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14060037�h I CITY OF CUPERTINO BUILDING PERMIT I 1 BUILDING ADDRESS: 10480 DAVISON AVE I BUILDERS INC : BAY AREA CUSTOM I PERMIT NO: 14060037 OWNER'S NAME: WENWU CUI 'S PHONE: 4082563288 LICENSED CONTRACT'OR'S DECLARATION License Class Lie. # q 4 Contractor % R ti I a e ` J4 I hereby affirr 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: 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 :Dp formance of the work for which this permit is issued. ive 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. 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 9.18.8 Signature Date__�� ❑ OWNER- BUILDER DECLARATION hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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) 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: 1 have and will maintain a Certificate ofConsent 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, 1 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, 1 must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 1 certify that l 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 ofCupertino 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. Signatu Date 1002 S DE ANZA BLVD STE AI ! DATE ISSUED: 09/03/2014 SAN JOSE, CA 95129 1 PHONE NO: (408) 446 -1200 JOB DESCRIPTION: RESIDENTIAL F] COMMERCIAL ❑ CONSTRUCT A ONE STORY ADDITION (485 SQ FT); COVERED PORCHES (34 SQ FT); REMODEL KITCHEN (233 SQ FT); RE -ROOF (1845 SQ FT); RELOCATE & UPGRADE Sq. Ft Floor Area: I Valuation: $125000 APN Number: 36926035.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DA T ISSUANCE OR 180 D ' OM LAS NSPECTION. Date: —7/1 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: O'% 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional n CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10480 DAVISON AVE CONTRACTOR: BAY AREA CUSTOM PERMIT NO: 14060037 BUILDERS INC OWNER'S NAME: WENWU CUI 1002 S DE ANZA BLVD STE Al DATE ISSUED: 09/03/2014 OWNER'S PHONE: 4082563288 SAN JOSE, CA 95129 PHONE NO: (408) 446 -1200 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ CONSTRUCT A ONE STORY ADDITION (485 SQ FT); LinQ as Lic. # L-1 L�_ COVERED PORCHES (34 SQ FT); REMODEL KITCHEN (233 '� �"Opt�,IkD-atr of ( SQ FT); RE -ROOF (1845 SQ FT); RELOCATE & UPGRADE Contra or G Y Q 1 I hereby affirm that I am licensed under the provisions of Chapter 9 REV # I - ADD TO SCOPE OF WORK: 13 S.F. OF LIVING SPACE TO (commencing with Section 7000) of Division 3 of the Business & Professions EXPAND MASTER BDRM ADDITION - ISSUED 9/15/14 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 grformance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $125000 �1 ave 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 APN Number: 36926035.00 Occupancy Type: permit is issued. 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 DAYS F LAS ALLED 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 Date: l with all non -point source regulations per the Cupertino Municipal Code, Sectio 9.18. RE- ROOFS: Signature fir / Date 7 � All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, 1 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 Signature of Applicant: Date: 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, wil I 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). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I 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 I 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 or authorized agent: Date: 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 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 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, ARCHITECT'S DECLARATION 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. Signature Date CUPERTINO NFW (VINCTR11(' CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building,@cupertino.org \ pzA �O t�V FION ADDITION II ALTERATION / TI 1 REVISION / DEFERRED ORIGINAL PERMIT # PROJECT .ADDRESS APN # OWNER NAME ' / PHONE E -MAIL STREET ADDRESS CITY, ST TE, ZIP 5�1Siz ✓,NCB FAX CONTACT NAME fr/ -G tc�J ..