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06120030 (2) CITY OF CUPERTINO BUILDING DIVISION PERMITCONTRACTORI�IFORN,[ATION BUILDING ADDRESS: ALLBRAND WINDOWS PERMR N0.06120030 OWNER'S NAME: PE 34TT ISSUE DATE jOk PAN YULIE 551 INDUSTRIAL RD 12 /11 /2006 NE: SANITARY NO. CONTROL NO. (650) 622-0330 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 to LICENSED CONTRACTOR'S DECLARATION lob Description 1 w I ion It .)mitre that 1 Me l'nenWtl under Provinces.(chapter 9(cnmmmeing wit Section 7sl(pt of Division 3 arts Business and Professions Code.and my license is ,HN imfall r.n.anderrg S REPLACE WINDOWS i F CZ Dao: Canuacar ARCHITECTS DECD ATIO i I understand my plans shall W used an public records :.0 LL o, Liccnad P iromonal 're3 OWNER-BUILDER DECLARATION I herby alTirm Nal I am exempt into We ConuacmYa Licunce law rat the p o following wan.(Sec6an 7f)31.5.Business and Professions Codc:Any city ser coumy <m which implies a permit as construct.alter,improve.dcmnlih,mr¢pair any structure $1060 ui< prior m its issuance.MIs requires the applicant for such permit ue file a signed statement tat he is licensed pursuanno one provieioot of be Contractor's Liccnrts law(Chapter 9 Sq.Ft.Floor Area Valuation (commencing with Section 7=)of Division 3 of the Business and Professions Code)or e3$ dot he is exempt tmefrom and to btu far to alleged examption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3AW f4jjfiMF Occupancy Type not mart tan five hundred dollars ❑I,uownet of the propuny,mmy emplaycu wit wagnm te'v sok compcwdon, Maid Pr Maes Mart and thestructureranalintended seraw it fatsalt(Sec.in at.,Budrcss and Pray he tae:The C dimear.And law aces nal apply m an rout.of Required Inspections pmpeny who builds mimpravu Neiman,and who daenoteh work himself at trough his awnemployru,provided Inori tat such improvemuits see trot ear oft opted n,for sat..B, however,the have Me or improvement is sold within Act year of improve for this owner, builder will Nve Mac burden of proving Cast k did ret htiW m improve far purpose of AMC.). ❑1,u owner of the prpeny,am eaclmivuly containing wit licensed camrantme so corutmct this project(Sec.7064,Business as Profusions Coe:)M Comeactofs U. came law don not apply to an owner of propeny who builds or imprvu thereon,and who Contracts for such pmjecu it A cantonsun at licensed pmsuam m Me Canusetor, License Law. ❑ 1.m nempm under Sea. ,B k P C far this won Owner Date WORKER'S COMPENSATION DECLARATION I hereby aflum under penalty of perjury one of to fallowing declamfiau: I have and will maintain a Cmtifinse of consent to self-insure far Warkefs Compen. Milan.As provided far by Section 37M of to Labor Code,for to perfmmance of the - work for which his permit is issued. j?kf'f have and will maintain Workce,Campensmion Imran.,as required by Section 370(1 of to labor Cads.for the perfurmanec of this work fm which Mass Permit is ounce. My Workers ca Pecona Insurance mer and Policy number art: Camricr. F Policy No.: CERTIFICA OFEXEMMONMOMWORKERS' COMPENSATION INSURANCE (Thu Auction reed nut beeamplated if Mac Permit is Intone hundred dollars($10() nr I...) 1 certify tm in to performanec of to wart for which tis permit is issued,l shall not employ any person in any manner so As m become subject in do Workers'Compcnsmion Laws of California.Dote Applicant NOTICE TO APPLICANT:If,ofcr making this COME=of Eamption,you should become subject b the Warkcts Compensation provision of be Labor Coe,you muse z 10MW lth comply wit such loovisinn or tit Permit shall be deemed evoked. Z D' CONSTRUCTION LENDING AGENCY [-a 1 hereby aRhm tam there is.coutruction lending agency for the perf....of eL > to Mark for which this Permit is union(Sec.3097,Cil ret a25Landels Name :D z Lender's Address V Q 1 anify tat 1 have mad this application and cute that the above information is IL F correct.I agree to comply wit At city and county ordinances and Mile laws relating to O C.1 building construction.and hereby aumhome representatives of this city to crcr upon the purp W ab.vC-mjudgm es,ca y(for eSpenes which may F y (We)agree to save,indemnify and kap harmless to City of Cupertino!gamut Z incoitiuticum,Or the Of thiseswhich may inany way.terve against said City V Z inconsequence of this granting of this permLL ^ APPLICANT UNDERSTANDS D WILL COMPLY WITH ALL NON-POINT Issued by: Date Sp �i t P2� REG NS. �� ( (/ta Sngnmure of Applican✓Canuacror pale Re-roofs HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will to applicant or future building occupant vat or handle hvallou material As define by the Cupenino Municipal Coe.Chapter 9.12,as the Healt and Safety code.Seaton 25532(a)?Oyinspected All roofs shall be prior to any roofing material being installed. Will to applicant or future building us:apart use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove - cut,ho.oktur air contamiranrs As de0ncd by to Bay Arca Air Quality Management all new materials for inspection. District? Yes I have mo the Woodcuts materialsmquiromems under Chapter6.95 of Mac Califor- niaHcaltk Safmy Codc,Secdons 25505,25533 0d25534.1 uaerstao tatifte Wilding does not 9wentlk h.ve a am ',Wt Il' my respome.ta ity m andfy w occupant of to require msw 'hma tpiior OMece yfseerdficateorOccupan Signature of Applicant Date N �4 t2�I 1 016 All roof coverings to be Class "B"or better Owner or autarized agent pale' g CA • �L1�0� PLAN SecoND NI45�• F Loop ot PQ �G�c. SPS /� QSi • 1 GJQ� 1 sQe rimes o�s����' e a work: aoa 6� es 0 S ti � 2 ..c��a�..Q �ve�'Yo�:�) �P\G� Zl\��reeao�l���ti��'�,G�asQQ��4� de�'eV'�o da t� EV g pCEIVDEC 1b20 r+ COPY • 12/04/2006 17:26 16506220320 WINDLIW-'( I .