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13090215I CITY OF CUPERTINO BUILDING PERMIT I 1 BUILDING ADDRESS: 10708 JOHANSEN DR I CONS RUCTOO GRAND NEST I PERMIT NO: 13090215 OWNER'S NAME: TAO XIONG OWNER'S PHONE: 6514310074 4' LICENSED CONTRACTOR'S DECLARATION License CIass 'yLic. # T Contractor �� / �,vty� (t7� Date S� I hereby affirm that 1 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 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 regulations per the Cupertino Municipal Code, Section 9.18. Signature Date ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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) 1, 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. I certify that in the performance of the work for which this permit is issued, l 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 1 certify that I have read this application and state that the above information is correct. 1 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 13428 CHRISTINE DR I DATE ISSUED: 04/01/2014 SARATOGA, CA 95070 1 PHONE NO: (408) 891 -8059 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL E] CONSTRUCT (N) 2 STORY SFD (2407 S.F.) SUNNYVALE SANITARY DISTRICT Revision 42 - Install Corbels on Left, Right and Rear Elevations Sq. Ft Floor Area: I Valuation: $500000 APN Number: 37536003.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 YS FROM LAST CALLED INSP CTI N. Issued by: V�QkO�UUJLk-N • Date: 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 25505, 25533, and 25534. Owner or authorized agent: 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 1 understand my plans shall be used as public records. Licensed Profess I CITY OF CUPERTINO BUILDING PERMIT I 1 BUILDING ADDRESS: 10708 JOHANSEN DR I CONSTR CT ON GRAND NEST I PERMIT NO: 13090215 OWNER'S NAME: TAO XIONG 113428 CHRISTINE DR I DATE ISSUED: 04/01/2014 1 I OWNER'S PHONE: 6514310074 1 SARATOGA, CA 95070 1 PHONE NO: (408) 891 -8059 1 EP LICENSED CONTRACTOR'S DECLARATION License Class 1.2 Lic.4 Contractor t9 I hereby affirm that 1 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 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. 1 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. ❑ OWNER - BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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) 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. 1 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 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, 1 become subject to the Worker's Compensation provisions of the Labor Code, 1 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 JOB DESCRIPTION: RESIDENTIAL E COMMERCIAL E] CONSTRUCT (N) 2 STORY SFD (2407 S.F.) SUNNYVALE SANITARY DISTRICT 7/28/14 - DEF # 1 - ROOF TRUSSES- ISSD 8/5/2014 Sq. Ft Floor Area: I Valuation: $500000 APN Number: 37536003.00 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: 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 App 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 ""22�5505, 25533, and 25534. %(h Owner or authorized agent: //i/'r�) Date: —y� —'tom v% 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 Name7� Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional FM_� CITY OF CUPERTINO • FEE ESTIMATOR — BUILDING DIVISION imADDRESS: 10108 Johansen Dr DATE: 07/09/2015 REVIEWED BY: Paul MISC ITEMS APN: 375 36 003 BP #: 'VALUATION: $0.00 %PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: 0.0 PENTAMATION 1 GENRES PERMIT TYPE: WORK Revision #2 - Install Corbels on Left Right and Rear Elevations SCOPE $0.00 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc). These fees are based on the Dreliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Eff 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes Q No $0.00 2 hours Plan Check, Hourly $286.00 1STPLNCI: Suppl. PC Fee: (F) Reg. 0 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 Work Without Permit? 