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13090141 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10108 RANDY LN CONTRACTOR:MICHAELS PERMIT NO: 13090141 CONSTRUCTION OWNER'S NAME: FRANK LIANG 707 LINCOLN AVE DATE ISSUED:09/19/2013 OWNER'S PHONE: 4084801168 SAN JOSE,CA 95126 PHONE NO:(408)292-4999 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIALE] License Class N Lic.# S9 Zy 4 REMOVE AND REPLACE 14 WINDOWS LIKE FOR LIKE t Contractor CW.* GONl TO$ Date 3 MEET EGRESS IN BEDROOMS 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. 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:$17760 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:31623068.00 Occupancy Type: ermit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EIBES IF WORK IS NOT STARTED correct.I agree comply with all city and county ordinances and state laws relating WTT� g DAYS OF PERMIT ISSUANCE OR to building const ruction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAY OM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the g /3? granting of this permit. Addition ly,the applicant understands and will comply Issued by: Date: / ! with all non-point source regula ons the Cupertino Municipal Code,Section 9.18. 11 RE-ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed.If a roof is A W11- installed without first obtaining an inspection;I agree to remove all new materials for inspection. ❑ OWNER-B ILDER 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) I,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 contaminantsas defined by t e Bay Area 4r Quality Management District I performance of the work for which this permit is issued. will maintain compliance with Cupertin un' 1 Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,MOPAMJ553 a 25534. Section 3700 of the Labor Code,for the performance of the work for which this Z/) permit is issued. Owner or authorized age Date: 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 CONSTRUCTION PERMIT APPLICATION � I U� 11-31 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION U� 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildinciAcupertino.org ❑NEW CONSTRUCTION ❑ ADDITION ❑ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS APN OWNER NAME Lf�N� PHONE�� 6O_`✓`�(�!! EMAIL a STREET ADDRESS `O`O Q �J CITY,STATE,ZIP TT CONTACT NAME t�AA,,,E= Q 'Y PHONE EMAIL STREET ADDRESS c� CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT —7 CONTRACTOR NA CR pEG f GO�t/.SY A� LICENSE NUMB LICENSE TYPE l COMPANY NAME / E '"C."wd�W! pK I/yK�/t�1� FAX J�9t'y7 q9 STREET ADDRESS 7� f��/N �+�a� CITY,STATE,ZIP j �� HO6 W7 �ATI_yQ99 ARCHITECT/ENGINEER NAME 7 LICENSE NUMBER `J BUS.LIC`#7 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK �-c= %G �X� Tz'vG G��tl /! 7� �,o?t o —L:�c� FOrti, ` cry EXISTING USE PROPOSED USE CONSTP-TYPE I #STORIES USE TYPE OCC. SQ;FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NETAREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODELAREA PORCH AREA DECK AREA TOTALDECIMRCH AREA I GARAGE AREA; DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT 0 YES SECOND STORY 0 YES BEING ADDED? ONO ADDITION' ONO PRE-APPLICATION i]YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECg '[T PLANNINGAPPL# ONO PLANNINGAPPROVALLETTER EICHLERHOME' 13 NO �Y��/ By my signature below,I certify to eac f the followin . T e property owner or authorized nt to act on the property owner's behalf.JI have read this application and the informarion I have ed' con t. h e read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to g authorize representatives of Cupertino to enter the ab< -i entifi property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMI� AL9NFORMAQION REQUIRED PLAN CHECK TYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for ovER-THE couxTER BUH nuvG PLAN REvtEw existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORTts form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to MAJOR ❑ SANITARY SEWER DIS submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH.. BldgApp 2011.doc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10108 Randy Ln DATE: 09/19/2013 REVIEWED BY: Mendez APN: BP#: *VALUATION: 1$17,760 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Duplex PENTAMATION 1GENRES USE: PERMIT TYPE: WORK remove and replace 14 windows SCOPE OHIO— R .. Tech.Plait Check Plumb,Plan Check flee.flan(.;hack ,Vlech.Pertnit Fee: Plum&Permit Fee: Elec.Permit Fee: Other,I'tercrh.Insp. Other Plumb Insp. Li Other Elec.Ins)), El A:Iech,Inq).Frye: Plumb. Insp.Fee: Flec,Imp. Fee: NOTE.This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Theseees are based on the prefinWha information available and are only an estimate. Contact the De t or addn 7 info, FEE ITEMS (Fee Resolution 11-053 Eff. 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 14 # Window/Sliding Glass Door Suppl.PC Fee: Reg. OT FO.0 I hrs $0.00 $557.00 IWINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee-0 Reg. Q OT 0.01hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: 77 Administrative.fee: Work Without Permit? 0 Yes (F) No $0.00 E) Advanced PlanningFee: $0.00 Select a Non-Residential Q Travel Documentation Fees: Building or Structure i Strong Motion Fee: IBSEISMICR $1.78 Select an Administrative Item Blda Stds Commission Fee: 1BCBSC $1.00 ..� $2.78 $557.006 F �3 $559.78 Revised: 08/01/2013 Z-/, y v /0/ 09 /��'�y • Y�,v'j' PLAAIN6 CHECKED BY �n/1��70L✓S� N� �i�c?'fDATE �'I A40 i/ OA.) pLA rNc DEpT <4)ST,vuo7't0A / DATE BLDG DEPS --� / COMFe1lJP,liTY DEVELOPMENT DEPARTMENT �� W�S 7—W ��5 / BUILDING DIVIS`0 �IGVPERTINO ! ��+ p%8�b6 7' 3 7 This set of falars and sp ci ications MUST be kept at the Ic,,� , :R during, constru tion. It is unlawful to make ar J -r Vi 6 G.i',a,,C�.1.. �,�i'r�ltrrc^atl ns on same,or to deviate Io �L l d2ovr►�+ � thea mann without ap roval foFryfPt'1`�f{�ufl�ling Official. Tt = tarnp!np of this pla i and specifications SHALL NOT R t ;: im, r mit or to be an approval of the violation .. U ",;y pr oVislons of ar y City Ordinance or State Law. V 'm RYa V�� PEP111"Off No. i3520111 V/1V pPoh, 0 6 p6 �� s dq0 TINO epa ��ilding ,�..� CODE CO pL1ANCE d f t