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14050107 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10590 LA RODA DR CONTRACTOR:CHAU JOEY AND PERMIT NO: 14050107 CHANG SHIH-CHI OWNER'S NAME: Cf AU JOEY AND CHANG SHIH-CHI 10590 LA RODA DR DATE ISSUED:06/11/2014 OWNER'S PHONE: 4088889668 CUPERTINO,CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL F] INTERIOR REMODEL(FAMILY ROOM TO MASTER SUITE License Class Lic.# AND BATH)(403 SQ FT); REMOVE AND REPLACE (2) Contractor Date WINDOWS; REMOVE(3)WINDOWS AND INFILL; INSTALL(2)NEW 1 hereby affirm that I am licensed under the provisions of Chapter 9 REV#1-REMOVE DECK FROM DINING RM TO OUTSIDE&REPLACE (commencing with Section 7000)of Division 3 of the Business&Professions WITH CEMENT STEPS(2)-ISSUED 8/4/2014 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. Sq.Ft Floor Area: Valuation:$20000 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 APN Number:36933019.00 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 L 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 A, granting of this permit. Additionally,the applicant understands and will com Y. Date: with all non-point source regulations per the Cupertino Municipal Code,S 9.18. RE-ROOFS: Signature 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 Signature of Applicant: Date: hereby affirm that I 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. 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,Sectio 505,25533,a 534. ection 3700 of the Labor Code,for the performance of the work for which this n Owner or authorized agent. Date:�f o permit is issued. certify that in the performance of the work for which this permit is issued,I shall /I 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 C RUCTION 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 plicant understands and will comply with all non-P;7ce regu i p e Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date L-o�� CONSTRUCTION PERMHT APPLICATION A COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX(408)777-3333• buddina(cDcuoertino.org CUPERTINO ❑NE\fir CONSTRUCTION ❑ ADDITION ❑ :SLI ERATION/TI ® REVISION/DEFERRe.D ORIGTNAL PERMIT" PROJECT ADDRESS /1 I APu� ? ' D O\\RvERNP.I4E u I t-]✓AIL �/ 1 ape -Cl'�Gz(.. L STREET ADDRESS G/i Y, STATE,ZIP G J r A- �o C0N714CT NA✓E TOC PHONL(!� L� _ �/� E-FAIL f� / / oc _C Q� �iV.eol U STRFET.hDDR=SS C, ,STATE, Z/I� L) FAX ORT:ROU'N.�ti-BUILDER. ❑ wxwER AGENT ❑ COT'7 ACTOR ❑CON`TT SCTOR AGENT ❑ F.RC1 i=CT ❑ENGLNT�R ❑ DEVELOPER ❑ TFNA?\'-r COi\TRACTORNAME Li CENSET\'IA+GER LICENSE TYPE BUS.LIC', COV2A.IvY NAME E-)�iAIL FAX STREET ADDRESS CITY,STATE,ZIP PHOhi ARCIE 1 ECTIE NGDTIBER NA-\4E LICENSE NUMBER BUS.LIC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONT I)ESCRIP-n ON OF WORK o o lap :/%q c o HC vrc 1 E):?ST[NG USE PROPOSED USE CONSTR TYPE I R STORIES USE TYPE I OCC. SQ.FT. VALUATION(S) EXLSiG I NEW FLOOR DE1,40 TOTAL AREA AREA AREA 1\'ET AREA BATHROOM Ki7C'r'FN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH ARES DECK IAREATOTAL.DECIVPORCH AREA GARAGE AREA: DETACH ❑ATTACH 9 DR_LLING UNITS: IS .4 SECOND L?' ❑S'ES SECOND STORY ❑PBS BEII.GADDED? El 140 ADDITION? ❑NO -PRE-r3PL-LC-4'AON-{�\=aS—:rte=rS.-P3i0]SDE.LOPL'OF �5 THi<BLDG AN I-I`ES TOT. .\?ALUATION: PLAXNINGAPPL: []NO PL.i)\1EN \' GAPPROV.ALLETTER EICHLERHOME? E] By my signature below,I certify to each of the following: I am the property oN�Ter or authorizedact o q er's behalf. I have read this appliczLion and the infor ration I have provided is co-ed. I h gad the Description of Work and verify i curate. I agree to comp all applicable local ordinances and State laws relating to ing co t o i. thorize representatives of Cupertino t r the move-denyfed prope( for inspec' urposes. Signature of Applicant/Agent: Date: l ( a t7 SUPPLE?ry L/ingo,. RA4ATIONREQLIRED ccT� � s,' ;rRo 114's W?vev,,SFD or A7ultifav Apply for demolition permit for �� �© D\T'S2 TA�COURTER � ��BUII,DZZGPLA'�RELSEW 3 existing building s). Demolition permit is required prior to issuance of building permit for new building. 1� AEss � i ��� P >� PLA `G�PLMN REZETs : _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure1�ARDryr���uBLic�u�oRks01 � form if any Hazardous Materials are being used as part of this project. T� � =.� I* °�riGE fix" �IRE�EkI _Copy of Planning Approval Letter or Meeting vpith Planning prior to � �� ���� � �� �0��� submittal of Building Permit application. p �4axM11ZzBRDISTP.TCI . M N O+.