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13070133 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21980 OAKNOLL CT CONTRACTOR:FIVE STAR WINDOWS PERMIT NO: 13070133 OWNER'S NAME: MUKESH&SEEMA GARG 1450 DELL AVE STE C DATE ISSUED:07/22/2013 OWNER'S PHONE: 4087778506 CAMPBELL,CA 95008 PHONE NO:(408)370-3331 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIALE] REPLACE 2(E)SLIDING GLASS DOORS& 1 (E)WINDOW, License Classl ( (� Lia# ��ZQ'� SAME SIZE&LOCATION Contractor Date.. ZZ 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 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:32639010.00 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 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 DAYS FROM LED 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 Z'7j granting of this permit. Additionally,the applicant understands and will comply Issued Date: 13 with all non-point s e regulations per the.Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signatu a ZZ 3 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. ❑ OWN 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. 1 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 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety ETRUCTION 5505,25533,and 25 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Owner or authorized Date -71-ZZ-1 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 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 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 h 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 GUPtRTIAEO 1 (408)777-3228•FAX(408)777-3333.build ing(a)cuoertino.org f ❑NEW CONSTRUCTION [:1ADDITION ❑ALTERATION/n ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS ,Z`a'6D ©mac, �� APN# 3 '7 //p' , -39 OWNER NAME Z 1 � PHONE L� ('Q�� E-MAII STREET ADDRESS �V1Q t r CITY,RATE,ZIP t FAX CONTACT NAME + ` l PHON L� E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR 1ILICENSE NUMBER LIC SE TYPE BUS.LIC# COMPANY NAME r j E-MAIL J FAX STREET ADDRES c C TATE,ZIP C r PHONE ARCHITECT/ENGIN`EER NAME LICENSE NUMBER \ V�`- BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK EXISTING USE I PROPOSED USE CON'S TR-TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NETAREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA EIDETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY- ❑YES BEING ADDED? ❑NO ADDITION? ONO , PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES -:BYE" - ,; � TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LEITER EICHLER HOME? ❑NO ' By my signature below,I certify to each of the following: I am the property owner or authorizella7aent to act o operty owner's behalf. I have read this application and the information I have, 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 relatin a tion orize representat o pertino to enter the above-identified property for inspection purposes._ SignatureofApplicant/Aee ate: ZZ SUPPLE NT ORMATI UIRED _mak: - Q mraie CHECK YPE. - OiTiTI1 � —New SFD or Multifamily dwellings: Apply for demolition permit forL � THIrCO_U TER A BUILDINGFLANRE - existin buildinag(s). Demolition permit is required prior to issuance of building permit for new building. P ,: a•1J�Pii>•;s � '� P T�vc PLA-n�v�w}� Commercial Bldgs: Provide a completed Hazardous Materials Disclosure — g P form if any Hazardous Materials are being used as part of this project. z e}RG �aC3FIREEAEP _Copy of Planning Approval Letter or Meeting with Planning prior to R � submittal of Building Permit application. � � E sr" � ''"`"� '-- 'm i1'YIROIVNIEhTA ,HEAIT'II -: ' BIdg.4pp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 21980 OAKNOLL CT DATE: 07/22/2013 REVIEWED BY: MELISSA APN: 326 39 010 BP#: 'EVALUATION: 1$7,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Duplex PENTAMATION 1 GENRES USE: p PERMIT TYPE: woRK REPLACE 2 E SLIDING GLASS DOORS & 1 E WINDOW SAME SIZE & LOCATION SCOPE Pkvn CYeo"- Irl"€dwb,Pki pt Check I"on,Ch'o£;'. ;'tech,Permit free: Per alit P`i€;: isle(-Petrrah FCC: tJrl ar;i feci?. Ir:',f>. 07-- 0Aer-1 hor ?h frn!.; olhe€1 YW%Ins;p, s„.•r flat ib.ImP,Fe'e: NOTE.This estimate does not include fees due to other Departments(i.e Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These&es are based on the prelimina information available and are only an estimate. Contact the De t or addn yin o. FEE ITEMS (Fee.Resolution 11-053 fff. 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F-37 # Window/Sliding Glass Door Supp/.PC Fee: Reg. ® OT 0.0 hrs $0.00 $418.00 1 WINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Supp/. Insp.Fee Reg. 0OT0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Constr uc tion 7.av Ac ministr a i ve°Fee: Work Without Permit? 0 Yes (E) No $0.00 0 Advanced Planning Fee: $0.00 Select a Non-Residential Building or Structure Ci•cx�•eC lirt�;•urrae;ratcatrt�rz.f�'c�ts: 0 Strong Motion Fee: IBSEISMICR $0.70 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 3 $1.70 $418.00 $419.70 µ Revised: 07/01/2013 Shining Above The Competition Family Owned and Operated Since 1983 �G � 1450 Dell Avenue, Suite C, Campbell, CA 35008 1' 1 Te1408-370-3331 Fax 408-370-3110 License#628381 www.fivestarwindows.com DATE: 7��� j� 3 JOB NAME: T' ENS N�oN�arGk�sr Fe�\,o.aabs s6�,oe�\dee r elm 393 xvGoM o "e � �&� �`oa ue01 ,a;� u Pians \. o� cprs�c t� 40 -�`sse e°d�«c� o�a\era p�°.Ia\\C c\t` t� e�\o\a a.N n 1°b 5\c��'�`�'es \�h°��a� a�a she o{ ok���s P\ a,°e a r c6��ar°e IVI® �3 s �3 'oe re C°v\5�O 0 o{any p No. CU ���IN�nt t� � 'Idin9 Qepattm I Lo--m AUL 2013 �-� D�rypl.1ANG X09 CUp�C 42eviewed BY ScaP C5= �Vp l p1.P►�� OFFICL' k�v- pL I1�6 DEpT. ,tom=• P Dever Promising More Than We Can Deliver. Striving To Deliver More Than We ProiTuse.