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10100212 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22371 SANTA PAULA AVE CONTRACTOR:ARGONAUT WINDOW& PERMIT NO: 10100212 DC AOR,INC OWNER'S NAME: PRATEP PAREKH 1901 S BASCOM AVE STE 800 DATE ISSUED: 10/29/2010 OWNER'S PHONE: 4089960735 CP MPBELL,CA 95008 PHONE NO:(408)378-4018 LICENSED CONTRACTOR'S pDECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL II License Class ii��II Lic.# !� 0 �� REPLACE 13 WINDOWS& 1 PATIO DOOR LIKE FOR LIKE Contractor �}e6(7 IV,t f U[(,W?l4V Date O Z I 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:$7000 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 f which this APN Number:35704060.00 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 DA 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 OM 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 the V granting of this permit. Additionally,the applicant understands and will comply Is:ued byDate: : with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. n RE-ROOFS: Signe Date I D I [' Al I roofs shall be inspected prior to any roofing material being installed.If a roof is LEin:tailed without first obtaining an inspection,I agree to remove all new materials for in„pection. ❑ OWNER-BUILDER DECLARATION Si;nature 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 C;ilifornia Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three an iintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: H math&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 ai,contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. w II 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,Sect' s 1>.5505 25 33,a 25534. Section 3700 of the Labor Code,for the performance of the work for which this f (v 2 permit is issued. Owner or authorized a t: te: 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 I iereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. w xk's for which this permit is issued(Sec.3097,Civ C.) L mder's Name APPLICANT CERTIFICATION L-nder'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 1 1 mderstand 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 L censed Professional 9.18. Signature Date CITY OF CL PERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: *VALUATION: 1$7,000 FPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY T 17 SFD or Duplex 1f PENTAMATION 1GENRES USE: �. PERMIT TYPE: WORK SCOPE NOTE. Thesefees are based on the preliminary information avail ible and are only an estimate. Contact the De t or addn7 info. FEE ITEMS (Fee Resolution 09-051 Elf T'1/10) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 13 # Window/Sliding Glass Door Suppl. PC Fee: (F) Reg. 0 OT Fol hrs $0.00 $506.00 I WINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 t."c?ttstrtrc tir�ft 7�/A_ r Acoustical Fee: 0 Yes E) No $0.00 Work Without Permit? 0 Yes G No $0.00 E) Planning f ee: $0.00 Select a Non-Residential 0 Trtr� �x I��r Irfrt�r�Ir�tir�rl ft f,g Building or Structure i Strong Motion Fee: IBSEISMICR $0.70 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.7C $506.00 TOTAL FEE: $507.70 Revised: 10/17/2010 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 / SUB("'ONTRACTOR LIST JOB ADDRESS: 2,2 3 7 C SW—A—z t 4UL,z4: A-VA PERMIT# 6° OWNER'S NAME: I-Z A-rr- or,. PHONE # GENERAL CONTRACTOR: r4,&V--- 4v-rCw, "J, BUSINESS LICENSE # ADDRESS: OF01 s- /3. C C'm gQ 9 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. / T Q 4A I am not using any subcontractors: ' / Z g ure Date Please check applicable subcontractors and c mplete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/ Carpeting Linoleum /Wood Glass /Glazing - w ' �p I,(" Heating Insulation Landscaping Lathing Masonry Painting /Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile sb Z � iG caner Wntractor Signature Date CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec : Twp: Rng: Sub: Blk: I,ot: APN . . . . . . . . : 35704060. 00 DATE ISSUED. . . . . . . : 10/29,2010 RECEIPT #. . . . . . . . . BS000011873 REFERENCE ID # . . . : 10100:'.12 SITE ADDRESS . . . . . : 22371 SANTA PAULA AVE SUBDIVISION . . . . . . CITY CUPER-INO IMPACT AREA . . . . . . . OWNER PRATE:? PAREKH ADDRESS 22371 SANTA PAULA AVE CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-2715 RECEIVED FROM . . . . : ARGONAUT WINDOW CONTRACTOR CHRIS ETTEMA LIC # 22820 COMPANY ARGONAUT WINDOW & DOOR, INC ADDRESS 1901 .3 BASCOM AVE STE 800 CITY/STATE/ZIP . . . : CAMPB3LL, CA 95008 TELEPHONE . . . . . . . . : (408) 378-4018 FEE ID UNIT QUANTITY AMO JNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---- ------ ---------- ---------- ---------- 1BCBSC VALUATION 7, 000 .00 1 . 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 7, 000 . 00 0 . 70 0 . 00 0 .70 0 . 00 1WINREP EACH 8 13 . 00 506 . 00 0 .00 506 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 507.70 0 .00 507 . 70 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 507 . 70 13841 --------------- TOTAL RECEIPT 507. 70 kit 1p (NL VrIQ Jv C\l � , ct � a 3 ob D f- M 3 a '74 cb r- INPUT Resources • AU M. n Dor Air Quality and Finishes 1.Use LowMo-VOC Paint 1 IAQ/iealth pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/-lealth pts y--yes 0 3.Use LowMo VOC Adhesives 3 IAQ/dealth pts y=yes 0 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 6IAQ/-lealth pts y=yes 0 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/dealth pts y=yes 7.Seal all dosed Particleboard or MDF 4 IAO/dealth. pts y=yes 0 B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Res)urce pts y=yes 0 10.Install Whole House Vacuum System 3 IAQ'Health pts y=yes 0 1 1 1 N.Flooring 1.Select FSC Certified Wood Flooring 8 Reso irce pts y=yes 0 2.Use Rapidly Renewable Flooring Materials 4 Reso irce pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Reso irce pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAQ[i"th pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 Reso irce pts y--yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Reso irce pts y=yes 0 1 f 1 Total Points Available: 140 130 57 Total Points Project Received: 0 51 0 (3:data/progs/greenbuildn guidelines/remodelers/greenpointsfina1212.04proteoted.)Js - CITY OF CIJPERTINO CUPEkTINO GENERAL BUILDING PERMIT APPLICATION FORM APN # Date: V Building Address: Mailing Address (if different from building address): Are Hazardous Materials being used as part of this proj(:ct? Yes o ❑ HOA: (Exterior work only) Yes ❑ N If yes, provide letter from HOA Owner's Name: 0 E_ Phone #:,4d C� �� J 3� t. Contractor: Phone: if a' (� l A4o k1-r- w � l L9041 lNif,- Fax: 1 Contractor License#: E K� C s Cupertino Business License#: Z Contact: -ryL Vjl�T,j� Phone: 4o 6 -'; F 491T Fax: - C�:S Residential Commercial ❑ Job Description: L Building Permit Info: Bld Elect ❑ Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ II/IIFV-A ❑ LVIII B, IV-HT, V-B ❑ _ ► Valuation: 061e Square Footage: it 1�7ti Project Size: Express L[d Standard ❑ Large ❑ Major ❑ Green Building: Please complete relevant portion of the Green AuRding/LEED Checklist & attach it to the application or if applicable, include in plan set & the sheet index. Points Achieved: - For help, contact Build it Green at www-buildityreen.orQ Revised 07/14/09 3