�E T??Hn TFI s BldgApp_2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10590 LA RODA DR 7DATE: 08/04/2014 REVIEWED BY: MELISSA APN: 369 33 019 BP#: 14050107 VALUATION: Iso :J PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1GENRES USE: PERMIT TYPE: A WORK REV# 1 - REMOVE DECK FROM DINING RM TO OUTSIDE & REPLACE WITH CEMENT STEPS 2 SCOPE -ISSUED 8/4/2014 NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works, Fire,Sanitary Sewer District,School District, etc.). These ees are based on the prelimin=information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS Fee Resolution II-053 Q' 7`1,13 FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? ®Yes Q No $0.00 1 hours Plan Check, Hourly Suppl. PC Fee: Q Reg. Q OT0,0 his $0.00 $143.00 ISTPLNCK PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. ® OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? 0 Yes D No $0.00 Advanced Planning, Fee: $0.00 Select a Non-Residential G Building or Structure Q Stronj, Motion Fee: $0.00 Select an Administrative Item B1d�i Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $143.001 TOTAL FEE: 1 $143.00 Revised: 07/10/2014 Building Department City Of Cupertino 10300 Torre Avenue 2 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: PERMIT# 0 -0/t) OWNER'S NAME: PHONE# O - GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *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 THE GENERAL CONTRACTOR AND ALL�7— TRACTORS AVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. �r I am not using any subcontractors: � Signature Date Please check applicable subcontr ors acomplete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring /Carpeting Linoleum/Wood Glass/Glazing Heating Insulation Landscaping Lathing Masonry IV Painting /Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile E ner/ r Signature CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10590 LA RODA DR CONTRACTOR:CHAU JOEY AND PERMIT NO: 14050107 CHANG SHIH-CHI OWNER'S NAME: CHAU JOEY AND CHANG SH1H-CHI 10590 LA RODA DR DATE ISSUED:06/11/2014 OWNER'S PHONE: 4088889668 CUPERTINO,CA 95014 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL Of INTERIOR REMODEL(FAMILY ROOM TO MASTER SUITE License Class Lic.# AND BATH)(403 SQ FT); REMOVE AND REPLACE (2) Contractor Date WINDOWS; I hereby affirm that I am licensed under the provisions of Chapter 9 REMOVE(3)WINDOWS AND INFILL; INSTALL(2)NEW (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. Sq.Ft Floor Area: Valuation:$20000 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 APN Number:36933019.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PER EXPIRES IF•WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WIT 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 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 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. Qj OWNER-BUILDER DECLARATION 1 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 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) as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.1044,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. I will 1 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 Cade,Section 25532(x)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 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 1 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 fIealth&Safety Code,Sections 505,25 5534. Section 3700 of the Labor Code,for the performance of the work for which this // Owner or authorized agent: Date: ermit is issued. 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 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 regulati s per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date '1 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION hh� 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 BV`V CUPERTlNO (408)777-3228• FAX(408)777-3333• building a cupertino.org \ ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS /!j�GJ� ! O� h� APN 9 �� �1 q-/\U OWNER NAME �o� �G.v j PHONE c�.OLT)pQ�X21 E-MAIL lJ STREET,ADDRESS CITY, STATE,ZIP CJO FAX CONTACT NAME'7� (/ / U PHONE/�O(�`QS7(0(�/" E-MAIL 'T�"- STREET ADDRESS CITY,STATE, ZIP a Jo(J o (b f FAX ❑ 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 ARCHITECTIENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK / / / 2 ��c�NVEY ✓'vv�Gl� a( /^ OlM �4l H'L� eco c�(� C-1 T 2 C L h c ,,l �l.ct./ZJ41C L 4--1 l,✓,x(.Inapt ' Y e' EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQTT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA #os PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ATTACH #DWELLING UNITS, IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEINGADDED' []NO ADDITION? