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11080200M CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10163 BYRNE AVE CONTRACTOR: YUNQIAN QI PERMIT NO: 11080200 OWNER'S NAME: YUNQIAN QI 10163 BYRNE AVE DATE ISSUED: 12/07/2012 OWNER'S PHONE: 4088731562 CUPERTINO, CA 95014 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL E] ADDITION (E) 2 STORY HOUSE -GREAT ROOM, �/J BEDROOM, License Class_ Lic. # OFFICE, 2 BATHROOMS, AND LAUNDRY (1,653 SQ FT.NEW Contractor Date PORCH AND DECK (1,144 SQFT) TOTAL SQ FT 2,797. I hereby affirm t at I am licensed under the provisions of hapter 9 REV # 1 - REVISE FOUNDATION FROM DRILL PEIRS TO SPREAD (commencing with Section 7000) of Division 3 of the Business & Professions FOOTING - ISSUED 12/19/2013 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: $200000 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 35711011.00 Occupancy Type: Sec +on 700 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 PERMIT EXPIRES + ORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITH AY + PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter AYS F ST CALLED INSPECTION. 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 l granting of this permit. Additionally, the applicant understands and will comply Is Date: with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signature Date 13 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: I 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 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 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(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 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, Sec1ions 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: _OT(l 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 G CONSTRUCTION LENDINAGENCY 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 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 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. Signature Date CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • build ing(cDcupertino.org ❑ NEW CONSTRUCTION [Y ADDITION ❑ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS to , APN #•�„ 0 WNER NAMET' 44 ` 1 V PHONE //t 1(��/� G1 rJ - ('f O Q-rJ lx� E MAII STREEADDRESS �I E CkT CITY, STATE, ZIP FAX CONTACT NAME 1/ I �►/ �A l I PHONE (q0 -&NE_ 1&J E- ' STREET ADDRESSQ Wk caiw U4 CITY, STATE ZIP M, �O FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME �j LICENSE NUMBER INCENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER C. 1 BUS. LIC # COMPANY NAME c ` �'� ^ J(� C I� ` E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK Y_.l&Ti'n !�^C�Mr` �� V� �'n I �d �� � � VO\ vvn 1 �x VI G. J �iY v` M Vit / S>k EXISTING USE �t�sM �K- PROPOSED USE I CONSTR. ,N R— TYPE # STORIES USE TYPE OCC. SQ -IT. VALUATION (S) EXISTG AREAAREA agq NEW FLOOR— ) � DEMO AREA TOTAL NET AREA ►1q9 /�%i v V 3 1 2 �© �. BATHROOM � I REMODEL AREA YV I f�- KITCHENa REMODEL AREA OTHER REMODEL AREA PORCH AREA Zsig DECK AREA {� F (i TOTAL DECKRORCH ARE. I �It } GARAGE AREA: ETACH LL ATTACH # DWELLING UNITS: IS A SECOND UNIT [:]:VES1 BEING ADDED? BiV0 SECOND STORY C] YES ADDITION? 110 OOF� T❑ PRE -APPLICATION [I YES IF YES, PROVIDE COPY PLANNING APPL #".2f4O PLANN APPROVAL LETTER IS THE BLDG AN YES EICHLER HOME? I—YNO J RECEIVED BL cf', e „ -f TO VALUATION: y J By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the prFperty 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 bui ' on ction. exe Fepresentatives of Cupertino to _ ter the above-identifie property, for inspection purposes. Signature of Applicant/Agent: Date: to � 1 SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIT ❑ 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 PIAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure El STANDARD El PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FM DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH Bldg 4pp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION igADDRESS: 10163 byrne ave. TYPE OF CONSTR. DATE: REVIEW BY: bobs. APN: BP#: 'VALUATION: 1$200,000 "PERMIT TYPE: Building Permit II-B,111-B,IV,V-B PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE $2,659.26 2nd Unit? Yes No OTC. 0 Yes E)No PENTAMATION 1 R3SFDADD PERMIT TYPE: WORK add great room bedroom office 2 bathrooms laundry =1653 s.f. porch and deck= 1144 s.f. SCOPE �sfd Permit Fee: $2,659.26 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 2,797 $2,758.37 1R3PLNCK $2,659.26 IR3INSP $0.00 PME Plan Check: $0.00 Permit Fee: $2,659.26 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: TOTALS: 2,797 $2,758.37 $2,659.26 MECH, HOURLY ® Yes G No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY Q Yes Q No MISC ITEMS 77 Plan $2,758.37 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. 0 OT 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 DeDZ for addn7 info. FEE ITEMS (I"ee Resolution 11-053 L ff 71./71) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,758.37 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $2,659.26 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 _T_T 0 G Work Without Permit? 0 Yes (D No $0.00 Advanced Planning Fee: PLLONGRNGR $363.61 Select a Non -Residential Building or Structure Q 14 Strong Motion Fee: 1BSEISMICR $20.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $8.00 SUBTOTALS: $5,809.24 $0.00 TOTAL FEE: 1 $5,809.24 Revised: 10/01/2011 CONSTRUCTION PERMIT APPLICATION / 12 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION l 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buildingacupertino.orq ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI PREVISION / DEFERRED ORIGINAL PERMIT # A ( Q v PROJECT ADDRESS /s.