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14070135 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22722 MAJESTIC OAK WAY CONTRACTOR:LAU HUNG W ANTH PERMIT NO: 14070135 OWNER'S NAME: LAU HUNG W ANTH 475 GUADALUPE DR DATE ISSUED:07/30/2014 OWNER'S PHONE: 6509492250 LOS ALTOS,CA 94022-2109 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL REPLACE 4(E)WINDOWS& 1 SLIDING GLASS DOOR, License Class Lie.# LIKE FOR LIKE(ALL TO MEET EGRESS&BE TEMPERED Contractor Date WHERE I hereby affirm that I am licensed under the provisions of Chapter 9 REQUIRED BY CODE) (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:$3150 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:34232125 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 ED 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 3 d C Date: granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the 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. 100 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 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: n permit is issued. lA F 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 112 4 Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 �b EUPERTIhlO 1 (408)777-3228• FAX(408)777-3333•Wiciino(c cuoertino.oro ❑NEW CONSTRUCTION ADDi7I0N ❑ALTERATION/11 REVISION/DEFERRED ORIGINAL PERMIT# PROTECT ADDRESS A3N 3 4 2 `32, 112-00 ,2 2722 j4A I rec 4f w /'t OWNERNAME UPRONE E-MAIL STREET ADDRESS CITY,STATE,ZIP r AX CONTACT NAME PHONE E-MAIL STREETADDRESS CITY,STATE.ZIP FAX ORR.'ER oxh,M BUUME t OWI.'£R AO_Nt I3 CONTRACTOR CI CONTRACTOR AGENT © RAG'S--CT 0 3wvGIA1✓TR ❑ DEvELOPER ❑ TENANT CONTRACTOR NAME LICENSE 111,I.4BER LICENSE T1TE BL'S.LIC R c nl - ,Gtc r7 .�06 6 ( -,,7f33 COMPANY Na114E FAX V/ (.J WiN.�W -,1 ad ! C- •Lv STREET ADDRESS d Ci"iY,S7A7E ZIP PHOI�i • � ,., f tc O Z9 77 ARCHITECT1EN1,V,7E-r.R NAI•:E LICENSE NL•MBER BUS.LIC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY.STATE,ZIPPHONE DESCRIPTION OFO �iV S E be Ll�� 1 a a 4G 1 N1700JI •S x& 2 ! 7C E/V W iA/ -rKro All tA s �n/ Li 3 3 'x �-G 4 2.rvo 0' W/W40W 70 >rrr EX STING USB PROPOSED USE I CONS TNIFF #S o=S USE TYPE OCG I SQ.FT. VALUATIONS) EXISTG A'£w FLOOR DEMO TOTAL NET AREA AREA AREA AREA BATHROOM K1TC OTHER REMODEL AREA REMODFIL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKMORCH AREA I GARAGE• PETAACH DWBLLC4GATr UNITS: rSASECONDUNIT ❑YES SECONDS70RY DYES BEING.ADDED? NO ADDITION? nNo -Pim-APPI3C-aTION �a Es-1F S,PROvm�r ry OF _�_ISSH£BLDG tR I-1 YES TOTAL VALUATION: PLANNING APPL R ©NO PLANNING APPROVAL LETTER EICHLER HOME? CIN 3 CS ate _ By my signature below,I certify to each of the following: I am the property owner or authorized agent to , 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 verifFit is accurate. I Mee to comply with all applicable local ordinances and state laws relating to building constructio, I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Sisnature of Applicant[Agent: Date: Z SUPPLEMENTAL ITORMATION REQUIRED . _New SFD or Multifamily dvuellings: Apply for demolition permit for "��` � � N} Pp Y P covxrEx ���I�er �.tt£�»tvr : existing buildina(s). Demolition permit is required prior to issuance of building � 07 � permit for new building. : � x R{ �i�aUBL G 9oRhS _Commercial BIdgs: Provide a completed Hazardous Materials Disclosure , �� an�� � foim if any Hazardous Materials are being used as part of this project. �fr � �� Copy of Planning Approval Letter or Meeting Arith Planning prior to submittal of Building Permit application. � Bld&4pp�2011.doc revised 06/21111 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ILI ADDRESS: 22722 MAJESTIC OAK WAY DATE: 07/30/2014 REVIEWED BY: MELISSA APN: 342 32 125 BP#: 'VALUATION: 1$3,150 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Du lex PENTAMATION 1GENRES USE: p PERMIT TYPE: WORK REPLACE 4 E WINDOWS & 1 SLIDING GLASS DOOR LIKE FOR LIKE ALL TO MEET EGRESS & SCOPE BE TEMPERED WHERE REQUIRED BY CODE) -, , Fete: 1'1rrrltb. Pc"mit Pee, 1 f i<x,<,. t},ltc i,e c6:, t;,,;r; CJtltvr1'Iurnh Ins°p. <:il,ar I+< Irt t. 1'hollb 1"Isp, Fee: NOTE: This estimate does not include fees due to other Departments('tie.