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY I TOTAL VALUATION: PLANNINGAPPL# []NO PLANNING APPROVAL LETTER EICHLER HOME? NO - ., O7® o L9 C> By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the prc5 erty owner's behalf. I have read this application and the information I have provided is correct. I ha rad the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating�big conycti ut Yize representatives of Cupertino to enter the above-iddentified property for inspection purposes.Signature of Applicant/Agent: (, Date: SUPPLE ME INF RMATION REQUIRED Pian cuEcx TYPE IiouTJxc SLIP New SFD or Mutif De dwel ngs: Apply for demolition permit for ❑ ovER FWE COUNTER ❑ BUIL DING PLAN REVIEW existing building(s). De olition permit is required prior to issuance of building 1 permit for new building. EaPizEss PLANING PLAN REVIEW z v Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ ruBLlcyvoxxs 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 submittal of Building Permit application. ❑ n�noxi SANITARYSEWERDISTRICT ❑ ENNUROMIENTAL HEALTH2?,", ' B1dgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ESS: 10590 La Roda Dr DATE: 05/19/2014 REVIEWED BY: Mendez BP#: VALUATION: $20,000 ;-PEURMITTYPE-: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Duplex PENTAMATION 1R3SFDREM USE: PERMIT TYPE: WORK convert e Family room to Master suite to include bathroom 403 sq ft remove and replace 8 window to SCOPE meet egrees bedrooms. add wood landing to dining room F-1 -I--- Ll _L_ NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These ees are based on the preliminary information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS (Fee Resolution 11-053 E,jf 'T 1,13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. Remodel,Other Suppl. PC Fee: Q Reg. Q OT 0.0 1 hrs $0.00 $488.00 IREMRES07H PME Plan Check: $0.00 1 # Deck/Deck Railing Permit Fee: $0.00 $488.00 IDECxwooD Deck(wood) Suppl. Insp. Fee.-(j) Reg. Q OT Q,Q hrs $0.00 11 8 # Window/Sliding Glass Door PME Unit Fee: $0.00 $418.00 I wINREP Replacement PME Permit Fee: $0.00 T7— Work Without Permit? © Yes (j) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential Q Building or Structure 0 i Strom Motion Fee: IBSEISMICR $2.00 Select an Administrative Item Bldg, Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $3.001$1,394.00 TOTAL FEE: $1,397.00 Revised: 04/01/2014 1 OWNER-BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333• building cDcupertino.orq CUPERTINO 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 ADDRESS1 ci 1 // �� APN BP# J _ OWNERNAME �--� L_ ��vCc` OWNER ADDRESS / tj DESCRIPTION OF WORK: t vd-_r I 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.) `''f. 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 coverage for injuries to workers on my property. Tom. I understand building permits are not required to be signed by property owners unless they are responsible for the construction hi( ng and are not hing a licensed Contractor to assume this responsibility. X/ - I understand as an"Owner-Builder" I am the responsible party of record on the permit. I 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. gC,4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. -TL 5. 1 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. 3-C-6. I 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 me to serious financial risk. 3-07. 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 performed under contract with a licensed general building Contractor. I 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 the workmanship or materials. Own erBuilde7Fonn 2010.doc revised 04/14/10 �9. I 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.cslb.ca.gov for more information about licensed contractors. TQ_10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the parry legally and financially responsible for proposed construction activity at the site address listed above. ��11. 1 agree that, as the party 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. :�'L'12. 