� Y APN # OWNER NAME • , PHONE D td (J STREET ADDRESS s CITY, STATE, ZIP FAX CONTACT NAME PH , n E-MAIL Kq r 0, ST T11j3Q $ „ 1 �Q I u; CITY, STATE, ZIP � l❑ `V w� FAX ❑ OWNER ❑DOWNER -BUILDER OWNER ARGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT` ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMEC EZ1SE NUMBER - LICENSE TYPE BUS. LIC # 11, COMPANY NAME 0 Sam as oorga,4 E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK , vDL C ed from wha Rier's�fl Same_Z.22124 EXISTING USE PROP SED,IJSE,* CONSTR. TYPE # STORIES 1 F/ C/ USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO. TOTAL AREA AREA AREA NET AREA BATHROOM`* REMODEL AREA N KITCHEN / REMODEL AREA �/ A OTHER REMODEL AREA PORCH A 11tt DECK,AREA TOTAL DECK/PORCH AREA GARAC� A: DETACH Q ATTACH •• `/ 3 / # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES - BEING ADDED? ❑ NO ADDITION? 9-r PRE -APPLICATION OYES IF YES, PROVIDE COPY OF IS THE BLDG AN 11Y$S RFC1 t V (.[] N TOTAL VALUATION: PLANNING APPL # PLANNING APPROVAL LETTER O EICHLER HOME? - ---__- y By my signature below, I certify to each of the following: I am the property owner o authorized agent to 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 I curate. I agree to comply with all applicable local ordinances and state laws relating to representatives of Cupertino to ent ovde tified property for in ection urposes. &Id' �tt�Ithrize Signature of Applicant/Agent: Date: SUPPLEMENTAINFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for - ❑ existing building(s). Demolition permit is required prior to issuance of building vER-THE-COUNTER BUILDING PLAN REVIEW permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ElSTANDARD El PUBLICWORKS 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.doe revised 06/21/11 s CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ialADDRESS: 10163 BYRNE AVE DATE: 12/19/2013 REVIEWED BY: MELISSA rLfec:h. Permit Fee: APN: 357 11 011 BP#: 11080200 'VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: PME Plan Check: PENTAMATION PERMIT TYPE: 1 GENRE WORK REV # 1 - REVISE FOUNDATION FROM DRILL PIERS TO SPREAD FOOTINGS ISSUED 12/19/13 SCOPE Suppl. Insp. Fee -0 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 ote )_ Thoco fooc aro hacod an the nreliminary information available and are only an estimate. Contact the Dept for addh 7 info. FEE ITEMS (Fee Resolution 11-053 Ef. 711113) ;1.9u <:h. Plan Check Phanb. Plan Check <ae c:. Plan Check rLfec:h. Permit Fee: Plumb. Permit Feer: Flee. Permit Fee: Other Afech. Insp Other Plumb Insp, Ll Other Elec. Insp. ,I,, 1,;;z I`.a' PME Plan Check: Diet. Insp, Fee NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District ote )_ Thoco fooc aro hacod an the nreliminary information available and are only an estimate. Contact the Dept for addh 7 info. FEE ITEMS (Fee Resolution 11-053 Ef. 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Yes (F) No $0.00 0 hours Plan Check, Hourly $278.00 1STPLNCK Suppl. PC Fee: (D Reg. () OT 0.0 hr's $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Feer $0.00 Conswuction Tav: Administrative Fee: E) Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee. $0.00 Select a Non -Residential E) Building or Structure i Travel l�oc:urrac�ntatiort l `CTS. Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $278.00 TOTAL FEE: $278.00 Revised: 10/01/2013 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVEL64ENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408)•777-3228 • FAX (408) 777-3333 • building(a)cupertino.org i (0�-6,Z_0c3 ❑ NEW CONSTRUCTION I 'ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERl✓IIT # PROJECT ADDRESS IQI / APN OWNERNA.1,fE 10H GUN PHONE(grO)SJ3 E-MAIL'Scamic STREET ADDRESS as f)Pif(± CITY, STATE. zip FAX r CONTACT NAMEPA IV_; 6 PHONE // �,�; (�[ �n� E -MA t V*Af In VL 7 IPAA "(11 STREET AD KESS 2V6a!Q JA CITY, STATE. ZIP t FAX d ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARC1=CT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMEJV LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECTENGINEER NAME.AQ\A r ` LICENSE NUMBER I� BUS. LIC # I � COMPANY NAME C44,( .. NS �l u E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK i lr AVl _ (; , �n V Ji` "nti/Wl Yo0Vvl 3 k1ko c6R s�'- ck\M qUW 1 '-�� S s. -1�0 1e. 141.6 5,-t EXISTING USE I PRO OSED U E CONSjR TYPE I # STORIES 2 USE TYPE OCC. S/Q.FT. (5) EXISTG AREA 3 t o NEW AREA O R AREA DEMO TNET AREA , ��[��11 , <� / / /V�AL/UUATION L� (J ®6O BATHROOM REMODEL AREA �\ I� lD�E/CK, KITCHEN OTHER REMODEL AREA REMODEL AREA PORCH AREA 2 3 A� Ili TOTAL DECICH AREA L��Ij3 GARAGEA AREDETACH `p}- ATTACH # DWELLING UNITS: IS A SECOND UNITYES SECON-D STORY C]YES BEING ADDED? ❑NO ADDITION? 2NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # �O PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? �O RECEIVED BY: TOTA�D5 0 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 provided is correct. I have :-cad the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER -TBE -COUNTER 1-1 BUII.DING 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. ^- IGLANrmvG PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure �'S7TARD LIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE EFmE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to C3 MAJOR SANTTARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH B1dgApp_j011.doc revised 06/31/11 CITY OF CUPERTINO FFF F.RTIMATOR - BUILDING DIVISION 611 ADDRESS: 10163 byrne ave DATE: 08/26/2011 REVIEWED BY: bob s. PC E ID APN: I BP#: "VALUATION: $120,0 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition IX PRIMARY SFD or Duplex USE: 2nd Unit? 0 Yes Q No OTC. 0 Yes E) No PENTAMATIO 1 R3SFDADD PERMIT TYP WORK sfd addition great room bedroom bath. SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC E ID BP FEES BP FEE ID R-3 (Custom) II-B,III-B,IV,V-B 1,111 $2,457.62 3PLNCK $1,653.76 IRMNSP $0.00 PME Plan Check: Permit Fee: $1,653.76 Suppl. Insp. Feed Reg. 0 OT 0.0 hr $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 1,111 2,457.62 � C�Jta•tCftf'tutti ICt,#� $1,653.76 MECH, HOURLY 0 Yes 0 No PLUMB, HOURLY Yes Q No ELEC, HOURLY 0 Yes 0 No MISC ITEMS Plan Check Fee: Arnlr . Irl. , f oc nro hncod na tho nre/inninnrr infnrn,ntia availahle and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-t)53 E . 