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13030039 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS:.10082 SENATE WAY CONTRACTOR:CUSTOM EXTERIORS PERMIT NO:13030039 INC. OWNER'S NAME: ALLEN KAY 440 BOULDER CT STE 400 DATE ISSUED:03/08/2013 OWNER'S PHONE: 4088394995 PLEASANTON,CA 94566 PHONE NO:(925)249-2280 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIALI License Class Li,,# 6 REPLACE 9(E)WINDOWS&4(E)PATIO DOORS (HANDOUT Contractor. C`-sf'-' e 0 Date 3 GIVEN,EGRESS&TEMPERED WHERE REQUIRED) 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. Sq.Ft Floor Area: Valuation:$7800 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:32653009.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify than 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 andcounty ordinances and state laws relating WITHIN 180 DAYS O 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 F ST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I a- ate: granting of this permit. Additionally,the,applicant understands and will comply y' with all non-point so r regulations per he 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 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) 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 I haveand will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sectio 2550 ,25533,and 25534. 2 l Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: ! / 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 CONSTRUCTION LENDING AGENCY 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228-FAX(408)777-3333-building(cDcupertino.org �' J ❑NEW CONSTRUCTION ❑ ADDITION ❑ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS f O R `b APN# '. 2 Q©4 OWNER NAME �� n� �r ` PHONE G�-3 O 31 1,� ) EMS �-��¢ A � O o [r i)✓� STREET ADDRESS V O ^a I 1 I CITY,STATE,ZiP�� ^v ii O I \,t FAX n' n CONTACT NAME PHO Z (� E-MAIL` V _ 4 q f'19 C V S f 0 0"^" 1 Q/`I()(-f STREET ADDRESS 1/ (J p 1 F /T CTTY.S h CJ S R i)�/1 CC. / 7��'F�I FAX fl , 4 q 'Z Z/ C.O✓`� ❑ OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER/ ❑TENANT CONTRACTOR NAME US �O 1 LICENSE NUMBS / LICENSE TYPE BUS.LIC C -5 36� C - )�- 0,1 6;�C COMPANY NAME ! g fj / /� m E-MAIL FAX STREET ADDRESS y y D !3 6 V(�{r l/1 LtV� C ��s,ZIn PHZ� z y y Z Z 9,0 ARCHITECTIENGINEER NAME ^/M LICENSE NUMBER V BUS.LIC# COMPANY NAME N/ /I E-MAIL FAX STREET ADDRESS N J!? CITY,STATE,ZIP PHONE DESCRIPTION OF WORKp �/A/ /J / r �9 �c l w � 'l do ) % ;-1 o( G�� oart �o C-1 cr n41 o < a f EXISTING USE PROPOSED USE CONSTR TYPE #STORIFS 11 ,b USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NETAREA BATHROOM KITCHEN OTHER REMODEL AREA REMODELAREA REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEINGADDED? []NO ADDITION? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIV ALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑N � By my signature below,I certify to each of the following: I am the property owner ora o' d agent act o e 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 veriIs accurate. I agree to comply with all applicable local ordinances and state laws relating to building c nstruction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. J Signature of Applicant/Agent: Date: 1 13 SUPPLEMENTALINFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for R-THE COUNTER LDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS 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 B1dgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 100$2:SENATE WAY DATE: 03/08/2013 REVIEWED BY: MELISSA APN: 326 53 009. BP#: *VALUATION: $7,800 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY PENTAMATION 1GENRES USE: SFD or Duplex PERMIT TYPE: woRK REPLACE 9 E WINDOWS &4 E PATIO DOORS HANDOUT GIVEN EGRESS &TEMPERED SCOPE WHERE REQUIRED) 11ech.Plan Check Plumb. Plan Check Elec,Paan Check "Week Permit Fee Plumb.Permit Fee: Ekx.Permit Fee: C)ther:llech:Insp. E)(her Plumb Insp. Li I tlrer Elec.InsLi P. :Meeh.Ins p.Fee: . Plumb. hrsp.Fee: Elec.Insp.Fee: 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 based on therelimina information available and are only an estimate. Contact the Dept-for addn'l info. FEE ITEMS(Fee Resolution 11-053 E . 7�{ /1112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 13 # Window/Sliding Glass Door Suppl.PC Fee:. (E) Reg. Q OT 0.0 hrs $0.00 $533.00 1WINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee-.(E) Reg. Q OT 10,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction :Tax. A d7ininistrativ Fee: Work Without Permit? 0 Yes No $0.00. E) Advanced Planning Fee: $0.00 Select a Non-Residential E) Building or Structure 0 Travel Documentation � � Strong Motion Fee: IBSEISMICR $0.78 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 $1.78 $533.00 v $534.78 Revised: 01/01/2013 x k Floor Plan Drawing (for Permits only) PLOT PLATS CSECKW BX MIC �Vt���r �Qcn<�� sCo PLA NGEP'� OC vo'rti. DATE C> IRLDG. DFPT XO Sr-'P 610 6• 3 �0D fo'Dr UP a, 7e,,, �, ERT1N0 a OK S ? � ilding Department dxs�� 610 MAR 081013 6 REVIEWED� T OR CODE COi'v! !J,'N'!-�r Dr:.r: COMPLIANCE SJILCI,d; C.lVI ii✓ r • A!)�NT Reviewed By: This set of Pane and<, ti's rvIUZ _pecificatior be kept at the "i'-: during co! s rL�ction. it' r<tt;ar;!a r;_. ,.• is unlawful to make any ��N a� ' d✓� 1 S 47 I t I /) S u (� A l c al_ r a,Jons on same,or to daviate E pProval from the Building Official. of til"' !^ n d ec spifications SHALL NOT �.,: h is te. 1 F„, s t•.; an aprol of z.'•' rovisi pvaof the vioia: ion City Ordinance or State Law. W o13 PERMIT NO, Q �� IT ICP- — n d c.� ah9 e S L 9!'f,S 7 o 1( CE Building Faces Direction (circle one) N S E � Last Name �.✓ `� Address I p �'Fe� City 6t/«iv wn' � Zf S/�d��y �N 3 Z� 5 3 U oFF'ICE COPY Floor Plan Drawing (for Permits only) IAli ste" a&� etas-��i3� ox s� vo tIg I�j e cS roc c 1 D� CupanirlDePa(tent 0 ?u n • 7 3 3) iidin MA .9 R 0 8 2013 REVIEWED AOR CODE COMPLIANCE Reviewed By: CE 1 Y!R'Zc( Building Faces Direction (circle one) N S E-G Last Namecc yOEM Address 10&3Z SeA-L0-je ( — copi�" . Cit -t, n ' �1L��d�j✓ = _ 9 -`. :,,Building Department City Of Cupertino 10300 Torre Avenue `'`Cupertino,CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR..LIST JOB ADDRESS: PERMIT OWNER'S NAME: A( ern tC a PHONE# 'L.- Z\-t°7 Z 7_18 D GENERAL CONTRACTOR: C„ {� ,, �r ;0/'�' BUSINESS LICENSE:#: o h -( P ADDRESS: v((' I�o✓l [ �F`•((1v CITY/zIPCODE: e4 o 6 *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 SUBC NTRACT RS HAVEr,,•OBTAINE . _A'CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: ZI Signature Date Please check applicable subcontractors and complete the following information. SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting 2j Linoleum/Wood Glass/Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile r Owner/Contractor Signature Date