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B-2016-3324CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-3324 20047 SOMERSET DR CUPERTINO, CA 95014-3115 (369 32 021) LUNG - SENG SHIN UNION CITY, CA 94587 OWNER'S NAME: MORSE CHIANG OWNER'S PHONE: 360-627-1796 LICENSED CONTRACTOR'S DECLARATION License Class 1} Lic. #839810 Contractor LUNG - SENG SHIH Date 05/31/2018 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: t. 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 j 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. AP-PLICANT 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. I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: t. 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) 2. 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: t. 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. 2. 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. 3. 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 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 Date 08/03/2017 DATE ISSUED: 04/24/2017 PHONE NO: (408) 655-8712 BUILDING PERMIT INFO: X BLDG X ELECT X PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: 1 ST FLOOR KITCHEN AND LIVING ROOM ADDITION (309 S.F.); (N) COVERED PORCH (49 SQ FT); IST FLOOR REMODEL (1033 S.F.); UPGRADE ELECTRICAL PANEL (200 AMP); (N) ELECTRIC SUB - PANEL (100 AMP); INSTALL TANKLESS WATER HEATER REV#3 - 2ND FLOOR BATH - REPLACE (E) PLUMBING FIXTURES; REPIPE (E) BATH DRAIN; REWIRE AT FLOOR; REPLACE WALL INSULATION - ISSUED 8/3/2017 REV#2 - ADD BEAMS FOR CEILING BREAK; SHEAR WALL CHANGED; HOLD-DOWN CHANGED - ISSUED 7/20/2017 REV #1 - RELOCATE 1/2 BATH (BATHROOM #2) AND CHANGE TO FULL BATH; CHANGE EXISTING SIDING; CHANGE WOOD SHAKE TO SHINGLE; REMOVE BATHROOM 5 FROM GUEST ROOM; REPLACE 4 WINDOWS ON 2ND FLOOR - ISSUED 5/18/2017 Sq. Ft Floor Area: 309 1 Valuation: $900000.00 APN Number: Occupancy Type: 36932 021 R-3 (Custom) PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Abby Ayende Date: 04/24/2017 RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without fust obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: 08/03/2017 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' Date: 08/03/2017 CONSTRUCTIONLENDIN AGEN-Y 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 CONSTRUCTION PERMIT APPLICATRIVISION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING I 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 #S-8. CUPERTINO I (408) 777-3228 •FAX (408) 777-3333 • building(a)cupertino.orgZ � ❑ NEW CONSTRUCTION ❑ ADDITION El ALTERATION/ TI REVISION / EORIGINAL PERMIT # PROJECT ADDRESS fir OWNERNAME PHONE / L�-J `�� `^ E-MAIL STREET ADDRESS CITY, STATE, ZIP �( 2LL FJ CONTACT NAME - "DO E -MAIL I I i��s ?� S s e 0 STREET ADDRESSCITY, STATE, ZIP FAX Ire ?6 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT 40 CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSSE NUMBEg/G LICENSE TYPE BUS. LIC # O 6 COMPANY NAME E-MAIL FAX ST ET ADD RESSSTATE, z , _ n � PHO re CHITECT GINEER NAME LIC jNS�NUMR BUS. LIC # C� COKPANY`N,A E-MAIL FAX a O STREET'ADDRESS CITY, STATE, ZIP�A+ PHONE C i e (�1 DESCRIPTION OF WORK R-13 l el EXISTING USE ' PROPOSED USE CONSTR. TYPE # STORIES ' USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEWFLOOR DEMO TOTAL AREA. AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA. REMODEL AREA REMODEL AREA PORCH AREA DECKAREA TOTAL DECK/PORCH AREA GARAGE AREA: DFrACH ❑ ATTACH I # DWELLING UNITS: ISA SECOND UNIT ❑YES SECOND STORY ❑ YES BEING ADDED? ❑NO ADDITION? ❑NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES REC VBx t e �z'A}j TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO By my signature below, I certify to each of the following: I am the property owner or authorized ager to act on the property owner's behalf. I have read this application and the info ation