0 Yes E) No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure Q i Strong Motion Fee: $0.00 Select an Administrative Item Bldg* Stds Commission Fee: $0.00 r SUBTOTALS: $0.00 $286.00 TOTAL FEE: 1 $286.00 Revised: 07/02/2015 n CITY OF CUPERTINO BUILDING PERMIT I� q BUILDING ADDRESS: 10708 JOHANSbN DR CONTRACTOR: GRAND NEST PERMIT NO: 13090215 CONSTRUCTION r OWNER'S NAME: TAO XIONG 13428 CHRISTINE DR DATE ISSUED: 04/01/2014 I OWNER'S PHONE: 6514310074 SARATOGA, CA 95070 PHONE NO: (408) 891 -8059 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL E] CONSTRUCT (N) 2 STORY SFD (2407 S.F.) SUNNYVALE License Class Lic. 4 SANITARY DISTRICT �„ iVD -7 Date � �/ � Contractor /�) Date REV # 1 - REVISE 4 REAR WINDOWS TO BAY WINDOWS - .n 1y 1/ ISSUED 7/22/14 1 hereby affirm that 1 am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions j Code and that my license is in full force and effect. 1 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 Sq. Ft Floor Area: Valuation: 5500000 performance of the work for which this permit is issued. 1 have and will maintain Worker's Compensation Insurance, as provided for by I,I Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 37536003.00 Occupancy Type: permit is issued. N APPLICANT CERTIFICATION '! I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PFILML1 ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAY INSPECTION. 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 ssue y: with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature 11����7 —`` Date 2L z'�� RE- ROOFS: All roofs shall be inspected prior to any rooting material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. OWNER- BUILDER DECLARATION j Signature of Applicant: Date: 1 hereby affirm that 1 am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should 1 store or handle hazardous I have and will maintain a Certificate of Consent to self - insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this , Owner )2 Date: !j permit is issued. or authorized agent: --- ---- V - -' — - - - - - -, --��e V- ll I certify that in the performance of the work for which this permit is issued, I shall employ any in any manner so as to become subject to the Worker's not person Compensation laws of California. If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that 1 have read this application and state that the above information is I 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. p, G l Signature Date I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10708 JOHANSEN DR CONS RUCTOOR: GRAND NEST PERMIT NO: 13090215 OWNER'S NAME: TAO XIONG 1 13428 CHRISTINE DR I DATE ISSUED: 04/01/2014 1 OWNER'S PHONE: 6514310074 1 SARATOGA, CA 95070 ' PHONE NO: (408) 891 -8059 LICENSED CONTRACTOR'S DECLARATION License Class Lic. #� 1.4 Contractor Contractor 5,fA5YD A& Date hereby affirm that I am licensed under the provisions o 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: 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. JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ CONSTRUCT (N) 2 STORY SFD (2407 S.F.) SUNNYVALE SANITARY DISTRICT Sq. Ft Floor Area: I Valuation: $500000 APN Number: 37536003.00 1 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAY ROM AST CALLED INSPECTION. 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 Issued by: Date: with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. RE- ROOFS: Signature (/7 Date 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. ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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) 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. 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 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 25505, 25533, and 25534. llate: - -�� Owner or authorized agent: 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 Profess CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300TORRE AVENUE • CUPERTINO, CA 95014 -3255 *-�J (408) 777 - 3228• FAX (408) 777 -3333 • building(a�cuoertino.orq z� S ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI REVISI / DEFERRED ORIGINAL PERMIT N IM] PROIECfADDRESS r!f]O(j JA��fi N 1 �m u ( APNR OyIn Clog,/ OWNER NAME ?