07060124 CITY OF CUPERTINO 77777777777��.7-77777777777777777777777.1
BUILDING DIVISION PERMIT � `]['R�� 7'+C'/R � ?RMI��Y'
BUILDING ADDRESS: PERMIT NO.
20724 GARDEN GATE DR ARGONAUP WINDOW & DOOR 07060124
OWNER'S NAME: PERMIT L%UE DATE
MARGARET LIMBERATOS P 0 BOX 110338 06/14/2007
ONE: SANITARY NO. CONTROL NO.
(408) 373-4018
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
O p LICENSED CONTRACTOR'S DECLARATION
U I hereby affirm that I am licensed under provisions of Chapter 9(commencing Job Description
Z w with Section 7000)of Division 3 of the Business and Professions Code,and my license isr
�y in full force and effect.
BEDROOM IaINDOW REPLACEMENT 96X48 .
? License Class Lic.#
F w Date Contractor
t ARCHITECTS DECLARATION
e I understand my plans shall he used as public records
.WU
Wo y Licensed Professional
H< OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the
p O following reason.(Section 703 1.5,Business and Professions Code:Any city or county
m ff which requires a permit to construct,alter,improve,demolish,or repair any structure
:Z w prior to its issuance,also requires the applicant for such permit to file a signed statement
s< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation
F (commencing with Section 7000)of Division 3 of the Business and Professions Code)or
$1000
that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty ofNumber OCCU
not more than five hundred dollars(5500). 32633014 .1� Occupancy Type
❑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
and Professions Code:The Contractors License Law docs not apply to an owner of Required Inspections
property who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improvements are not intended or offered for sale.If,
however,the building or improvement is sold within one year of completion,die owner-
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
$1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li-
cense Law does not apply to an owner of property who builds or improves thereon,and,
who contracts for such projects with a contractors)licensed pursuant to the Contractors
License Law.
❑I am exempt under Sec. B&P C for this reason
Owner/Z%4t/rid??` �C iAYIP/�ifCP(>9 S Date C9
Owl J ORKER COMPENSATION DECLARATION
O
I hereby affirm under penalty of perjury one of the following declarations:
L]I have and will maintain a Certificate of Consent to self-insure for Workces Compen-
sation,as provided for by Section 37000 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 required by Section
37000 of the Labor Code,for the performance of the work for which this permit is issued.
My Workers Compensation Insurance carrier and Policy number are:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(this section need not be completed if the permit is for one hundred dollars(51000)
or less.)
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 to bee me subject to the Workers'Com 'on
Laws of Calif *roa Date /
Applicant
NOTICE TO APPLICANT(rafter after making thw( rtilicae of Exemption,you should
become subject to the Wor is Compensation provisions of the Labor Code,you must
O forthwith comply with such provisions or this permit shall be deemed revoked.
z CONSTRUCTION LENDING AGENCY
[-�►� I hereby affirm that there is a construction lending agency for the performance of
;X the work for which this permit is issued(Sec.30997,Civ.C.)
RWi Q Lender's Name
a z Lenders Address
U 0 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
rJ U building construction,and hereby authorise representatives of this city to enter upon the
Uahove-mentioned property for inspection purposes.
(We)agree to save,indemnify and keep harmless the City of Cupertino against
rA liabilities,judgments,costs and expenses which may in any way accrue against said City
U Z in consequence of the granting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date C,�- 7
SOURCE REGULATIONS. GL"� /
-2' �_�ic lir 91' 0 /� O 7 Re-roofs
Signature of A I' t/Contractor Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupant store or handle hazardous material
as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety
Code,Section 25532(a)?
C]Yes Bi�Pd All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new mat rials for inspection.
District?
❑Yes JD-No
I have read the hazardous materials requirements under Chapter 6.95 of the Califor-
nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building
docs not currently have a tenant,that it is my responsibility to notify the occupant of the
requirements which must betrek prior tr cc err certificat r Occn Signature of Applicant Date
hh// �r r
Owner or aut izcd agent All roof coverings to be Class"B"or better
Dae
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . . 32633014.00
DATE ISSUED. . . . . . . : 06/14/2007
RECEIPT #. . . . . . . . . : BS000001661
REFERENCE ID # . . . : 07060124
SITE ADDRESS . . . . . : 20724 GARDEN GATE DR
SUBDIVISION . . . . . .