I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws r ating to ilding construction. I authorize r reser fives of Cupertino to enter the above-identifie roperty for inspection purposes. Signature of Applicant/A� t Dat l SUPPLEMENTAL INFORMATION REQUIRED PLA -T, SLIP r. _ New SFD or Multifamily dwellings: Apply for demolition permit for r4 ❑ ❑ BUILDING PLAN existing building(s). Demolition permit is required prior to issuance of building O\ ER THE COUNTER REVIEW a + pennit for new building. ❑ ExPRESS = ❑ PLANNING PLAN REVIEW; t.. e Commercial Bldgs: Provide a completed Hazardous Materials Disclosure sTANnARD ' ❑ PUBLIC WOKS R f6—nn if any Hazardous Materials are being used as part of this project. = f x*F5 r LARGE r ` ❑ FIRE DEPT x Copy of Planning Approval Letter or Meeting with Planning prior to , , , a r` _ submittal of Building Permit application. ❑ MAJOR° ❑ SANITARX'SEWERDISTRIQT BldgApp 2011. doe revised 06121111 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-3324 20047 SOMERSET DR CUPERTINO, CA 95014-3115 (369 32 021) LUNG - SENG SHIN UNION CITY, CA 94587 OWNER'S NAME: MORSE CHIANG DATE ISSUED: 04/24/2017 OWNER'S PHONE: 360-627-1796 PHONE NO: (408) 655-8712 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class 5 Lic. #839610 Contractor LUNG - SENG SHIH Date 05/31/2018 X BLDG X ELECT X PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing — MECH X RESIDENTIAL —COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: 1ST FLOOR KITCHEN AND LIVING ROOM ADDITION (309 S.F.); (I) I hereby affirm under penalty of perjury one of the following two declarations: COVERED PORCH (49 SQ FT); 1ST FLOOR REMODEL (1033 S.F.); 1. I have and will maintain a certificate of consent to self-insure for Worker's UPGRADE ELECTRICAL PANEL (200 AMP); (I) ELECTRIC SUB- Compensation, as provided for by Section 3700 of the Labor Code, for the PANEL (100 AMP); INSTALL TANKLESS WATER HEATER . performance of the work for which this permit is issued. REV#2 - ADD BEAMS FOR CEILING BREAK, SHEAR WALL Zi., I have and will maintain Worker's Compensation Insurance, as provided for by CHANGED; HOLD-DOWN CHANGED - ISSUED 7/20/2017 bi Section 3700 of the Labor Code, for the performance of the work for which this REV #1 - RELOCATE 1/2 BATH (BATHROOM #2) AND CHANGE TO permit is issued. FULL BATH; CHANGE EXISTING SIDING; CHANGE WOOD SHAKE APPLICANT CERTIFICATION TO SHINGLE; REMOVE BATHROOM 5 FROM GUEST ROOM; I certify that I have read this application and state that the above REPLACE 4 WINDOWS ON 2ND FLOOR - ISSUED 5/18/2017 information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize Sq. Ft Floor Area: 309 Valuation: $900000.00 representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the APN Number: Occupancy Type: City of Cupertino against liabilities, judgments, costs, and expenses which 36932021 R-3 (Custom) 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. PERMIT EXPIRES IF WORK IS NOT STARTED Signature Date 7/20!2017 WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the Issued by: Abb,iz A, e� nde following two reasons: Date: 04/24/2017 1. 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 RE-ROOFS: sale (Sec.7044, Business & Professions Code) All roofs shall be inspected prior to any roofing material being installed. If a roof is 2. I, as owner of the property, am exclusively contracting with licensed installed without first obtaining an inspection, I agree to remove all new materials for contractors to construct the project (Sec.7044, Business & Professions Code). inspection. I hereby affirm under penalty of perjury one of the following three declarations: t. I have and will maintain a Certificate of Consent to self-insure for Worker's Signature of Applicant: Compensation, as provided for by Section 3700 of the Labor Code, for the Date: 7/20/2017 performance of the work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance, as