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11040072 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10139 N BLANEY AVE CONTRACTOR:ARGONAUT WINDOW& PERMIT NO: 11040072 DOOR,INC OWNER'S NAME: JIANJUN CHEN 1901 S BASCOM AVE STE 800 DATE ISSUED:04/11/2011 C R'S PHONE: 4085645436 CAMPBELL,CA 95008 PHONE NO:(408)378-4018 ❑ LICENSED CONTRACTOR'S DECLARATIOND r X BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class : Lie. v MECH RESIDENTIAL r- COMMERCIAL I Contractor a r (�ti Gji Date I I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: 12 WINDOW REPLACEMENT 2 DOORS NON- (commencing with Section 7000)of Division 3 of the Business&Professions STRUCTURAL, INCLUDE RE-WIRING FOR NEW EXTERIOR LIGHTS 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. 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 Sq.Ft Floor Area: aluation:$15000 permit is issued. APPLICANT CERTIFICATION APN Number:31623042.00 Occupancy Type: I certify that I have read this application and state that the above illation 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Tonally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point sour a reg anon;Iperthe Cupertino Municipal Code, a/ction 9.18. �'LC� Date 4l!lI Date: I Signature Date Issued bp / :_ ' L OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. 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 Owner aut ri e a ent forthwith comply with such provisions or this permit shall be deemed revoked. Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of Hork's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save ind—nify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address C kid expenses which may accrue against said City in consequence of the gr,.. ..ag of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31623042 .00 DATE ISSUED. . . . . . . : 04/11/2011 RECEIPT #. . . . . . . . . : BS000013153 REFERENCE ID # . . . : 11040072 SITE ADDRESS . . . . . : 10139 N BLANEY AVE SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . . JIANJUN CHEN ADDRESS . . . . . . . . . . : 10139 N BLANEY AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : JIAN JUN CHEN CONTRACTOR . . . . . . . : CHRIS ETTEMA LIC # 22820 COMPANY . . . . . . . . . . : ARGONAUT WINDOW & DOOR, INC ADDRESS . . . . . . . . . . : 1901 S BASCOM AVE STE 800 CITY/STATE/ZIP . . . : CAMPBELL, CA 95008 TELEPHONE . . . . . . . . : (408) 378-4018 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 15, 000. 00 1. 00 0.00 1. 00 0.00 1BREMFIXT NO. FIXTURES 2 . 00 63 .00 0. 00 63 .00 0. 00 1BSEISMICR VALUATION 15, 000.00 1.50 0. 00 1.50 0.00 1EPERMITFE FLAT RATE 1.00 42 .00 0. 00 42 . 00 0.00 1TRAVDOC FLAT RATE 1.00 42. 00 0. 00 42 .00 0.00 1WINREP EACH 8 14 .00 506 . 00 0. 00 506.00 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT 655.50 0. 00 655 .50 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 655.50 MC --------------- TOTAL RECEIPT 655.50 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10139 n. blaney ave. DATE: 04/11/2011 REVIEWED BY: bobs. APN: BP#: '"VALUATION: $15,000 °PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex TPP ENTAMATION 1GENRES USE: ERMIT TYPE: WORK 12 window replacement 2 doors non structural include re-wiring for new exterior lights. SCOPE Elec.Plan Check 0.0 hrs $0.00 Elec.Permit Fee: IEPERMIT LiOther Elea Insp. 0.0 1 hrs $42.00 NOTE: Thesefees are based on the prelintinary in ormation available and are only an estimate. Contact the De t or addn'1 info, FEE ITEMS (fee Resolution 09-051 E;ff 71110) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Window/Sliding Glass Door Suppl.PC Fee: (F) Reg. 0 OT 0.0 1 hrs $0.00 $506.00 1WINREP Replacement PME Plan Check: $0.002= Electrical Permit Fee: $0.00 $63.00 1BREWIXT I Fixtures,Lighting Suppl. Insp.Feer Reg. 0 OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $42.00 Acoustical Fee: Q Yes (F) No $0.00 Q Work Without Permit? 