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12080321CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10457 VISTA KNOLL BLVD CONTRACTOR: HOMEOWNER PERMIT NO: 12080321 OWNER'S NAME: CUPERTINO, CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL License Class Lic. N 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. 1 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 Cede) I, 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. 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 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. REMODEL 1,027 SQ FT THROUGH OUT, BATH 80 SQFT, KITCHEN 168 SQ FT Sq. Ft Floor Area: I Valuation: $50000 APN Number: 32613031.00 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: le) `C;? RE -ROOFS: 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. 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 Date: CONSTRUCTION LENDING AGENCY I 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 Date /� aY��-- CITY OF CUPERTINO BUILDING PERMIT BUILDE14G ADDRESS: 10457 VISTA KNOLL BLVD CONTRACTOR: CHANG BO-SOON 80321 OWNER'S NAME: CUPERTINO, CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION F r r BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic. N Contractor Date 1 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 eRecL 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. Signature Date ❑ OWNER -BUILDER DECLARATION 1 hereby affirm that 1 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). 1 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 die 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, 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 1 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 regul ions per the Cupertino Municipal Code, Section 9.18. Signature Date MECH r RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: REMODEL 1,027 SQ FT THROUGH OUT, BATH 80 SQFT, KITCHEN 168 SQ FT 10/15/12- REV#I - STRUCTURAL FOOTING, RELOCATE DOOR WALLS AND HOLDDOWNS, ALTERED CEILING JOISTS AND ROOF FRAMING, AND VAULTED CEILING DETAIL-10/22/12 REVNI ISS'D Sq. Ft Floor Area: I Valuation: $50000 APN Number: 32613031.00 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 a,7 / RE -ROOFS: 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. Signature of Date: ALL ROOF COVERE14GS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) 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 I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or aut e n Date: -,-- 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 ARCHITECT'S DECLARATION 1 understand my plans shall be used as public records. CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 10457 Vista Knoll Blvd DATE: 10/15/2012 REVIEWED BY: jsg APN: BP#: 'VALUATION: 1$2,500 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: PENTAMATION 1GENRES PERMIT TYPE: WORK Revision includinq structural footin relocate door walls and holddowns altered ceiling oists and roof SCOPE framing, and vaulted ceiling detail Wcch. Plan Check Phunn. Plun Check Elea. Plan (.:heck dfech. Permit Fee. Phord). Pei'mir Fee: Eler_. Permit Fee: .Vech. Insp O!i c r Ph:rr.' Ir:. y . Wier [!;•r. limp. FTChi;r:r �,!,.ch. ln.ip. 1'cx: PhIndh. In.y. Fee: Eke. Insp Pce: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, Schoo! District etc). Thesefees are based on the preamina information available and are only an estimate- Contact the De t or addn 7 info. FEE ITEMS (Fee Resolution / /-053 Eff. 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes Q No $0.00 727 hours Plan Check, Hourly $266.00 ISTPLNCK Suppl. PC Fee: Q Reg. © OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? ® Yes Q No $0.00 Suppl. Insp. Fee-0 Reg. © OT Fo,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C_10111'17'rrC1iW7 7 ax: ,1dministrutive Fee: Q O Work Without Permit? O Yes (E) No $0.00 Advanced Planning Fee. $0.00 hours Inspections E$1 .00 ISTINSP Inspection, Hourly 0 ©� T ruvel Docilmenlation Fees: Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item 1 � %/;-> Bldp- Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $399.00 TOTAL FEE: 1 $400.60/ Revised: 10/01 /2012 CITY OF CUPERTINO FM-1 FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10457 Vista Knoll Blvd DATE: 08/31/2012 REVIEWED BY: Sean APN: BP#: 'VALUATION: 1$50,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: PENTAMATION 1R3SFDREM PERMIT TYPE: WORK I Remodel entire residence 1275 sq ft SCOPE ;i,fech. Pion Check Pfrunh. Plan Check Elec. Pion Chock bfech. Permit Foe Plumh. Pcrmil ree: Elec. Permit Fee: 01//Cr .1fc c;!i Imp. 01/wr Plumb laveLi 01her E,7ec ln..w. Li dlcch. lrr.NP. l ,r,': Phmth. hi.ep. Fee rick. snap. /,ec. 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 nreliminary information available and are only an estimate. Contact the Dent for addh 7 info. FEE ITEMS (Fee Resolution 11-053 E . 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F1,2751 s.f. $4,281.00 Remodel, Other IREMRES2 Suppl. PC Fee: � Reg. Q OT 0,0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Conslruclion .Tax.- Adinim.slralive Pee. Q 0 Work Without Permit? © Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 Travel Documentation Fees: Strong; Motion Fee: IBSEISMICR $5.00 Select an Administrative Item Bldg Stds Commission Fee: IaCaSC $2.00 SUBTOTALS: $7.00 $4,281.00 TOTALnE.-I $4,288.00 Revised: 07/01 /2012