14040198 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20051 NORTHWOOD DR CONTRACTOR:BROTHERS HOME PERMIT NO: 14040198
IMPROVEMENT
OWNER'S NAME: WYNNE THOMAS P 2510 DOUGLAS BLVD DATE ISSUED:04/29/2014
OWN=PHONE: 3364093017 ROSEVILLE,CA 95661 PHONE NO:(408)295-0680
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑
F50-17
REPLACE 5 WINDOWS&2 SLIDING GLASS DOORS,LIKE
License Class to '✓C r'7 Lic.# 9106FOR LIKE&SAME LOCATIONS(WILL MEET EGRESS&
BE
Contractors9U4., Date TEMPERED WHERE REQUIRED BY CODE)HOA LETTER
I hereby affirm that I am licensed under the provisions of Chapter 9 REC'VD
(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:$6518
71 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:31637060 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 18 IT 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 18 �SJE 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
granting of this permit. Additionally,the applicant understands and will c e'
with all non-point source regu ions per the Cupertino Municipal Code,S ction
9 18.
f�+ 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.
R-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(Scc.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 Code,Secflv
5505, ,and 25534. QQ
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized age 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 A,
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 �O
CUPERTINO (408)777-3228 FAX(408)777-3333•building(uD-cupertino.org \
❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERA O /TI ❑ REVISION/DEFERRED ` ORIGINAL PERMIT#
PR07ECr ADDRESSO y�G I N .,,.`g APN# j / L too
OWNER NAME 2S� v+v��vwi PHONE �►,�_ !_of ;,0/-7E-MAIL
STREET ADDRESS CITY, STATE,ZIP a_I -M / �l FAX
CONTACT NAME i �r PHONE IS _7y5-
W�r+�( E-MAIL
STREET ADDRESS Q n -�' CITY,STATE,ZIP %,gi -5 FAX
OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ENGLNTER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAMErt�& 0 LICENSE NUMBER LICENSE TYPE BUS.LIC k
COMPANY NAME 69D E-MAIL ` FAX
WOS
STREET ADDRESS /f Ate
CITY,STATE,ZIP �r-w qp/ PHONE/,oD / iJ ? 7?7
ARCHITECT/ENGINEER NAME LICENSE NUMBER J1J BUS.LICA! (Q L l
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK
5wov, W-<3
Z AM Vo eV< i r-a b Li c_6c�-e_
EXISTING USE PROPOSED USE CONSTR TYPE 1 4 STORIES
USE TYPE OCC. SQ.FT. VALUATION($)
EXISTG NEW FLOOR DEMO TOTAL
AREA AREA AREA NET AREA
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH
[]ATTACH
k DWELLING UNITS: IS A SECOND UNIT []YES SECOND STORY ❑YES
BEING ADDED? ❑NO ADDITION? ❑NO
PRE-APPLICATION ❑1'ES IF YES,PROVIDE COPY OF IS THE BLDG AN []','ES TOTAL VALUATION:
PLANNING APPL k ❑NO PLANNING APPROVAL LETTER EICHLER HOME? `e _&5191
By my signature below,I certify to each of the following: I am the property owner or authori ed agent t the property owner's behalf. I have read this
application and the information I have rovided i ct. I have read the Description of Work and veri it is accurate. I agree to comply with all applicable local
ordinances and state laws relatin cod tract' n. I authorize representatives of Cupertino to enter the abv entifiied property for inspection'purposes.
Signature of Applicant/Agent: Date:all—
SUPPLEb1E AL 2gs!
RM ON.REQUIRED �p� ��x�xYPE s.�=��, ��;�' .xo>:Ixl.�c�si��
New SFD or Multifami wApplyfor demolition permit for
L� OVER- FIF CQ SER 3 0421 BDexisting building(s). Demolition permit is required prior to issuance of building t �� M . �permit for new building• EaPR SSLA UNlr��s3�
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure s= saRn �: UBLIC�oRKs
form if any Hazardous Materials are being used as part of this project. PENN—
HIM �
Copy of Planning Approval Letter or Meeting with Planning prior to 2 m,
su_bmittal of BuildingPermit application. ' ® >+ o A ItYSEw>R�IsrlucT
0
00
ORIO
. � ❑.. IR'OT911EI\TL"HEALTH
BldgApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 20051 NORTHWOOD CIR DATE: 04/29/2014 REVIEWED BY: MELISSA
APN: 316 37 060 BP#: *VALUATION: 1$6,518
xPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY Building is PENTAMATION
USE: Multi-Family Dwelling >3 Stories 0 Yes Q No PERMIT TYPE: 1GENRE
WORK REPLACE 5 WINDOWS &2 SLIDING GLASS DOORS LIKE FOR LIKE & SAME LOCATIONS WILL
SCOPE MEET EGRESS & BE TEMPERED WHERE REQUIRED BY CODE) HOA LETTER REC'VD
. - �
9ee:,r. P!an f r87c.
