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B-2016-2485I CITY OF CUPERTINO BUILDING PERMIT II BUILDING ADDRESS: 10138 MYER PL CUPERTINO, CA 95014-2336 316 CONT CT R. PERMIT NO:B-2016-2485 ( 23 045) JENIICO HAYWARD, CA 94544 OR'NER'S NAME: MARY HIGDON BATE ISSUED:08/10/2016 OWNER'S PHONE: 408-504-1084PHONE No: (866)420-4109 i LICENSED CONIRACTOR'S DECLARATIONCONTRACTOR' BUILDING PERMIT INFO: License Class B: C-39• C-1 G_17 Lie. #972702 Contractor JEMICO LLC Date 05/31/2018 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. hereby affirm under penalty of perjury one of the following two declarations: i. 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. I have and will maintain Worker's Compensation Insurance, as provided for by S Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION 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 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 with all non -point source regulations �p)er the Cupertino Municipal Code, Section 9.18. Signature i j Date 08/10/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. 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 (See.7044, Business & Professions Code) 2. I, as owner of the property,am exclusively contracting with licensed contractors to construct the project (See.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 1. 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.. 2.. 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 permit is issued. a. 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9Ait1_ – ---- Date 08/10/2016 X BLDG —ELECT —PLUMB _ MECH X RESIDENTIAL DESCRIPTION: i ..ACE 19 WINDOWS, LIKE FOR LIKE (TO; MEET ESS/TEMPERED PER CODE) Sq. Ft Floor Area.,, I Valuation: APN Number: Occupancy Type: 316 23 045 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Kim Dunbar RE -ROOFS: 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: Signature ofApplicant: Date: 08/10/2016 ALL ROOF COVERINGS TO BE CLASS "A” OR BETTER HAZARDOUSMATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino, Municipal Code, Chapter 9.12 -and the health & Safety Code, tions 25505, 25533, and 25534. Owner or authorized agen't:' Date: 08/10/2016 I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed ICUPERTIINO � FINTW CnNSTRTTC..TTC1N CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(@cupertino.org F-1 AnT1TTTnN F-1 AT TPP ATTONT / T[ F-1 RFA7TCTnNT / TIFRFRRRTI nDT!_TATAT DT�U A.AT'P 44 PROJECT ADDRESS APN # OWNER NAME6 r IG� 14,JOA _ ► PHONE g.o% - 50,t— 0,t " (� E-MAIL - - - - - t �d 3 P p STREET ADDRESS01 L t ..CITY, STATE, FAX CA d CONTACT NAME ) ('� �( t� C'ilW4 PHONE, Jr'�' 219 7'^_,I E-MAIL _... STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT .CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER. : ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER X72 LICENSE TYPE tf 7 (r COMPANY NAME 9 A �JE-MAIL 1 -�, b✓1''1 t»Wt fAP�' fs-,FAX STREET ADDRESS ShtjCITY STATE, ZIP PHONE L ARCHITECT/ENGINEER NAME LICENSE NUMB R BUS. LIC # COMPANYNAME E -MATT. FAX - STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK 0 6d — cilL� EXISTING USE - _ - PROPOSED USE - - CONSTR. TYPE # STORIES - - - USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO. TOTALAREA AREA AREA. NET AREA BATHROOM KITCHEN - OTHER - REMODEL AREA - REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA. GARAGE AREA: LJ DETACH - .. F] ATTACH , # DWELLING UNITS: IS A. SECOND UNIT ❑YES SECOND STORY ❑ YES - BEING ADDED? ❑NO ADDITION2 ❑NO. - PRE -APPLICATION Fl YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YE -. "''� TOT VALUATION' PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ~oo FTA By my signature below, I certify fy to each of the following: I am the property owner act on the propertybehalf. I have read this application and the information I have rovided is 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 relating to i ng construction. I authorize representatives of Cupertino to enter the above-'dentifiedgproperty for inspection purposes. Signature of Applicant/Agent: Date: !