7I1%I U E QTY/FEE MISC ITEMS Plan Check Fee: $/,457.62 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: e) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: Permit Fee: $1,653.76 Suppl. Insp. Feed Reg. 0 OT 0.0 hr $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 _ � C�Jta•tCftf'tutti ICt,#� Acoustical Fee: 0 Yes 0 No $0.00 0 d Work Without Permit? 0 Yes 0 No $0.00 Planning Fee: PLLONGRNGR $144.43 Select a Non -Residential i Building or Structure 0 Strong Motion Fee: IBSEISMICR $12..00 Select an Administrative Item Bld( Stds Commission Fee_ IBCBSC $5.00 SUBTOTALS: $4,272.81 $0.00 TOTAL, FEE: T$4,272.81 Revised: 07/04/2011 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: D/6 3 14Ao = PERMIT # l/� OWNER'S NAME: v� n/ PHONE # Z,�X • GENERAL CONTRACTOR:^/,W 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 SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Z/-' 7 ate r t Susan Winslow To: 'susanchen8@yahoo.com'; 'SC Design Group' Subject: Extension Request receipt Hi susan, Attached is your receipt for payment of the extension request. Your permit application for 10163 Byrne Ave #11080200 has been extended till 12/21/12. You will need to have the permit approved, paid for, and issued by this date or it will re -expire and additional fees will be due. Let me know if you have any questions. Sincerely, Susan Winslow Administrative Clerk Cupertino Building Dept 408-777-3246 l 0/6 3 G5� atq/k w t v s4,-q\t, -.Sv w -�,sw5� CG, ,Zz el I ITEM 1 OF 1 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35711011.00 DATE ISSUED.......: 11/28/2012 RECEIPT #.........: BS00O018682 REFERENCE ID # ...: 11080200 SITE ADDRESS .....: 10163 BYRNE AVE SUBDIVISION ...... CITY .............. CUPERTINO IMPACT AREA ...... OWNER YUNQIAN QI ADDRESS 10163 BYRNE AVE CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: suew COPY # : 1 RECEIVED FROM ....: SUSAN CHEN CONTRACTOR TBD - TO BE DETERMINED LIC # 00096 COMPANY TBD - TO BE DETERMINED ADDRESS .......... CITY/STATE/ZIP ...: TELEPHONE ........: FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC ---------- NEW BAL ---------- ---------- 1ADMIN ------------- HOURS ---------- 4.00 ---------- 168.00 ---------- 126.00 42.00 0.00 1BCBSC VALUATION 200,000.00 8.00 0.00 0.00 8.00 1BSEISMICR VALUATION 200,000.00 20.00 0.00 0.00 20.00 1PLLONGR SQUARE FEET 2,797.00 363.61 0.00 0.00 363.61 1R3INSP SQUARE FEET 2,797.00 2659.26 0.00 0.00 2659.26 1R3PLNCK SQUARE FEET 2,797.00 2758.37 2758.37 0.00 0.00 1SUPPKFEE HOURS 6.00 798.50 0.00 0.00 ---------- 798.50 ---------- TOTAL PERMIT ---------- 6775.74 ---------- 2884.37 42.00 3849.37 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT AMOUNT --------------- 42.00 --------------- 42.00 REFERENCE NUMR7 v --------------- VISA-EXTENSION BUILDIIIO 10300 TORRE HE CUPERTIHO. CP 95014 TERIIIHAL ID: 005743919 PIERCHAHT 0: 324170162998 VISA #xxxxxxxxxxxx915O SALE BATCH: 000418 IHUOICE: 018078 DATE: 110U 28, 12 TIfIE: 1306 50: 005 RUTH 110: 086216 CC: P TOTAL $42.00 Patricia Garcia From: Yunqian Qi [ygi9688@yahoo.coml Sent: Tuesday, November 26, 2013 2:54 PM To: Patricia Garcia Subject: Permit Extension, Attachments: construction.jpg Dear Patricia I am writing to request a building permit extension, #11080200. for my property at 10163 Byrne Ave. Cupertino, CA 95014 Basically, the construction has been started from late Oct and the status is showed in the photo. However, due to narrow access to the backyard from the setback, the process has been slow. It has not been to a stage for a formal inspection .The general contractor expects that the inspection will be done by Dec 6. Your approval is greatly appreciated. Best regards, Yunqian Qi (408)887-2020 TIN 1 2) \Q,)o N CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10163 BYRNE AVE CONTRACTOR: YUNQIAN QI PERMIT NO: 11080200 OWNER'S NAME: YUNQIAN QI 10163 BYRNE AVE DATE ISSUED: 12/07/2012 OWNER'S PHONE: 4088731562 CUPERTINO, CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ff— License Class Lic. # ADDITION (E) 2 STORY HOUSE -GREAT ROOM, BEDROOM, Contractor Date OFFICE, 2 BATHROOMS, AND LAUNDRY (1,653 SQ FT.NEW I hereby affirm that I am licensed under the provisions of Chapter 9 PORCH AND DECK (1,144 SQFT) TOTAL SQ FT 2,797. (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 Sq. Ft Floor Area: Valuation: $200000 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 APN Number: 35711011.00 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 FROM LAST CALLED INSP C ON. 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. 