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14080226CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20956 HOMESTEAD RD CONTRACTOR: SMI CONSTRUCTION PERMIT NO: 14080226 INC OWNER'S NAME: ERIC HUANG & MARGARET YEUNG 595 MONTAGUE AVE DATE ISSUED: 01/05/2015 OWNER'S PHONE: 4082024718 SAN LEANDRO, CA 94577 PHONE NO: (510)351-3288 LICENSED CON CTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL E] SUITE A-TAIWAN PORRIDGE KINGDOWM-COMM. T.I TO License Class—�% _ ic. N 3 7 INCLUDE NEW PARTITION WALLS, KITCHEN HOOD 2200 Contracto Date I > SQ I hereby affirm that I am I'censed under the provisio of apter 9 (commencing with Sectio 7000) of Division 3 of the Business & Professions Code and that my licensd 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 Sq. Ft Floor Area: Valuation: $150000 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 APN Number: 32609061.00 Occupancy Type: issued. pemit � - APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is PERMIT E + IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 80 DAYS OF PERIM ISSUANCE OR to building constriction, and hereby a horize representatives of this city to enter upon the above mentioned property r inspection purposes. (We) agree to save 180 DAYS ROM LAW4' ALL INSPE TION, indemnify and keep harmless the ity of Cupertino against liabilities, judgments, ,�r costs, and expenses which may ccrue a ainst said City in consequence of the / granting of this permit. Ad ' nally applicant understands and will comply Issued by: Date: _5 with all non-point sour c re dation p r the Cupertino Municipal Code, Section 9.18. - 1 RE-ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed. If roof is installed without first obtaining an inspection, 1 agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: 1 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) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). 1 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(x) should ore or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally, should I use equip a 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 A' a Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cr p ti.no Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sectio 25 , and 25534. Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Owner or authorized agent; Date! 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 tlris certificate of exemption, l 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 'V 0""i CONSTRUCTION PERMIT ALICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • building(ocupetno.org ❑ NEW CONSTRUCTION ❑ ADDITION ALTERATION / TI ❑ REVISION/ DEFERRED ORIGINAL PERMIT 1t PROTECT ADDRESS APNq W 2 oggi� OWNER NAME PHONE L, E-MAIL -V STREET ADDRESSCITY, STATE, ZI FAX o I' CONTACT NAME PHONE E-MAIL kA WQND .s ri o - 6 162,4r s' N STREET ADD4SJ CITY, ST T P FAX Jam❑ ST. 2bay El OWNER OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR. AGENT ❑ ARCH FECT lvENIFNEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSENUMBER LICENSE TYPE BUS. LIC 9 C73 COMPANY Ni ME E-MAIL FAX STREET S CI STATE. IP PHONE iM 6AA ARCI-aTECT/ENGrNEER NA LICENSE NUMBER BUS. LIC k COMPANY NAME E-MAIL FAX CIA Q STREET AyCITY, ST TC- ZIP PHONE 3 Z ll DESCRIPTION OF WORK A `- cC Neo EXISTI 'G USE PROPOSED USE CO 'STR TYPE H STORIES USE TYPE OCC. SQ.FT. VALUATION (S) LXISTG NEW FLOOR DEMO TOTAL AREA Zv� AREA .AREA NET AREA BATHROOM KITCHEN OTHER REMODEL .AREA REMODEL AREA REMODEL AREA PORC­HA A DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA DETACH ❑ ATTACH P DWELLING UNITS. - ' IS A SECOND UNIT _._.....❑YCS._.. SECOND STORY OYES BEING ADDED? ❑NO ADDITION? ONO �--- PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLOC AN ❑ YES RF,CEWED „„w^^°"° TO AL VALUATION: PLANNING APPL k ❑ NO PLANNING APPROVAL LETTE EICHLER HOME? ❑ NO By my signature below, I certify to each of the fol am the property owner or authorized agent to ac ner's behal . I have read this application and the information I have pro v i torr I. have the Description of Work and verify it is accurate. t agree to comply with all applicable local ordinances and state laws relating to buil g Structiol . I ze representatives of Cupertino to enter the above-identitie property for inspection purposes. Signature ofApplicant/Agent: _ Date- SUPPLEMENTAL INF RMATION REQUIRED PLAN CRECK yPIE ROUTING SLIP ❑ OVFR-T149;COUNTrR ButLDtNG PLAN REVIEW New SFD or Multifamily dwellin s: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. © EXPRESS ❑ PLANNING PLkNIZEVIFVV Commercial Bldgs: Provide a completed Hazardous Materials DisclosureANDARIa ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑,, LARGE FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. MAJOR ANITARI SE)VERb1sTRICT ❑ ENVIRONMENTAL HLALTH BldgApp_201 Ldoc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 20956 homestead rd DATE: 08/21/2014 REVIEWED BY: Mendez PC FEE ID APN: BP#: �� `VALUATION: 1$150,000 `PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building IATIPLNCK PENTAMATION PERMIT TYPE: 1A T� WORK porridge kin dowm- comm. t.i to include new partition walls kitchen hood 2200 sq ft SCOPE �taiwan OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID A (Tenant Improvements) II-B,111-B,IV,V-B 2,200 $2,499.39 IATIPLNCK $1,294.95 1ATUNSP hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,294.95 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: TOTALS: 2,200 $2,499.39 $1,294.95 MECH, HOURLY 0 Yes E) No PLUMB, HOURLY 0 Yes 0 No ELEC, HOURLY 0 Yes 0 No NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution I1-053 E ' T'l/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,499.39 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: 0 Reg. 0 OT FO.07 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,294.95 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 0 Work Without Permit? (D Yes (Q No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) 0 A Strom klotion Fee: IBSEISMICO $42.00 Select an Administrative Item Bldg; Stds Commission Fee: IBCBSC $6.00 SUBTOTALS; $3,842.34 $0.00 TOTAL FEE: $3,842.34 Revised: 07/10/2014