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 'ty may be required to be presented when the permit is issued to verify the property owner's si re. Property Owner's Signature: Date: - -------------------------------Zri;�ii6_- ------------------------------------------------------------------------------------------------ (NOTE: The following Aut 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: Tel No Address of Authorized Agent: 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: OwnerBuildeYFornn 2010.doe revised 04/14/10 BUILDING DEPARTMENT - Bu CITY OF CUPERTINO L i mAy 21 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 -j (408) 777-3228 • FAX (408) 777-3333 'REVIEWED FOR CO CUPERTINO reviewed 8y. GENERAL REQUIREMENTS 1. Occupancy Groups (R-3 for residence and U for garage) 2. Type of Construction (VB — Fully-Sprinklered) 3. Project shall comply with the 2013 California Building Code (Base code 2012 IBC), 2013 CA Residential (2012 IRC), 2013 CA Plumbing (2012 UPC), 2013 CA Mechanical (2012 UMC), 2013 CA Electrical (2011 NEC), 2013 CA Fire (2012 IFC) and 2010 CA Energy Code (2008 Building Energy Efficiency Standards). 4. Install the required safety glazing (Tempered) conforming to the human impact loads of per Sections R308.3 and hazardous locations per 308.4 as listed below. a) Fixed and operable panels of swinging, sliding and bi-fold door assemblies. (R308.4.1) b) Glazing in an individual fixed or operable panel adjacent to a door where the nearest vertical edge is within a 24-inch arc of the door in a closed position and whose bottom edge is less than 60 inches above the floor or walking surface. (R308.4.2) c) Glazing in an individual fixed or operable panel that meets all of the following conditions: (R308.4.3) 1) Exposed area of an individual pane greater than 9 square feet. 2) Bottom edge less than 18 inches above the floor. 3) Top edge greater than 36 inches above the floor. 4) One or more walking surfaces within 36 inches horizontally of the glazing. 5) Glazing in railings. (R308.4.4) d) Glazing in enclosures for or walls facing hot tubs, whirlpools, saunas, steam rooms, bathtubs and showers where the bottom edge of the glazing is less than 60 inches measured vertically above any standing or walking surface. (R308.4.5) 5. Provide an exterior landing at each exterior door that is the width of the door and a minimum 36 inches in the direction of travel. (R311.3) a) The landing or floor at other than the required egress door shall not be more than 7.75 inches lower than the top of the threshold (R311.3.2) 1) Exception: A landing is not required where a stairway of two or fewer risers is located on the exterior side of the door, provided the door does not swing over the stairway. 6. Basements (except those only for mechanical equipment and not over 200 sq ft in floor area), habitable attics and every sleeping room shall have at least one operable emergency escape and rescue opening (R310.1). Indicate compliance on plan and provide the following as plan notes: a) Minimum net clear openable dimension of 24 inches in height (R310.1.2). b) Minimum net clear openable dimension 20 inches in width (R310.1.3). c) Minimum net clear openable dimension of 5.7 square feet in area. Grade floor openings shall have a minimum net clear opening of 5 sq ft(R310.1.1). d) The bottom of the clear opening shall not be greater than 44 inches measured from the floor (R310.1). 7. The installation of the exterior plaster/stucco shall comply with the following code minimums: a) Weather resistive barriers shall be installed as required in Section R703.2 and, where applied over wood-based sheathing, shall include a water-resistive vapor-permeable barrier with a performance at least equivalent to two layers of Grade D paper (R703.6.3) b) Plastering with Portland cement plaster shall not be less than three coats when applied over metal lath or wire lath and shall be not less than two coats when applied over masonry, concrete, pressure-preservative treated wood or decay-resistant wood as specified in Section R317.1 or gypsum backing (R703.6.2). c) A minimum 26 ga. galvanized corrosion-resistant weep screed with: (R703.6.2.1) 1) A minimum vertical attachment flange of 3-1/2 inches provided at or below the foundation plate line at all exterior walls. 