1Z OWNER -BUILDER DECLARATION Signature of Applicant: Date: I 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 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 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, 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: Z 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, atter 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 vU 5 ITEMS OF 5 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35711011.00 DATE ISSUED.......: 12/07/2012 RECEIPT #.........: BS000018766 REFERENCE ID # ...: 11080200 SITE ADDRESS .....: 10163 BYRNE AVE SUBDIVISION ...... CITY .............: CUPERTINO IMPACT AREA ...... OWNER ............: YUNQIAN QI ADDRESS ..........: 10163 BYRNE AVE CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: counter COPY ## : 1 RECEIVED FROM ....: QI YUNQIAN CONTRACTOR .......: TBD - TO BE DETERMINED LIC # 00096 COMPANY ..........: TBD - TO BE DETERMINED ADDRESS .......... CITY/STATE/ZIP ...: TELEPHONE ........: FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ---------- ----------------------- -ADMIN HOURS ---------- 4.00 -------------------- 168.00 168.00 ---------- 0.00 0.00 1BCBSC VALUATION 200,000.00 8.00 0.00 8.00 0.00 1BSEISMICR VALUATION 200,000.00 20.00 0.00 20.00 0.00 1PLLONGR SQUARE FEET 2,797.00 363.61 0.00 363.61 0.00 lR3INSP SQUARE FEET 2,797.00 2659.26 0.00 2659.26 0.00 1R3PLNCK SQUARE FEET 2,797.00 2758.37 2758.37 0.00 0.00 1SUPPKFEE HOURS 6.00 798.50 0.00 798.50 0.00 ---------- TOTAL PERMIT ---------- ---------- 6775.74 2926.37 ---------- 3849.37 0.00 METHOD OF PAYMENT AMOUNT REFERENCE -------------------- NUMBER ----------------- --------------- CREDIT CARD 3,849.37 MC --------------- TOTAL RECEIPT 3,849.37 Cupertino Union School District 10301 Vista Drive, Cupertino, CA 95014 Tel (408) 252-3000 • Fax (408) 865-0326 N° 9533 13eveloper Impact Fee Compliance The Cupertino Union School District has adopted Resolution Nos. 1403 and 1404, imposing developer impact fee pursuant to Government Code 53080. Building Permit Request The City of '!/,Q has received a request for a Building Permit described as follows: Residential Development Project ❑ Commercial/Industrial Development Project Name of Developer: �./N-✓v/'^V, Project Address: �l/ �l0 3 ��l'�/✓✓� Description: --- Square Footage: �� Lot/Parcel #: 3� 7- /Z 1:511 Permit #: /Xm;; Date: ��' �G / By. �� .�'N L�i�jL t� City Authorized Representative Square footage will be verified by the city prior to issuance of a building permit; fees may be adjusted accordingly. Important Notice: Cupertino Union School District gives no credit for total demolition of existing square footage area, which makes way for new construction as mandated in the Government Code Sections 53080, 53080.6 and 65995. SCHOOL DISTRICT DEVELOPER IMPACT FEE CERTIFICATE OF COMPLIANCE The authorized representative of the Cupertino Union School District has reviewed the City of (' ; Building Permit Request described above and hereby certifies that the developer or authorized representative has met the requirements of the District's Developer Impact Fee requirements. Dated: By: Authorized Representative Cupertino Union School District Fee: $ 1 `t ' '7 to Certificate not valid without Check No.: 4. 7' District seal, initial, and date. Facilities Planning - White City - Yellow Requestor - Pink Accounting - Gold The City of FREMONT UNION HIGH SCHOOL DISTRICT 589 WEST FREMONT AVENUE SUNNYVALE, CALIFORNIA 94087 408-522-2200 Developer Impact Fee Compliance Building permits will not be issued without a completed Certificate of Compliance Building Permit Application has received a request for a Building Permit described as follows: _ New Residential Development _ Residential Addition (501) sq. ft. or more _ Commercial Development Name of Owner / Developer: �✓ �� Project Address: 7 — �✓ ~ Lot/Parcel # �` 7 /A Square Footage: Permit / Plan Check # Date Description: By: City Building Inspector Square footage verified by the city prior to issuance of a building permit; fees may be adjusted accordingly. Feeder Elementary District G4 A 7I-) .......................................................................................................................... SCHOOL DISTRICT DEVELOPER IMPACT FEE CERTIFICATE OF COMPLIANCE The authorized representative of the Fremont Union High School District has reviewed the City of Building Permit Request described above and hereby certifies that the developer or authorized representative has met the requirements of the District's Developer Impact Fee requirements. Dated: Certificate not valid without District Seal, Initial, and Date By: Fremont Union High School District Authorized Representative Fee $ Distribution: Facilities Planning —White City — Yellow Requestor — Pink Accounting — Gold Dev. Impact Fee Compliance (Rev. 11/22/05) [12/08 — 10001 ITEM 1 OF 1 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35711011.00 DATE ISSUED.......: 12/01/2011 RECEIPT #.........: BS000015470 REFERENCE ID # ...: 11080200 SITE ADDRESS .....: 10163 BYRNE AVE SUBDIVISION ...... CITY .............: CUPERTINO IMPACT AREA ...... OWNER ............: YUNQIAN QI ADDRESS ..........: 10163 BYRNE AVE CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: suew COPY # : 1 RECEIVED FROM ....: KIRK TANG CONTRACTOR .......: TBD - TO BE DETERMINED LIC # 00096 COMPANY ..........: TBD - TO BE DETERMINED ADDRESS .......... CITY/STATE/ZIP ...: TELEPHONE ........: FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ----------------------- 1BCBSC VALUATION ---------- 200,000.00 -------------------- 8.00 0.00 ---------- 0.00 ---------- 8.00 1BSEISMICR VALUATION 200,000.00 20.00 0.00 0.00 20.00 1PLLONGR SQUARE FEET 2,797.00 363.61 0.00 0.00 363.61 1R3INSP SQUARE FEET 2,797.00 2659.26 0.00 0.00 2659.26 1R3PLNCK SQUARE FEET 2,797.00 2758.37 2457.62 300.75 ---------- 0.00 ---------- TOTAL PERMIT ---------- ---------- 5809.24 2457.62 300.75 3050.87 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- CREDIT CARD 300.75 -------------------- VISA --------------- TOTAL RECEIPT 300.75 CUPERTINO October 10, 2012 BUILDING PERMIT/ APPLICATION EXPIRATION LETTER COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingCcDcupertino.org Yunqian Qi 10163 Byrne Ave. Cupertino, CA 95014 SUBJECT: BUILDING PERMIT APPLICATION EXPIRATION LETTER -2ND EXTENSION Site Address: 10163 Byrne Ave Permit Number: 11080200 -Addition Permit Application Expiration Date: 09/18/2012 According to our records, a building permit has not been issued for your permit application 11080200 for 10163 Byrne Ave. Since an extension was either not requested or not granted, your construction