13110066 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7510 DE FOE DR CONTRACTOR:KS gtt=---M/G PERMIT NO:13110066
CoNs7dt ✓C771 eV
OWNER'S NAME: JINPYO KIM DATE ISSUED: 11/12/2013
OWNER'S PHONE: 4085155760 PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIAL
License ClassLic.# 6 / 9 T 0 L UPGRADE(E)100 AMP PANEL TO 200 AMP PANEL,SAME
LOCATION
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:
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
erformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$1500
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:35924032.00 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 LED 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 is Date: 2
granting of this permit. Additionally,the°applicant.understands and will comply
/13
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
i RE-ROOFS:
Date
Signature �-�10' Date/////t �j 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
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(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. 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 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
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this �
Owner or authorized agent:�i9 z�a A Date:
If
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
9.18.
Signature Date
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7510 DE FOE DR CONTRACTOR: KS C o tJS'rKJ--'C ERMIT NO: 13110066
G•'ryt c G
OWNER'S NAME: JINPYO KIM DATE ISSUED: 11/12/2013
OWNER'S PHONE: 4085155760 PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL
License Class C !0 , 8 Lic.# t0!?2 +Q(P UPGRADE(E)100 AMP PANEL TO 200 AMP PANEL,SAME
LOCATION&RUN(N)CONDUIT FOR FUTURE EV
Contractor S e ,�`7:CL'e=ing Date �'E' �3 CHARGING
I hereby affirm that I am licensed under the provisions of Chapter 9 STATION
(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:$1500
SI 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:35924032.00 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 F ALLED 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 Iss y:
10
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
SignatureQ/C tee"- 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.
❑ 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)
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
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 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
I have and will maintain Worker's Compensation Insurance;as provided for by the Health&Safety Code,Sections 25505,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authorized ager Date:
permit is issued. l�
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,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
9.18.
Signature Date
GENERAL PERMIT APPLICATION uJ MEP
its COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 \�
(408)777-3228•FAX(408)777-3333•buildinp(tupertino.orgMISC
CUP.ERTINO ��]
❑PLUMBING ❑MECHANICAL ELECTRICAL ❑MISCELLA"""N��,EOUS
PROJECT ADDRESSt
APN# Z 2
L &
oe
OWNERNAME 1 PHONE '/Y jO E-MAIL
STREET ADDRESSD CITY, STATE,ZIP/ 1i�� FAX De-
egL
CONTACT NAME PHONE (�� v E-MAIL
STREET ADDRESS CITY,STATE,ZIP FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME 50 LICENSENUMBER LICENSETYPE BUS.LIC#
C
COMPANY NAME E-MAIL FAX
.e- ` C-1 c i o ryh
STREET ADDRESS CITY,STATE,ZIP PHONE
Z �l 0
ARCHrrECT/ENGINEER NAME LICENSE NUMBER _ BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑SFD m DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES
BUILDING: El COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑ NO
DESCRIPTION OF WORK n
Qj zoo
s
TOTAL VALUATIO
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the erty own
application and the information I have provided is correct. I have read the Description of Work and verify it is a rate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-ide ified property for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAL WRMATION REQUIRED
z
` a �n
RES
MEPMiscApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 7510 DE FOE DR DATE: 11/12/2013 REVIEWED BY: MELISSA
APN: 359 24032 BP#: *VALUATION: 1$1,500
*PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair
PRIMARY SFD or Du lex PENTAMATION 1 REAP2
USE: p PERMIT TYPE:
WORK UPGRADE E 100 AMP PANEL TO 200 AMP PANEL SAME LOCATION
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
Services 1ERT<200 200 Amps $47
TOTALS: i ._ $47.00
s�
1ec:h. Plan(:'heck Phrrrrb. Plan Check Elec.Plan Check 0.0 hrs $0.00
illech. l'ernait Fee: Plumb.Permit Fee: Elec.Permit Fee: IEPERMIT
C)ther Mxh.Insp. Other-Plumb Insp. Other Elec.Insp. 0.0 hrs $47.00
_9lech.Insp.Fee: Plumb. Insp.Fee: Elec.Insp. Fee:
NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc). These fiws are based on the prefintina information available and are only an estimate. Contact the Dept-for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 E . 711113) FEE QTY/FEE MISC ITEMS
Plan Cheek Fee:
Suppl. PC Fee
PME Plan Check: $0.00
Perinil Fee:
Suhpl. Insp Fee
PME Unit Fee: $47.00
PME Permit Fee: $47.00
(Amsirticlion T x.
Administrative Fee: IADMIN $44.00
Work Without Permit? 0 Yes (E) No $0.00
,Idvaneed Planning Pees:
Travel Documentation Fee: ITRAVDOC $47.00 i
Strom Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $1.00
B
. 186.50 $0.00 " >H' $186.50
$
F r
Revised: 10/01/2013