� SUPPLEMENT INFORMATION REQUIRED C7 o It 'rtaltNrE - It�PtA _ New SFD or Multifamily dwellings: Apply for demolition permit for existing buildng(s). Demolition permit is required prior to issuance of building permit for new building. S Commercial Bldgs: Provide a completed Hazardous Materials Disclosure LtD P LTcwo FIs _ form if any Hazardous Materials are being used as part of this project. A �� Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. BldgApp_2011.doc revised 06121111 uz S V- I E ALARMS 'SMOKE I CARRUN MO N=01 OWNER CE"PICATE OF COMPLIAUGGE COMMUNITY DEVELOPMENTE)EPARTMENT -BUILDING D:IVISIION 10300 TORRE AVEN-.U;E*,CUPERTINO.,CA 95014-32551 C "U V I A TU" I I (408) 777-8228 - FAX,(,408) 777-3383, b.uH,6hq9.cw.ppr.Un6,orcj -e�xf, 4�5` PUR-Post Mis affidavit is a self -certification for the installatioi L of all required Smoke ,anal Carbon Monoxide Alarms for comphanice with 2013 CRC. Section R814, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GANPMAL INFORMATION Existing single-family and in-ulti-farnily dwellings shall be provided with Smoke Alarms an'A Carbon Maa,oxide alarms. When en, the valuation of additions, alterations, or repairs to existing dwelling uni=ts exceeds $1690.00, CRC Section R-314 and CDC Sections 907.2.11.5 and 490.6 require thai Smoke Adan6s and/or Carbon, Iv onmide Alarms be installed in the following locations: AMA SMOKE ALARM i CO' A\LAIM Outside of each separate sleeping area in the immediate vicinity of the 'dr©W X q Q(DA ,P-,Ve-ry)e�eIqf a X Wilthiin (�ad�i gfeep Carbon MiainoAde alarms- are not requir'ed in dwellings- which de, i-tiot co nitalixv fuel-bum,,i nag i appliances and ffi,,at die xuqfltme an attached garage. Carbon monoxide alarz s coxnbixeed with str oke alarms s n3all comply wif% CSC' Sect (x -L,420.6, aAd, shall be aypxoved'by the Office of the State dire Marshall. Puwer Supp-ly. In dwelling, units With nu com-mmercial pDwex- supp-Ty., alar, m,-(ks)i,,nay,.`be sorely. baftlezry operated. In exkstkrag, d1we]"Ting, uauitq, alar ma are peymmitted, for be, solely-bameTiy uperalted, where. repai+r�� oar aReTminialsi aa, not: res-allf, Wit, the reino al of wall, airLdiceiig-.,L�gf,iniisl, es, or there is nu access by mmeanas; of alfiz,,;Wanemene o.+r crawl space.. Refer to CR,C Sect ozxt;1314 a 1 t i CB`C Sectiains 90'7'.2.11!.4 and 4201.6.2.. An elecfr=seal pefrnif is, sequined, four a,farins-WINI-i-CIM mu'�st be mi awiede-d to, the built ting wiring, As, owner - of t-.'h,,e ab-ove-referenced pi, operty, I hereby certify that flee alar m �(p)!efere needl above haa)&�ay.. e: beei% instaililled in, acc, or, diaince with the- mmnuf actuairers, instrum fioms and i-,ai camplin,atCe w ithm the CaAifioirmia, and CaREorrda, R-eai&iq,.ta-a:,T, Codes. The alairms, Ifta-ve beeri, tested', and. are oper alikartall, as, of OLed-,,a,..te sitpe d, below.. Project name: Higdon,Mary 10138 Myer PI Cupertino 95014 Backyard/Rear Setback Living. 101 - DS CEO - 213/8 57 21 565/8 Living. 102 PW CEO 571/4 57 _ 567/8 565/8 Living... 103 DB CEO 213/8 57 21 565/8 Dining 104 DB CEO 213/8 571/4 21567/81 Dining 105 PW CEO 691/4 571/4 687/8 567/8 -Dining- - 106- -DB CEO 213/8 571/4 21 567/8 Kit 107 DB CEO 167/8 451/2 161/2 451/8 Kit 108 -. -PW - CEO 333/8 453/8 33 45 Kit 109- DB CEO 167/8 451/2 161/2 451/8 Garage 110 GL -AP CEO 453/8 453/8 45 __.. 45 104-106 107-109 dining kit 1.1 -Factor: 0.32 SHGC: 0.25 ts� F1000 living ® ® ®\ 101-103 entry garage #110 1 JY PLOT PLANBY © 110 PLANNING DEPT CUPERTINO Scope of work: Replacing 19 window inserts like for like ■V_ col �—q CUE�ERTihF{) Building Depzrtrnenf l7Frrtc� REVIEWED FOR CODE COMPLIANCE keVewedBy, � Y C "jt rrY cnTIiNO � T -Pt Pt the a v�l; i o„alce�ny 01, to t _ a Ti P 1 �, 9do, 1 m"�p, 100% Plge-r 10 150lq L1- hi( -tog- 1 0.3 2. 51IGG " a'5 4 a, 1 IV) li I 1:e loto, 3 2A9 x w97 IV GS cS ha D D13 -3 -2 '7 ig X LN 7/t 5(-ep- OF Ljo/Lv: �Y,t 1� &1) i ej b o Li's L I V -e, (--OIL 11L• e CUPERTINO Ruildliq Department [Tpr REVIEVVED FOR CODE COMPLIANCE Reviewed By.