� /� O ( Q v PHONE 4U6 / l es E -MAIL STREET ADDRESS !'ome aS �,` �� CITY, STATE, ZIP C V FAX CONTACT NAME PHONE E -MAIL STREET ADDRESS CITY, STATE, ZIP FFAX El OWNER ❑ OWNER - BUILDER ❑ 01AWERAGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME �qv LICENSENUMBER LICENSETYPE BUS. LIC* COMPANY NAME E -MAIL FAX r STREET ADDRESS CITY, STATE, ZIP PHONE V Q a O ARCHITECTEN A �V -s SE UMBER BUS,LICJ' COMPANY NAME E -114AIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK ni i n oy- Gin S '�- Ca EXISTING USE PROPOSED USE CON SIR r STORIE USE TYPE OCC. SQ.FT. VALUATION F (S) E>aSTG AREA `� % "'(" NEW FLOOR, AREA L)% // DEMO AREA S' TOTAL NET AREA Xq J BATHROOM KITCHEN OTHER. REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK /PORCH AREA I GARAGE AREA: DETACH ❑ATTACH DIIELLINGUtJiTS: IS A SECOND UNrr ❑YES SECOND STORY []YES BEING ADDED? NO ADDITION? []NO PRE - APPLICATION ❑YES IF YES, PROVME COPY OF IS THE BLDG.AN El YES PLANNNINGAPPL,- ❑NO PLANNING APPROVAL LETTER EICHLERHOME? ❑NO _ = f+► Via �'*_ TOTAL UATION: By my signature below, I certify to each of the following: I am the property owner or author ed agent to act on the property owner's ehalf. 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 building const I authorize representatives of Cupertino to enter the above- identi ed(yproperty for inspection purposes. Applicant/Agent: Date: ,J Signature of / SUPPLEMENTAL INFORMATION REQUIRED rxourP.csLIP �.� J PLM1 HECKIPE_ w: New SFD or Multifamily d��Neilings: Apply for demolition it forte KMexisting 'K.7. :- building(s). Demolition permit is required prior to i uance of buildin,, permit for new building. Exrss £yam CrLani iAnxEvlEw Commercial Bldgs: Provide a completed Hazardous Materials Disclosure sTaD PirBLTewOizres _ form if any Hazardous Materials are being used as part of this project. _ Letter Meeting Planning _ Copy of Planning Approval or with prior to7oR� �-�� ',�� ��SATTT.ARY SEFi'Eit�ISTRICT � submittal of Building Permit application. � BldgApp_2011.doc revised 06121111 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION O 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 ^ �� (408) 777 -3228 • FAX (408) 777 -3333 • building(a1cupertino.org i J - ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/T1 ❑ REVISION /DEFERRED ORIGINAL PERMIT # t PROJECT ADDRESS 1 6 70 /� Jo 4 kM ,51E5?13 r APN # -3-79 ^ 2 6 — O6 2 OWNER NAME /� I ty.1 y 1 L,y�jr PHONE i/- , a 51 E-MAIL STREET ADDRESS 5. ME i CITY, STATE, ZIP FAX CONTACT NAME .514 V I V KN PHONE 650 -7q4 -7(5 E -MAIL 9S AtSI s-Q SFS LA--st6Ns STREET ADDRESS P6 n a x n n CITY, STATE, ZIP T74 ; A /� it A a 2 FAX ' '❑ 1:1 OWNER 13 OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT 13 ARCHITECT ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME n� ! LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE A ARCHITECT/ENGINEFR NAME I c J Vr/ l LICENSE NUMBER BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK C r1j �C t R•� • ` (N J� 4 / i vl "f „L+ T `N • _t. �.v �I�S 2 11 � W6 EXISTING USE f h Y PROPOSED USE CONSTR. . C, P. 1 V TYPE V/ a # STORIES Z USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG AREA / j NEW FLOOR %% AREA O'% / DEMO + AREA f�/ / TOTAL NET AREA D7 BATHROOM REMODEL AREA KITC EN REMODEL AREA OTHER REMODEL AREA PORCH AREA DECK AREA TOTAL DECK %PORCH AREA GARAGE AREA: LJDETACH []ATTACH DWELLING UNITS: 1S A SECOND UNIT ❑ YES BEING ADDED? ❑NO SECOND STORY ❑ YES ADDITION? []NO PRE - APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER IS THE BLDG AN EICHLER HOME? RYES _ C I T TAL VALUATION: O 4 do _I,-- By my signature below, l certify to each of the following: 1 am the property owner or authorized agent Ie property owner's behalf. I have red this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. 1 agree to comply with all applicable local ordinances and state laws relating to b ing construction. I authorize representatives of Cupertino to enter the above -iden ified prop ty for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED 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. Commercial Bldgs: 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. PLAN CHECK TYPE ROUTING SLIP ❑ OVER- THE - COUNTER ❑ EXPRESS ❑ STANDARD ❑ LARGE ❑ MAJOR ❑ BUILDING PLAN REVIEW ❑ PLANNING PLAN REVIEW ❑ PUBLIC womKs ❑ FIRE DEPT SR ❑ SANITARY SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06121111 M CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10708 JOHANSON DR DATE: 07/2812014 REVIEWED BY: MELISSA APN: 375 36 003 BP #: 13090215 `VALUATION: Iso PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex [JSE: PENTAMATION 1GENRES PERMIT TYPE: WORK 7/28/14 - DEF # 1 - ROOF TRUSSES SCOPE Suppl. PC Fee: E) Reg. Q OT NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, eta ). These fees are based on the reliminar information available and are on[ an estimate. Contact the De t or addn'1 in o. FEE ITEMS jFee Resolu ion 11-05�1',UjJ FEE QTY /FEE MISC ITEMS Plan Check Fee: $0.00 = # $286.00 Deferred Submittal 1DEFSUBM Suppl. PC Fee: E) 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 0 G) Work Without Permit? © Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure � i Strom Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS-T $0.00 $286.00 TOTAL FEE: F $286.00 Revised: 07110/2014 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building ZDcuoerbino.org ❑ MEW CONSTRUCTION ❑ ADDITION ❑ ALTEKATION / T I ❑ REVISION / DEFERRED ORIGINAL PERMIT 4 PROJECT .ADDRESS /07o8 14anSP,, ✓ it - �Li)e Who A�PN' �' /j 00 3 O'A '' A4E %%A o j(Xoe' [' PHONE �L`iS �I'JQJ,3 r`V '` '-v 1I E- N..AIL -t-ti XiO� `"D ••MI �( STRE ADDRESS CITY, STATE, ZIP FAX CONTACT .' A E PHONL E -MAIL STREET ADDRESS CITY, STATE, ZIP FAX OWNER ❑ OWN'ER- BbILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARC: -MCT ❑ ENGi-NMR ❑ DEVELOPER ❑ TENANT CONTRACTOR NAA4E i 6a t" Ale LICENSE NUAMER 17% /,' I LICENSE TYPE BUS. LIC k COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ,( .ARCMTECT/ENGINTEER NAME Jaime P LA � ( IPS LICENSE NUMBER /// BUS. LIC'' COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP I PHONE DESCRIPTION OF WORK ruS S ca (bt(-crn S a -14 7 u - - - a Qr ea fKbM; ff'P( out EXISTING USE PROPOSED USE CONSTR n PE STOP '-S USE TYPE OCC. SQ.FT. VALUATION (S} EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN 07HER PLENODEL AREA REMODEL AREA REMODEL AREA PORCHAREA DECK AREA TOTALDECK/PORCH.AREA GARAGEAREA: DETACH ❑ ATTACH 9 DWELLING UNITS: I5.4 SECOND UNIT ❑ YES SECOND STORY ❑ ITS BEING ADDED? []NO ADDITION? []NO - PRE- rhPPL1C-. AAON- {y1'ES--- ff�- zS,FROI�ELOP�01 _IS -THE BLDG A:�_� } - TOT.gL V ALU.4TI ; PLA2.TTNGAPPL# []N'0 PLA'NT`D�G APPROVAL L_F'ITER EICHLERAOA4E? M-1 — By in), signature below, I certify to each of the following: I am the property owner or authorized agent to on the,rope 1 mer's behalf. I have read this application and the information I have provided is correct. I have read the Description of Wo-k and veri it is actor agree to comply with all applicable local ordinances and state law's relating to building cor ction. I authorize representatives of Cupertino to enter t e a ovee- identified rope ty for inspection purposes. Signature ofApplicant/Agent: Date: ?/ash SLTPPLEI, ENTAL INFORMATION IRED r%A3 ca> cx.TiPE NMR0 uri:c iP te= e� `y � `© OVERTA]rCOU1tTfiR 7 Q" -- = " - ��BUIIDLlGPL4'�REkZEi� New SFD or Multifamily d��%ellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building s s permit for new building. �h ❑EPRESS - nLPI q*�NI\GPLii2E�7> 53 s r s rte- v. h Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 1OR sTvAxD PUBLG ;voxi`s _ form if any Hazardous Materials are being used as part ofthis project. }E r ��4 _ y _ Copy of Planning Approval Letter or Meeting with Planning prior to 0�1TARi�SERRDISTRiCT k submittal of Building Permit application. � � :. _ E �1 IROri �4E �Tfil HE 4tiTA ,..v. Bldg.App_2011.doc I- evised 06121111 rm--7 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10708 JOHANSEN DR DATE: 07/22/2014 REVIEWED BY: MELISSA APN: 375 36 003 BP #: "VALUATION: Iso PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: PENTAMATION 1GENRES PERMIT TYPE: WORK REV # 1 -REVISE 4 REAR WINDOWS TO BAY WINDOWS -ISSUED 7/22/14 SCOPE PME Plan Check: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution II -053 E' iiL,'_131 FEE QTY /FEE MISC ITEMS Plan Check Fee: Hourly Only? © Yes (j) No $0.00 2 hours Plan Check, Hourly FISTPLNCK $286.00 Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:G Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? Q Yes No $0.00 Advanced Plannin- Fee: $0.00 Select