permit application has expired. The permit application is null and void and you have 15 business days from the date of this letter to pick up your plans and documents or they will be recycled. The permit application will be voided in our Permit Tracking System and all documents pertaining to the permit application will be recycled. Please let me know if you have any questions. Sincerely, Susan Winslow Administrative Clerk City of Cupertino suew@cupertino.org Expiration Letter.doe revised 12/06/10 �VV211-624J i �V* (3fo 104 A SN� :000 f —vz>,� a<d Aa IN azmtit a,�p .a� 914 �! U� xa � "ro✓� ry�r2r�. INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE M PERMIT INVOICE Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35711011.00 INVOICE DATE......: 10/22/2012 REFERENCE ID # ...: 11080200 SITE ADDRESS .....: 10163 BYRNE AVE SUBDIVISION ......: CITY .............: CUPERTINO IMPACT AREA ...... OWNER ... .........: YUNQIAN QI ADDRESS ..........: 10163 BYRNE AVE CITY/STATE/ZIP ...: CUPERTINO, CA 95014 CONTRACTOR .......: TBD - TO BE DETERMINED COMPANY ..........: TBD - TO BE DETERMINED ADDRESS .......... CITY/STATE/ZIP ...: , TELEPHONE ........: FEE DESCRIPTION DUE FOR --------------------------- ---------------- CAL BLDG STAND COMMISSION F PRINTING PERMIT SEISMIC RESIDENTIAL PRINTING PERMIT RES LONG RANGE PLANN FEE PRINTING PERMIT DWELLINGS INSPECTIONS PRINTING PERMIT DWELLINGS PLAN CHK APPLICATION ADMIN/CLERICAL FEE APPLICATION SUPPLEMENTAL PLAN CHECK APPLICATION OPERATOR: counter LIC # 00096 AMOUNT DUE PAID BALANCE ---------- ---------- 8.00 ---------- 0.00 8.00 20.00 0.00 20.00 363.61 0.00 363.61 2659.26 0.00 2659.26 2758.37 2758.37 0.00 126.00 126.00 0.00 532.50 0.00 532.50 ---------- ---------- 6467.74 ---------- 2884.37 3583.37 INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE PERMIT INVOICE Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35711011.00 INVOICE DATE......: 10/22/2012 REFERENCE ID # ...: 11080200 SITE ADDRESS .....: 10163 BYRNE AVE SUBDIVISION ...... CITY CUPERTINO IMPACT AREA ...... OWNER YUNQIAN QI ADDRESS 10163 BYRNE AVE CITY/STATE/ZIP ...: CUPERTINO, CA 95014 CONTRACTOR TBD - TO BE DETERMINED COMPANY TBD - TO BE DETERMINED ADDRESS ..........: CITY/STATE/ZIP ...: TELEPHONE ........: FEE DESCRIPTION DUE FOR --------------------------- ---------------- CAL BLDG STAND COMMISSION F PRINTING PERMIT SEISMIC RESIDENTIAL PRINTING PERMIT RES LONG RANGE PLANN FEE PRINTING PERMIT DWELLINGS INSPECTIONS PRINTING PERMIT DWELLINGS PLAN CHK APPLICATION ADMIN/CLERICAL FEE APPLICATION SUPPLEMENTAL PLAN CHECK APPLICATION OPERATOR: SylviaM LIC # 00096 AMOUNT DUE PAID ---------- BALANCE ---------- ---------- 8.00 0.00 8.00 20.00 0.00 20.00 363.61 0.00 363.61 2659.26 0.00 2659.26 2758.37 2758.37 0.00 126.00 126.00 0.00 798.50 0.00 798.50 ---------- ---------- 6733.74 ---------- 2884.37 3849.37 INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE CITY OF CUPERTINO PERMIT INVOICEe INVOICE INVOICE INVOICE OPERATOR: SylviaM Sec: Twp: Rng: Sub: Blk: Lot: APN 35711011.00 INVOICE DATE......: 05/08/2012 REFERENCE ID # 11080200:�2j` SITE ADDRESS 10163 BYRNE AVE SUBDIVISION ......: CITY CUPERTINO IMPACT AREA ......: OWNER YUNQIAN QI ADDRESS 10163 BYRNE AVE CITY/STATE/ZIP ...: CUPERTINO, CA 95014 CONTRACTOR TBD - TO BE DETERMINED LIC # 00096 COMPANY TBD - TO BE DETERMINED ADDRESS .......... CITY/STATE/ZIP ...: , TELEPHONE ........: FEE DESCRIPTION DUE FOR --------------------------- ---------------- CAL BLDG STAND COMMISSION F PRINTING PERMIT SEISMIC RESIDENTIAL PRINTING PERMIT RES LONG RANGE PLANN FEE PRINTING PERMIT DWELLINGS INSPECTIONS PRINTING PERMIT DWELLINGS PLAN CHK APPLICATION ADMIN/CLERICAL FEE APPLICATION SUPPLEMENTAL PLAN CHECK APPLICATION AMOUNT DUE ---------- PAID BALANCE ---------- 8.00 ---------- 0.00 8.00 20.00 0.00 20.00 363.61 0.00 363.61 2659.26 0.00 2659.26 2758.37 2758.37 0.00 41.00 41.00 0.00 520.00 ---------- 0.00 520.00 ---------- 6370.24 ---------- 2799.37 3570.87 ITEM 1 OF 1 CITY OF CUPERTINO 0 PERMIT RECEIPT' Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35711011.00 DATE ISSUED.......: 02/17/2012 RECEIPT #.........: BS000016056 REFERENCE ID # ...: 11080200 SITE ADDRESS .....: 10163 BYRNE AVE SUBDIVISION ...... CITY .............: CUPERTINO IMPACT AREA ...... OWNER ............: YUNQIAN QI ADDRESS ..........: 10163 BYRNE AVE CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: suew COPY # : 1 RECEIVED FROM ....: YUNQIAN QI CONTRACTOR .......: TBD - TO BE DETERMINED LIC # 00096 COMPANY ..........: TBD - TO BE DETERMINED ADDRESS .......... CITY/STATE/ZIP ...: , TELEPHONE ........: FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ---------- -ADMIN ------------- HOURS ---------- 1.00 ---------- 41.00 ---------- 0.00 ---------- 41.00 ---------- 0.00 1BCBSC VALUATION 200,000.00 8.00 0.00 0.00 8.00 1BSEISMICR VALUATION 200,000.00 20.00 0.00 0.00 20.00 1PLLONGR SQUARE FEET 2,797.00 363.61 0.00 0.00 363.61 1R3INSP SQUARE FEET 2,797.00 2659.26 0.00 0.00 2659.26 1R3PLNCK SQUARE FEET 2,797.00 2758.37 2758.37 0.00 0.00 TOTAL PERMIT ---------- 5850.24 ---------- 2758.37 ---------- 41.00 ---------- 3050.87 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT : AMOUNT --------------- 41.00 --------------- 41.00 REFERENCE NUMBER -------------------- 4086 HAIYING ZHAO 19 January 19, 2012 PLAN REVIEW EXPIRATION NOTICE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building (a)cupertino.org Yunqian Qi 10163 Byrne Ave Cupertino, CA 94014 SUBJECT: PLAN REVIEW EXPIRATION NOTICE Site Address: 10163 Byrne Ave Building Permit Application #11080200 Expiration Date: February 22, 2012 As a courtesy, the Building Department makes every effort prior to the expiration of a construction permit application to notify the applicant of the impending expiration. Per the California Building