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14020019 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10601 E ESTATES DR CONTRACTOR:BROTHERS HOME PERMIT NO: 14020019 IMPROVEMENT OWNER'S NAME: CHOKSHI JAYESH A AND JANKI J 2510 DOUGLAS BLVD DATE ISSUED:02/04/2014 OW NER'S PHONE: 4084219622 ROSEVILLE,CA 95661 PHONE NO:(408)295-0680 M/ LICENSD CONTRACTOR'S DECLAARATION JOB DESCRIPTION• RESIDENTIAL 11 COMMERCIALU License Clas � C f Lic. (42110-01 REMOVE AND REPLACE 8 WINDOWS,TO MEET EGRESS IN Contractor Date a' 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:$9600 1 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:36925016.00 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 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 F477ST 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 granting of this permit. Additionally,the applicant understands and will comply Issued by: 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 installed without first obtaining an inspection,I agree to remove all new materials for inspection. E] //0 ILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of 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. 1 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,Sec' s 255 3,and 25534. 1WAI Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent Date: Z 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 CON CTION 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 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION b` 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 GUpERT1N0 (408)777-3228•FAX(408)777-3333•building0cupertino.org \,�d [:]NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS • APN# W ♦ �O/�` OWNER NAME — � � PHONE q6 �/n'�i �J E-MAIL STREET ADDRESS CITY,STATE,ZIP ((� (� (� �T,A Gj(7� FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS Cr 17Y,STATE,ZIP FAX to N ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ///❑ENGINEER 1:1 DEVELOPER El TENANT CONTRACTOR NAME LICENSE NUMBER b f? LICENSE TYPE f��� BUS.LIC# COMPANY NAME E-MAIL (` %✓ FAX STREET ADDRESS Zu CITY,STATE,ZIP PHONE 7?-? I ARCHITECT/ENGIIdEER NAME LICENSE NUMBER vV G BUS.LIC# 7 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK J�� ✓ �j-r j`Q �� j� EXISTING USE PROPOSED USE CONSTR-TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM . KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: 0 DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? ONO ADDITION? ONO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES :B TOTAL VAL ON: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? [:]NO F �� By my signature below,I certify to each of the following: I am the property owner or authorizqf author' agent to a property owner's behalf. I have read this application and the information I ha ided is c c !rupth= the Description of Work anverify it is accurate. I a ee to comply with all applicable local ordinances and state laws relating ldi onstruc' representatives of Cupertino to enter the aboveri a fied property for inspection purposes. I Signature of Applicant/Agent Data: !/ SUPPLE NT O TION RE =ition DNew SFD or Multifamily well' s: Apply`for opermit for existing building(s). Demolitio perm prior to issuance of building Tluz permit for new building. Commercial Bldgs: Provide'a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. _Copy of Planning Approval Letter or Meeting with.Planning prior to 1' submittal of Building Permit application. o z T •_1�R611tMENT_ _ _. B1dgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION all ADDRESS: 10601 a estates dr DATE: 02/04/2014 REVIEWED BY: Mendez APN: BP#: *VALUATION: $9,600 rPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Duplex PENTAMATION 1GENRES USE: p PERMIT TYPE: WORK remove and replace 8 windows to meet egress in bedrooms SCOPE ° I no Nla NOW IMMM ..� xur}. 1,10n C ',r.r__K Plrwlh. Plan ChecA f/cc c. Plan(.`h ck f_�.,. P.�tuit Foe: Plcr nll. Perm 7/"e, l.'c.c. 11,y� i C)?ftti i Lirr. ,'r�,t> Lj £)1hFrPiu.as?r Irsp. Otlx,f }r.�c.Is�s�. 1°:e NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These fees are based on the prelimina information available and are only an estimate. Contact the Dept for addh7 info. FEE ITEMS (Fee Resolution 11-053 Eff.7.1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 ® # Window/Sliding Glass Door Suppl.PC Fee: (F) Reg. ® OT 0.0 hr's $0.00 $418.00 IWINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-(F) Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Con, Ir•wvion Kr:c: Work Without Permit? ® Yes (F) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential E) Building or Structure 0 Strom Motion Fee: IBSEISMICR $0.96 Select an Administrative Item Bl�Stds Commission.Fee: IBCBSC $1.00 S ga $1.96 $418.00 TOTAL FEE: $419.96 ti =� bu _ Revised: 01/15/2014 t { • ( I' 4 fi� r X0 sx, �v i r of } j ( { 1 I} I t 4 i' i i y1 (p�� Tb- ci II r I I � j �1 CU 1 ( �/ 3xt itYt 1�,,v •.3 ILI�t :�,1 :}1 If.1 Him 8uij',` ���1P� ('21. j nt ' I' �r. BI)��C�I�1Q �?p�[t(Y1e f �E yt yII�1f1 ` ! 1 } r(•' C {,�jS 1 ie l w� it C. tc ,I .iVc.. 0,all'1 Vk;iauun Ir t, `� t Jit" GCI., n C t o ur, G�Y :��an��ora:v� w { ? } g �, DE OMI, 4 iNil Bt�1 �p RE IE�rJ u � Ft(� i �Al� { :' t a: Reuiew BY: i r '1' LAIN_ � PERMIT CH CKE B ! x i I I Cj I i i. sl Ika e I l s 1 I cs ;PATE � I. t t } l�RT�G. PEL'.i, j ( t '�• , I5. ,1 111 i i t ;I� f q ;,j j�j I ;x fit i. : 11 ..