HomeMy WebLinkAboutB-2017-2048CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-2048
22647 OAKCREST CT CUPERTINO, CA 95014-0830 (342 48 039)
HOMEOWNER
BUILDER
OWNER'S NAME: Yang Li And Haining Yu
DATE ISSUED: 11/30/2017
OWNER'S PHONE: 408429-0566
PHONE NO:
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class Lic. #
Contractor HOMEOWNER BUILDER Date
X BLDG —ELECT _ 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:
GARAGE REMODEL - DRYWALL CEILING AND WALL; INSTALL (2)
I hereby affirm under penalty of perjury one of the following two declarations:
CEILING FANS; INSTALL 9 RECESSED LIGHTS; CONSTRUCT
1. I have and will maintain a certificate of consent to self -insure for Worker's
WATER HEATER ENCLOSURE
as provided for by Section 3700 of the Labor Code, for the
,Compensation,
eperformance of the work for which this permit is issued.
042have 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: $2400.00
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
APN Number:
Occupancy Type:
and state laws relating to building construction, and hereby authorize
342 48 039
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
PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit.
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally, the applicant understands and will comply with all non -point
-
'source regulations per -the Cupertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED'INSPECTION.
S .• ature Date 11 /30/2017
Issued by: Abby Ayende
Date: 11/30/2017
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE -ROOFS:
following two reasons: I
All roofs shall be inspected prior to any roofing material being installed. If a roof is
1. I, as. owner of the, property, or my employees with wages as their sole
installed without fust obtaining an inspection, I agree to remove all new materials for
compensation, will do the work, and the structure is not intended or offered for
inspection.
ale (Sec.7044, Business & Professions Code)
,, as, owner of the property, am exclusively contracting with licensed
Signature of Applicant:
� contractors to, construct the project (Sec.7044, Business & Professions Code).
YL
Date: 11/30/2017
I hereby affirm under penalty of perjury one of the following three declarations:
"A"
1. I have and will maintain a Certificate of Consent to self -insure for Worker's
ALL ROOF COVERINGS TO BE CLASS OR BETTER
Compensation, as provided for by Section 3700 of the Labor Code, for the
.dperformance'of the work for which this permit is issued.
HAZARDOUS MATERIALS DISCLOSURE
I'have and will maintain Worker's CompensationInsurance, as provided for by
I have read the hazardous materials requirements under Chapter 6.95 of the
-Section 3700 iof'the Labor Code, for the performance of the work for which this
California Health & Safety Code, Sections 25505, 25533, and 25534.. I will
permit is issued.
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
s. I certify that in the performance of the work for which this permit is issued, I
Health & Safety Code, Section 25532(a) should I store or handle hazardous
shall' not cmploy, any person in any manner so as to become subject to the
material. Additionally, should I use equipment or devices which emit hazardous
Worker's;Cofimpensation laws Califomia. If,
air contaminants as defined by the Bay Area Air Quality Management District I
of after making this certificate of
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code, Sections 25505, 25533, and 25534.
labor Code,,i must forthwith comply with such provisions or this permit shall
be deemed revoked.
enter or authorized ag CL;4�_
APPLICANT CERTIFICATION
ate: 11 /30/2017
I certify that I have read thisapplication and state that the above information is
CONSTRUCTION LENDING AGENCY.
correct. I .agree to comply with all city and county ordinances and state laws
I hereby affirm that there is a construction lending agency for the performance
relating t0;'tiuilding construction, and hereby authorize representatives of this city
of work's for which this permit is issued (Sec. 3097, Civ C.)
to enter upon the above mentioned property for inspection purposes. (We) agree
Lender's Name
to save indemnify and'!keep harmless the City of Cupertino against liabilities,
judgments, costs, and ;expenses which may accrue against said City in
Lender's Address
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
ARCHITECT'S DECLARATION
Code, Section 9.18.
1 understand my plans shall be used as public records.
atur Date 11/30/2017
Licensed
Professional
M
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 1 ^�
(408) 777-3228 • building@cupertino.or;; PEMIT #B -�L�
CUPERT1140 ' REV # DEF #
F-1 I�IF.w (,C)NSTRT T'TTON n ADDITION n ALTERATION n T.J. n MEP n RE -ROOF ❑ SWIMMING POOL/SPA
PROJECT ADDRESS u '
APN #
22647 OAKCREST CT, CUPERTINO, CA
�1
OWNERNAMEPHONE
E-MAIL
YANG LI 408-429-0566
�YANG.LIY@GMAIL.COM
STREET ADDRESS
CIrY, STATE, ZIP
22647 OAKCREST CT
CUPERTINO, CA 95014
❑ CONTRACTOR NAME [j] OWNER -BUILDER COMPANY
NAME
LICENSE NUMBER
LICENSE TYPE
STREET ADDRESS _r,
STATE, ZIP
E-MAIL
PHONE BUS. LIC #
❑ ARCHITECT 0 OWNER, ❑ OWNER AGENT ❑ CONTRACTOR AGENT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTACT NAME I ' .