Code Section 105.3.2, ... "an application for a permit for any proposed work shall be deemed to have been abandoned 180 days after the date of filing, unless such application has been pursued in good faith or a permit has been issued" This notification letter is issued as a reminder that the construction permit application for the specified project will expire on the date shown above unless the following action is taken: A. A building permit application is approved and the building permit is paid for and issued prior to the expiration date specified; or B. A request for an extension is submitted in writing with a justifiable cause demonstrated to the Building Official prior to the expiration date of the application. A $41.00 fee shall apply to all extension requests, payable to the City of Cupertino at the time the request is made. Each extension, if granted will be for a period of not more than 90 days. Extension requests shall be hand delivered to the building department or e-mailed to suew@cupertino.orQ. If a plan review application expires, the renewal of the application will NOT be granted unless the construction plans comply with the 2010 California Codes and any new local regulations that came into effect from the date of the original application. Additional plan review (and associated fees) will be required to verify compliance with these new regulations. The plans will become null and void after the expiration date if a building permit is not secured or an extension is not granted. You will have 10 business days pick up your documents or they will be recycled. The permit application will then be voided in the Permit System and all documents pertaining to the permit application will be recycled. Sin U SusanWinslow, Administrative Clerk City of Cupertino Building Department ya8- 777-3� PlanReviewa-pirationNotice.doc revised 12/06/10 0 N Sum C�� ITEM 1 OF 1 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35711011.00 DATE ISSUED.......: 05/24/2012 RECEIPT #.........: BS000016900 REFERENCE ID # ...: 11080200 SITE ADDRESS .....: 10163 BYRNE AVE SUBDIVISION ...... CITY .............: CUPERTINO IMPACT AREA ...... OWNER ............. YUNQIAN QI ADDRESS ..........: 10163 BYRNE AVE CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: suew COPY # : 1 RECEIVED FROM ....: SUSAN CHEN CONTRACTOR .......: TBD - TO BE DETERMINED LIC # 00096 COMPANY ..........: TBD - TO BE DETERMINED ADDRESS ..........: CITY/STATE/ZIP ...: , TELEPHONE ........: FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ----------------------- -ADMIN HOURS ---------- 2.00 ---------- 82.00 ---------- 41.00 ---------- 41.00 ---------- 0.00 1BCBSC VALUATION 200,000.00 8.00 0.00 0.00 8.00 1BSEISMICR VALUATION 200,000.00 20.00 0.00 0.00 20.00 1PLLONGR SQUARE FEET 2,797.00 363.61 0.00 0.00 363.61 1R3INSP SQUARE FEET 2,797.00 2659.26 0.00 0.00 2659.26 1R3PLNCK SQUARE FEET 2,797.00 2758.37 2758.37 0.00 0.00 1SUPPKFEE HOURS 4.00 520.00 0.00 0.00 520.00 ---------- TOTAL PERMIT ---------- 6411.24 ---------- 2799.37 ---------- 41.00 3570.87 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- CREDIT CARD 41.00 -------------------- VISA --------------- TOTAL RECEIPT 41.00 Susan Winslow To: SC Design Group Cc: k Subject: Permit application expiration notice Attachments: 10163 BYRNE AVE.docx Hi Kirk, Attached is a 2nd notice expiration reminder. I sent the first one to the owner with no response. The 2nd was sent out today so I decided to fax you a copy. If they are no longer going to do the project please notify me to cancel the permit. If they are proceeding then they need to apply for an extension before the permit application expires 2/22/12. There has been no re -submittal of plans since November 2011. The extension request can be done by email with the $41.00 extension request fee being paid with a credit card over the phone, or the letter and fee can be brought in to the Building Department. Please let me know what you want to do. Sincerely, Susan Winslow Administrative Clerk Cupertino Bldg Dept 408-777-3246 Susan Winslow From: Susan Winslow Sent: Wednesday, December 14, 2011 9:11 AM To: 'SC Design Group' Subject: RE: Change of scope of work -10163 Byrne Ave Attachments: 10163 BYRNE AVE.docx Hi Kirk, I was out sick Mon & Tues so just got your email this morning. Attached are the plan review comments for 10163 Byrne Ave #11080200. Please make the changes and re -submit 5 sets of plans with the comment responses for all departments attached to each set of plans to the building department. Also I have enclosed our holiday closure schedule. Please let me know if you have any questions. Sincerely, Susan From: SC Design Group jmailto:scdesign4roupCabatt.net1 Sent: Monday, December 12, 20112:28 PM To: Susan Winslow Subject: Re: Change of scope of work -10163 Byrne Ave Hi Susan, Thank you for clarifying all the confusion and helpings us move the project forward. I was wondering if you can give me an update at where the project is. When will we get some comments back? Thank you for your help. Kirk Associate Designer SC Design Group 20370 Town Center Ln. SCDesi_c7nGroup CcDAtt. Net From: Susan Winslow <suew(cbcupertino.org> To: SC Design Group <scdesigncaroup(@att.net> Cc: Patricia Garcia <PatG(@cupertino.org>; Robert Sabich <BobS()Cupertino.org> Sent: Thu, December 1, 20113:26:55 PM Subject: Change of scope of work -10163 Byrne Ave Hi Kirk, It has been brought to my attention from our Plan reviewer that the scope of work for both permits house & 2nd unit have changed significantly. You will need to come in to our office and update both permit applications and additional fees will need to be paid. You need to list in detail the changes that were made. Also the plan 1 review will take longer than the 1 week turn around. This needs to be done right