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10090071I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10540 WUNDERLICH DR CONTRACTOR: JASON TAN PERMIT NO: 10090071 OWNER'S NAME: CUPERTINO, CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ 11/3/10- CHANGED TO NEW ONE STORY SFDWL, HOUSE License Class Lic. N TAKEN DOWN TO FOUNDATION. NOTHING ELSE LEFT. 1,006 (E) FOUNDATION -ADDING NEW 887 SQ FT. ATTACHED Contractor Date 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: 1. 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. 2. 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 permit is issued. APPLICANT CERTIFICATION I certify that 1 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, costs, and expenses which may accrue against said City in consequence of the 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. Signature Date OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. 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) 2. 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). � 7 I hereby affirm under penalty of perjury one of the following three declarations: 1. 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. 2. 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 permit is issued. s. 1 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 become subject to the Worker's Compensation provisions of the Labor Code, 1 must forthwith comply with such provisions or this permit shall be deemed T t revoked. �J APPLICANT CERTIFICATION 1 certify that 1 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, costs, and expenses which may accrue against said City in consequence of the granting of this permit.yAdditionally, the applicant understands and will comply with all non -point source reg lations per the Cupertino Municipal Code, Section 9.18. Signature Date /t / t) Sq. Ft Floor Area: I Valuation: $180000 APN Number: 37527037.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issue y ate:���� RE -ROOFS: 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. Signature of Applicaia-'f' Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain co pliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner over ed a ent � Date: CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Add ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional ��—�� �• CITY OF CUPERTINO n FF.F. ESTIMATOR — BUILDING DIVISION (/ ADDRESS: 10540 WUNDERLICH DR DATE: 11/03/2010 APN: BP#: 10090071 REVIEWED BY: SUEW "VALUATION: 1$180,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY USE: SFD or Duplex �: =; ; r:: PENTAMATION 1 R3SFDW PERMIT TYPE: i WORK 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,III-B,IV,V-B 1,888 $2,513.34 1R3PLNCK $2,062.78 1R3INSP TOTALS: 1 1 8 8 2 7 8 5 3.34 '';77 NOTE: These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 09-051 E . 7111102 FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,513.34 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: G Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $2,062.78 Suppl. Insp. FeeO Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Constr. Tax: IBCONSTAXR 1 Tbld#gs $558.42 Acoustical Fee: 0 Yes G No $0.00 0 G Work Without Permit? 0 Yes G No $0.00 Planniny- Fee: PLLONGRNGR $245.44 Select a Non -Residential Building or Structure 0 0 i StronyMotion Fee: IBSEISMICR $18.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $8.00 ,',,:'rr:r:":....:•;i:' $5 405.98 0-.00 Revised: 10/17/2010 �U�p 0 1 �N CITY OF CUPERTINO FF.F. ESTIMATOR — BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: *VALUATION: 1$180,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Du lex USE: p OVER THE COUNTER? 0 Yes 0 No PENTAMATION 1 R3SF PERMIT TYPE: WORK SCOPE i OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,III-B,IV,V-B 1,033 $2,367.26 1R3PLNCK $1,53 .42 1R3INSP T TALS: 1,033 $2,367.2642 �C{ � t ��Sdr .. `��t�l f�Cics y:)C•=:i1 ' ec4 flan Cihe,.ck rLti>ch. Perini! Fee: OaliE'r A4kh. I4.sf) .1lcch. ln.Np. fcc: P17110. permit Fee: Other Pl.'s w7, Phanh. In.y. Fee L NOTE: These fees are hated an the nreliminary information Elec. Plan Check Flec. Permit hire. Other Elec. Insp. E-1,,r- Insp. f-'ec. are only an estimate_ Contact the Dent for addn'1 into_ FEE ITEMS (Fee Resolution 09-051 E . 7/1/10) FEE TY'/VEE MISC ITEMS Plan Check Fee: $2,367. 250 'sf. Remodel, Kitchen (<=300 sf) $570.00 EMRESKIT Suppl. PC Fee: 0 Reg. 0 OT 0.0 1 hrs $ .00 PME Plan Check: $0.00 250 s.f. $570.00 ,Remodel, Bath (<=300 sf) IREAD ,$'BAT Permit Fee: 1,539.42 Suppl. Insp. Feed Reg. © OT 0.0 hrs $0.00 500 s.f. $443.00 Re er MRES1 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax Acoustical Fee: 0 Y s 0 No $0.00 0 0 Work Without Permit? © es 0 No $0.00 Planning Fee: PLLONGRNGR $134.29 Select a Non-Residen 'al Building Structure 0 0 Travel Doctnnentation hecs: Strong Motion Fee: IBSEISMICR $18.00 Select an Administrative Item B1djz Stds Commissio ee: IBCBSC $8.00 .+ l F . �•..,, r(i'a r t -i`t"�=r.'(;T:.^,•;;.- ; ,2Y,:7S 7•s.. ��l;rt5:-i j�t;, r �I �''`•S,7Y�IfsyS 51. �. �I,:S�1��=i5`•��:'� 1 a;;� S.i . '�S`i,�.til;,. �1ISY tea:: Viz?,;%:JS-'t�,''j.'.'i)iti=` ' Ci::;�t • ;z' $4,066.9 7 .3: n " f i AS`45�; $1,583.00 0s �atrj� ..Urt $5 649.97 Revised: 8/17/2010