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 Ef. 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 0 # Window/Sliding Glass Door Suppl. PC Fee: (F) Reg. 0 OT 0.0 hrs $0.00 $431.00 1 WINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee: Reg. () OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? 0 Yes (F) No $0.00 Advanced Plal�ee: $0.00 Select a Non-Residential Building or Structure 71'eb t'l I>tir t r?csadttztzon Feces: � Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldy,Stds Commission Fee: IBCBSC $1.00 I B � $1.50 $431.00 TOTAL FEE• $432.50 rc � ,. „. Revised: 07/10/2014 y OWNER-BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•building(@cupertino.org Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SITE ADDRESS / Z2 22 c ® 1C LW,q <-ef �tf APN Z 2-—12�-�J Bt' a�10 13-5 OWNER NAME OWNER ADDRESS OrXAL DESCRIPTION OF WORK: Jw We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS:Please read and initial each statement below to signify you understand or verify this information.) 61. 1 understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- ui der' building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. &. 2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. 3. 1 understand as an"Owner-Builder" I am the responsible party of record on the permit. I understand that I may pr ect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. .,4, 44. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. an California licensed Contractors, and the tots value of my construction is at least five hundred dollars($500), including labor and materials, I may be considered an "employer" understate and federal law. 6. 1 understand if I am considered an"employer" under state and federal law, I must register with the state and Craede I government,withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. 4-47. 1 understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 8. 1 understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s)that result from any latent construction defects in the workmanship or materials. OwneYBuildeYForm 2010.doe revised 04/14/10 i ��9. 1 understand I may obtain more information regarding my obligations as an"employer"from the Internal 'Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. �10. 1 am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the site address listed above. 11. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide y all applicable laws and requirements that govern Owner-Builders as well as employers. 4&12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS:Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued,this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note:A copy of the property owner's driver's license, form notarization, or other verification acceptable o the cit ip5ly be required to be presented when the permit is issued to verify the property owners signature. Property Owner's Signature: Date: J 2m/ ---------------------------------------------------------------------- ---------------------------------------------------- ---------- (NOTE: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner,the execution of which I understand is my personal responsibility, I hereby authorize the following person(s)to act as my agent(s)to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project(or Description of Work): Project Location or Address: Name of Authorized Agent: Tel No Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note:A copy of the property owners drivers license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature- Date: OwneYBuildeYForm 2010.doe revised 04114/10 Building Department City Of Cupertino LM 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:22 ,ZZ M is6#4 VJ4V PERMIT# OWNER'S NAME: ,i, PHONE# 22 J GENERAL CONTRACT R: 097k BUSINESS LICENSE# ADDRESS: 4 z 2 V€- CITY/ZIPCODE) Ufa= *Our municipal code requires all businesses working in the city to have a City ofCupertino 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. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: t/ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/Glazing Heating Insulation Landscaping Lathing M /itQ�o7.✓ r' urin ✓ Lv Painting/Wallpaper o0 nT Paving t Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date S U hIr CLAS 4 t: ; tau CJ0 t1 CPMENT DEPARTMENT LiLDING,i ,'.i(1N-CUPERTINO l t ,' ;"I" s�r, f!cations MUST be kept at the It is unlawful to make any n y* on same,or to deviate 7 0!Oui 0;.;r�owal from the Building Official. let ` ' .a O ,.i ..•>> n ; 'this nl,^n ane!�;5lc i l a io SL��OT� it r�, tc :! an a proval of the lation -- "y ' Uk o ' Ordinance or Sta a La w. 1 pa Prr{JIT IVO. * --�- -4- t?> J-t4ai ki41) - ~- a E fill FF1 CE i Al/ < � f G9.. k^ j Ai 1 F Q L W aevv `� x _ � � ..•- �.�._e,.e...-�._... _fir-. 7/29/2014 Grommit Webmail::RE:double pane window---22722 Majestic Oak Way. Subject RE: double pane window --- 22722 Majestic Oak Way. From Pauline Moore <PMoore@communitymanagement.com> To Tony Lau <Tonylau@grommit.com> Date 2014-07-2210:26 The Board at its meeting last night approved your application for permission to install new windows at the above address in that it meets the specifications required by the Board. Pauline Moore Senior Association Manager CMS, Inc. 1935 Dry Creek Road Campbell, CA 95008 408-559-1977' 408-559-1970(FAX) From: Tony Lau'[maiIto:Tonylau@grommit.com] Sent: Wednesday, July 02, 2014 10:41 PM To: Pauline Moore Subject: RE: double pane window --- 22722 Majestic Oak Way. Thanks for the reply. Yes,the new windows will open the same way as existing and be approximately the same size. Please let me know if you have further questions. Anthony Lau. On 2014-06-30 17:43,Pauline Moore wrote: Please confirm that the new windows will open the same way as existing and be approximately the same size. Pauline Moore From: Tony Lau [mailto:Tonylau(a)grommit.com] https://grommit.com/roundcube/? task=mail&_action=print&_uid=38544& mbo)c--INBOX& safe=1& eAWn=1 1/2 7/29/2014 Grommit Webmail::RE:double pane window---22722 Majestic Oak Way. Sent: Monday, June 30, 2014 4:02 PM To: Pauline Moore Subject: double pane window --- 22722 Majestic Oak Way. I am planning to replace all the windows and patio door into Energy star compliance white vinyl,double pane windows and door in my townhouse at 22722 Majestic Oak Way. Please present rrry request at the neat Westridge board meeting on July 21,2014 on my behalf Below is the details ofthe project. 1. All windows and door will be Energy Star compliance retrofit replacements in white vinyl without any grids. 2. 2 windows in the living room, 3. 1 window in the second bedroom facing the front, 4. 1 kitchen window facing the back yard,and 5. 1 patio door in master bedroom Any necessary permit fimr the j ob will be applied 8mr before the job com rrences.The windows and door will be the Vista Series fromCrystal Pacific Windows&Door Systems,Inc. The project will be carried out by the licensed and insured contractor listed below. Ifyou need further information fromme,please let me know ASAP. S'unnyview Window & Door 42743 Roberts Ave, Fremont,CA 94538 Phone:(408)888-2977 https://grommit.conVroundcube/? task=nail& action=print&_uid=38544& mbo)c--INBOX& safe=1&_exWn=1 2/2 CUPERTINO Address SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building(a)cupertino.org Permit No. 14 O% 6 13S PURPOSE This affidavit is a self- certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314,2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single - family and multi- family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and /or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel- burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above - referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. I have read and a ree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: ` fir' Sign ture .... ........................ . ...................... ............................... Date:2. ......... Contract 6r Name: Signature.................................... ............................... Lie.# ....... ............................... Date: ................... Smoke and CO form.doc revised 03118114 I