away. Please let me know if you have any questions. Sincerely, Susan Winslow Cupertino Bldg Dept January 19, 2012 PLAN REVIEW EXPIRATION NOTICE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingacupertino.oro Yunqian Qi 10163 Byrne Ave Cupertino, CA 94014 SUBJECT: PLAN REVIEW EXPIRATION NOTICE Site Address: 10163 Byrne Ave Building Permit Application 911080200 Expiration Date: February 22, 2012 As a courtesy, the Building Department makes every effort prior to the expiration of a construction permit application to notify the applicant of the impending expiration. Per the California Building Code Section 105.3.2, ... "an application for a permit for any proposed work shall be deemed to have been abandoned 180 days after the date of filing, unless such application has been pursued in good faith or a permit has been issued" This notification letter is issued as a reminder that the construction permit application for the specified project will expire on the date shown above unless the following action is taken: A. A building permit application is approved and the building permit is paid for and issued prior to the expiration date specified; or B. A request for an extension is submitted in writing with a justifiable cause demonstrated to the Building Official prior to the expiration date of the application. A $41.00 fee shall apply to all extension requests, payable to the City of Cupertino at the time the request is made. Each extension, if granted will be for a period of not more than 90 days. Extension requests shall be hand delivered to the building department or e-mailed to suew(a,cupertino.or . If a plan review application expires, the renewal of the application will NOT be granted unless the construction plans comply with the 2010 California Codes and any new local regulations that came into effect from the date of the original application. Additional plan review (and associated fees) will be required to verify compliance with these new regulations. The plans will become null and void after the expiration date if a building permit is not secured or an extension is not granted. You will have 10 business days pick up your documents or they will be recycled. The permit application will then be voided in the Permit System and all documents pertaining to the permit application will be recycled. Sincerely, Susan Winslow, Administrative Clerk City of Cupertino Building Department PlanReviewExpirationNotice.doc revised 12/06/10 Susan Winslow To: SC Design Group Subject: 10163 BYRNE AVE Hi Kirk, I left you a voicemail earlier and am following up by email. I have sent 2 permit expiration notices with no response. This is my last notice. Plans were re -submitted today 2/16/12. The application will still expire Wed 2/22/12 if not approved & issued. You still need to request an extension in writing and pay the $41.00 extension request fee before 2/22/12 or the appl will expire and new fees will need to be paid. Our office is closed Mon 2/20/12 for president's day. Please notify the owners. Let me know if you have any questions. Sincerely, Susan Winslow Cupertino Bldg Dept. 408-777-3246 Susan Winslow To: YQQ 1868@YAHOO. COM Cc: SC Design Group Subject: Permit appl extension Hi Yunqian, I have extended your permit application for 10163 Byrne Ave #11080200 for 3 months till 5/22/12. Your permit will need to be fully approved, pd for, and issued by this date or it will re -expire and additional fees will need to be paid. Please let me know if you have any questions. I am sending a copy of this to your contact person Kirk at SC Design Group. Sincerely, Susan Winslow Administrative Clerk Cupertino Bldg Dept 408-777-3246 Cupertino City Building Dept: I am requesting an extension of the building application for my property: 10163 Byrne Ave, Cupertino, CA 95014. Your assistance is greatly appreciated. 1 Thanks. CJScW Yunqia Qi Feb 17, 2012 Y Q Q L'6 6 3 0 YA H o D, (a M 0Ki The application will still expire Wed 2/22/12 if not approved & issued. You still need to request an extension in writing and pay the $41.00 extension request fee before 2/22/12 or the appl will expire and new fees will need to be paid. Our office is closed Mon 2/20/12 for president's day. Please notify the owners. Let me know if you have any questions. Sincerely, Susan Winslow Cupertino Bldg Dept. 408-777-3246 CUPERTINO OWNER -BUILDER NOTICE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building a5cuoertino.oro Effective January, 1, 2009, Assembly Bill 2335 amends California Health and Safety Code, Section 19825, regarding disclosures and verifications required for all applicants seeking Owner - Builder construction permits. These new application requirements provide an enhanced level of consumer awareness and protection for property owners accepting the risks associated with Owner -Builder construction permits. "The Legislature hereby finds and declares that there is an urgent and statewide public interest in assuring that building contractors comply with the Contractors License Law... and provisions of law relating to Workers' Compensation Insurance for building construction, that property owners are informed about, and protected from, fraudulent representations, liability for worker's injuries, liability for material and labor costs unpaid by contractors, licensing requirements, and employer's tax liabilities when improving their property as owner -builders" Important information you need to know BEFORE pulling your permit! The term "Owner -Builder" can mean three different things: "Owner as Worker", "Owner as Contractor" or "Owner as Employer" Understand each has Benefits or Risk, and it is possible to combine them! Hiring a California Licensed Contractor means you do not personally perform any of the construction work, the permit is not