Numb,pho-1 t`hec/ I t�c.Ilan C"hxri
F7111,
f:c-,i. P",-mit Fee: Pkrmb. Pe rm t FeFr:
ttex laz>r3.
/'."c., P,rWnh. Ins!". Fee: l fee.?nit, t'ec
NOTE.This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . Thesefees are based on the prelhiniina information available and are only an estimate. Contact the Dept/or addn'l info,
FEE ITEMS (&e Resolution 11-053 E f 7/1113) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 # Window/Sliding Glass Door
Suppl.PC Fee: Reg. ® OT 0.0 hrs $0.00 $418.00 1WINREP Replacement
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Fee-.(E) Reg. Q OT 0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
{.CIte:m'ZIcfion 7'47X.
Work Without Permit? 0 Yes (F) No $0.00 E)
Advanced Planning Fee: $0.00 Select a Non-Residential G
%i�cr3��L L)r�c:rrrerafcarirut lees: Building or Structure
Strong Motion Fee: IBSEISMICR $0.65 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
$1.651 $418.00 TOTAL FEE:,,. $419.65
Revised: 04/01/2014
NORTHPOINT HOMEOWNERS ASSOCIATION
PROPERTY MODIFICATION NOTICE
Please indicate below which modification(s) are planned for your property. Provide
brochure(s) if possible and a copy of any proposal(s), including the contractor's
license number. Any modification not expressly listed herein, or not conforming to
the restrictions and requirements listed herein for that modification will require an
Architectural Review Application to be submitted to the Grounds and Architectural
Committee and the Board of Directors for approval. Satellite Dish installation has a
separate form to be completed and submitted for approval.
Modification Restrictions and Requirements
Air conditioning unit Unit will be designed for quiet
residential use. Unit will be
located within the enclosed yard
of the property. There will be no
part of the unit visible to common
areas. Installed by a licensed
/ contractor.
v Replacement window/ Must be same size aperture and
Sliding door location of existing window or sliding
door. Any necessary touch-up
lt,m� painting is the responsibility of the
Homeowner. Installed by a license
T" contractor.
Garage door Must be windowless and in conformity
with general architectural style of the
complex. Repainting to conform to
exterior color scheme is responsibility
of the Homeowner. Installed by a
licensed contractor.
Any damages caused to property as a result of modifications will be the homeowner's
responsibility. All prohibitions, restrictions, conditions, and rights of the Association
enumerated under Article V of the amended and restated Covenants, Conditions and
Restrictions of the Northpoint Homeowners Association are applicable to modifications
Contained herein. City permits may be required.
Please Print '
Homeowners Name(s): �/ ly1 x /�l4 �!� 1/1004 axJr
Property Address: 2y �/ ��)/:!O t WOOD Phone: 33 to 7,03 e9e,%V
Date of Notification: Date of Completion:
Homeowner has 6 months to complete the designated modifications and is responsible for
notifying management upon project completion.
ice Use Only
Notification received by: Date:
Completion verified &appr ved by: Date:
Form adopted 8/10/1999 Revised 5/00
r2gicolAi ulezc� t &
PLAT PLANS
CHECKED BY. l
DATE
PtANINING DEPT.
OATEC'O
�y. Z�
_ c
H1,1N;. DEPT
COMMUNITY D"'PLOP!,AE 7!;_7A7^7.1',ENT
X BUILDING DI'Vi:,lo!':- t1`' ;No
Thisqp.t of plans and spec`c< n MUST he kert
joie site during cot?structiIt i%unlavvf d t(-,
changes or alterations an:>3me,or to(7:+1VI-11a
therefrom,without approval frorn the E3 ii Jio��C`•} i`i .l.
The stamping of this plan andsa.:aSHALL NOTificatians v,...
be held to per or to
of any r s o «nce or uta.�W Law.
DATE
PERMIT NO. REC V
ED
APR 2 9 014
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$fes°1�ra�ts 79 Yt6�rT-
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