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09050138 7777 77 CITY OF CUPERTINO PERMIT BUILDING DIVISION Cd1 TR�k:VTOM MA' IQ�N PERMIT NO. BUILDING ADDRESS: 20539 CEDARBROOK TER H LDER PERMIT ISSUE DATE OWNER'S NAME: 7\ 1A F-IjEWSK 4429 R=_2HAR_B_ SXWA CONTROL NO. PHO : 408) 496-9960 BUILDING PERMIT INFO ::HITECflENGINEER: BLDG ELECT PLUMB MECH u O O LICENSED CONTRACTOR'S DECLARATION Job Description U I hereby affirm that I am licensed under provisions of Chapter 9(commencing z with Section 70()0)of Division 3 of the Business and Professions Code.and my license is RE PLC W I NDW S & PATIO DOORS LIKE 4 L I KE TEMPERD & y in full force and effect j ? License Class Lle•S C -a Dam Contractor EGRESS RHERE REQUI 'D A(3)WINDOWS (2) PATIO DOOR ARCHITECTS DECLARATION a U I understand my plans shall be used as public records n. `U.in Licensed Professional y OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the p O following reason.(Section 7(Y31.5,Business and Professions Code:Any city or county k m Pi which requires a permit to construct,alter,improve,demolish,or repair any structure prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation E=G that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area yF_$ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $4950 y 5.. that he is exempt therefrom and the basis for the alleged exemption.Any violation or Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number not more than five hundred dollars(SSoo). 32345012 . 00 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 Required Inspections and Professions Code:The Contractor's License Law docs not apply to an owner of property who builds or improves thereon,and who does such work himself or through his awn 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,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.){ as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractors Li- cense Law does not apply to an owner of property who builds or improves thereon,and. who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License ❑I me pt u •C� j h� Owner � ti6 ORK ' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑I have and will maintain a Certificate of Consent to self-insure for Worker's Compen- ,tion,as provided for by Section 3700 of the Labor Code,for the performance of the rk for which this permit is issued. L]I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Workees Compensation Insurance carrier and Policy number arc: Cartier. Polity No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (chis section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for hie,4,Lhis permit is issued I shall not employ any perso any t to the Workers'Compensation Laws of Califo r D Applicant NOTICFLTp PP C ,af0ff making Ws Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must Oforthwith comply with such provisions or this permit shall be deemed revoked. Z 0.4CONSTRUCTION LENDING AGENCY E~-c new I hereby affirm that there is a construction lending agency for the performance of (Y 5 the work for which this permit is issued(Sec.3097,Civ.C.) �)Q Lender's Name z Lender's Address U 0 I certify that I have read this application and state that the above information is LL.H sorest I agree to comply with all city and county ordinances and state laws relating to 0 V building construction.and hereby authorise representatives of this city to enter upon the /107 Uabove-mentioned property for inspection purposes >4 a (We)agree to save,indemnify and keep harmless the City of Cupertino against ,Hc liabilities,judgments,costs and expenses which may in any way accrue against said City V Z in consequence of the granting of this permit. - Date APPLICA UNDERST AND L COMP L TH ALL NON-POINT Issued b): SOURC UL S. Re-roofs Si ore o App' UContrxorDatc HAZARDOU'M S ATERIALS 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)? All roofs shall be inspected prior to any roofing material being installed. _ [3 Yes If a roof .s installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new riaterials for inspection. District? \_- 0 Yes u I have read the heardousimaterials requirements under Chapter 6.95 of the Califor- nia Health aktyC Z2=14533 and 25534.1tmderstaridthat ifthe building does n cu ndy respo ' ' y j�Ew no reqs' men w bt met pea certirSignature:of Applicant Date All roof coverings to be Class or or better Datc Own or authorized agent ooo lid, J CITY OF C.UPERTINO CITY OF CUPEkTINO GENERAILd BUILDING PERMIT APPLICATION FORM APN # � � " , U � Date: S/Z!