2) The screed shall be placed a minimum of 4 inches above earth or 2 inches above paved area. ENERGY CODE REQUIREMENTS 8. Comply with the following Energy Code mandatory measures for lighting: a) All permanently installed high efficacy luminaires shall be switched separately from low efficacy luminaires. (150(k)(7)) b) Permanently installed luminaires in bathrooms, garages, laundry rooms and utility rooms shall be high efficacy luminaires OR are controlled by an occupant sensor(s) certified to comply with Section 119 that does not turn on automatically or have an always on option. (150(k)(10)) c) Permanently installed luminaires located in other than kitchens, bathrooms, garage, laundry rooms and utility rooms shall be high efficacy luminaires (except closets less than 70 sq. ft.): OR are controlled by a dimmer switch OR are controlled by an occupant sensor that complies with Section 119 that does not turn on automatically or have an always on option. (150(k)(11)) d) Luminaires providing outdoor lighting and permanently mounted to a residential building or to other buildings on the same lot shall be high efficacy luminaires OR are controlled by occupant sensors with integral photo control certified to comply with Section 119. (150(k)(13)) PLUMBING PLAN REQUIREMENTS 9. Comply with the following minimum plumbing code requirements as specified below: a) Water closets shall have an average water consumption of not more than 1.28 gallons per flush. (CalGreen 4.303.1.1) b) Shower heads shall have a water flow not to exceed 2.0 gallons per minute. (CalGreen 4.303.1.2) c) The maximum flow rate of residential lavatory faucets shall not exceed 1.5 gallons per minute at 60 psi. (CalGreen 4.303.1.4.1) 10. Shower compartments, regardless of shape, shall have a minimum finished interior of 1024 square inches and shall also be capable of encompassing a 30 inch circle. (CPC 408.6) 11. Comply with the following minimums: a) Shower compartments and walls above bathtubs with installed shower heads shall be finished with a smooth, nonabsorbent surface to a height not less than 72 inches (6 ft). (CRC R307.2) b) The maximum hot water temperature discharging from the bathtub and whirlpool bathtub filler shall be limited to 120 degrees Fahrenheit. The water heater thermostat shall not be considered a control for meeting this provision. (CPC 409.4) c) Showers and tub-shower combinations shall be provided with individual control valves of the pressure balance, thermostatic, or combination pressure balance/thermostatic mixing valve type that provide scald and thermal shock protection for the rated flow rate of the installed showerhead. (CPC 408.3) 2 12. Provide a 30-inch clear width for water closet compartment and 24 inch clearance in front of water closet. (CPC 402.5) ELECTRICAL PLAN REQUIREMENTS 13. Install and inspect smoke alarms in all of the following areas in the residence: (R314.3) a) On the ceiling or wall outside of each separate sleeping area in the immediate vicinity of bedrooms. b) In each room used for sleeping purposes. c) In each story within a dwelling unit, including basements but not including crawl spaces and uninhabitable attics. 14. Install and inspect carbon monoxide alarms in the following areas in the residence: (R315.1) a) Approved carbon monoxide alarms shall be installed outside of each separate sleeping area in the immediate vicinity of the bedrooms and on every level including basements in dwelling units that have fuel-fired appliances or attached garages. 15. Comply with the following electrical code minimums: a) A minimum of two 20 amp small appliance branch circuits shall be provided for all receptacle outlets in the kitchen, dining room, pantry, or other similar areas. (CEC 210.11(C)(1)) b) At least one 20 amp branch circuit shall be provided to supply bathroom receptacle outlets. Such circuits shall have no other outlets. (CEC 210.11(C)(3)) 16. All wall spaces, 2 feet or more in width, shall have receptacles installed such that no point measured horizontally is more than 6 feet from a receptacle (12 foot maximum spacing) (CEC 210.52(A)(1) & (2)) 17. Balconies, decks and porches accessible from inside the dwelling unit shall have at least one receptacle installed within the perimeter of the deck, balcony or porch. (CEC 210.52(E)(3) 18. Comply with the following Electrical Code minimums: a) All branch circuits that supplying receptacles in family rooms, dining rooms, living rooms, parlors, libraries, dens, bedrooms, sunrooms, recreation rooms, closets, hallways and similar rooms or areas shall be protected by a listed arc-fault circuit interrupter (AFCI). (CEC 210.12(A)) b) All receptacles in bathrooms, garages, accessory buildings, outdoors, crawl spaces, unfinished basements, kitchens (where receptacles serve counter top surfaces), laundry, utility, wet bar sinks (within 6 feet of the edge of the sink), shall have ground-fault circuit interrupter (GFCI) protection. (CEC 210.8) c) In all areas specified in 210.52, all 125-volt, 15- and 20- ampere receptacles shall be listed tamper-resistant receptacles. (CEC 406.12) 3 Page 2 Subject: Residential Remodel.