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15050023 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10340 LOCKWOOD DR CONTRACTOR:HOLDER INC DBA ABLE PERMIT NO: 15050023 GLASS OWNER'S NAME: SU JOHN T AND JEAN K 850 ALDO AVE DATE ISSUED:05/05/2015 OWNER'S PHONE: 4084065129 SANTA CLARA,CA 95054 PHONE NO:(408)496-9960 JOB DESCRIPTION:RESIDENTIAL F] COMMERCIAL LICENSED CONTRACTOR'S DECLARATION REPLACE 15(E)WINDOWS&2(E)SLIDING GLASS License Class `'' Lic.# �D DOORS,WILL MEET EGRESS&BE TEMPERED WHERE � REQUIRED BY CODE Contractor 1 ( -C Date 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:$9325 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:34215051.00 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 NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 O + T ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter ALLED INSPECT O upon the above mentioned property for inspection purposes. (We)agree to save 180 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 comp by' with all non-point source re a'ons per the Cupertino Municipal Code,Section e- 918. 6lrr�i RE-ROOFS: Signature Date r a,_ 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. ❑ OWNER-BUILDER DECLARATION Date: Signature of Applicant: 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 Cupe o Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 2 533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this 400"ft Date: Owner or authorized agent: 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 "CONSTRUCTION LENDING AGENCY Compensation laws of California. If,after making this certificate of exemption,I 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 918. Signature Date v� CONSTRUCTION PERMIT APPLICATION (� COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION r 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 / u (408)777-3228• FAX(408)777-3333•building(a7cupertino.org CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# P: 1'0 RES S W C 0 /14�✓L' APN 7 L/ OWNERNAME O lyti S ON) �Q1 25 /^� E-MAIL STREET ADDRESI I I n� - / s rZAAn_ C. Crry, STATE,Z �J `/r ( / FAX CONTACT NAME^_.6' 40 to p� 74 E r`'G �GI STREET ADDRESSq /� C QU ' C TAN,ZIP C V �� FAX IJnCIJ ❑'-OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT . ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CO L RNAMETN` 013A �i-/ LICENSE / L� SET BUS.LIC# COMPANYN �G 1L ,t' E M.AIIx l�C � (' FAX STREET Al� J b , CIT TE,ZIP �!n A 1 q? ,{ C 71 7�O ARCHITECT/ENGINEERNAME LICENSENUMBER ( C T BUS.LIC 9 7(O COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRiP��OFyT 1 L_? ` ( y �-,e /_e C N lP i EXISTING USE PROPOSED USE - CONSTR TYPE #STORIES USE TYPE OCC. SQ.I7. VALUA'T'ION(S) EXISTG NEWFLOOR. .DEMO TOTAL AREA AREA AREA NET AREA BATHROOM. KITCHEN. OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA: DELACH ❑ATTACH 4 DWELLING UNITS IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEINGADDED? E]NO ADDITION? ❑NO PRE-APPLICATION G APP ON ❑YES IF YES,PROVIDE COPY OF THE BLDG AN P. s ,� -. -.•� x �it.:� TOf ALUATION: PLANNING ADPL 4 ❑NO' PLANt�'IIdG APPROVAL LETTER EI -� - � - i,'�, ``�/`C7/S By my signature below,I certify to each of thVfng', I am the property owner or authorized agent �property owner's behalf. I have read this application and the information I have providI have read the Description ofWork an is accee to comply with all applicable local ordinances and state laws relating to buildingon. authorize representatives ofC. nter the abl ed erty for inspection purposes. Signature of Applicant/Agent: Date: �� ! SUPPLEMENTAL INFORMATION REQUIREDSE P �cicxlT�PEL New SFD or Multifamily dwellings: Apply for demolition permit for F o �'� OVER iB�COUhTER * BUIIDII\GPL,fs7QREVIE�Vr � existing building(s). Demolition permit is required prior to issuance of building _ �r permit for new building. F��E mss z � " ❑��P 'r -p k�, r �v1NI� GPLAI�REVLEw'I c _ al Commercial Bldgs: Provide a completed Hazardous Materials Disclosure €Q k form if any Hazardous Materials are being used as part of this project. � � rN { �, _Copy of Planning Approval Letter or Meeting with Planning prior to >sa �" x' `per submittal of Building Permit application. t� oR$j Ri 3 � sAi\ aY u RnlsrRlcr�r Y BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FVFEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10340 LOCKWOOD DR DATE: 05/05/2015 REVIEWED BY: MELISSA APN: 342 15 051 BP#: -VALUATION: 1$9,325 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Repair PRIMARY �PENTAMATION1GENRES USE: SFD or Duplex RMIT TYPE: i WORK REPLACE 15 E WINDOWS &2 E SLIDING GLASS DOORS WILL MEET EGRESS & BE SCOPE TEMPERED WHERE REQUIRED BY CODE Hec:h. Plan Check Phuld). Plan Chceli Flec.Piave Check blech.Permit Fee: 111?4mb,Pernit Tree: Islet. Permit Fee: Other A1c;cdt. IvrsTr. CT OtherPlumb InsTz Lj 07her Elec.Insp. Li -Wcch hul). hee: Pharrab.hrsp. Fee: t lcc.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These fees are based on the prefimina information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/131 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 17 # Window/Sliding Glass Door Suppl. PC Fee: ) Reg. Q OT 0.0 hrs $0.00 $717.00 1WIIVREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee-.(F) Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 t;onstruction Tax: Administrative Fee: Work Without Permit? 0 Yes E) No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential G Building or Structure 0 Travel l?ocuinenialion fees: Strom Motion Fee: IBSEISMICR $1.21 Select an Administrative Item Bldy Stds Commission.Fee. IBCBSC $1.00 SUBTOTALS: $2.21 $717.00 TOTAL FEE: $719.21 Revised: 04/01/2015 CXCN= 19*i2oy-A,�g Vly,6� X0 u (to o-r T-o -9 (Z) -A IVIS Go ox 0 1(Yq,b KL "X0 T�M fo L(Al LOT � �,o")Ly DEPARTtvIENTO Z�,o )(0 VA%4jjt,4JTy DEVELOPM ENT pERTINO 131JILIDING DIVlSiON CU APPRoVED (10)WWD'sw� DAP,,mmm -,A;s Set of plans 3-,,d specifications jjUST be kept at the during it is un!a,,%;fuj to make any job Bite or to deviate changes of �jjterations on same, i6al. -l'-'!-;! approval from the Building Off V tz;W t4.�e f bt Uk, c- e therefrom. wW SHALL NOT �' ;tarnping 0 �nj� pllan and V1, rtl,�-o 4&j uvr h P� - Of the Violation be held to pew,,-M State Law. 9�eCKED BY P �PLA � WS . 7-C�t/`P(S�C'� �i r of a e-- tA)Wfe (rZQ Lk t'r-1?0 0 1 E 'ERN-11- PLANNING DEPT CUPERTINO Jo t4 S L4 610 U W 6 r07(to to �&Yo AtU J,9 1 0 xy o CupESIN® F2 IkD 1, easc-Tel 3uildin4 nan��Pnt ��nfauM ; '`, Y p 5 2015 =06o6o( Rev1eed By A l'0" X6 ro"xys C-7 Whi Dcswc lAgWl,rcrr-