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13070027 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21040 CORY CT CONTRACTOR:BROTHERS HOME PERMIT NO:13070027 IMPROVEMENT OWNER'S NAME: S YALLAPRAGADA. 2510 DOUGLAS BLVD DATE ISSUED:07/05/2013 OWNER'S PHONE: 4082458695 ROSEVILLE,CA 95661 PHONE NO:(408)295-0680 LICENSED CONTRACTOR'S'DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIAL[] License Class ` Lie.# - ��- 1 REPLACE 13(E)WINDOWS&2(E)SLIDING GLASS DOORS,SAME SIZE&LOCATION.ALL WINDOWS WILL Contractor 0l4A;]0XFDate MEET I hereby affirm that I am licensed under the provision o apter 9 EGRESS AND BE TEMPERED WHERE REQUIRED (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:$10000 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:35904029.00 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 WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITBIIN 180 DAYS OF P&RMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 FR ALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said.City in consequence of theI granting of this permit. Additionally,the applicant understands and will comply ed b • Date: with all non-point source regulations per the.Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date , All roofs shall be inspected prior to any roofing material being installed.If a roof is 1 1 3 installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWN ER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: 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) 1,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 Cupertino Municipal Code,Chapter 12}nd I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sect' s 505,25 and 25534. 7V( /3 Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: 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 Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY 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 9.18. Signature Date n .T CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE'AVENUE•CUPERTINO, CA 95014-3255 O CUPEI�TINO (403)777-3228• FAX(408)777-3333•building Ca�cupertino.org ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT 9 PROJECT ADDRESS - U. r.- APN# 3 S - d Lf 29 OWNER N4 PHONED STREET ADDRESS CITY, STATE,ZIP S CA FAX CONTACT NAME TONE E-MAIL STREET ADDRESS C J CITY,STATE,ZIP FAX OVXTIER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ,` LICEt�TSE NUMBER /j-oe LICENSE TYPE n I BUS.LIC COMPANY NAME 1-a- , 1I EMAIL •� (/ FAX STREET ADDRESS ,� lav CITY,STATE,ZIP ` �1_� ^ �Z� PHONE 960021171��2 ARCHITECT/ENGINEER NAME LICENSE NUMBER ( l/� BUS.LIC# COMPANY NAME EMAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK I '� . Nnow Si�L171N S O d+Z EXISTING USE PROPOSED USE CONSTR TYPE R STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA I GARAGE AREA: DETACH [:I ATTACH 'DWELLINGUNITS: IS ASECOND UNIT []YES SECONDSTORY E]YES BEING ADDED? [3NO ADDrrION? C]NO PP.EAPPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YE '' -3 `- TOT.4j,V_LUAIION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? By my signature below,I certify to each of the following: I am the property owner or authorized age e properly owner's behalf. I have read this application and the information I have provided 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 relatin uilding c s tion. I authorize representatives of Cupertino to enter the above-jde tir property for inspection purposes._ SignatureofApplicant/Aeent: Date: `/ `� 7s t SUP= OR ION REQUIRED New SFD or Multifa Wellings Apply for demolition permit for orn,TER� � ffillOil existing building(s). Demolition permit is required prior to issuance of buildings ;, a permit for new building. ���ExpREss yAzvt,-l��`PLA��y3Ew= -. � �� _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STAND P form if any Hazardous Materials are being used as part of this project. h LARGk xII FII2E�EPT� a _Copy of Planning Approval Letter or Meeting with Planning prior to 317A3OR �, � SA�T�ARY S R�ISTuR1.0submittal ofBuilding Permit application. x En�i�Ron�NTa�:gEALTi �, Bldg-App_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 21040 CORY CT DATE: 07/05/2013 REVIEWED BY: MELISSA APN: 359 04 029 BP#: "VALUATION: 1$10,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1GENRE WORK REPLACE 13 E WINDOWS &2 E SLIDING GLASS DOORS SAME SIZE & LOCATION. ALL SCOPE WINDOWS WILL MEET EGRESS AND BE TEMPERED WHERE REQUIRED Mech. Plan Check Phvnb.Plan Check Dec.Plan Check ilvlec:h.Permit Fee_ Plumb.Permit Fee: F,lec. Permit Fee: Ether rtlech.&"r, Other Plumb Insp. Other Elec.Insp. daech.Insp. Fee: Plumb. Insp.Fee.: Elec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,eta). These -fees are based on the relimina information available and are only an estimate. Contact the De t or addn7 info. FEE ITEMS(Fee Resolution 11-053 E . 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 15 # Window/Sliding Glass Door Suppl. PC Fee: Reg. OOT 0.0 hrs $0.00 $557.00 1WINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee:Q Reg. O OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administrative Fee: Work Without Permit? O Yes O No $0.00 O Advanced Planning Fee: $0.00 Select a Non-Residential Travel Documentation Fees: Building or Structure Strong Motion Fee: IBSEISMICR $1.00 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 $2.00 $557.00 . Ar $559.00 iU m� , Revised: 07/01/2013 Building Department City Of Cupertino 10300 Torre Avenue P-k ARA! 1_%^Re Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 :.CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# D OWNER'S NAME: PHONE# D 2-4/5- GENERAL 4/5GENERAL CONTRACTOR BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: 14W IV *Our municipal code requiresall businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL-OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND:ALL_ CONT ORS HAVE OBTAINED A CITY OFUPERTINO BUSINESS LICENSE µ: I am not using any subcontractor —& t Si re Date Please check applicable Wbcontras ~ comp - rstllete the following information: SUBCONTRACT©R BUSINESS NAME BUSINESS LICENSE# Cabinets & Millwork " Cement Finishing, t J Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/"Contractor.Signature Date COMMUNITY DEVELOPn hgFNT DEP„pTnENT ,n q1 BUILDING DIVISION CUPERTiNO� /l APS. VED 3 j 7hfs set of plans and specifications MAST be kP` N Il job siie d ging constructicn. ft is unla�r nt at the 5 chances or niter-t' f_�I to,�^, V any 2 a lcr�S on same,or to Y �✓ therEfrorn, without a^�- ViF:te �Nr'oval from the 8ui(din9 Official. The '. .nping of this plan anc? be hBld.`o specifications SHALL NOT perr pit or to be anC. crrcva!of tl u vic�;r.ticn of any V 1-dinance or State Law. Wk L- P6 ? s X13 CUPERTINO Building Degadrnent J& EWED FOR CODE GO FF MPI-tA�C —0 REVI Ti ed By.. CO °� �� Q y Zlc,qo (-b* ( Oic 2-v- 4&r 6P&-5Z GcoPmt 16A fb a � � Wim ' o � s p C4� 5 (r., sc c� CUP suilding��a��C) .� °., ent REV/ JULAUd 5 2013 SEC y 2 R VieweBR.CDOE�oMPLIANCE Y o � �M