E-MAIL
YANG,LI
YANG.LIY@GMAIL.COM
STREET ADDRESS ;,
CITY, STATE, ZIP
PHONE
22647 OAKCREST•CT
CUPERTINO, CA 95014
408-429-0566
DESCRIPTON
Garaize project 578 s ft. 1) Put dry wall on walls and ceilings to finish. the inner surface to make the looking better. '
2) Install 2 ceilingfans to iin rove.air venting and cooling during summer.
3) Install 8 to 10 recessed. LED lights on ceiling.
4) Install wall to isolate the water heater and furnace to reduce noise.
❑X SINGLE-FAMILY/DUPLEX E MULTI -FAMILY ❑ INDUSTRIAL ❑ COMMERCIAL
USE
TYPE
OCC
SQ.FT.
VALUATION ($)
EXISTING USE
EXISTING SF;
NEW FLOOR SF
PORCH
SF DECK,
DEMO
S q
7GARAG.
TOTAL NET SF
! REMODEL ,REMODEL
KITCHEN
REMODEL OTHR
❑x ATTACHED
BATHROOM SF
SF
SF
❑ DETACHED
EXLSING ❑ YES
FIRE SPRINKLERS ❑ NO
EICHLER ❑ YES
❑ NO
SECOND STORY ADDITION []YES
- ❑ NO
DWELLING SECOND DWELLING ❑ YES ❑ ATTACHED[] DETACHED OTHER
'
i UNITS # UNIT ADDITON: , ❑ NO S F
POOLS •❑ FIMRGLASS , ❑: VINYL -LINED ❑ GUNITE ❑ PREFABRICATED
_
POOL - SF. SPA - SF ... SPA ATTACHED ❑ YES ❑ NO TOTAL - SF
. , I
RIVED BY:
IIEJY+
Commercial ar Mitlti-Family Buildingsi with PuhlicSmimrniug Pools requires Deparhnent ofEnvironrnental Heath ayproval
RE -ROOF
EXISTING ROOF TYPE: EJ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑
WOOD SHING ES ❑TILE OTHER (SPECIFY)
REMOVE /REPLACE NO
IF'NO
PLYWOOD ❑'A- ❑ 3/8" PLYWOOD
TYPE:
PITCH:
ROOF CLASS
YES
# OF LAYERS
I
THICKNESS ❑ 5/8" OTHER
❑ OSB ❑ CDX OTHER
, 2
A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER
*Provide a signed copy of the Cupertino's Tear -Off Policy SF #of SQUARES
By my signature below I certify to each of the following: I am the property owner or authorized agent to act on the property owners 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 apphcable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to
enter the above -identified property for inspection purposes. I acknowledge and authorize all information, contained on this application form
to be made available for ublic record.
Signature M, Tt.
SUPPLEMENTALINEORMATION RE D
*New SFD/Second Dwelling Units/Multifamily Dwellings: A Demolition permit is required prior to issuance of a building permit for all new construction.
*Commercial Buildings: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project.
*Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application.
*HOA -Provide a letter of approval from the Home Owner's Association
BldgApp_2017.doe revised 08101117
CUPERTINO
OWNER -BUILDER DISCLOSURE FORM
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building0-cupertino.org
Dear Property Owner(s):
An application for a building .permit has been submitted in your name listing yourself as the builder of the property
improvements specified at:
SITE ADDRESS �/. ,L, 9
APN 3�
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OWNERNAME n WC
fT
OWNER ADDRESS
d vim} / [ p C ((
23M aGjKii o V� �Vo� /�"�
AQ�T/1�(7r
DESCRIPTION OF WORK: I'L,+ N wAh i� �✓ t'4k' Ivimers;u /4 Wall a-+ cel -1114 tY Qr`C ° /Md 2,
Cel�, Ih Arc. ` %}dcP AtoLt'' tZL�S � ��v in r �Uf �,+ �( 40 ;so y e. A V rNaee
f
We are providing you with an Owner -Builder Acknowledgment and Information Verification, Form to make you aware of
your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We
will not issue a building permit until you have read, initialed your understanding of each provision, signed, and
returned this form to us at our official address indicated. An agent of the owner cannot. execute this notice unless
you, the property owner, obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
(DIRECTIONS: Please read and initial each statement below to signify you understand or verify this information.)
V// 1. 1 understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -
Builder" building,permit that erroneously implies that the property owner is providing his or her own labor and material
personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries. sustained by
an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not
provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my
insurance coverageifor injuries to workers on my'property.
