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B-2017-1172
. CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1172 10555 S DE ANZA BLVD STE 150 CUPERTINO,CA 95014-4464(359 18 058) YUANLONG CONSTRUCTION INC • ROSEMEAD,CA 91770 OWNER'S NAME: ABC DEANZA PLAZA PARTNERS DATE ISSUED: 10/04/2017 • OWNER'S PHONE:510-380-6381 PHONE NO:(626)213-4599 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class)3 Lic.#1012793 Contractor YUANLONG CONSTRUCTION INC Date 04/30/2018 X BLDG _ELECT _PLUMB MECH_RESIDENTIAL X COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: NO.1 FOOT SPA&MASSAGE T.I.(1910 SF) I hereby affirm under penalty of perjury one of the following two declarations: REV#1 8'X 8'WALL IN OPEN OFFICE AREA-ISSUED 10-20-2017 1. 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 peof the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by / rformance ction 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: . Valuation:$30000.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances APN Number: Occupancy Type: and state laws relating to,building construction,and hereby authorize 359 18 058 A(Tenant Improvements),B(Tenant Improvements) representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,'the applicant understands and will comply with all non-point source regulations,per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature . ��� Date 10-20-2017 Issued by:Abby Ayende Date: 10/04/2017 __ OWNER -BUILDER DECLARATION I hereby affirm that I amexempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. I,as owner of theproperty,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for ' compensation,will do the work,and the structure is not intended or offered for inspection. • sale(Sec.7044,Business.&Professions Code) 2. I,as owner blithe prbperty,am exclusively contracting with licensed Signature of Applicant:. contractors to construct the project(Sec.7044,Business&Professions Code). Date:10-20-2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER i. 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. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain„Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of Califomia. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: ----11,-La-----r-2--k72---DDD� APPLICANT CERTIFICATION Date: 10-20-2017 I certify that I have read this application and state that the above information is CONSTR TION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the'above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against-said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all,non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION ' Code,Section 9.18. I understand my plans shall be used as public records. Licensed Signature Date 10-20-2017 Professional CONSTRUCTION PERMIT APPLICATION „,,,,,/ COMMUNITY DEVELOPMENT DEPARTMENT-• BUILDING DIVISION _I 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 • SS.lP ` w , s (408) 777-3228 • building@cupertino.org PEMIT i#13- tJ 2.&l 7- 1 P l 7 Z CUPERTINO REV E " DEF E ❑ NEW CONSTRUCTION ❑ADDITION ❑ALTERATIONf T.I. ❑MEP ElRE-ROOF ❑SWIMMING POOL/SPA PROJECT ADDRESS / `` APN A i �j t 0 t5-s-- s-- 42. p6 A-Ai -/A- ( v .x 1�v to , '6 /0 -3 `9 b 05p OWNER NAIvJE `�� (rA‘K cPHONE ��.-i .s .9 tE-MAIL STREET ADDRESS CITY, STATE,ZIP , ❑CONTRACTOR NAME 0 OWNER-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE LC0 C ON- kcpoi� �,vc. 1 o IZ 7'73JSTREETA DRESS t�l J \ �� ✓ CITY,STATE, ZIP ;6 v \02� � QQ,5 E-MAIL c ^ PHONE /``Jlf BUS.LIC �1 ii. te ❑ARCHITECT ❑OWNER ❑OWNER AGENT CONTRACTOR AGENT❑ENGINEER❑DEVELOPER ❑TENANT CONTACT NAMo L- 6'4 .