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10120056 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19089 TILSON AVE CONTRACTOR:WELKIN INTERNATIONAL PERMIT NO: 10120056 IND INC ER'S NAME: TAIPING WANG 20731 HANFORD DR DATE ISSUED:05/02/2011 OWNER'S PHONE: 4082047589 CUPERTINO,CA 95014 PHONE NO:(408)888-9096 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# R I Z [ oF — MECH RESIDENTIAL COMMERCIAL Contractor Date I hereby affirm that I'snAicensed under the provisions of Chapter 9 JOB DESCRIPTION:CONSTRUCT SINGLE STORY SFDWL 3,322'LIVING AREA- (commencing with Section 7000)of Division 3 of the Business&Professions ATTACHED GARAGE 637-SANITARY IS SUNNYVALE'S Code and that my license is in full force and effect. JURISDICTION. ,ori S'�` WZ, I hereby affirm under penalty of perjury one of the following two declarations: 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. 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 Sq.Ft Floor Area: Valuation:$380000 permit is issued. APPLICANT CERTIFICATION APN Number:37508056.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Date Issued by: Date:. Z__ a � � c- OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued contaminants as defined by the Bay Area Air Quality Management Distr*t I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&S de,Sections 25505,25533,and 25534. 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 O orized agent: forthwith comply with such provisions or this permit shall be deemed revoked. Date: 10 / APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to` "ling construction,and hereby authorize representatives of this city to enter Lender's Name u e above mentioned property for inspection purposes.(We)agree to save inounnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18• I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19089 TILSON AVE CONTRACTOR:WELKIN INTERNATIONAL PERMIT NO:10120056 IND INC OWNER'S NAME: TAIPING WANG 20731 HANFORD DR DATE ISSUED:05/02/2011 OWNER'S PHONE: 4082047589 CUPERTINO,CA 95014 PHONE NO:(408)888-9096 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F ELECT F PLUMB r- License Class Lic.# 2 G 1 0 1— 1 F_ MECH RESIDENTIAL COMMERCIAL Contractor � Date I hereby affirm that I a icensed under the provisions of Chapter 9 JOB DESCRIPTION:CONSTRUCT SINGLE STORY SFDWL 3,322'LIVING AREA- (commencing with Section 7000)of Division 3 of the Business&Professions ATTACHED GARAGE 637-SANITARY IS SUNNYVALE'S Code and that my license is in full force and effect. JURISDICTION. AVI 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 Sq.Ft Floor Area: Valuation:$380000 permit is issued. APPLICANT CERTIFICATION APN Number:37508056.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK ISNOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Sign Date _s�� Issued by: Date: L( OWNER-BUILDER DECLARATION RE-ROOFS: 1 hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1 hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(x)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&S de,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,1 must O orized agent: forthwith comply with such provisions or this permit shall be deemed revoked. Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CITY OF CUPERTINO CUPERTINO NEW SINGLE/MULTI FAMILY DWELLING PERMIT APPLICATION FORM O 1 APN# Date: =37� Is a 2"d unit being added? Yes No If yes, fill out the permit application for a 2,dunit. Is this house an Eichler? Yes ❑ No 9 If yes, needs planning approval. Building Address: 19089 T/�C.sON fl Ur-7_ Mailing Address (if different from building address): Owner's Name: Phone#: M r . W A►v g- c -4 08� 2 0-d---7 S �� Do you have the planning Residential Design Review/Minor Residential Permit approval? Yes ❑ No�91 If yes, please provide a copy of your planning approval letter. Planners Name: If no, see Planning before submitting plans to the Building Department. Have you applied for the demolition permit?Yes ❑ NoX Applicant Signotif a Demo If no, pick up application and procedures. Requirements): Contractor: Phone#: T. Fax/e-mail: Cupertino Business License #: State Contractor License#: Contact: Phone#: [-4-6ff,) r-_D•fA V ( C�:- PN Fax/e-mail: (-T69) 99G --7SOri Landscape Ordinance Compliance: Landscape area in sq. ft. (includes all irrigated areas): If 2,500 sq. ft. or less, compliance with the Landscape Water-Efficiency Checklist is required. If more than 2,500 sq. ft., a complete Landscape Project Submittal is required. Compliance Method: N Plant Type a Water Budget Single-Story Two-Story ❑ Three-Story ❑ Basement ❑ Hillside ❑ Multi-family Apartment ❑ Condo ❑ Townhouse ❑ Sq.Ft. Living Area-Including Basement& Attached Garage: Sq. Ft. Garage (Detached Only): Living area: Basement: Attached Garage: 6 3? Total Sq. Ft: Job Description: o�U� sra�r Type of Construction(Usage Class): Occupancy Type: _ cJ tc 1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B Valuation: �Q Project Size: Standard 19 Lar e❑ Major❑ Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable,include in plan set & the sheet index. Green Building Points Achieved: 8 For help, contact Build it Green at www.buildit reen.or Revised 12/06/10 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# OWNER'S NAME: A I I tA a vtOl PHONE# r7 GENERAL CONTRACTOR: 'C'. 1-S . Q aBUSINESS LICENSE# ADDRESS: V 7f 1150VI .A CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE# Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/ Carpeting Linoleum/Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile O wn /Caidractoir Signat a Date Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: 7;ZSon 4tleoPERMIT# O 0 OWNER'S NAME: �.�; ;h i,✓� PHONE# a 0,7o GENERAL CONTRACTOR Lo a, j BUSINESS LICENSE# ADDRESS: 20 7j DY CITY/ZIPCODE: CC4 e b *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. / I am not using any subcontractors: �iYH9 � Z�� Z Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum /Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile --,V' A Owner/Contkacto4 Signat re /Date Building Department CITY OF CUPERTINO 10300 TORRE AVENUE • CUPERTINO,CA 95014-3255 CUPERTINO TELEPHONE: (408)777-3228 • FAX: (408)777-7606 OFFICIAL NOTIFICATION OF NEW/ADDRESS CHANGE TO: All Agencies FROM: City of Cupertino DATE: February 14, 2011 RE: New./Change of Address APN #375-08-056 Please note the following address change: 19089 Tilson Ave is being demolished and a new house and a attached 2nd unit are being built. The main house will remain 19089 Tilson Ave and the 2nd unit has been assigned 19091 Tilson Ave. See attached map. The new addresses will take effect 30 days from the date of this letter. If you have any questions, please call me at (408) 777-3246. Sincerely, Susan Winslow Administrative Clerk a City of Cupertino N 1� Basemap Labels Abc Street Names Labels Secondary Address Lab ' 394 .. Primary Address Labels 10401) Freeway map a Street Centerline 10408 rr --- County Freeways County Major Roads Right-of-Way ka Parcels 10422 Community Development 0 City Boundary ® •Aerials-2006 '113 0 to■ AA ■■ h f .. . N SCALE 1 : 1,019 l 100 0 100 200 300 FEET /2 � %maLrs/LP v 457 .http:/�issvr/cupertinointranet/home/mapFile.aspx Monday, February 14, 2011 2:55 PM o' l O F F I C E O F C O U N T Y A S S E S S O R S A N T A C L A R A C O U N T Y, C A L I F O R N I A BOOK PACE 375 8 i This is not a survey of rhe land and is inserted as a matter ofWormaAan only,and while the 0 same is compiled from in/ormo7ion we believe +� II to be coned,no liability is auumed by ; FidslityNational Tile Group astothe TRACT Ns 550 ••LOREE ESTATES•-UN. N22 comdness of said information. 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