FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 10284 s. stelling rd.
DATE: 06/20/2011
REVIEWED BY: bobs.
APN:
BP#:
"VALUATION:
1$80,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY SFD or Duplex
USE:
2nd Unit? • Yes No
PENTAMATION 1 R3SFD2ND
PERMIT TYPE:
WORK
construct new detached bldg.
SCOPE
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE 1D
BP FEES
BP FEE ID
R-3 (Custom)
II-B,III-B,IV,V-B
518
$2,349.00
IR3PLNCK
$1,474.00
IR31NSP
TOTALS:
518
$2,349.00
$1,474.00
NOTE. These fees are based on the nreliminarv, information available and are only an estimate. Contact the Dent for addn'1 info.
FEE ITEMS (Fee Resolution 09-051 E . 711110)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,349.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: E) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$1,474.00
Suppl. Insp. Fee-0 Reg. 0 OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Constr. Tax: IBCONSTAXR
1
new
units
$569.36
Acoustical Fee: 0 Yes E) No
$0.00
Q
E)
Work Without Permit? 0 Yes (D No
$0.00
Planninp, Fee: PLLONGRNGR
$67.34
Select a Non -Residential
Building or Structure
i
Strong- Motion Fee: IBSEISMICR
$8.00
Select an Administrative Item
Bldg_Stds Commission Fee: IBCBSC
$4.00
SUBTOTALS:
$4,471.70
$0.00
TOTAL FEE:
1 $4,471.70
Revised: 04/29/2011
June 7, 2011
To: The City of Cupertino
Planning and Building Department
10300 Torre Avenue, Cupertino, CA 95014
To Whom It May Concern:
This is to inform you that we have authorized Mr. Francis T. Kun with Atelier Designs,
located at 482 W Hamilton Avenue #137, Campbell, CA, to represent us and act in our
behalf in submitting the plan for our Residential Addition located at 10284 S Stelling
Road, Cupertino, CA 95014. If you have any questions, you may call us at:
Work no. for Luis: (408) 480-3193
We will appreciate all your efforts to work with Mr. Francis T. Kun with our application
for a buiding permit for our Residential Addition. Thank you.
Sincerely, %
Mr. and rs. Luis and Lisa Yu
Homeowners
Building Department
CITY OF CUP ERTINO
IMO TORRE AVENUE • CUPERTINO. CA 95014-3255
I-ELEI'HONE: (408) 777-3228 • FAX: (408) 777-3333
OUTSIDE AGENCY PLAN CHECKING FEES
Date: &/,2.0//
Agency Name:
Permit Number:
Project Address:
Plan Check Fees:
1st & 2nd plan checks included in initial plan check fee:
3 %CO X65%=$ es
3rd plus plan checks:
Number of hrs X $126.00 = $
X65%=$
Please attach this form with the number of hours spent on the 3rd plus plan checks and
send with the plan check comments or if plans are approved, with the plans & approval
letter. ''
Please email the plan check comments to:
Suew@cupertino.org and Sylviam@cupertino.org.
"Please do not give plan check comments directly to the customer. We don't give out
the comments until we have all of them back from each department.