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10070050
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10430 FINCH AVE CONTRACTOR:UPPAL CONSTRUCTION PERMIT NO: 10070050 CO C `FR'S NAME: AMITA AGARWAL _245 PETERSBURG DR DATE ISSUED:07/07/2010 OWNER'S PHONE: 6509065292 MILPITAS,CA 95035 PHONE NO:(408)507-6750 ❑ LICENSED CONTRACTOR'S DECLARATION 'WILDING PERMIT INFO: BLDG r ELECT r PLUMB License Class_ �� _ Lic.# �— t S MECH F RESIDENTIAL F COMMERCIAL Contractor 1/ P100 6Z NS7,VLeate IOB DESCRIPTION:REPLACMENT WINDOWS LIKE FOR LIKE;NON- I hereby affirm that I am licensed under the provisions of Chapter 9 iTRUCTURAL (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. I have and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$3500 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. jj �u"y APN Number:37540053.00 Occupancy Type: APPLICANT CERTIFICATION 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. , y,� /�-� –'/ f Issued by: y] Date: r S: nture V!f� Date / / -0 ❑ OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. 1,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, Signature of Applicant: Date: Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). 1 hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. 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 Owner or authorized agent: `71 Il C7become subject to the Worker's Compensation provisions of the Labor Code,I must Date: L� forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter he above mentioned property for inspection purposes.(We)agree to save Lender's Address aify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date l/ CITY OF CUPERTINO FEE ESTIMATOR-- BUILDING DIVISION ADDRESS: I DATE: REVIEWED BY: APN: BP#: "VALUATION: $3,500 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY 101 i r APPLICATION USE: SFD or Duplex 1:/00f, 4i LATYPE: MECHANICAL O Yes O No PLUMBING O Yes O No ELECTRICAL O Yes O No xW rx a. cc 3 � OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. sq .ft. R-3 (Custom) II-B,111-B,IV,V-B 0 $0.00 $0.00 TOTALS: 0 $0.00 $0.00 F-1 IF I I NOTE: These fees are based on the preliminary information zvailable and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 0.9-051 Et: 7.1/0.9) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 8 # Window/Sliding Glass Door Suppl. PC Fee: Reg. OOT 0.0 hrs $0.00 $380.00 1WINREP Replacement PME Plan Check: $0.00 Permit Fee: $).00 Suppl. Insp.Feer Reg. O OT0.0 hrs $).00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 ,-III 1 11 i'' F Acoustical Fee: O Yes Q No $0.00 O Work Without Permit? O Yes (F) No $0.00 E) Planning Fee: $0.00 Select a Non-Residential E) Building or Structure O Strom Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $380.00 TOTAL FEE: $381.50 Revised: 5/27/2010 CITY OF CUPERTINO CUPERTINO GENERAL BUILDING PERMIT APPLICATION FORM APN# ( � Date: / u `T 0 Building Address: 10 q 3,o r(),J C�H 14U Mailing Address (if different from building address): S7 4 m a_ Are Hazardous Materials being used as part of this project? Yes No HOA: Exterior work only) Yes E No ❑ If yes, provide letter from HOA Owner's Name: Phone#:t�o l Iv` � vv1 Contractor: r- Phone: Hog ZC, Z L) CP Pf 1 G©Opt s ` • Cc Fax: Contractor License#: 'F C� 3 2—e1 Cupertino Business License#: Contact: —Fax: b J Residential Commercial ❑ Job Description: Ke r,..`01 L9�1..�� Building Permit Info: Bldg Elect ❑ Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: `> 1-A, 1-BL7 II/III/V-A ❑ II/III B, IV-HT, V-13 [� Valuation: _ Square Footage: Project Size: Express StandardEl Large 1] Major ❑ Green Building: Please complete relevant portion of the Green Building/LEED Checklist & attach it to the application or if applicably;, include in plan set & the sheet index. 'oints Achieved: For help, contact Build it Green at www.builditgri:en.or Revised 07/14/09 M.Indoor Air Quality and-Finishes INPUT ResDurces Energy 1ADIHeafth 1.Use Low/No-VOC Paint 1 IAQ/Health pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 3.Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes 0 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Health pts y=yes 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0 7.Seal all Exposed Particleboard or MDF 4 IAQ/Health. pts y=yes 0 B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes D 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0 10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0 1 1 1 N.Flooring ' 1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 ' 1 1 Ed Total Points Avallable:1 1 1401 130 57 Total Points Project Received: 0 1 01 0 -7/7110 G:datalprogs/gr:enbuildngguidelines/remodelers/greenpointsfina12.12.04proteoted.xis r.« Sliding Window a) @ w - m - . . U) 0C- 2$ ° 0 �D q E oa E C>— ## B :* C, ��_ 9 ƒ> E ° § m 3 ' !\x E7 0g \ [5 2m /c C U M. fu /3 _ 2 $ = , �\ (D CD - Sz c � 0 ] §a cg� Lti, = =-0 o00 > (1) =3 CID _\ƒ® � §� i --4 i \ E � /r \j � /f CD � \ /\ k/� j �& E : » ; ok CL `� � � /� �x C) - 0 &±0L', �0 § - \ a22[ ¥ , 0 C 0 co - = 2 _ � � k a = o _. E } ± ) 0 \ , . [ � - !. 2 CEI E* aJ q n /a \ # ( S % k & Z R R r { T-3,7 x ! \ s � �E �/ � ka ,� 5Q \ X0 \t | 3 3 0 E CT —3-zz� . | ±e «x« � 2 Gdggk_ ! � , � �