provided for by ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 3. I certify that in the performance of the work for which this permit is issued, I I have read the hazardous materials requirements under Chapter 6.95 of the shall not employ any person in any manner so as to become subject to the California Health & Safety Code, Sections 25505, 25533, and 25534. I will Worker's Compensation laws of California. If, after making this certificate of maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the exemption, I become subject to the Worker's Compensation provisions of the Health & Safety Code, Section 25532(a) should I store or handle hazardous Labor Code, I must forthwith comply with such provisions or this permit shall material. Additionally, should I use equipment or devices which emit hazardous be deemed revoked. 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 APPLICANT CERTIFICATION the Health & Safety Code, Sections 25505, 25533, and 25534. 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 Owner or authorized agenS relating to building construction, and hereby authorize representatives of this city Date: 7/20/2017 JU to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, I hereby affirm that there is a construction lending agency for the performance judgments, costs, and expenses which may accrue against said City in of work's for which this permit is issued (Sec. 3097, Civ C.) consequence of the granting of this permit. Additionally, the applicant understands Lender's Name and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. Lender's Address Signature Date 7/20/2017 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUI •lF IGHI'+:.JN _..���... 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building aCkuperlino.org CiiPERTttitt� — &U 11-332/ ❑ NEW CONSTRUCTION ❑ ADDITION F I ALTERATION /TT �FVTT(11FFFRRPT) nurr:IMAT 13PPAMT 44 PROJECT ADDRESS _ g i" APN OWNER NAMEi ®V s e Cc c�T PHO ��� a� J2 E-MAIL STREET ADDRESS 6�4-7 Sam"sem D -r .fi�� CITY, TATE, ZIP '� FAX CONTACT NAME PHCx� �9cs STREET ADDRESS44,�_3 -C i>re. 5t. t - g CITY, STATE, ZIP V h' y ` 7 FAX ❑ OWNER 11 OWNER -BUILDER ❑ OWNER AGENT L7 CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT 11 ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME f+f - ®� jty /I LICENSE NUMBER314 0 LICENSE TYPE BUS. LIC # 14 COMPANY NAME A E-MAIL i FAX STREET ADDRESS yp 5-f - ° 4 �(4!' CITY, STATE, ZIP � � /� `d e- ,p >�. W ` - (� PHONE / e "� I� ® I ARCHITECT/ENGINEER NAME c5�� LICENSE NUMBER _ LICENSE BUS. LIC # COMPANY NAMEf /E fit,/ USA�® $ E-MAIL FAX STREET ADDRESS> -03 0 1-y _ c&W�e ;'(� _ yt CITY, STATE, ZIP c� ?_t/ �� PHONE t7 �f�' a ( 6J DESCRIPTION OF WORK _ v t� � KC er • _"'—' o ��r"_ _ 1+� t V v' e V V1'��P i4�yf'V 9 9 . Ear a EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES 1 USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL,AREA REMODEL AREA PORCH AREA DECK AREATOTAL DECKTORCH AREA GARAGE AREA: DETACH []ATTACH ft DWELLING UNITS: IS A SECOND UNIT ❑YES SECONDSTORY OYES BEING ADDED? []NO ADDITION? []NO PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RE i3Y TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO By my signature below, I certify to each of the following: I am the property owner or authorized gent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to b ng construction. I authorize repreusematives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Ager Date: SUPPLEMENTVL INFORMATION REQ RED PLAN CHEC' k TYPE ROUTING SLIP ❑ OVEx.THE-COUNTER © BUILDINGPLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW, _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ 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 ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doe revised 06/21111 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-3324 20047 SOMERSET DR