13030111 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10250 S TANTAU AVE CONT 1
CONSTRUCTION INC
OWNER'S NAME: ANDY&JULIE KANG 6172 BOLLWGER RD STE 151 DATE ISSUED:06/07/2013
OWNER'S PHONE: 4086914778 SAN JOSE,CA 95129 PHONE NO:(408)329-2831
❑ LICENSED CONTRACTOR'S�711/DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
License ClassLic.# 0 6 ��� CONSTRUCT 2 STORY SFDWL,LIVING 3,733 SQ FT,
ATTACHED GARAGE 431 SQ FT,FRONT PORCH 100 SQ FT,
Contractor /V Date BACK PORCH 440 SQ FT-SUNNYVALE JURISDICTION
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.
I hereby affirm under penalty of perjury one of the following two declarations:
1 have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$610000
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:37508041.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
1 certify that 1 have read this application and state that the above information is RES IF WORK IS NOT STARTED
correct.1 agree to comply with all city and county ordinances and state laws relating WITHIN 180_
_ YS 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 .ASI LAST 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 /
granting of this permit. Additionally,the applicant understands and will comply Is y:/ Date:
with all non-point source regulations per the Cupertino Municipal Code,Section !.v -
9.18. /
fj RE-ROOFS:
Signature Date 7/ 0 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
I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date:
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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)
I,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
1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 255 ,255,33,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Owner or authorized agen�. y Datc:0Zo
1 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,1 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 Len Address
1 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
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10250 S TANTAU AVE CONTRACTOR:TR DEVELOPMENT& PERMIT NO: 13030111
CONST
013
OWNER'S PHONE: 4086914778 SAN JOSE,CA 95129 PHONE NO:(408)329-2831
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL L1 COMMERCIAL
License Class Lic.# CONSTRUCT 2 STORY SFDWL,LIVING 3,733 SQ FT,
ATTACHED GARAGE 431 SQ FT,FRONT PORCH 100 SQ FT,
Contractor MAL Date BACK PORCH 440 SQ FT-SUNNYVALE JURISDICTION
I hereby affil that I am licensed under the provisions of 6apter 9
(commencing with Section 7000)of Division 3 of the Business&Professions REVISION#2 REVISE MAIN DOOR-ISSD OTC 9/17/2013
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarQons:
I have and will maintain a certificate of consent to self-insure for Wor
Compensation,as provided for by Section 3700 of the Labor e
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$610000
have and will maintain Worker's Compensation Insurance,as Ifor by
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. APN Number:37508041.00 Occupancy Type:
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 0 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 DA RSM LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments, �f
costs,and expenses which may accrue against said City in consequence of the �� 7
granting of this permit. Additionally,the applicant understands and will comply Issued by. Date.
with all non-point source regulatio 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.
❑ 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
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(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 1
performance of the work for which this permit is issued. will tain 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, 533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Dater—�
permit is issued.
I certify that in the performance of the work for which this permit is issued,I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
I certify that I have read this application and state that the above information is
correct.I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION
costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10250 S TANTAU AVT: CONTRACTOR:TR DEVE1,011M1?NT& PERMITNO: 130301 If
CONSTRUCTION INC
OWNER'S NAME: ANDY&JULHl KANG 6172 BOLLINGER RD STL 151 DATE ISSUED:06/0712013
OWNER'S PHONE: 4086914778 SAN,IOSE,CA 95129 PHONE NO:(40S)329-2831
❑ LICENSED CONTRACTOR'S DECLARATION =�
BUILDING PERMIT IN BLDG ' ELECT PLUMB
License Class_ --,O I'i'.44
�} 6— c MECH RESIDENTIAL COMMERCIAL.
Contractor Y�I���� ���f Date C
1 hereby affix thrh at 1 am licensed under the provisions of Chapter 9 708 DESCRIPTION:consrHcc'rz 0SQ 1:srowt.,r.ivi�c,.�a�s�rr
A"rTA(I IIID G,AR,�GI;J31 SQ P"r PRO,A"I'PORCI I I un SQ FI_
(commencing with Section 7000)of Division 3 of the Business&Professions 13 WK PokCu aao sp rr SUSNYVnri: IRIS DK I10v Rsvrn ki_ViSi_rw,sin.or vci\DO\r IN%r Asn k
Code and that my license is in full force and effect. uLDROOM,KCVrsr.tin Rt(I I,RAI,ro kr.r,rr.rrcAM[:INS Tr AD or iuP TO%1A ICH AR(ini rt It R:\I,Pi.
Si naris-iss1)OVCR'nn.roL\'rr.kn
1 hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to scll'-insure for Workers
Compensation,as provided for by Section 3700 of the Labor Code,for the REVISION
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation]nsurance,as provided 6or by
Section 3700 of the Labor Code,for the pedormance of the work for which this
permit is issued. Sq. Ft Floor Area: Valuation:S610000
APPLICANT CERTIFICATION
I certil'y that 1 have read this application and state that the above information is APN Number:37508041.00 Occupancy"Type:
correct. I agree to comply with all city and county ordinances and stale 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
ndcmnily and keep harmless the City ofCupertino against liabilitics,judgmcnts' PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City iu conscqucncc 01'111C
granting of this peen t. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISS Oil
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18. V
Signature_ Date_._ Issued by: �✓ Date: !/
❑ ONVNER-BUILDER DECLARATION — — — —
I hereby affirm that I am exempt from the Contractor's License Law for one of RF,-ROOFS:
the following two reasons: All cools shall be inspected prior to any rooting material being installed. II a roofis
L as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection.