V 2. 1 understand building permits are not required to be signed by property owners unless they are responsible for
the construction and are not hiring a licensed Contractor to assume this responsibility.
Vl/ 3. 1 understand as an "Owner -Builder" I am the responsible party of record on the permit. 't understand that I may
protect,myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her
name instead of my own.
VA. I understand Contractors are required by law to be licensed and bonded in California and to list their license.
numbers on permits and contracts.
//
�5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the
total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be
considered an "employer' under state and federal law.
V/6. 1 understand if I am considered an "employer' under state and federal law, I must register with the' state and
federal government, withhold payroll taxes, provide workers' compensation disability insurance, and;contribute to
unemployment compensation for each "employee." I also understand my failure to abide by these laws, may subject
m- a to serious final ncial risk.
V/ 7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family
residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by
licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work
is
pe ormed under contract with a licensed general building Contractor.
78. 1 understand ,as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for
any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction
defects in tl'e workmanship or materials.
OwnerBuilderForm 2010.doc revised 04/14110
V/9. 1 understand I may obtain more information regarding my obligations as an "employer" from the Internal
Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments,
and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State
License Board (CSLB) at 1-800-321-CSLB (2752) or www.csib.ca.gov for more information about licensed
contractors.
10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I
am the party legally and financially responsible for proposed construction activity at the site address listed above.
11. 1 agree that, as the parry legally and financially responsible for this proposed construction activity, I will abide
by all applicable laws and requirements that govern Owner -Builders as well as employers.
V12. 1 agree to notify the issuer of this form immediately of.any additions, deletions, or changes to any of the
information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If
you contract with someone who does not have a license, the Contractors' State License Board may be unable to
assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed
Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or
employee of that.individual or firm is injured while working on your property, you may be held liable for damages. If
you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not
those Contractors are properly licensed and the status of their workers' compensation insurance coverage.
CONSTRUCTION LENDING AGENCY
(DIRECTIONS: Please complete the following construction lending agency information.)
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued
(Sec 3097 Civ.)
Lender Name: Lender Address:
Before a building ,permit can be issued, this form must be completed and signed by the property owner and
returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license,
form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued
to verify the property owner's signature. ,
Property Owner's Signature: , Date:
(NOTE: The following Authorization Form is required to be completed by the property owner only when designating an
agent of the property owner to apply for a construction permit for the Owner -Builder).
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
-Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility; I hereby
authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an
Owner -Builder Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location_or Address:
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the
above information and certify its accuracy. Note: A copy of the property owner's driver's license, form notarization, or other
verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's
signature.
Property Owner's Signature: Date:
Owne7BuildelFornt 2010.doc revised 04/14/10
CUPERTINO
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • build inaCo?cuoertino.oro
W T CANi1T BFyIl�IALED ill\?TIL.THIS CEItTIFIGATE.HAS BEEN
C£31M£ �;ETEi�9 Sf ftTm &
T1C3 THE B1.IlLj) G i3IUISI{aN
PURPOSE
This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2016 CRC Section R314, R315, 2016 CBC Sections 420 6 and 907.2.11.2 where no interior access
for inspections are required.
GENERAL INFORMATION
Existing single-family and multi -family dwellings shall be -provided with Smoke Alarms and Carbon
Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds
$1000 00, CRC Section R314, R315, and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or
Carbon Monoxide Alarms be installed in the following locations.
AREA
SMOKE ALARM
CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s) — (Smoke alarms shall not be located within 3 feet of bathroom door)
X
X
On every level of a dwelling unit including basements and habitable attics
X
X
Within each sleeping room
X
Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burring appliances and that
do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with
CBC Section 420 6 and shall be approved by the Office of the State Fire Marshal.
Power Supply In dwelling units with no commercial power supply, alarm(s) may be solely battery operated.
In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do
not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl
space. Refer to CRC Section R314 and CBC Sections 907.2.114 and 420.6.2. An electrical permit is required for
alarms which must be connected to the building wiring
As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been
installed in accordance with the manufacturer's instructions and in compliance with the California Building
and California Residential Codes. The alarms specified below have been tested and are operational, as of the
date signed below
Address- 12W tlrie ke (g�,+ Cf, CLAmrj j , C 11-U l L _ Permit No.6-2 V1 ? Cly
Specify Number of Alarms - # Smoke Alanns # Carbon Monoxide Detectors 177771
f
l have read and aoree to romnfv with tha tArm„ - and nnnrlrirnnc of Phio oinfn nv
Owner (or Owner Agent's) Name:
p
Si nature.... — Date:
Contractor Name:
aO
Signature Lic.# Date:
S727oke and COfonmdoc revised 0111012017
Abby Ayende
11/30/17
11/30/17
B-2017-2048
Abby Ayende