0 Yes G No $0.00 Planning Fcc: $0.00 Select a Non-Residential E) Travel Documentation Fee: ITRA VDOC $42.00 Building or Structure 0 i Strong Motion Fee: IBSEISMICR $1.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: 1 $86.50 $569.00 TOTAL FEE: $655.50 Revised: 01/15/2011 PROJECT DATA - RESIDENTIAL COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERT1Na (408)777-3228 • FAX(408)777-3333•building (a cupertino.org PROJECT ADDRESSt APN# If 0 i '7 `7 /V, 1316 vieI- �i, rt I' CA i OWNER NAME — PHONE E-MAIL a� �, C �.-e�. �6 ' ;c�� ��_Com. _ q Q Y 't STREET ADDRESS CITY, STATE,ZIP J FAX S Q 0-k- APPLICANT NAME PHON E-MAIL STREET ADDRESS -CITY,STATE, ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑cONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT x}ESCRFP i�QN(J> wQI AA N EXISTING USE(S): l^�/1 PROPOSEa-LI,S ($ OCCUPANCY(S): TYPE OF /w J Y PARCEL CONSTRUCTIONC,//'— AREA: [FIRE Y N AM AREA: Y N FLOOD AREA: Y N SIESMIC AREA: Y N SINKLERS: Existing Proposed Floor Area: First Floor: s.f. S.f. Second Floor: s.f. S.f Garage _s.f. S.f. TOTAL: S. S. . Are there at least two 10 feet by 20 feet clear spaces inside the garage? Y N Is privacy protection planting required for the project? Y N Governing Codes: 2010 California Building Code(based on the 2009 International Building Code) 2010 California Residential Code(based on the 2009 International Residential Code) 2010 California Plumbing Code(based on the 2009 Uniform Plumbing Code) 2010 California Mechanical Code(based on the 2009 Uniform Mechanical Code) 2010 California Electrical.Code(based on the W(International Electrical Code) 2010 California Energy Code ^' 2010 California Green Building Stantra?Ko3d�, Cupertino Municipal Code y ProjectData-ResidentiaLdoc revised 03/09/11 x �x fes= X j ly Q9 f •o X �. oa x IN z c� C GJ © ;K4Ct v o � ve �+ em-- '' w a F r, C 2- 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 CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION 2ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROTECT ADDRESS ' A ,. ✓ ! APN# � I (4r> Z� C)(� OWNER NAME ✓ 1\� i LA ix C w►^ PHONE (I i�J 1 ;[/I S/�3{ E-MAIL STREET ADDRESS S6t w _ CITY, STATE,ZIP ��„��' 6 FAX L6 CONTACT NAME ' PHONE E-MAIL Av� STREET ADDRESS CITY,STATE,ZIP FAX OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME /t Y � LICENSE 1 D LICENSE TYP BUS.LIC# COMPANYNAME n E-MAIL FAX STREET ADDRESS 4U. CITY,STATE,ZIP/ PHONE AA ARCHITECT/ENGINEER NAME /, LICENSE NUMBER p BUS.LIC 0 COMPANY NAME E-MAII FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK VV `",444-, -r oioa L'__tler I-4A 1% PAC, -b /L-),f C J(f�?- )kA EXI5IINGUS PROPOSEDCONSMTYPE fkSTORIES TSE_ EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA . BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑ DETACH ❑ ATTACH M DWELLING UMTS: IS A SECOND UNIT YES SECOND STORY ❑YES BEINGADDED! ❑NO ADDITTONr ❑NO - - PRE-APPLICATION Cl YES IF YES,PROVIDE COPY OF PLANNER'S NAME: I Oe N" PLANNING APPI,A ❑NO PLANNING APPROVAL LETM IS l By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have ead this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. 1 agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED I —New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building, _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure . form if any Hazardous Materials are being used as part of this project. _Copy of Planning Approval Letter or Meeting with Planning prior to , � a>t submittal of Building Permit application. braK NAlm BldgApp 201 Ldoc revised 03/16/11