—(403so —Submittal No. 1 Name: Chau and Chang Residence Address: 10590 La Roda Drive, Cupertino APN: 369-33-01.9 Permit No.: 14050107 All conditions, requirements and recommendations are to be completed at the (Owner/Developer)'s expense. Storm water from surface or roof drains, other general surface runoff water or condensate from any residential HVAC equipment shall not be discharged to the sanitary sewer. Yours very truly, MARTS THOMAS & COMPANY,INC. District Manager-Engineer Cl For: Richard K. Tanaka. If you have any questions or need additional information,pleagc call.Tulie Chiu or Thanlh Nguyen at 408-253-7071. U:IAdmrinictrationK:orresPnnda�cc-GeneraALel.Icrs12O1411.,ctier 11 14-218(:uhatinv BuiIdi,19 DePuTiment 14050107 kcsidmilinI Addn Remodel 1050O l.,a Rodu 1)rive Suh 1 05-2 -2014.doc SUPPLYING SANITARY SEWERAGE SERVICES Pok;CITY OF CUPERTINO,PORTIONS OF THE CITIES OF SARATOGA,SUNNYVALE,LOS ALTOS AND SURROUNDING UNINCORPORATED AREAS OWNER-BUILDER DISCLOSURE FORD{ COMMUNITY DEVELOPMENT DEPARTMENT •BUILDING DIVISION 1 D300 T ORRE AVENUE- CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333- buil di no0�cuoetino.ora CJPERTIN0. 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: SFEADDRES3/cygc �� / \ ;;rN 13rj OVdiIER NIAME - OWNER ADDRESS D-SCRIPTION OF WORK: �e;�► � We are providing you with an Owner-Builder Acknow!edgment and Information Verfication 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. VVe will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to Ls at our o Ficial address indicated. An acent of the owner cannot execute -his notice unless you,the propety owner, obtain the prior approval of the permi«ing authority. OWNER'S ACKNOWLEDGIliENTAND VERIFICATION OF INFORMATION (DIRECTIONS:Please read and initial each statement below is signiy you undersand or veriy this information.) 1 1. 1 understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- ilder"building permit that erroneously implies that the properly 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 coverage for injuries to workers on my property. "(12. 1 understand building permits are not required to be signed by prop erty.own ers unless they are responsible for Lhhelconstruc-ion and a.re not hiring a licensed Contractor to assume this responsibility. ' 3. 1 understand as an "Owner-Builder 1 am the responsible party of record on the permit. 1 understand that l may /protect myself from potential financial risk by hiring a licensed Contractor and having the permit;fled in his or her name instead of my own. �.( . 1 understand Contractors are required by la,v to be licensed and bonded in California and to list their license numbers on permits and contracts. �• 5. I understand if I employ or othen✓ise engage any persons, other than California licensed Contractors, and the total value of my construction is at least rive hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. ire;�_al 6. I understand if I am considered an 'employer' under state and federal law, I must register with the state and government, withhold payroll taxes, provide vvorkers' compensation disability insurance, and contribute to unemployment compensation for each"employee." I also understand my Failure to abide by these lauds may subject me to serious financial risk. 7. I understand under California Contractors' State License Law, an Owner-Builder who builds sincle-family rsidential structures cannot legally build them v✓ith the intent to offer them for sale, unless all work is performed by licensed subcontracto rs and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 4 8. 1 understand as an Owner-Builder if 1 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 the workmanship or materials. O,+-ner3u;?de;Fo;-n ?OiO.a.'oc revised D�/1-?/10 r t 6 1 understand I may obtain.more information regarding my obligations as an "employer" from the Internal ev=nue Service, the United States Small Business Administra_tion, the California Deparrient of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the Califomia Contractors' State License Board (CSLB) at 1-B00-321-CSLB (2752)or v,rww.cslb.ca.gov]or more information about licensed contractor. ,10. 1 am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that l �m the party legally and financially responsible for proposed construction activity at the site address listed above. F/11. 1 agree that, as the party legally and financially responsible for this proposed constructionactivity, l vrill abice y all applicable lavJs and requirements that govern Ov,lner-Builders as well as employers, Xin 12. 