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11050024CITY OF CUPERTINO BUILDING PERMIT ,: BUILDING ADDRESS: 21989 LINDY LN CONTRACTOR: FRANK SUN PERMIT NO: 11050024 OWNER'S NAME: 21989 LINDY LN DATE ISSUED: 01/24/2012 OWNER'S PHONE: CUPERTINO CA, 950I4-4810 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lie.# Contractor Date 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. 1 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. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 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 and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature, Date OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1, as owner of the property, or my employees with wages as their sole compensation, wil I do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 1 hereby affirm under penalty of perjury one of the following three . 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. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I certify that in the performance of the work for which this permit is issued, 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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 and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date MECH r RESIDENTIAL r COMMERCIAL r— JOB DESCRIPTION: ADD DINING ROOM 458 SQ FT; NO RE- ROOFTOUNDATION @ RETAINING WALL @ REAR OF BLDG & COLLECTOR DETAILS @ ROOF FRAMING ARE ALL FUTURE DEFERRED 3/20/2012 -REV#I REPLACE STRONG WALL TO STEEL CANTILIEVER COLUMN SYSTEM-3/23/2012 REV#1 ISS'D Sq. Ft Floor Area: I Valuation: $50000 APN Number: 35625024.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: 1�0' %l G�� Date: -�� - fg- RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, 1 agree to remove all new materials for inspection. Signature of Applicant: Date ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: Date:_ 2 CZ_ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of %ork's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21989 LINDY LN OWNER'S NAME: OWNER'S PHONE: ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. 4 Contractor Date 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: 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. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 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 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 indemnity and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date —OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I certify that in the performance of the work for which this permit is issued, 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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 and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 2 �Z. CONTRACTOR: FRANK SUN 21989 LINDY LN CUPERTINO CA, 95014-4810 PERMIT NO: 11050024 DATE ISSUED:01/24/2012 PHONE NO: BUILDING PERMIT INFO: BLDG ' ELECT PLUMB MECH r— RESIDENTIAL r— COMMERCIAL f— JOB DESCRIPTION: ADD DINING ROOM 458 SQ FT; NO RE -ROOF **SEE NOTES" 0 & /647/%% Sq. Ft Floor Area: I Valuation: $50000 APN Number: 35625024.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued byres�— Date: / Z 1" RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant:, Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authori�zed a jent: Date: - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional ��CITY OF CUPERTINO I.�W FEE ESTIMATOR — BUILDING DIVISION imADDRESS: 21989 lindy In. DATE: 03/20/2012 REVIEWED BY: APN: BP#: "VALUATION: Iso 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: PENTAMATION 1GENRES PERMIT TYPE: WORK Revision # e lace strong wall to steel cantiliever columns stem. SCOPE NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc)_ These fees are hated an the nroGninary infarmadan availahlo and aro nnly an o_wimato_ Contact tho Dolt fnraddn'l info_ FEE ITEMS (Fee Resolution 11-053 Eff. 71111) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Q Yes 0 No $0.00 2­1 hours Plan Check, Hourly $260.00 ISTPLNCK Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 �(nrirrr,e'f7'ettl+'c Fret: Q 0 Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure Q Strom Motion Fee: $0.00 Select an Administrative Item BldgStds Commission Fee: $0.00 SUBTOTALS: $0.001 $260.00 TOSTAL FEE: $260.00 Revised: 111912012 l�0506� � FMR7 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 21989 lindy In. DATE: 01/24/2012 REVIEWED BY: bobs. APN: BP#: 11050024 "VALUATION: 1$50,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: 2nd Unit? Yes No 0 OTC. 0 Yes � No PENTAMATION 1 R3SFDADD PERMIT TYPE: WORK I sfd add 458 s.f. dining room no re -roof. SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,III-B,IV,V-B 0 $0.00 $0.00 TOTALS: 0 $0.00 $0.00 MECH, HOURLY ® Yes 0 No PLUMB, HOURLY ® Yes Q No ELEC, HOURLY () Yes Q No i NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. eta). These fees are based on the orelininary information available and are only an estimate Contact the Dent for addn'L info. FEE ITEMS (fee Resolution 11-053 E . 7'1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. (C) OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Suppl. Insp. Fee.S Reg. Only? ® Yes (*-) No C) OT f 0,01 hrs $0.00 $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? © Yes (F) No $0.00 Advanced Plannine Fee: $0.00 9 hours Inspections $1,170.00 ISTINSP Inspection, Hourly � A ,•,.,-. r., Strom. Motion Fee: 1BSEISMICR $5.00 Select an Administrative Item Bldg- Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: $7.00 $1,170.00 TOTAL FEE: 1 $1,177.00 Revised: 1 /19/2012 CHIA-CHING LIN 45741 CHABLIS COURT FREMONT,CA 94539 TEL 5105868380 CHIACION:_� .LIN; P.E. March 4,2012 City.of Cuperti'no 10300 Torre.Avenue Cupertino, CA 95014 Dear Sir or Madam: This. letter mainly is to notify you that I, Chia-Ching Lin, P.E., have inspected the preparation of the,drilled piers and the rebar cages for the piers for the addition of the single family house located at.21989)Lindy.Lane, Cupertino, CA. The preparation of the drilled holes,;.the depth.and the associated rebars is found good and acceptable per the general engmeenng+practice and'the current Building code. If you have any question regarding this, pleas-616ume know.. Sincerely, ogCFE53t e�a�GHING Fy Chia-Ching Lin; P.E. 4574 1:1 Chablis Court Fremont,CA 94539 { �S'f7 CIV p�r23 /�q • � FG CH1A-CHING LIN 45741 CHABLIS COURT FREMONT,CA 94539 TEL:5105868380 CfHA-CHNG LIN, P.E. May 15, 2012 City of Cupertino 10300 Torre Avenue Cupertino, CA 95014 Dear Sir or Madam: This letter mainly is to notify you that I, Chia-Ching Lin, P.E., have inspected the installation of the epoxy hold-down bolts of shear walls to existing foundation for the addition of the single family house located at 921 89 Lindy Lane, Cupertino, CA. The preparation of the drilled hole for bolts is found conforming to the requirements by the Simpson and standard construction practice. The size and depth of holes are adequately drilled and prepared and the holes are air blown clean and ready for epoxy hold-down bolt installation. The epoxy hold-downs were installed per Simpson's guidance. The epoxy hold-down bolts were adequately installed and acceptable. If you have any question regarding this, please let me know. Sincerely, �Q40fESS/pp'� a'� CHINO � v 's ce w. W P'1 y� 1J9. I! f 'lf OF CAUA��� Chia-Ching Lin, P.E. . . . . . . . . . . . . . . . . . . . . . . . . . . . .