B-2016-1242CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-1242
20776 HANFORD DR CUPERTINO, CA 95014-1824 (326 30 066)
SIMON YUE ZHANG
SARATOGA, CA 95070
OWNER'S NAME: CHANG PETER S AND TINA L
DATE ISSUED: 04/20/2016
OWNER'S PHONE: 408-218-2183
PHONE NO: (408) 887-0591
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class GENERAL BUILDING CONTRACTOR Lic. #905734
X BLDG ELECT PLUMB
Contractor SIMON YUE ZHANG Date 10/31/2017
— — —
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:
New 2 -story single family dwelling (3696 SF), (N) attached garage (431
I hereby affirm under penalty of perjury one of the following two declarations:
SF); (I) covered porch (279 SF)
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.
2.. I have and will maintain Worker's Compensation Insurance, as provided for by
j ? Section 3700 of the Labor Code, for the performance of the work for which this
C Section
is issued.
Sq. Ft Floor Area: 8812
Valuation: $600000.00
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
Number:
Occupancy Type:
information is correct. I agree to comply with all city and county ordinances
26
326 30 066
3
Deferred Submittal (R -3),R-3 (Custom)
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
PERMIT EXPIRES IF WORD 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 SPECTION.
Signature_ Date 04/20/2016
Issued by: MELISSA NAMES
Date: 04/20/2016
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
following two reasons:
1. 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 for
compensation, will do the work, and the structure is not intended or offered for
inspection.
sale (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed
Signature of Applicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 04/20/2016
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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.
HAZARDOUS MATERIALS DISCLOSURE
2. I have and will maintain Worker's Compensation Insurance, as provided for by
I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of 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 employ any person in any manner so as to become subject to the
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If, 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.
a
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agent:
APPLICANT CERTIFICATION
Date: 04/20/2016
I certify that I have read this application and state that the above information is
CO STRUCTIONLE E
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 to building 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.
Licensed
Signature Date 04/20/2016
Professional
CONSTRUCTION PERMIT APPLICATION
CO(vh4UNl I Y DEVELOPhItEN T DEPARTMENT . BUILDING DIVISION
10300 TOR RE AVENUE - CUPER T INO, CA 95014-3255
C U P E RTI NO• (408) 777-3228 • FAX (408) 777-3333, build! nof6,cuperiino.ora
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By my signature below, I certify to each of the following: I am the propel j+ owner or Euthori7ed ent fo act on the opa owmor's behalf. I hs� e read this
application and the information -I - have pro%,ided-i -aq ,ect--I ha;re read the Desoriptien of- k-and;'eriTj it is acaurater I egree to -comply �'it1T'ell'ap ltcable l'o�al "—"'-
ordinances and state laws relating to buslding con f. tion. ffithorize representatires of Cuper<ino to'the ebove-�penti lea prop ry for inspection purposes.
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FILE
EDWARD J, HAHAM'IAN-CIVIL ENGINEER
10158 RICHWOOD DR.
CUPERTINO 95014
408-257-8298
May 12, 2016
Building Official
City of Cupertino, CA
SUBJECT: 20776 HANFORD DR., TRACT 783 LOT 124
RE PAD & SETBACKS CERTIFICATION
On this day I visited this site, made the required measurements and hereby state that
the following items were found to be in accord with the approved plans for this site:
1) The padelevation.
2) All setbacks -front, rear and sides.
Lot survey and building staking was performed by the undersigned as per monuments
found and delineated on -the tract map.
--
Submitted by:
Lp 5117
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Building Department
City of Cupertino
10300 Torre Ave.
Cupertino, CA 95014
F1
CAPEX ENGINEERING INC.
PO BOX 14198, FREMONT, CA 94539
Tel: (510) 668-1815 Fax: (510) 490-8690
Project No. 9087
May 16, 2016
Subject: Proposed Two -Story New Residence at
20776 Hanford Dr.
Cupertino, CA
SITE DEMOLITION AND BUILDING PAD GRADING
OBSERVATION -REPORT
Dear Sir:
CAPEX ENGINEERING INC., has provided observation service for site demolition,
primary and final grading of building pad. On the basis of our observation and testing, we
concluded building pad, compaction operation were performed in general accordance
with recommendation of soil report and compacted to a minimum of 90% relative
compaction.
If you have any questions, please contact our office at your convenience.
Sincerely,
CAPEX ENqINEERING INC.,
Gary �Ijs
Principal
QApFESSIO
OF
CAPER PEX ENGINEERING INC.
