B-2017-0182CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-0182
1132 YORKSHIRE DR CUPERTINO, CA 950144917 (362 08 003)
KYLE KAI KWONG
CUPERTINO, CA 95014
OWNER'S NAME: ZHU HAIKUN AND WANG LINGYUN
DATE ISSUED: 02/06/2017
OWNER'S PHONE: 858-761-7579
PHONE NO: (408) 506-0861
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class .B Lic. #987008
Contractor KYLE KAI KWONG Date 09/30/2017
X BLDG —ELECT _PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
— 1VIECH 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:
(1) WINDOW (1); REMOVE WALL BETWEEN LIVING ROOM AND
I hereby affirm under penalty of perjury one of the following two declarations:
FAMILY ROOM
1. 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.
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.
Sq. Ft Floor Area:
Valuation: $10000.00
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
APN Number:
Occupancy Type:
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize
362 08 003
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.
Additionally, the applicant understands and will comply with all non-point
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source regulations per the Cupertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signature s~` " = ' ' _.______. � Date 2/6/2017
Issued by Abby Ay nde
Date: 02/06/2017
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:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
1. 1, 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. 1, as owner of the property, am exclusively contracting with licensed
Signature of Applicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 2/6/2017
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1. 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.
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.
Labor Code, I must forthwith comply with such provisions or this permit shall
_
be deemed revoked.
.Owner or authorized agent: 4gL
APPLICANT CERTIFICATIONDate:
2/6/2017
I certify that I have read this application 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 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
ARCIHTECT'S DECLARATION
Code, Section 9.18.
1 understand my plans shall be used as public records.
Licensed
Signature Date 2/6/2017
Professional
15
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CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building&cuper ino.oM
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LICENSE NUMBER
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VALUATION ($)
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PORCH AREA
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TOTAL DECK/PORCH AREA
GARAGE AREA: DETACH
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# DWELLING UNITS:
IS A SECOND UNIT ❑YES
SECOND STORY ❑YES
BEINGADDED? ❑NO
ADDITION? ;rO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER
IS THE BLDG AN F YES
EICHLER HOME? RNO
RECDJYED BY:TOTAL
VALUATION:
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By my signature below, I certify to each of the following: I am the property owner or authorized agent to aA on the Apperty 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 buil ' construction. I authorize re n tives of Cupertino to enter the above -identified property for inspection purposes.
Signature ofApphcant/Agent: Date: %Am - 2b 1 kv O
SUPPLEMENTAL INFORMATION RE D
PLAN CHECK TYPE
ROUTING SLIP
New SFD or Multifamily dwellings: Apply for demolition permit for
❑ OVER-TITE-COUNTER
,�
Lt BUILDING PLAN REVIEW P�NIQIA
existing building(s). Demolition permit is required prior to issuance of building
34
permit for new building.
❑ EXPRESS
PLANNING PLAN REVIEW
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
El, 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.doc revised 06/21/11
M
SMOKE I CARBON MONOXIDE ALARMS
ri OWNER.CERTIFICATE OF COMPLIANCE
� ' sr
t:1kt> COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
Cu PET[t+t® 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255
(408)777-3228 • FAX(408)777-3333•buildinq(a7cupertino.orq
V O CAVI t)T BE EINALED TT LTFII -CE TIE COE
-tit)1 ZK1 FB,SIGNEDjAN`I3$ETURNED TO T .BVILDINGDWI.SION
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 X X
bedroom(s)--(Smoke alarms shall not be located within 3 feet of bathroom door)
On every level of a dwelling unit including basements and habitable attics X X
I Within each sleeping room X J
Carbon Monoxide alarms are not required m dwellings which do not contain fuel-burning 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 /f 3 2 p24< j-.4 i OR a6+, Ci/(,+o,, r' ' Permit No `2O1.`7°- O(�2'
Specify Number of Alarms #Smoke Alarms #Carbon Monoxide Detectors. DrAllil
I have read and agree to comply with the terms and conditions of this statement
Owner(or Owner Agent's)Name:
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Signature Date:
Contractor Name:
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P., — `moi !# Dater
�� Signature �,!/ .
Smoke and CO}bnn.doc revised 01/10/2017