CITY CUFERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : MARGARET LIMBERATOS
ADDRESS . . . . . . . . . . .
CITY/STATE/ZIP . . . :
RECEIVED FROM . . . . : M. LIMBERATOS
CONTRACTOR . . . . . . . : CHRIS ETTEMA LIC # 22820
COMPANY . . . . . . . . . . : ARCONAUT WINDOW & DOOR
ADDRESS P C BOX 110338
CITY/STATE/ZIP . . . : CAFPBELL, CA 95011
TELEPHONE . . . . . . . . : (408) 378-4018
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BENERGY PERMIT FEE 83 .16 39 .92 0. 00 39 .92 0. 00
BPERMFEE VALUATION 1, 000. 00 83 .16 0. 00 83 .16 0. 00
BSEISMICRE VALUATION 1, 000.00 0:-50 0. 00 0.50 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 123 .58 0. 00 123 .58 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 123 .58 #981
---------------
TOTAL RECEIPT 123 .58
i fsr: . CITY OF C UPERTINO
wCITY OF ��'� ERT�41T APPLICATION FORM
CUPER�TIfUO
_CPN# `` ' , r Date: 6 11y�67
Building Address: -34ailing Address (if different fro/m� building address):
Owner's Name: Ph1-1 S) -;�
one #:
Contractor: License#: _
Contact: Phone: 6 1-1�/o Cupertino Business License#:
f2---C) Fax:/-/c E14 Fs-:k-
Building Permit Info:
Bldg JR jA�tLrb1,j Elect ❑ P[umb ❑ Mech ❑
Job Description: q Zo 1>C L-F
Residential Chi �1�/d�PX /( � J Y e �� al El
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: Occupancy Group:
Type of Construction: Please check this box if the project is a
second-story addition:
Project Size: Standard ❑ Large ❑ Maj)r ❑
Quantity Fee ID I+ee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILER1 Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler > 100K to 500K Btu MECHANICAL
BBOILER3 Boiler>500K to 1M Btu MECHANICAL
BBOILER4 Boile:-> 1M to 1.75 M Btu MECHANICAL
BBOILER5 Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX In(VOff/Comm/Quasi BUILDING
BCONSTAXBQ Coii. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax —Resi/Mobile BUILDING
BELEC 1000 El(;c 600V <= l OOOA ELECTRICAL
BELEC1001 K.ec 600V> 1000A ELECTRICAL
BELEC200 Elec Svcs 600V<= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA [nvestigation fee BUILDING
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CITY OF C'UPERTINO
CITY OF PERMIT APPLICATION FORM
CUPS TING
Quantit Fee ID Fee Description Fee Group
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
BNUCOMME N,;w Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BOVERTIME Inspection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
j BPERMFEE 1',Idg Permit Fees BUILDING
BPFIXTURE Pblg Fixture PLUMBING
BPGAS Gas Piping System Fee PLUMBING
BPINTERCEP Incl Waste Interceptor PLUMBING
BPLANCHK Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plari Check Repeat Fee BUILDING
BPREPIPE Re i e Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lavin SprinklerBackflo PLUMBING
BPSTORM Storm/Rain Water PLUMBING
BpTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain &Vent PLUMBING
BPWATER Instill/Alter Water Pie PLUMBING
BPWHEATER Water Heater/Vent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Rc location of Furnace MECHANICAL
BREMFURNOV Rel c) Furnace> I OK btu MECHANICAL
BREMHEAT Neater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power Device/Apparatus ELECTRICAL
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT R-,pair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
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CITY OF CUPERTINO
CITY Of PERMIT APPLI=CATION FORM
CUPERTINO
')uantity Fee ID lee Description Fee Group
BREMSIGNAD Rmd 1 Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Marquee ELECTRICAL
BREMTHEATR The itrical Lighting Fix ELECTRICAL
BREMVENFAN Ven t Fan Single Duct MECHANICAL
BREMVENSYS Ve utilation Systems MECHANICAL
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Sei:;mic Commercial BUILDING
BSEISMICRE c eismic Fee Res BUILDING
BSPECIAL Special Inspection BUILDING
BSWIM Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Temporary BIdg Permit BUILDING
BTEMPSVCS ",emp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanical sq. foot MECHANICAL
MPERMITFEE Mec I Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issue PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING
PLLONGRNGR Planning ong Range Residential PLANNING
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