PO BOX 14198, FREMONT, CA 94539
Tel: (510) 668-1815 Fax: (510) 490-8690
Building Department
City of Cupertino
10300 Torre Ave.
Cupertino, CA 95014
Project No. 9087
May 16, 2016
Subject: Proposed Two -Story New Residence at
20776 Hanford Dr.
Cupertino, CA
FOOTING EXCAVATION (GRADE BEAMS & SPREAD
-F-O-OTIN-.G.S).-AN-DPREPARATION-OBSERVATION REPORT --
Dear Sir:
CAPEX ENGINEERING INC., has provided inspection service for footing excavation
and preparation. Footing depth and width were excavated adequate in accordance with
approved foundation plan and specifications. The exposed soil conditions of excavated
foundation are beyond design bearing capacity and acceptable.
Any questions, please call our office at your convenience.
Sincerely,
APEX
E 'NEERING INC.,
u4'E
Principal
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STRUCTURAL OBSERVATION REPORT
Date: September 12, 2016
Project: New Residences
20776 Hanford Drive
Cupertino, CA
To whom it may concern,
As requested by the contractor, I visited the project site on September 12, 2016 to
perform a inspection for the complete structural framing of 20776 Hanford Dr. Cupertino.
Based on my observation, I think that the structural framing is in general conformance
with the approved plans.
Please contact me at (510) 996-2704, if you have any question regarding this report.
Sincerely,
Yu - r Chen, SE 2762
�OVESS/0/�ql
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cox No. 2762 a'
y[ Exp, 0913 }117 T
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Tel/Fax 5ro.687,0939 vujarchen@hotniail.com
FILE
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YU AR CHEN, S.E.
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JNB Associates
Bate
4o66o Robin Street
Job Munber
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E N 3 9 1 E E Q
Fremont, GA 94538
Rage Number
STRUCTURAL OBSERVATION REPORT
Date: September 12, 2016
Project: New Residences
20776 Hanford Drive
Cupertino, CA
To whom it may concern,
As requested by the contractor, I visited the project site on September 12, 2016 to
perform a inspection for the complete structural framing of 20776 Hanford Dr. Cupertino.
Based on my observation, I think that the structural framing is in general conformance
with the approved plans.
Please contact me at (510) 996-2704, if you have any question regarding this report.
Sincerely,
Yu - r Chen, SE 2762
�OVESS/0/�ql
r,
cox No. 2762 a'
y[ Exp, 0913 }117 T
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Tel/Fax 5ro.687,0939 vujarchen@hotniail.com
MEED KE v EMUIN FILE
Date: September 30, 2016
Project: New Residences
Cupertino, CA
To whom it may concern,
I fit; 4'-'UMgFfYwwU' wap magmM Lac aluadupti.;--ut WUHUS ki MIU-t Unty UumptauvU vy
blocked roof diapbragm as shown in the attached partial roof plan.
Please contact me at (510) 996-2704, if you have any question regarding this report.
Sincerely,
.01 01
CJNOW�
YuJar Chen, SE 2762
N
No, 2762
Te TI.Fax- poA7-0939
YU- AR CHEN, S.E. Tate
Q� JIB Associates_
Job Number
40660 Robin Street ,
Q Fremont, GA 94538 Page Number
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STRUCTURAL OBSERVATION REPORTS
Date: October 5, 2016
Project: New Residences
20776 Hanford Drive
Cupertino, CA
To whom it may concern,
As requested by the contractor, I visited the project site on October 5, 2016 to inspect the
installation of epoxy anchors at 20776 Hanford Dr. Cupertino.
Based on my observation, I think that the installation of epoxy anchors is in conformance
with the manufacturer's guideline.
Please contact me at (510) 996-2704, if you have any question regarding this report.
Sincerely,
Yu -Jar Chen, SE 2762
"""'S51 oN��.
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No. 2762
Exp. 09!30117
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Tel/Fax 5ro.687.0939 yujarchenChotmail.com
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Building Department
City Of Cupertino
V 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: o
PERMIT -#
OWNER'S NAME:
PHONE # 40S'
GENERAL CONTRACTOR:(FYI
BUSINESS LICENSE #4016-1
ADDRESS:(476"'S'CITY/ZIPCODE:
rrt G' S
*Our municipal code requires all businesses working in the city to have a City of Cupertino busidbss 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:
Owner / Contractor Signature
Date
7
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
0QW91CAL CD
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Excavation
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Z& N
O l.p C) 0
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
�ti
4-o Q 7.1-9
Septic Tank
'4
Sheet Metal
Sheet Rock
1A. 1 OWALL INC.
3000
Tile
Owner / Contractor Signature
Date
7