CUPERTINO, CA 95014-3115 (369 32 021) LUNG - SENG SHIN UNION CITY, CA 94587 OWNER'S NAME: MORSE CHIANG DATE ISSUED: 04/24/2017 OWNER'S PHONE: 360-627-1796 PHONE NO: (408) 655-8712 LICENSFD CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. #839610 Contractor LUNG - SENG SHIH Date 05/31/2018 X BLDG X ELECT X PLUMB MECH X RESIDENTIAL COMMERCIAL 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. JOB DESCRIPTION: 1 ST FLOOR KITCHEN AND LIVING ROOM ADDITION (309 S.F.); (N) I hereby affirm under penalty of perjury one of the following two declarations: COVERED PORCH (49 SQ FT); 1ST FLOOR REMODEL (1033 S.F.); t. I have and will maintain a certificate of consent to self-insure for Worker's UPGRADE ELECTRICAL PANEL (200 AMP); (N) ELECTRIC SUB- Compensation, as provided for by Section 3700 of the Labor Code, for the PANEL (100 AMP); INSTALL TANKLESS WATER HEATER. performance of the work for which this permit is issued. REV #1 - RELOCATE 1/2 BATH (BATHROOM #2) AND CHANGE TO 2. I have and will maintain Worker's Compensation Insurance, as provided for by FULL BATH; CHANGE EXISTING SIDING; CHANGE WOOD SHAKE Section 3700 of the Labor Code, for the performance of the work for which this TO SHINGLE; REMOVE BATHROOM 5 FROM GUEST ROOM; permit is issued. REPLACE 4 WINDOWS ON 2ND FLOOR - ISSUED 5/18/2017 Sq. Ft Floor Area: 309 Valuation: $900000.00 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 APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for 369 32 021 R-3 (Custom) 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. PERMIT EXPIRES IF WORK IS NOT STARTED Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9.16. WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 5/18/2017 Issued by: Abby Ayende OWNER-BUILDER DECLARATION Date: 04/24/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: RE-ROOFS: 1. I, as owner of the property, or my employees with wages as their sole All roofs shall be inspected prior to any roofing material being installed. If a roof is compensation, will do the work, and the structure is not intended or offered for installed without first obtaining an inspection, I agree to remove all new materials for sale (Sec.7044, Business & Professions Code) inspection. 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). Signature of Applicant: I hereby affirm under penalty of perjury one of the following three declarations: Date: 5/18/2017 1. 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 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER performance of the work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance, as provided for by HAZARDOUS MATERIALS DISCLOSURE Section 3700 of the Labor Code, for the performance of the work for which this I have read the hazardous materials requirements under Chapter 6.95 of the permit is issued. California Health & Safety Code, Sections 25505, 25533, and 25534. I will 3. I certify that in the performance of the work for which this permit is issued, I maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the shall not employ any person in any manner so as to become subject to the Health & Safety Code, Section 25532(a) should I store or handle hazardous Worker's Compensation laws of California. If, after making this certificate of material. Additionally, should I use equipment or devices which emit hazardous exemption, I become subject to the Worker's Compensation provisions of the air contaminants as defined by the Bay Area Air Quality Management District I Labor Code, I must forthwith comply with such provisions or this permit shall will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and be deemed revoked. the Health & Safety Co Sections 25505, 25533, and 25A34. APPLICANT CERTIFICATION Owner or authorized agent: I A A A-4-1 's 841,L�L I certify that I have read this application and state that the above information is Date: 