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10110080CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21618 ROSARIO AVE CONTRACTOR: HOLDER INC DBA ABLE PERMIT NO: 10110080 GLASS OWNER'S NAME: MOHAN PARTHASARATHY 1129 RICHARD AVE DATE ISSUED: 11/12/2010 JVNER'S PHONE: 4088131500 SANTA CLARA, CA 95050 PHONE NO: (408) 496-9960 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL License Class Lie. # REMOVE AND REPLACE 12 WINDOWS LIKE FOR LIKE Contractor Date 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 Sq. Ft Floor Area: Valuation: $7750 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 permit is issued. APN Number: 35619015.00 Occupancy Type: 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 WITHIN 180 DAYS OF PERMIT 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 DAYS FROM 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 Issued by: granting of this permit. Additionally, the applicant understands and will comply p.,/" Date: with all non -point source regulations per the Cupertino Municipal Code, Section d 9.18. RE -ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. 9 OWNER -BUILDER 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). 4.- 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 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 0 p Owner or authorized agent: j `—� 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 --on the above mentioned property for inspection purposes. (We) agree to save mnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION .acs, 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. 7- 1 �' Signature I'`j( Date L47- Q� 9. 1 understand I may obtain more information regarding my obligationss an "employer" from the Internal Revenue Service, the United States Small Business Administration, the Calif ,mia Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1 -800-321 -CSLB (2752) or www.csib.ca.gov for more information about licensed contractors. 10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the site address listed above. ' 11. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well ass employers. t ( 12. 1 agree to notify the issuer of this form immediately of any additions, ,deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. i CONSTRUCTION LENDING AGENCY (DIRECTIONS: Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: 1_- A JJ-.-..... LGI Juf ll--. vvv. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's si naf r . Property Owner's Signature: Date: - - -------• --------- - ------ ---- ----- -- --- ----- ---- - -- ------------------ ----------------------------------------------- (NOTE: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder). F 'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is any personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Tel No Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: OwnerBuilderForn:_2010.doc revised 04/14/10 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: 2-161& RD -COLI- tvk CQ�C r-"' Ch ;�,r it PERMIT # Q %r OWNER'SNAME: [ir-�,tiw P61- ,050VA-rrlr PHONE# o& GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: CITY/ZIPCODE: *Our municipal code requires all 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 SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date Owner / Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing 1; L � C L A Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date 3 ITEMS OF 3 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Elk: Lot: APN ........: 35619015.00 DATE ISSUED.......: 11/12/2010 RECEIPT #.........: BS000011990 REFERENCE ID # ...: 10110080 SITE ADDRESS .....: 21618 ROSARIO AVE SUBDIVISION ...... CITY .............. CUPERTINO IMPACT AREA ...... OWNER ............: MOHAN PARTHASARATHY ADDRESS ..........: 21618 ROSARIO AVE CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: SylviaM COPY # : 1 RECEIVED FROM ....: PADMAPRIYA PARTHASA CONTRACTOR .......: HOLDER, ERIC LIC # 22037 COMPANY ..........: HOLDER INC DBA ABLE GLASS ADDRESS ..........: 1129 RICHARD AVE CITY/STATE/ZIP ...: SANTA CLARA, CA 95050 TELEPHONE ........: (408) 496-9960 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ----------------------- 1BCBSC VALUATION ---------- 7,750.00 -------------------- 1.00 0.00 ---------- 1.00 ---------- 0.00 1BSEISMICR VALUATION 7,750.00 0.78 0.00 0.78 0.00 1WINREP EACH 8 12.00 506.00 0.00 506.00 0.00 TOTAL PERMIT ---------- ---------- 507.78 0.00 ---------- 507.78 ---------- 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- CREDIT CARD 507.78 -------------------- me --------------- TOTAL RECEIPT 507.78 CITY OF CUPERTINO Fm_� FEE ESTIMATOR -BUILDING DIVISION NOTE: These fees are based on the nreliminary information available and are onlv an estimate. Contact the Dept for addn 7 info. FEE ITEMS (fee Resolution 09-051 a.. 7�7/10) 21618 rosario ave. DATE: REVIEWED BY: 11alADDRESS: APN: BP#: *VALUATION: 1$7,750 