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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