5/18/2017 correct. I agree to comply with all city and county ordinances and state laws T relating to building construction, and hereby authorize representatives of this city I hereby affirm that there is a construction lending agency for the performance to enter upon the above mentioned property for inspection purposes. (We) agree of work's for which this permit is issued (Sec. 3097, Civ C.) to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Name judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands Lender's Address and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Signature Date 5/18/2017 Licensed Professional CITY OF CUPERTINO BUILDING PERMIT j BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-3324 20047 SOMERSET DR CUPERTINO, CA 95014-3115 (369 32 021) LUNG - SENG SHIN UNION CITY, CA 94587 OWNER'S NAME: MORSE CHIANG OWNER'S PHONE: 360-627-1796 LICENSED ONT A TOR'S DECLARATION License Class B Lic. #839610 Contractor LUNG - SENG SHIH Date 05/31/2018 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: 1. 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 4/24/2017 hereby affirm that I am exempt from the Contractor's License Law for one of the DATE ISSUED: 04/24/2017 PHONE NO: (408) 655-8712 BUILDING PERNHT INFO: X BLDG X ELECT X PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: 1 ST FLOOR KITCHEN AND LIVING ROOM ADDITION (309 S.F.); COVERED PORCH (49 SQ FT); IST FLOOR REMODEL (1033 S.F.); UPGRADE ELECTRICAL PANEL (200 AMP); (N) ELECTRIC SUB - PANEL (100 AMP); INSTALL TANKLESS WATER HEATER. Sq. Ft Floor Area: 309 1 Valuation: $900000:00 APN Number: Occupancy Type: 369 32 021 R-3 (Custom) PERMIT EXPIRES IF WORK IS NOT STARTED WITIIIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. by: Abby Ayende two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is ''I I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials ford compensation, will do the work, and the structure is not intended or offered for inspection. 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). hereby affirm under penalty of perjury one of the following three declarations: 1. I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 37,00 of the Labor Code, for the, performance of the work for which this permit is issued. i. 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. 3. 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 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. Date 4124/2017 Signature ofApplicant: Date: 4/24/2017 TO BE CLASS "A" 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 f 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. a, Owner or authorized agent: ®ate: 4/24/2017 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.) it Lender's Name jI i Lender's Address ARCHITECT'S DECLARATION = 1 understand my plans shall be used as public records. Licensed Professional cuprzI1ETlNQ 1- 1 NEW CONSTRTICTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX ((408) 777-3333 bulldingftupertino.oig i I AT1nTIr)W I 1 AT-rZPA'rTrW111 Irl er_•ti ,rorr.,,r ,,.,�,,�,,,,,.,. 3326-F PROJECT ADDRESS APN #� OWNER NAME ® { M PH NE E - IL L rc STREETADDRESS Cl , STAT ! CA 61-:311,10 FAX CONTACT Cntj E h4AII, STREETADD ESS` tTE, Zip FAX (j -01 � I I ' ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGGNT ❑ CONTRACTOR ❑ CONTRACTOR AGENT VARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME 5k i k va�A DCM I.IR a 8`3 o tICENSENUMB LICENSE TYPE BUS.iIC 6 d i3 COMPANY NAME E-MAIL FAX s kikis s6cilo6ak nat— STRE4t�DDRESS Fj Le- <a7t CITY, STATE, ZIP pHO g'ii' i' �t CA -f-14297 LOOM4712- ARCHITECT/ENGINEER NAM�SENUMBER. ` t BUS. LIC COMPANY NAME E-MAIL JAC STREiTADDRESS -A� S AP 403 5tt;� DESCRIPTIOBLOB _ - ----" +1 - 44 INA 107-1 t7 { `/y 'h i i 4#L f� o k—a-west 4 yt m SKIS TNG USE- P OSED USE y� CONSTR. TYPE N STORIESUSE TYPE OCC. SQ.FT. VALUATION {$) ExiS'rG AREA NEW FLOOR AREA DEMO TOTAL AREA ,BATHROOM CHEN REMODELAREA� REMODEL OTHER REM L E� PORCBkREA DECKAREA BC CHARE A GEAREA: ❑DETACH ❑ ATTACH c W DWELLING UNITS: IS A SECOND UNIT '❑ ]'ES SECOND STORY NrYES BEING ADDED? O ADDITION? NO PRE -APPLICATION ❑YES IPYES,PROVIDECOPYOF PLANNINGAPPLY ❑ NO PLANNING APPROVAL LETTER ]STUB BLDG AN E] YES EICHLER HONIE7 ❑ NO CEN;E_I% ^=-_' "` -_ -_-_ - - _ _ _ = •_'"` =n-'= v� '��' _ ___-_' _ _ _ -- T ALVALUATION: if s�TGo By my signature below, I certify to each of the following: I and the property owner or authorized ager' to act n theproperty owner's behalf. 