-CZM--0j -NAIL -04/27 c% i JOB NO A01111175 DATE 12/512006 MEASURE TECH PAUL BORDEWICZ TIME 141 prn Items Notes Anderson Assemb Be Roof Bow No Roof Build U s coil w Cut Down Cut Posts not structural Cutti Steel Frame susi Door IS 6&8 Door 9,10&12 Electrical move outlet for cut down Ent Door Double w/sidelights E Door Double EntryDoor sin to wiside' hts E Door sin le Exterior sill MetaVvin SiII Ca French Door Double w/sideG French Door Double French Door Sin le wlsideli hts French Door Single • Garden New Const w/Flashing` Garden Retm Installdtion ` IG units Inside New Wood Sto Iron Bars take down Jamb&Case Jamb&Case Trim Kit Jamb ExtensionlL-Trim New Const.on Rough Frami Onl Now Const.Wimtows w/Flashi New meaderfRafrannim Included Inside Flnishin New Wood Stool other take hoto rhour Out Side Wood Trim Reframe O enin 1 Build Post Re lace Framin Roof for Be Roof for Bow Roof Metal for B Roof metal for Bow Sheetrock for Build Up itnClUdes to mete,comers Sid for Build U Stucco for Build U Stucco for New Construction WffidowsiDoors Stucco from Door to Window Build U Windows Please make sure you COMPLETE this form A TURN 1N on a LY Dads. Your bonus pay will • be hased on the axurecy of your written 6domtedon. Thank you. CITY OF CUPERTINO 2 of 2 PERMIT RECEIPT OPERATOR: bethe COPY # 2 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35920040.00 DATE ISSUED. . . . . . . : 12/11/2006 RECEIPT #. . . . . . . . . : 36993 REFERENCE ID # . . . : 06120030 SITE ADDRESS . . . . . : 20816 MCCLELLAN RD SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : PAN, YULIE ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : ALLBRAND WINDOWS CONTRACTOR . . . . . . . : JACEK PASTERNAK LIC # 24829 COMPANY . . . . . . . . . . : ALLBRAND WINDOWS ADDRESS . . . . . . . . . . : 551 INDUSTRIAL RD CITY/STATE/ZIP . . . : SAN CARLOS, CA 94070 TELEPHONE . . . . . . . . : (650) 622-0330 OE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL BENERGY PERMIT FEE 1.00 34.86 0.00 34 .86 0.00 ' BPERMFEE VALUATION 1, 060.00 83.16 0.00 83.16 0.00 ' BSEISMICRE VALUATION 1, 060.00 0.50 0.00 0.50 0.00 BPLANCHK PERMIT FEE 1.00 83 .16 0.00 83 .16 0.00 ---------- TOTAL PERMIT 201.68 0.00 201.68 0.00 METHOD OF PAYMENT AMOUNT NUMBER __________________ OTHER 535.70 VISA TOTAL RECEIPT 535.70 • Community Development 10300 Torre Avenue Cupertino CA 95014 4 µ Telephone(408)777-3228 CITY OF Fax(408)777-3333 #UPEkTINO .Building Department JOB ADDRESS: PERMIT # 20916 cclella Ca 1 D 6/ Z- 3 6 OWNER'S NAME: u LC/ � PHONE # GENERAL CONTRACTORb„y. , 'o, , FAX # I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring,. Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile _• 1 2 Owner/Contractor Signature D to SP CITE' OF CUPERTINO CUP TY' OF PERMIT APPLICATION FORM 04Qla0O D APN# ;26� Date: 12- 11 /06- Building Address: Mailing Address (if aiffereAt from building address): focciellawG., �. CP) Owner'sNam • Pho e#: e � ,. . .36 - I Contractor: License#: A 11 X27 _T- Contact: Contact: Phone: 180o)4pD-0?q? Cupertino Business License#: 0_6 l3 as�t 1 Fax: 65o 6 BuildirIgPernit Info: Bldg Ly/ Elect ❑ Plumb ❑ Mech ❑ Job Descriptio:/ Residential L Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: Occupancy Group: I 060 \2-3 Type of Construction: Please check this box if the project is a second-story addition: ❑ *roject Size: Standard Large �E] M�ajor Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> I OOK to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> IM to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH . Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC1000 Elec 600V <= IOOOA ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Ener y Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of3 ,�,pvt CITY OF CUPERTINO ciTYOF - PERMIT APPLICATION FORM CUPEkjlNO, Quantity Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees. BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/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 Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> IOK btu MECHANICAL BREMHEAT Heater 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 Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2 of 3 i✓d ? CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPERTINO Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Mar uee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Insection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanical sq. foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/ Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Change BUILDING • 3 of 3