13060178 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 22744 MAJESTIC OAK WAY CONTRACTOR:SGK HOME SOLUTIONS, PERMIT NO: 13060178
INC.
OWNER'S NAME: WILLIAM WOODARD TRUSTEE 3801 CHARTER PARK CT STE B DATE ISSUED: 11/18/2013
OWNER'S PHONE: 6504657229 SAN JOSE,CA 95136 PHONE NO:(408)264-6964
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIALE]
License Class Lic.# REMOVE&REPLACE 5(E)WINDOWS& 1(E)SLIDING
DOOR,SAME SIZE&LOCATION(EGRESS&TEMPERED
Contractor Date WHERE REQUIRED)
I hereby af trm that I a licen d under the provisions hapter 9
(commencing with Section 700 )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
Craveation,as provided for by Section 3700 of the Labor Code,for the
nce of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:54690
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:34232120.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the aboveinformation is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN/V80 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 F�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
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date:
with all non-point rce reAplations per the Cupertino MuniciWCode,9.18.
RE-ROOFS:
Signature DateAll 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-BUIL DER 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
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)
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 nd
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,SectiqUY255q5,A533,and 25534.
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
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 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 a�cupertino.org ` -J
[:]NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED \ORIGINAL PERMIT#
PROJECT ADDRESS .,�-2 -AIV
AAPPN# �Ty(��7/ Z_i — r Z_
OWNER NAME / / �/1/ �✓ PHONEC% -- (/J Com/ E-MAIL
STREET ADDRESS CITY, STATE,ZIP FAX
CONTACT NAMEV A , P a � E-MAIL
STREET ADDRE::,:�]W Z TTY,ST FAX
❑OWNER 13 OWNER-BUILDER: ❑ O AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR N ENSE NUMBE LICENSE T BUS.LIC#
COMPANY NAME r'(. E-MAIL FAX
STREET ADDRESS /�``�� CITY,STATE,Z PHO
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAII, FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
t
DESCRIPTION OF WORK
EXISTING USE 1 PROPOSED USE CONSTR.TYPE #STORIES
USE TYPE OCC. SQ.FT. VALUATION($)
EXISTG NEW FLOOR DEMO - TOTAL
AREA AREA AREA 1 NET AREA
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH
ATTACH
#DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES
BEING ADDED' ❑NO ADDITION? ❑NO
PRE-APPLICATION [3 YES IF YES,PROVIDE COPY OF IS THE BLDG AN 13 YES TO
PLANNING APPL# ❑NO PLANNING APPROVAL r HITER EICHLER HOME? ❑NO
F :..•`
By my signature below,I certify to each of the following: I am the property owner or authori n on the propertygo— is behalf I have read this
application and the information Ihave rovid correct. I have read the Description of Work and verify it is accurate. I agcomplyithall applicable local
ordinances and state laws relating ui I g truction. I authorize representatives of Cupertino to enter the above-i ntiopeerty r in ection purposes.
Signature of Applicant/Agent: Date:
SUPPLEME TAL W ORMATION QUIRED '
_New SFD or Multifamily dwellings: Apply for emolition permit for g ouNT� Uu DnvcraNitEcvv
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. ❑,EIiPItESS CI PLANNINo.E> 1N REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials DisclosureAiin C� C1LtC woxls ;
form if any Hazardous Materials are being used as part of this project.
LAKGI. .EIRE DEPT
Copy of Planning Approval Letter or Meeting with Planning prior to
submittal of Building Permit application. Q MAJOR ` SANTfARYSEKERDISTRICT
134--, HEALTH
B1dgApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 22744 MAJESTIC OAK WAY DATE: 06/21/2013 REVIEWED BY: MELISSA
APN: 342 32:11M BP#: *VALUATION: 1$4,690
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY PENTAMATION
USE: SFD or Duplex : PERMIT TYPE: 1GENRE
WORK REMOVE& REPLACE 5 E WINDOWS & 1 E SLIDING DOOR SAME SIZE & LOCATION
SCOPE (EGRESS &TEMPERED WHERE REQUIRED)
MN
_..
5 a 4
_ A
o `3
N&ch.Plan Check Plumb.Plan Check Elec.Plan Check
.tfech.Permit Fee; Plumb.Permit Fee: Elec.Permit Fee:
Ocher.1fech.Imp. Other Plumb Insp. Other Elec.Insp. Li
Vech.Insp,Fee: Plumb. Insp.Fee: Elec.Insp,Fee:
NOTE:This estimate does not include fees due to other Departments(ie.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . Theseees are based on the prelimina information available and are only an estimate. Contact the Dept for addn'1 info.
FEE ITEMS(Fee Resolution 11-053 E . 7/1112) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 = # Window/Sliding Glass Door
Suppl.PC Fee: (E) Reg. 0 OT0.0 hrs $0.00 $400.00 1 WINREP Replacement
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Fee-0 Reg. 00T. 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Construction Tem- F-1
Administrative Fee:
Work Without Permit? 0 Yes (j) No $0.00 0
Advanced Planning Fee: $0.00 Select a Non-Residential 0
Building or Structure
Trawl Uvclttnentution Fees: Building
Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
Bldjz Stds Commission Feer IBCBSC $1.00
$1.50 $400.00 ,a `_� $401.50
�. Revised: 04/29/2013
P.1
Print https:/lus-mg204.mail.yahoo.com/neollaunch?.rand=5vi74aho5lcq...
Subject Fw: Westridge Country Club Homes
rrnm Alice Wichman(wichmanal@yahoo.com)
To: evansprague@hotmail.com;
Date: Monday, June 24,2013 3:52 PM
Hi Evan,
Here is the approval from the Westridge HOA to get the Permit.
Thanks,
Alice
----Forwarded Message-----
iFrom: Pauline Moore <PMoore@communitymanagement.com>
To: Alice Wichman<wichmanal@yahoo.com>
Sent: Monday, June 24, 2013 3:06 PM
Subject: Westridge Country Club Homes
TO WHOM IT MAY CONCERN:
This will confirm that Alice Wichman of 22744 Nbjestic Oak, Cupertino,CA 95014,has the permission
of the Board of Directors to replace all the windows at her home,by a licensed and insured general
contractor,as the application for permission meets the guidelines of the Association.
Pauline
Pauline Moore
Senior Association Manager
CN4S,Inc.
1935 Dry•Creek Road
Campbell,CA 95008
408-559-1977
408-559-1970(FAX)
I Of 1 11/15113 2:32 PM
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