^A4� E-MAIL tiLSTREET ADORE CITY,STATE,ZIP PHONErflO) /-C6/r2-:3 DECRIPTON // ) & ,J V ft A L u i `5' - ' `� i�VI` 1 u/- ❑SINGLE-FAMILY/DUPLEX 0 MULTI-FAMILY 0 INDUSTRIAL nk1°COMMERCIAL EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF S RIES A TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION(5) i q i o REMODEL REMODEL KITCHEN REMODELOTHR GARAGE ❑ATTACHED BATHROOM SF SF SF SF 0 DETACHED , EX151NGES EICHLER ❑ YES SECOND STORY ADDITION ❑YES FIRE SPRINKLERS 0 NO 0 NO ❑NO DWELLING SECOND DWELLING ❑YES ❑'ATTACHED❑DETACHED OTHER UNITS A UNIT ADDITON: ❑NO S F POOLS" 0 FIBERGLASS 0 VINYL-LINED ❑GUNITE ❑PREFABRICATED POOL-SF SPA-SF j SPA ATTACHED❑YES 0 NO I TOTAL-SF A R� ED BOTAL ALU�4TION: Convuerciu!or Multi-Family Buildings with Public Swimming Pools requires Department of Environmental Heath approval , Ae7 k RE-ROOF EXISTING ROOF TYPE: E BUILT-UP ROOF❑ASPHALT SHINGLES WOOD SHAKES❑WOOD SHINGLES❑TILE OTHER(SPECIFY) REMOVE/REPLACED NO IF NO PLYWOOD E 1" ❑3/8" PLYWOOD TYPE: PITCH: ROOF CLASS ❑YES A OF LAYERS THICKNESS❑5/8" OTHER ❑OSB 1=1CDX OTHER '12 A PROPOSED ROOF TYPE:❑BUILT-UP ROOF ❑ASPHALT SHINGLES 0 WOOD SHAKES❑WOOD SHINGLES 0 OTHER *Provide a signed copy of the Cupertino's Tear-Off Policy SF Poi SQUARES 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 read the Description of Work and verify it is accurate. I agree 1 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. I acknowledge and authorize all information contained on this application form to be made available for public record. __- - Signature of Applicant/Agent: ,/ Date: 1 0 l I ( SUPPLEMENTAL INFORMATION r It RED *New SFD/Second Dwelling Units ultifamily Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction. *Commercial Buildings: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. *Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. *HOA-Provide a letter of approval from the Home Owner's Association BldgApp_2017.doc revised 08/01/17 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1172 10555 S DE ANZA BLVD STE 150 CUPERTINO,CA 95014-4464(359 18 058) YUANLONG CONSTRUCTION INC ROSEMEAD,CA 91770 OWNER'S NAME: ABC DEANZA PLAZA PARTNERS DATE ISSUED: 10/04/2017 OWNER'S PHONE:408-255-4100 PHONE NO:(626)213-4599 • LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic.#1012793 Contractor YUANLONG CONSTRUCTION INC Date 04/30/2018 X BLDG _ELECT _PLUMB MECH RESIDENTIAL COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: NO.1 FOOT SPA&MASSAGE T.I.(1910 SF) I hereby affirm under penalty of perjury one of the following two declarations: 1. 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 'J`.erformance of the work for which this permit is issued. s11' 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 1\- permit is issued. Sq.Ft Floor Area: Valuation:$30000.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 359 18 058 A(Tenant Improvements),B('Tenant Improvements) representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save Indemnify and,keep harmless the City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue;against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source;regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. 01 ignature I'"-I `� Date 10/4/2017 Issued by:Abby Ayende Date: 10/04/2017 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the BE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:10/4/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. 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. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 255 . Labor Code,I must forthwith comply with such provisions or this permit shall •L be deemed revoked, ner or authorized agent: F APPLICANT CERTIFICATION ate:10/4/2017 I certify that'I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. I understand my plans shall be used as public records. Licensed Signature Date 10/4/2017 Professional CONSTRUCTION PERMIT APPLICATION ,V. : COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION si9r 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 B . .. .... „„....,...„:„. (408)777-3228•FAX(408)777-3333•buildinq cupertino.o , CUPERTINO Z®1 '--/ i - . ❑NEW CONSTRUCTION El ADDITION 'irk(ALTERATION/TI ❑ REVISION/DEFERRED L ORIGINAL PERMIT# 1",i' -' PROJECT ADDRESS 1,�S 5., QC / -A . .'e LV 2 r-15v APN# q r• /(5. . 6 5-(> - . it � 8 O '' OWNER NAME 1 J pe �l�2GC L/pr/t Q2� PHONEgoy 25,1 000 E-MAIL GY i e iccO' bee'p,'o,p ;iii0l•'C>.1' - STREET ADDRESS CITY,.STATE,ZIP FAX - (0 12 1 2416? 42/e s'e 2©0 c• , 4,4i Yto CONTACT NAME PHONE E-MAIL. • - -'iiaiI;1a (up STREET ADDRESS.97C611,0 j a46/1-(j f c�� CITY.$ E I o ` -A ,r,tF t FAX _ - 0 OWNER 0 OWNER-BUILDER 0 OWNER AGENT 0 CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT• CONTRACTOR NAME � !!!t ZAt,I, r+„,-, L L e LICENSE NUMBER rot.Z-?93 LICENSE TYPE BUS.LIC H • COMPANY NAME( E-MAIL l k`fl/^~ T/MC !M LIQ E-MAIL (F�„fl1JJ, j -n33 n_r/'` FAX STREET ADDRESS ` 3,, W�" 1 V I '•' � CITY,STATE,ZIPZI �e W'i-.? 0 PHONE (/;� , h ��y Uuvl�rw� l �v G� g I `c ��7 7 ARCHITECTFENGINEER'NAME , LICENSE NUMBER BUS.LTC H COMPANY NAME E-MAIL PAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK ,...1.--1 1 VO a � 1t/�� lq /Dr- , /, Fool- SpA i EXISTING USE PROPOSED USE CONSTR.TYPE U STORIES USE TYPE OCC, SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL T AREA AREA AREA NET AREA 1 BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA , PORCH AREA I DECK AREA • TOTAL DECK/PORCH AREA GARAGE AREA: 0 DETACH D ATTACH N DWELLING UNITS: ISA SECOND UNIT 'I]YES SECOND STORY DYES I,EINGADDED? DNO ADDITION? ONO PRE-APPLICATION DYES 1F YES,PROVIDE COPY OF IS 141E BLDG AN 0 YES ',,,,,,r, --E_sLL.•� ; Vr-...`_ TAL VA AT1oN:' ' PLANNING APPL# ONO PLANNMGAPPROVAL LEITER EICHLER HOME? ONO W000 50 I3y my signature below,[certify to each of the following: I am the property owner or authorized agent to act on the property owner'sbehalf. I have read this', • application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable';local ordinances and state laws relating to buildi__ -• structi. . I authorize representatives of Cupertino to enter the above-identified pro erty for inspection purposes. Signature ofApplicant/Aged.' Date: id r 1 : -- - - :-las:- - - SUPPLE NIA 4N-. ATION REQUIRED .._.. • __-...-_.......,.._.'( Pj::--__ ...:114.- -- - - :..,._-:__.....ET;ANGHEL�:cC'-YP.H;- :�-:.._�_,:s.-_;.,_.._..-:R.-t7:TZNG�$L;�'`���:=��?'_=1=: nz New SFD or Multifamil d.-flings: Apply for demolition permit for - - - _- - - = . =-= A=:niv_ _ `0�U�'EIt��T'fTfi=CbT)I¢TER� <=-'r,C.-,�, :II.U(1.��NGY'-LT.\:32E\RTs`35., =��5 existingbuilding(s). Dent •ton is requiredprior to issuance of building - -- - -- ---i_:, _ I-M, 0 4 F».7 : U permit4 g - ---- -���r_f�- - - - -,:,ter_ - - - -- - - u�fa permit for new building, - —• :._::-__�::W,-.= 'i - ::V:;, .f.LE?:.._=:_s1.;_:ru:._.:.__:�_ca_m_:::......::.� _- .,�.�.PJ.`AI�I J.T1jy1i- - `><I>yY Commercial Bldgs: Provide a completed Hazardous Materials Disclosure :"srn inpiin'= a_ _4;1!__ri sli difiiRKs _UTI.7— =- form if anyHazardous Materials are beingused as part of this project. : --R'-- "- ,,