�� .4 `c PHONE q y 1 E -MAILt ZXa��d il�l7� iiz f r> STREET ADDRESS / 2 _ (� �� CITY, STAT ZIP FAX C�Z YZ ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT NGME i Ne�,ME _ r LICEN NUI�B�ER_ �® BUS. LIC # D ' COMPANY NA E t E-MAIL FAX t STREET ADDRESS CITY, STATE, ZI DESCRIPTION OF WORK U Sal �T ( EXISTING USE PROPOSED USE CONISTR . TYPE # STORIES f2 f USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG+ AREA l� S•7 NEW FLOOR AREA DEMO AREA �— TOTAL �yI 2 NET AREA _1 114 ^ ' /' I✓�� � r5 r / C/ BATHROOM KITCHEN ,,,,����//// REMODEL AREA REMODEL AREA ''f^I OTHER REMODEL AREA ^^ ©lL PORCH A 2 A DECK AREA TOTAL DECK/P CH AREA GARAGE AREA DETACH jn TTACH # DWELLING UNITS: IS A SECOND UNIT YES SECOND STORY 0 YES ^U `d AT BEING ADDED? ol—Fi NO ADDITION? pO PRE-APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECE]>yEDB Y: TOTAL VAJ_,UATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? WO f � / - lip 5 By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provide is o ect. 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 buildin c s tion. 1 authorize representatives of Cupertino to enter the abo -identi6 d property for inspect ion purpose . ( Signature of Applicant/Agent: Date: SUPPLEMENTAL INFIIkAkTION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER- THE - COUNTER BUILDING PLAN 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 FiRR DEPT Copy of Planning Approval Letter or Meeting with Planning prior to ❑ - �❑ submittal of Building Permit application. MAJOR yY..,SANITARY SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH BldgApp_2011. do c revised 06,121111 I t' c 60,41 i CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISIO 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building a cupertino.orq ❑ NEW CONSTRUCTION ❑ ADDITION El ALTERATION/T1 REVISION DEFERRED ORIGINAL PERMIT # L " D o PROJECT ADDRESS to,,At, 777; 4P 61 ' • �� OWNER NAME PHON E -MAIL STREET ADDRESS CITY, STATE, ZIP FAX a CONTACT NAME �l,�y/J •1/ "' G/� PHONE E- AIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ♦ G k— 4 2 L 1 04-1 LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME L L FAX STREET ADDRESS CITY, STATE. ZIP PHONE A CI-IITECTIE GINEU4NAME LICENSE NUMBER ©' A"I isi4 N BUS. LIC # CO PINY AM e t �� E -MAIL �O •/ FAX STRE ADDRESS CITY, STATE, ZIP I I P O O 5 DESCIPPTION OF WORK Ncn:> V5 12V D %41I-L 5 d GI�o� fc�T S S EXISTING USE PROPOSED USE -Pr #STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH ❑ ATTACH #D WELLING UNITS IS A SECOND UNIT ❑ YES SECOND STORY []YES BEING ADDED° ❑ NO ADDITION? []NO PRE- APPLICATION El YES IF YES, PROVIDE COPY OF IS THE BLDG AN I-] YES RE D ,;.. ", TOTAL VALUATION: PLANTING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME ". E] NO By my signature below, I certify to each of the following: I am the property owner or authorized agent to actgRS5,fr owners behalf. I have read this application and the information I have provided is correct. I have read the on of Work and verify it is ac rate I agree to comply with all applicable local ordinances and state laws relating to building constr i representati s of Cupertino to enter the above - identified property for inspection purposes. Signature of Applicant/Agent: te: SUPPLEMENTAL 17qrORMATION REQUIRED 4LAN CHECK TYPE ROUTING SLIP ❑ OVER -THE- COUNTER ❑ BMLDINC PLAN 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 ❑ SANITART SEWER DISTRICIT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH B1dgApp_2011.doc revised 06121111 qw, I_1% CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10480 DAVISON AVE DATE: 09/15/2014 REVIEWED BY: MELISSA APN: 369 26 035 BP #: 14060037 *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex PENTAMATION USE: PERMIT TYPE: WORK REV # 1 - ADD TO SCOPE OF WORK: 13 S.F. OF LIVING SPACE TO EXPAND MASTER BDRM SCOPE ADDITION -ISSUED 9/15/14 x% 1 NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School nietrirt_ Ptr. L Thoco feos aro hasod nn . the nreliminary infarmatinn available and are nick an estimate_ Cantart the Dent for addn'I info. FEE ITEMS (Fee Resolution 11 -053 Eff. 