1 have read this application and the information I have provided is correct. I have read the Description of �'+viork and verify it is accurate. I agree to comply with all applicable local - ordinances and state laws relating t bili ing aonnsttion. I aut Drize representatives of Cupertino to enter the above-ide tified property ft inspe tion purposes. Signature of ApplieantlAgent: Date: a - INFORMATION RBQIJIitE SUPPLEMENTAL INFORM _ - _ - - �5�_;'._"-�7.OUTING.SLiP=_::tri:_":>::�; ,R - - - - - New SFD o1Mul Multifamily dwellings.- s� AP P1 for demolition rITi for existingbuilding(s). Demolition permit is required prior to issuance ofbuildin ., permit fornew building. S < _ LA,.'1\INGPliAIv` fo. ' Commercial Bldgs Provide a completed Hazardous Materials Disclosure _ti STAND4RD_ . If any Hazardous Materials arebenlg used as part aF�lus project'DEPr Copy Pnml Approval Letter or MeetinO withPlanning yI1 to'..4-7. ,R.:-._ ::,_ .`'.:t.2.s.:.5-r=::._7:._:u''._-- •__:_.:":;::=:.:">':.:c..:..>?I;;.S:A:_:N.,I�-T-;r O :1:c.R::.Y:;�S:.B:_::}::Y:E-_-R--.:.D-.-:_-7�_ : Submittalapplication. Of Building Permit a lication. _ - --: .." : c-:; <_,-:,;,.--. ::,::.-.s -� 1-• tee• :.�:c:e�;-.-::;:.:: _._..:..; ------y :-:� •_>tr. BldgApp_201 Ldoc revised 06121111 • M 5— 2ent6 - 3_J2'Y RONG CHANG USA CORPORATION kr 2050 Concourse Drive, #50, San Jose, CA 95131 fa} Phone: (408) 892-7680 Fax: (408) 321-9987 ARCHITECTURAL PROJECT DEVELOPMENT a PLANNING o MANAGEMENT City of Cupertino, California Building ,& Safety Division Re: Structural Revision 20047 Somerset Dry Cupertino CA 94014 July 27th, 2017 Dear Sir or Madam: This letter is. to ' confirm that I gone to the job site on July 27th, 2017, to do structural field .observation, it ,is, My professional judgment that the overall structural work was performed in accordance with -industry standard practices, and was based on approved plan and specifications. The following items have been inspected: • ;! 4 Epoxy; HDU2 holdowns installed with 5/8" diameter anchorage bolt with minimum 12" ember; depth, Simpson SET -XP structural epoxy -tie anchoring adhesive used. If you have any, -questions regarding the above, please contact me at (408) 321-9988 Sincerely; Sy -Cheng Tsai, Architect RONG CHANG USA CORPORATION 2c 2050 Concourse Drive, #50, San Jose,CA 95131 �� Phone: (408)892-7680 Fax: (408)321-9987 ARCHITECTURAL PROJECT DEVELOPMENT • PLANNING • MANAGEMENT City of Cupertino, California Building & Safety Division Re: Structural Revision 20047 Somerset Dr Cupertino, CA 95014 Aug 11th, 2017 Dear Sir or Madam: This letter is to confirm that I gone to the job site on Aug 11th, 2017, to do structural field observation, it is my professional judgment that the overall structural work was performed in accordance with industry standard practices, and was based on approved plan and specifications. The following items have been inspected: • Shear wall with 4" or less nailing at line-1,3&B. • Change the location of the anchor bolt to the top of the sill plat w/min 6" embedment and blocking under the sill plate at line-A on sheet S2.1 • Using(3) 2x4 for boundary nailing stager at continuous panel edges. If you have any questions regarding the above,please contact me at(408) 321-9988 Sincerely; 6DA \ ( ;H ; sAIA)IA, DAM a Q, . � OF CA1aF°