1 agree to notlfy the issuer of this tom immediately of any additions, deletions, or changes to any of the nation I have provided on this torn. Licensed contractor gra regulated by lauds designed to protect the public. If yontract 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 Contractor 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 perm as Owner-Builder and Wish to hire Coni actors, you will be responsible for veffying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LEN DINGAGEN'CY (DIRECTIONS:Please complete the follov✓ing construction lending agency information.) I hereby aiilmn That them 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 verrication acceptable to the city maybe required to be presented when the permit is issued to Verify the property owner's slo 4fure. Property Owners Signature: Date. -- -- - - - - - - - - ---- -- ---- - --- --- ---- - --- -- - ---- ------ ---------------------------- (NOTE: he fbilov,4ng thoriz. Lion Form is required to be completed by the property ov✓ner only when designating an Egenf or'fhe property owner to apply for a construction permit for the Ov✓ner-Builder). AUTHOR[ZATION OF AGENT TO ACT ON PROPERTY OWNER, BEHALF Excluding the Notice to Propery Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following peron(s)to act as my agent(s)to apply for, sign, and file the documents necessary to obtain an Ov✓ner-Builder Permit for my project. Scope of Construction Project(or Description of Work): Project Location or Address: Name of,41.uthorized Agent: Tel No A ddi-ecs Gf Al hGflzed Agerit: 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, '��ofe:A copy of"rhe property owner's driver's license, form nofarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verity the property owner's signature, Property Owner's Signature: Date: Di,fief 3Lilc�rrorn= ?010.doc revised 04114/10 COMM -10590 La Roda Dr., � �� BUILDINU -Cupertino, CA 95014 X �� APP'_F,..: APN: 389 33 019 \ 0-� �. ,�Y�� �ti 1\\\ 3t the JPRTINt� S yet of plans and specify ., -(408)888-9668 ,�}� ��i I✓ CbV ling Department job site during construction. It iS ;e Of ERTINO changes or alterations on save, ,CUP i4roval therefrom,without app from Department tial8,::,:�cg �� The Stamping of this pian and specificati:: kanw. -Joey Chau& 8hlh-Ch1 Chang Address: -10580 La Roda Dr., -Cupsrtlno,CA 95014 -APN:369-33-M9 glillu Nil 16'11 " 22'11 " = 163� 2 3 Doable Hung Window [D9 Roort►] (N) �) ] Remove Window 13111 [Icitcnen] p 12'0' 12'$" 8° c�) : ;§noveyWndow . W4Tinfio� 16 KV° W;-'- - Double Hung Window Sfiding:VVatdow Sliding Window. ' DOor 16'x54" 72'X48° 36"x34" " rn (N) tE) 1 &T, (E): ) Sliding Window (TempSiding Door Light 1611 tt Swing Window ? 36"x24) 5 t t 72"x80" (N) 48x„ (N) ( x ood Landing Exterior Light AFG + 3t . ��.►,� "x60 (E) [Master Bedroom] Fan nt►+�, sliding Door 3aa�sgFt (N) oma, 2_ 84" 0" (gyp � �l�.�at Ans (E) `� er Bath �t*.trr �.,. t it t it t t na Convert former W*room Into a master bedroom(309 sgrt)and bMroom(93 sqn) 17 1 F) q.,. 9 8 1 -Remove one existing window 36"x48" AM AFp' GFG Replace one 36`door with a 36`x48'tempered s"windowindowSliding window Pocket Door: 6 Qttti, , n Replace one 36"x48"sliding window with a 36"x48•tempered sliding window -Add non-load wall to divide exp " bearfng fling Den {now Family Roam)and master suite 32`x80. -Cha windows In F Room (E) (N) .: GFG 1 -Remove two 16"X28°single-paned windows �G t -Replace two 16"5¢8"single paned windows wtM 16'64"double hung windows Sliding Window t p"T t T,�Ar"-Change Dining Room to have sfiding door exit 44"x60" - o xu -i ... F'i -Replace existing 72"x48"Sliding Window with a 72"x80"Sliding Door (E) nFa -Add Wood Landing(84"x60-x14"(helght)outside the Sliding Door -Add Exterior Light next to Wood Landing Remove Window Sliding Window 36"x48" (Temp) w z Q� 36'x48" - ,�.� E T1 N 0 (N) ^�.'t ren, LEGEND: (N)-New (E)- Existing (TEMP)-Tempered =, _ C!7MPU,;;N(;F feet 1 2f 24ft 36ft floor®planner . 1 q Wood height: 14" ep wig: 80"' CUPERTINO l ?uAing Deoarmen` 2V (;OVPLIANCE reviewed By. I ' IL Iwindow Elevation:1811 ._... ;.,,. ...-..�-..--..Ng,x..y�,�w..�rr._.�,.�s.._•nrT•-�....;...s.�._. _.T...-_a.s.'�"'--q•��-..�.r...-r�:_.„..._.�.m.P....;...�_".�i.r�.r. SPF.-r-•..q-T_ .- .'4 ^:�� •.�+..:•'.wer:'�ne:-�+rn-+4r.-.�. - ,. �.•;.:L nor�'i ,•�_ �i i.I. Y Z f �I ,e CUPERTINO Rutidinat OsOa�ent 20 2014 UR CODE COM�'I tA//NCF La �gasP�� :.L kX - I'f'