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (F) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0,00 Suppl. Insp. Fee:(D Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure G 0 Strong Motion Fee: $0.00 1-7 # $859.00 Revisions 1REYSFDWL 7 SFDWL Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $859.00 TOTAL FEE: 1 $859.00 Revised: 08/20/2014 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10480 DAVISON AVE DATE: 06/06/2014 REVIEWED BY: MELISSA PC FEES APN: 369 26 035 BP #: Ct� `VALUATION: 1$125,000 - PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: 2nd Unit? 0 Yes 0 No OTC. G Yes GNo PENTAMATION 1 R3SFDADD PERMIT TYPE: WORK ADD 485 S.F. ADDITION TO EXPAND (E) FAMILY RM &CREATE (N) MASTER BEDRM & N SCOPE FRONT ENTRY /PORCH. REMODEL (E) KITCHEN (233 S.F). RE -ROOF 14 SQ'S RELOCATE & OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R -3 (Custom) II- B,III- B,NN -B 485 $1,579.00 I,4DDPLCK $1,284.00 IADDINSP Suppl. Insp. Fee:G Reg. G OT O.Q hrs $0.00 200 amps Electrical $47.00 IBELEC200 Services PME Unit Fee: $0.00 PME Permit Fee: $47.00 77— — TOTALS: 485 $1,579.00 Advanced Plannintz Fee: IPLLONOR $1,284.00 MECH, HOURLY G Yes G No PLUMB, HOURLY G Yes G No ELEC, HOURLY G Yes Q No MISC ITEMS Elec. Plan C7EIec. 0.0 hrs $0.00 $1,579.00 233 s.f. $626.00 1,400 s.f. $224.00 Permit Fee: IEPERMIT Suppl. PC Fee: G Reg. G OT 0.0 hrs PME Plan Check: Other Elec. Insp. F6.61 hrs $47.00 NOTE: This estimate does not include fees clue 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 onlv an estimate. Contact the Dept for addn'l info. FEE ITEMS 0- eeResolution II -053Lt 7 P I j FEE QTY /FEE MISC ITEMS Plan Check Fee: $1,579.00 233 s.f. $626.00 1,400 s.f. $224.00 Remodel, Kitchen (< =300 sf) IREMRESKIT Re -roof IREROOFRES Suppl. PC Fee: G Reg. G OT 0.0 hrs PME Plan Check: $0.00 $0.00 Permit Fee: $1,284.00 Suppl. Insp. Fee:G Reg. G OT O.Q hrs $0.00 200 amps Electrical $47.00 IBELEC200 Services PME Unit Fee: $0.00 PME Permit Fee: $47.00 77— — G Work Without Permit? G Yes G No $0.00 Advanced Plannintz Fee: IPLLONOR $67.90 Select a Non - Residential Building or Structure G G i Travel Documentation Fee: ITRRVDOC $47.00 Strong; Motion Fee: IBSEISMICR $12.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $5.00 SUBTOTALS: $3,042.40 $897.00 TOTAL FEE: $3,939.40 Revised: 04/01/2014 04/16/2015 12:43PM FAX 4084461241 BAY AREA CUSTOM BUILDERS 0001/0001 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014 -3255 C O P E RT I N O Telephone: 408 --777 -3228 Fax: 408 -777 -3333 CONTRACTOR / SUBCONTRACTOR LIST JOB A DDRESS:10480 DAVISON AVE PER MIT # 14060037 OWNER'S NAME:H+IYAN LI _ PHONE: #408-446-1200 GENERAL CONTRACTOR:BAY AREA CUSTOM BUILDERS BUSINESS LICENSE #31905 ADDRESS; 1002 S. DE ANZA BLVD. #1 CITY /ZIPCODE :SAN JOSE 95129 "'Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY .INSPECTION(S) WILL BE SCHEDULED UNTIL, Tim GENERAL CONTRACTOR AND ALL SIJBCONTRACTORS HAVE OBTAINED A CITY OF CUPER'CINO BUSINESS LICENSE. 1 am not using any subcontractors: Signature Please clieck applicable subcontractors and complete the following information: F;-7s6 BCONTRACTOR — BUSINESS NAME Cabinets & Millwork Cement Finishing X Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating X Insulation Landscaping _ Lathing Masonry fainting / Wallpaper _ Paving Plastering _ _ Plumbing K Roofing Septic Tank Sheet Metal EDEN E PONZINI INSULATION A. Q. ROOFING Sheet hock Tile — Tile Own / -Contractor Signature Date BUSINESS LICENSE # 34369 26001 29852 UA e