11070172I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 20682 SCOFIELD DR I CONSTRUCTOR J MARVEN RD I PERMIT NO: 11070172
OWNER'S NAME: QIONG & JUAN LIU 1 665 ALBERTA AVE I DATE ISSUED: 08/25/2011 1
OWNER'S PHONE: 6507767530 SUNNYVALE, CA 94087 PHONE NO: (408) 480-1098
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL LJ COMMERCIAL
License Class Lic.lt
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
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of die work forwhich this
permit is issued.
APPLICANT CERTIFICATION
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 auhorize 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.
Date
R OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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
construct the project (Sec.7044, Business & Professions Code).
Q, L .
I hereby affirm under penalty of perjury one of the following three
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 whichthis permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for die performance of the work for which this
permit is issued.
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
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.
APPLICANT CERTIFICATION
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,
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. _ f
REMODEL KITCHEN 120 SQ, 480 SQ FT THROUGH LIVING
AREA, ADD 2 SKYLIGHT, REPLACE 2 DOORS, 2
WINDOWS,
RE -STUCCO 344 SQ FT, 1 COVERED PORCH, RE -ROOF 17
REVISION #1- REVISE WATER HEATER, SERVICE UPGRADE-
ISSD 10/18/11
Sq. Ft Floor Area: I Valuation: $15000
APN Number: 35910005.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued b, _ Date: ,-�/oe'-(,-
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 Applicant:
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 compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or authorized agent: 4 o TEA Date: I ° P �U /l
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 Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
Signature.
t(4
0 / (Vl� 2-., /1(
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20682 SCOFIELD DR
OWNER'S NAME:
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lic. #
Contractor Date
I hereby affirm that 1 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
performance of the work for which this permit is issued.
I 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 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,
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.
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, 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
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
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.
I 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.
I certify that in the performance of the work for which this permit is issued, I shal I
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
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.
APPLICANT CERTIFICATION
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
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 ��
CONTRACTOR: QIONG & JUAN LIU PERMIT NO: 11070172
20682 SCOFIELD DR DATE ISSUED: 08/25/2011
CUPERTINO, CA 95014 PHONE NO:
BUILDING PERMIT INFO: BLDG F ELECT F PLUMB r
MECH r- RESIDENTIAL F COMMERCIAL f—
JOB DESCRIPTION: REMODEL KITCHEN 120 SQ, 480 SQ FT THROUGH LIVING
AREA, ADD 2 SKYLIGHT, REPLACE 2 DOORS, 2 WINDOWS,
RE -STUCCO 344 SQ FT, I COVERED PORCH, RE -ROOF 17
Sq. Ft Floor Area: I Valuation: $15000
APN Number: 35910005.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by Date: ,d?— 2-i L,
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 Applicant: 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(s) should 1 store or handle hazardous material.
Additionally, should 1 use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District 1 will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Owner
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of mrk's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
CITY OF CUPERTINO
Fm-7- FEE ESTIMATOR - BUILDING DIVISION
ADDRESS:
DATE.
REVIEWED BY:
APN:
BP#:
"VALUATION: Iso
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
PENTAMATION 1GENRES
PERMIT TYPE:
WORK
SCOPE
11n.'p, Dote:
(',gilth. lj.Tp'
NOTE: These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn7 info.
FEE ITEMS (Fee Resolution 11-053 Eff 7111111)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
0 #
$392.00
Skylight
ISKYL<10SF <= 10 s.f.
Suppl. PC Fee: 0 Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
# Window / Sliding Glass Door
$392.00 1 WINPEP Replacement
Permit Fee:
$0.00
Suppl. Insp. Fee-0 Reg.
0 OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Acoustical Fee:
0 Yes 0 No
$0.00
0
0
Work Without Permit? 0 Yes 0 No
$0.00
Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
0
0
I
Strong Motion Fee:
$0.00
Select an Administrative Item
Bldg Stds Commission Fee:
$0.00
SUBTOTALS:
$0.00
$784.00
TOTAL FEE:
$784.00
Revised: 07/04/2011
CITY OF CUPERTINO
FM_7 FEE ESTIMATOR - BUILDING DIVISION
i9lADDRESS:
20682 scofield dr.
DATE: 07/25/2011
REVIEWED BY: bobs.
APN: � � � �� ( ?��
BP#:
*VALUATION:
1$15,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Addition
PRIMARY SFD or Duplex
USE:L
PENTAMATION 1R3SFDREM
PERMIT TYPE:
WORK
sfd remodel new porch, entry door, rear door, 2 skylights, re -roof, re -stucco. remodel kitchen living
SCOPE
area.
EIF-L-
ET
J.
�,:. <.._..'.
NOTE_ These Pees are hated on the nreliminary information availahle and are only an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution 11-053 E . 711111)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
=1 s.f.
$588.00
Remodel, Kitchen (<=300 sf)
1REn1REsx1T
Suppl. PC Fee: G Reg. 0 OT
0.0
1 hrs
$0.00
PME Plan Check:
$0.00
=s.f. Remodel, Other
$457.00 IREV ESOTH
Permit Fee:
$0.00
Suppl. Insp. Fee:O Reg. 0 OT
0.0
hrs
$0.00
1,688 s.f. Re -roof
$238.00 IREROOFRES
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
344 s.f.
$457.00
Restucco
ISTUCOAPP
(
Acoustical Fee: 0 Yes 0 No
$0.00
0 #
$914.00
Covered Porch
ICOVPORCH I
0
0
Work Without Permit? 0 Yes 0 No
$0.00
Planning Fee:
$0.00
�� I '
�� �,- Select a Non -Residential
Building or Structure
Q
0
1'�'e:'.�:
Strong; Motion Fee: IBSEISMICR
$1.50
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$2.50
$2,654.00
TOTAL FEE:
1 $2,656.50
Revised: 07/04/2011
FM_7
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 20682 scofield dr.
DATE: 10/18/2011
REVIEWED BY: bob s.
APN:
BP#:
"VALUATION: j$1,000
'PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
PENTAMATION 1GENRES
PERMIT TYPE: id
WORK
revise water heater location service upgrade.
SCOPE
n
Plumb. Plan Check 0.0 hrs $0.00
Elec. Plan Check 0.0 hrs $0.00
-
Plumb. Permit Fee: IPPERMIT
Elec. Permit Fee: IEPERMIT
•ETOther
Plumb Insp. Ej hrs $44.0
Other Elec. Insp. 0.0 hrs $44.00
NOTE: This estimate does not include fees due to other Departments (i.a 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 addn'l info.
FEE ITEMS (I ee Resolution 11-053 E . 7/1,-11)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: (F) Reg. Q OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
F200 am s Electrical
$44.00 IERT<200 I Services
Permit Fee:
$0.00
Suppl. Insp. Fee:Q Reg. Q OT
0.0
hrs
$0.00
1 # Plumbing
$26.00 1PRWHEATR Water Heater
PME Unit Fee:
$0.00
PME Permit Fee:
$88.00
( (,�lti'IYTiF1ctr7 i'o'
Administrative Fee: IADMIN
$41.00
Q
0
Work Without Permit? C) Yes (F) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
Q
0
i
Travel Documentation Fee: ITRAVDOC
$44.00
Strom Motion Fee: IBSEISMICR
$0.50
hrs Admin./Clerical Fee
$41.00 IADMIN
,
Bldg; Stds Commission Fee: 1BCBSC
$1.00
SUBTOTALS:
1 $174.501
$111.00 TOTAL FEE:
0
Revised: 10/01 /2011