a Non - Residential Building or Structure G 0 i Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $286.00 TOTAL FEE, $286.00 Revised: 07/10/2014 / Aw tz'C.7pxs.. - CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • buildinoCcDcupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ A1,TER4TI0N 1 TI 59 REVISION 1 DEFERRED ORIGNAL PEP-1.4IT 4 PRO,'ECI .ADDRESS /072 l L-1 q�u APN 4 _3 9_S— / _ A O OtYNERNAME Aq 1 CWG PP`ON- [Q O 21 p57 7 E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAME PHONE E -MArL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER- BUMXER OWI.'ERAGENT ❑ CONTRACTOR ❑ CONIILACTORAGENT ❑ ARCH1-1.CT ❑ ENGLNEER ❑ DEVELOPER ❑ TENANT /❑ COhiRACTORN.AME / 1 ./L I LICENSENUMBER ) ` I LICENSE TYPE I BUS.LIC� COMPANY N,04E _ E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP 1 PHONE L ql -4 :4 I � f 0 ARCWi ECT/ENGINEER NA_ IE I LICENSE N`UKBER I BUS. L1C R COMPANY NAME I E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK \_ / Al t CA67 i}� b,)x LA/1)► %(UW .l,j i i t%'�V5 1 EXISTING USE PROPOSED USE CONSTR TYPE '-' STORES USE TYPE OCC. SQ.FT. VALUATION (S) EXLSTG NEW FLOOR DEN40 TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTALDECK/PORCH AREA GARAGE P.REA: DETACH [].ATTACH i �' DWELLING UNITS: IS 9 SECOND UNIT [] YES SECOND STORY ❑ YES I,' GADDED? El NO ADDITION? ❑NO — - - -- -1-tS _PR0XME- COPY_Oi___ _IS TE BLDG AN ❑ EICHLER HOME? - .::.,`: - _'- TAL 1%ALU.4TION: PLA.N:N7NG APPL: []NO PLA-NNTNG APPROVAL LET-ER -- -- By my signature below, I certiry to each of the following: I am the property owner or authorized agen 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 buildinE construction. I authorize representatives of Cupertino to enter the above - identified property for inspection purposes. S ignature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED cKTiPE >_ RouTiccilP © , New SFD or Multifamily d-o ellings: Apply for demolition permit fora' existing building s). Demolition permit is required prior to issuance of building OVER TA�COUNTER X $UII,DINGPL4� RE'V 3 z for new building. _ ©E P ESS � ` g ❑Nkip NININGPL�NR permit Ian z TIES' $2� T x UBLIC�VORi _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure BTATMMD e form if any Hazardous Materials are being used as part of this project. `� s s 4RGE x- FIRl DEPT { ZARN Copy of Planning Approval Letter or Meeting v,,ith Planning prior to MAZY _ ❑ I4A70R : eS ITAR vism tiISTRICT submittal of Building Permit application. �,s - `- RbR- H4EhT;4L'HEA3T'.FI BIdg,4pp_2011.doc revised 06121111 Fm_� CITY OF CLTPERTINO FEE ESTIMATOR - BUILDING DIVISION imADDRESS: 10708 JOHANSEN DR DATE: 09/27/2013 REVIEWED BY: MELISSA PC FEE ID APN: 375 36 003 BP #:j *VALUATION: $500,000 %PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY SFD or Duplex USE: 2nd Unit? Yes • No PENTAMATION 1 R3SFDW PERMIT TYPE: WORK CONSTRUCT N 2 STORY SFD 2407 S.F. SCOPE Suppl. Insp. Fee:Q Reg. Q OT OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R -3 (Custom) II- B,111- B,IV,V -B 2,407 $2,877.45 /R3PLNCK $2,693.25 IR31NSP Permit Fee: $2,693.25 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXR —1] # new units $647.24 Work Without Permit? 0 Yes (F) No $0.00 TOTALS: 2,407 $2,877.45 $2,693.25 Strong; Motion Fee: IBSEISMICR t FEE QTY/FEE MISC ITEMS Plan Check Fee: r. Select a Misc Bldg /Structure or Element of a Building Suppl. PC Fee: (j) Reg. 0 OT 0.0 ET $0.00 PME Plan Check: $0.00 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the Dreliminary information available and are only an estimate. Contact the Dept for addn I info. FEE ITEMS (Fee Resolution 11 -053 Eff 7/1113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,877.45 Select a Misc Bldg /Structure or Element of a Building Suppl. PC Fee: (j) Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $2,693.25 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXR —1] # new units $647.24 Work Without Permit? 0 Yes (F) No $0.00 Advanced Plannin& Fee: IPLLONGR $336.98 Select a Non - Residential Building or Structure i Strong; Motion Fee: IBSEISMICR $50.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $20.00 SUBTOTALS: $6,624.921 $0.00 TOTAL FEE: $6,624.92 Revised: 08/01/2013