/� g � l Building Address: a05-3-? Mailing Address (if different from building address): Owner's Name: Phone#: ANNA -,��ws (409 ) ass- - 77 HOA: (Exterior work only) Yes ❑ No ❑ If yes, provide letter from HOA Contractor: Phone: �04) W9,6.T 96 v 64 ss Fax: 9,6 Contractor License#: 6 Cupertino Business License#: Contact: Phone: Fax: Residential Commercial / / Job Description: /e�P//1 GE W l'A) 74'4-71'0 �rs- I�KP � 6II KC ,4o," �5t�ecr w4-ele e&o tl-e6 (3) 4V;NoOWr CZ) 1)001-f Building Permit Info: Bldg ILS/ Elect ❑ Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B 0�-5 Valuation: *,5k 9 C-O Square Footage: Project Size: Express �tandard ❑ Large ❑ Major ❑ Green Building: Please complete relevant portion of the Green Building/LEED Checklist & attach it to the application or if applicable, include in plan set & the sheet index. Points Achieved: For help, contact Build it Green at www.builditg een.or Revised 02/05/09 CITY OF CUPERTINO CITY OF GENERAL BUILDING APPLICATION CUPEI�TINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM 1STUCOAP Stucco Applications (up to 400 sf) B additional stucco application 1 WINREP Replacement windows/sliding glass B door (ea 3 windows) I WINMEWSTR New Window-structural shear B wall/masonry(includes plan ck fee) 1 EPERMITFEE Electrical Permit Fee E 1 MPERMITFEE Mechanical Permit Fee M 1 PPERMITFEE Plumbin€,Permit Fee P IELCPLNC K Stand Alone Electric Pln Ck (hourly) E 1 MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M I PLMBLNCK Stand Alone Plumbing Pln Ck (hrly) P 1 STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B when not over counter) hourly-stand alone / 1 BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES I BSEISMICR Seismic Residential B 1 BSEISMICO Seismic Commercial B 1 TRAVDOC Travel &,Documentation B IBUSLIC Business License B 5 of 5 Oumlex, fir•b:eo 0, o SHEE-T 3 '6x T7"xd a PA-77.0 &Oft- lvD tiock- ff o 5 , f � c; (Nor 7-0 SCAC C--7), wow* sip pot�, l M , bt< t� Wei IV( 10411-1080 7GNVS3G03 k kU 314 u mlaj 0,100 A ��7i o ��vv2 �EI�jEI� 6©xb'8 AY 212009 C�% �'� Perl (A v , .Sim � �t'� � • (�� ��ri!� ����-� ��� 1�i��t1�1,� �' A-,1 A) : 1Jn�✓ 7 �L'C►l'a a,K �Z ii s (Nor- VIA/ BY: r /ED ,°�� �Cr— COMMUNITY MANAGEMENT SERA ICES,INCORPORATED May 12, 2009 Anna Fijewski 20539 Cedarbrook Terrace Cupertino, CA 95014 F:e: Cupertino Countrywood Homeowners Association Dear Ms. Fijewski: The Cupertino Countrywood Board of Directors has approved your architectural request to install dual pane windows and sliding doors, subject to: 1. The installation being performed by a licensed contractor. 2. Any necessary City of Cupertino perry.its being obtained. 3. Any damage or maintenance resulting from the window installation being your responsibility to repair. 4. The white vinyl window trim not exceeding a half-inch more than the existing aluminum trim. 5. No grids being installed on the windows. 6. The glass being clear and untinted. (N reflective coating is permitted. Low E is allowed as long as it is not reflective.) 7. The windows being recessed like the Existing windows and the wood trim re-installed to maintain the exterior building appearance. 8. Any touch up painting being completed to match the existing colors. 9. It is our understanding that the upstairs bedroom windowsills must be lowered approximately 3 inches to meet fire cede egress requirements, thus requiring constriction grade windows to be installed in the upstairs bedroom windows. You should check with your contractor and the City of Cupertino to verify. Thank you for submitting your architectural r.-quest to the Association. It is suggested that you keep this letter with your other important real estate documents. ;sincerely, Community Management Services, Inc. a ►3� 3ob Soares, Senior Association Manager Cupertino Countrywood Homeowners Association BS/S cc: Board of Directors File: 4 1935 Dry Creek Road, Suite 203 • Campbell CA ` 95008-3631 ■ voice (408) 559-1977 - fax (408) 559-1970