BUSinesS&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to Signature ol'ApphcanC _Date
construct the project(Sec.7044,[3usiness&Professions Code). —
1 hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
declarations:
I have and will maintain a Certificate ofConsent to Sell'Insure for Worker's IIA''/.ARDOCS.NIATF,RIALS DISCLOSVRE:
Compensation,as provided for by Section 3700 of the Labor Code,for tilt
performance of the work for which this permit is issued. 1 have read the hazardous materials requirements under Chapter 6J5 of the
I have and will maintain Worker's Compensation Insurance,as provided lir by California Ilealdu&Safery Code,Sections 25505,25533,and 25534, twill maintain
compliance with the Cupertino Municipal Code,Chapter 9.12 and the I Icalth&
Section 3700 of the labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material.
permit is issued Additionally,should 1 use equipment or devices which emit hazardous air
1 certify that in the performance of the work for which this pennrt is issued.I shall contaminants as defined by the Ray Area Air Quality Management District 1 will
not employ any person in any manner so as to become subject to the Workers maintain compliance with the Cupertino NI unicipal Code,Chapter 9.12 and file
Compensation laws of California. If,after making this certilicale of exemption,I Ilealth&Safety Code,Sections 25505,25533,and 225534.
become subject to the Worker's Compensation provisions ofthe Labor Code,I nnust
O.+'ger or a u fhorize4 a L
forthwith comply with such provisions or this parmit shall be deemed revoked. _ Date: l
APPLICANT CERTIFICATION CO\S"TRl'C'f10N LENDING AGENCY
1 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 I herebv affirm that there is a construction lending agency for the perfbrnnance of Work's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097.Civ C.)
upon the above mentioned property for inspection purposes.(We)agrcc to save Lender's
indemnify and keep harmless the City ofCupertino against liabilities, judgments.
costs_and expenses which may accrue against said City in consequence 01-the Lender's Address-__
granting of this pcnnit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Codc,Section ARCIII"TECT'S DECLARATION
9.18,
1 understand my plans shall be used as public records
Signature Date
Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR— BUILDING DIVISION
ADDRESS: 10250 S Tantau Ave DATE: 08/19/2013 REVIEWED BY: Sean
APN: BP#: 'VALUATION: Iso
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex PENTAMATION 1GENRES
USE: PERMIT TYPE:
WORK Revision #1: Revise the size of window in master bedroom; revise structural to reflect gable instead of
SCOPE hip to match architectural plan sheets.
,
LJ I
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc). Thesefees are based on the prelimina information available and are only an estimate Contact the Dept or addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff' 7%1;'12) FEE QTY/FEE MISC ITEMS
Plan Check Fee: Hourly Only? 0 Yes (E) No $0.00 1 hours Plan Check,Hourly
Suppl. PC Fee: Q Reg. () OT 0.0 hrs $0.00 $139.00 1sTPLNcx
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 Fee: $0.00
Work Without Permit? 0 Yes No $0.00
Advanced Planning_Fee: $0.00 Select allon-Residential E)
Building or Structure
Strong Motion Fee: $0.00 Select an Administrative Item
Bldg Stds Commission Fee: $0.00
S 7I3T TAL :� $0.00 $139.00 ` TOTAL FEE: $139.00
Revised: 07/01/2013
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10250 S TANTAU AVE DATE: 03/21/2013 REVIEWED BY: MENDEZ
APN: BP#: �?O/ *VALUATION: 1$610,000
'PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction
PRIMARY SFD or Duplex 2nd Unit? Yes • No PENTAMATION 1R3SFDW
USE: PERMIT TYPE:
WORK CONSTRUCT 2 STORY SFDWL LIVING 3,733 SQ FT ATTACHED GARAGE 431 SQ FT FRONT
SCOPE PORCH 100 SQ FT, BACK PORCH 440 SQ FT
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.f.
R-3 (Custom) II-B,111-B,IV,V-B 4,704 $3,101.52 IR3PLNCK $3,698.28 IR3INSP
TOTALS: 4,704 $3,101.52 $3,698.28 ,3�s
tit''c:11. Man CAC-., (n
r1.f n, i','YIIYI C',', i�fi17. i"PY.-t/2L':
orx r 11c� h Ir.;,n );rx r i',`u; l Iri 0(h,r t',lcc,bi
ifc.h' ),P ), /,Ci. F 7t 1,,h 1 ��c': i, L,t,ir, ,r F,-
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 therelimina information available and are only an estimate Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff.' 7/1112) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $3,101.52 Select a Misc Bldg/Structure
Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 or Element of a Building
PME Plan Check: $0.00
Permit Fee: $3,698.28
Suppl. Insp.Fee-.0 Reg. Q OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
#new 9
Construction Tax: IBCONSTAXR 1 units
Work Without Permit? 0 Yes (F) No $0.00
Advanced Planning Fee. IPLLONGR $611.52 Select a Non-Residential
Building or Structure
Trmvc�l Doer-t n�t��rafcilirfrt Fats: �
Strong Motion Fee: IBSEISMICR $61.00 Select an Administrative Item
Bldg Stds Commission Fee: 18CBSC $25.00
SCI) TO "ALS; $8,126.61 $0.00 TCJTAI.il+E . ; $8,1.26.61
Revised: 01/01/2013 '