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: 7� ��, - PENTAMATION 1GENRES PERMIT TYPE: WORK hrs SCOPE PME Plan Check: NOTE: These fees are based on the nreliminary information available and are onlv an estimate. Contact the Dept for addn 7 info. FEE ITEMS (fee Resolution 09-051 a.. 7�7/10) FEE r. MISC ITEMS Plan Check Fee: $0.00 12 # $506.00 Window / Sliding Glass Door 1 WINREP Replacement Suppl. PC Fee: (F) Reg. 0 OT0.0 NOTE: These fees are based on the nreliminary information available and are onlv an estimate. Contact the Dept for addn 7 info. FEE ITEMS (fee Resolution 09-051 a.. 7�7/10) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 12 # $506.00 Window / Sliding Glass Door 1 WINREP Replacement Suppl. PC Fee: (F) Reg. 0 OT0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feed Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C"on lrii °tion 7a Acoustical Fee: 0 Yes (E) No $0.00 0 E) Work Without Permit? 0 Yes E) No $0.00 Pla�'ee: $0.00 Select a Non -Residential Building or Structure Q 0 lrul eI I)ociol?c''nfolio "t d`cc'\ Strong Motion Fee: IBSEISMICR $0.78 Select an Administrative Item Bldj4 Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.78 $506.00 TOTAL FEE: 1 $507.78 Revised: 11/08/2010 i rf\;r � vFW'� (i't f� .S�t tWu 'j Of CA PI AC C k 6 i tNZ.NJ w f'E� ?czly 12'� ya,x N Z J z � v t7 ,f'1 Z N Z z t7 ,f'1 Z � � J L 1 ?p 1 � � s 7 n � N Z z S L WINDOW REPLACEMENT REQUIREMENTS COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION Ila ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 •FAX (408) 777-3333 • buildinq(�cupertino.orq PURPOSE The purpose of this guideline is to clarify the minimum building code requirements when repairing, replacing or adding windows in a residential building. Structural plans and calculations may be required if window/door openings are added to an existing lateral resisting element (shearwall). PLAN REQUIREMENTS 1. Provide a completed `Addition/Remodel' building permit application. 2. Provide three sets of completely dimensioned floor plans showing the size, type and/or location of all windows proposed to be replaced.. Floor plans shall indicate the following: 3. Owner -Builder Disclosure Form (for property owners applying for their own building permit) 4. Provide structural plans and calculations if window/door opening is (are) being added to an existing shearwall and the overall design does not meet the conventional construction requirements of the California Building Code. GENERAL INFORMATION — EMERGENCY ESCAPE AND RESCUE OPENINGS • Per Section 1029 of the 2010 California Building Code, provisions shall be made for emergency escape and rescue in Group R occupancies. This also applies to replacement windows per 2010 CBC Section 3407. • Every sleeping room shall have at least one exterior emergency escape and rescue opening or exterior door approved for egress or rescue. • All emergency escape and rescue openings from sleeping rooms shall have a net clear opening of 5.7 square feet, except that the minimum net clear opening for emergency escape and rescue grade - floor openings shall be 5 square feet. • The minimum net clear opening height shall be 24 inches. The minimum net clear opening width shall be 20 inches. • Emergency escape and rescue openings shall have the bottom of the clear opening not greater than 44 inches measured from the floor. • Bars, grills, grates or any similar devices are permitted to be placed !Eer emer cy escape and rescue openings provided the minimum net clear opening size compl with t4opening requirements of the egress window and such device shall be releasable or remc* le from the inside without the use of a key, tool, special knowledge or effort or farce greater -than that which is required for normal operation of the escape and rescue opening. • Bars grills, grates or any similar devices shall be equipped with an a roved exterior release To device for use by the fire department. WindowReplacePolicy.doc revised 11/05/10 CITY OF CUPERTINO CUFEkTINO GENERAL BUILDING PERNUT APPLICATION FORM /d //06(�-o APN # 3� Co � a l s o Date: Building Address: Mailing Address (if different from building address): Are Hazardous Materials being used as part of this project? Yes No �] HOA: xterior work only) Yes ❑ No ® If yes, provide letter from HOA Owner's Name: iii o r+ i�� nR €�' i �; y Phone* f PAun•%kz4a P AV -V M; n SAt� �Z rt Contractor: A Phone: Fax: o 4 6( X66 Contractor License Cupertino Business License #: Contact: Phone: T�_. Fax: .esidential Commercial ❑ Job Description:k, 1_, t' L -IN k 0,! 1 s a� t �� J ` car- tna,l Building Permit Info: Bldg 0 Elect ❑ Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ II/III/V-A ❑ II/VI B, IV -HT, V -B s Valuation: � .17 S (J Square Footage: Project Size: Express r7—Standard ❑ 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. "oints Achieved: ar help, contact Build it Green at een.o Revised 07/14/09