taken out in your name, you are not personally responsible for the construction and you are not an Owner -Builder. Instead, you become a "Customer" and California law provides you the benefit of protection from poor workmanship, failure to finish the job and financial risk due to worker injury. Benefit/Risk: Highest Benefits and the Least amount of Risk Owner -as -Worker is a type of Owner -Builder where you personally perform the construction work, the permit is taken out in your name and you are personally responsible for the construction management, knowledge, workmanship, and completion of the job. You benefit by not paying others to perform this work for you and your risk depends on your own ability to complete the job successfully. Benefit/Risk: Possible Benefit with LoiN Financial Risk Owner -as -Contractor is a type of Owner -Builder where you personally act as your own General Contractor, the permit is taken out in your name and you hire California licensed sub -contractors to perform portions of the construction work. WARNING: The benefit of protection provided by law when you hire only California licensed sub -contractors can turn to serious financial risk if you hire unlicensed contractors to perform any of the work. Benefit/Risk: Possible Benefit and Significant Financial Risk Owner -as -Employer is a type of Owner -Builder where you pay any individual to perform any construction work valued at more than $500.00, the permit is taken out in your name and you are personally responsible for their employment requirements, supervision, performance, safety and welfare while on your property. WARNING: Cost savings benefit can tum to serious financial risk if you fail to deduct payroll taxes or provide workers compensation insurance for each worker. Benefit/Risk: Possible Benefit with Significant Financial Risk Over 20,000 consumer complaints are filed each year. Many complaints relate to owner/builder projects and include workmanship and workers' compensation issues Homeowners suffer financial harm due to defective workmanship and injured employees. OwnerBuilder 2010.doc revised 06/08/10 Following are alarming examples of what has occurred with Owner -Builder permits: Example 1: Homeowner received insurance money to rebuild burned -down home. ■ Owner/Builder permit pulled to rebuild structure. ■ Unlicensed contractor built substandard structure — must be torn down and replaced. ■ Estimated financial injury is $225,000. ■ Additional financial injury - IRS threatened to tax insurance payout if house not completed by the end of the year. Example 2: Brother-in-law had active license but filed an exemption from Workers Comp. ■ Owner -Builder hires brother-in-law to install a new roof. ■ Employee falls and sustains multiple spinal and extremity fractures as well as a head injury and remains in a coma to this day. ■ The Owner -Builder, who has sold the home, is now a defendant in a lawsuit for reimbursement for benefits paid to the injured worker. Example 3: Employee of contractor without Workers Comp is hired by Owner -Builder to install septic system and suffers injury that results in permanent disability. ■ The Owner -Builder did not have a homeowner's insurance policy on the house against which to submit a claim. ■ The Owner -Builder is now a defendant in a lawsuit for reimbursement for benefits paid to the injured worker. Did you know — unlicensed persons frequently have the property owner obtain an "Owner - Builder" building permit which erroneously implies that the property owner is providing his or her own labor and material personally? Did you know — your homeowner's insurance may not provide coverage for injuries sustained on your property by an unlicensed contractor and his/her employees? Did you know — if you are considered an "employer" under state and federal law, you must register with the state and federal government, withhold payroll taxes, provide workers compensation and disability insurance and contribute to unemployment compensation for each "employee"? Did you know — that if you fail to abide by these laws you may be subjected to serious financial risk? OWNERS BEWARE AND CONSIDER THE RISK BEFORE ACCEPTING FULL RESPONSIBILITY FOR YOUR CONSTRUCTION PERMIT OwnerBuilder 2010.doc revised 04/12/10 CUPERTINO OWNER -BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildino(alcuoertino.org 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 ADDRESS O ( 8 �n fOWN]ERADD'RESS APN BP# OWNER NAME lX- O Y►'L LIE DESCRIPTION OF WORK: 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.) `" 1. 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. — 2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. ✓ 3. 1 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. *'-� 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. ✓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. ✓ 6. 1 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. 7. 1 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. %/ 8. 1 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. OwnerBuilderForm 2010.doc revised 04/14110 ,J9. 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. __t/_10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the site address listed above. 611. 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. V 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 city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Y Date: t Z O7 2-1 - ---------------------------------I---------------------------------------------------------------------------------------------------------- (NOTE: The following Authorization 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: Address of Authorized Agent: Tel No 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: OwnerBuilderForm 2010.doc revised 04114/10