The URL can be used to link to this page

15120087C CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10668 HALE PL CONTRACTOR: BENTSON ENTERPRISES PERMIT NO: 15120087 OWNER'S NAME: KOPELS BARBARA S AND DAVID N TRUSTE 535 UNION AVE DATE ISSUED: 12/09/2015 OWNER'S PHONE: 4084611195 CAMPBELL, CA 95008 PHONE NO: (408) 677-1028 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL j� �j �� REMOVE AND REPLACE (2) DOORS AND (10) WINDOWS License Class ` Lic. # / IN r � ontractor �� r'"CJ�✓ Date / Z- — /� DUPLEX. 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: $12000 performance of the work for which this permit is issued. �I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 32640013.10668 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which this 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 FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses w ' may accrue against said City in consequence of the J � l -o -7 -� Issued by: / �i Com! Date: /n' granting of this p it. Additionally, the applicant understands and will comply ��+'1/ with all non -poi ations per the Cupertino Municipal Code, Section 9.18. y/so/reu 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. ❑ OWNER -BUILDER 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. 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 Ba Area Air uality Management District I performance of the work for which this permit is issued. will maintain compliance with the u r ' o icipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sectio s 5 , 2 , and 25534. Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. caner or authorized agent: 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 �K 1 CUPERTINO GENERAL PERMIT APPLICATION COMMUNITY DEVELOPI\/TENT DEPARTMENT- BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (4-08) 777-3333 • build inO(8)Cuoeriino.org /�()��' 7 ❑PLUI,/,3N'G ❑MECHA1\'ICAL ❑ELECTRIC.A1h611SCELLA\IEOUS PROJECT .4DDPESS/6 /, /l .42?\ OWTiRNp11,z pe Is I PHO?\ 0 K Y6 / (1 Cf \ E•?J=�Z STREET :MDP.ES�� / /' / I CITY, STATE, F -,X COx.-IACT N.4V'E PHONS E-? L4LT STREET a.DDPESS CITY, STATE, ZIP FAX 01 1 -E -R.❑ 0\+ 1. ?-BU Ti D ❑ O'WNER AGE1, r ❑ C01,77.4CTOR ❑ CO.gr ACTOR AGS T ❑ ARCHEECT ❑ DvGL =E2 ❑ DZ�cLOPER ❑ i_ Sh7 C0NTR4CTORN?JAL U� �® LICEI.SETL� /' I �j I LICTS 'PE I BUS. LIC COM T.UN N.41a ( I E-Ny411� � U� �ZZ l4l S I I #6 U U (J \ 1 ✓vl STREET ADDRES3 3 c� ( J - l� a (J� V N CITY, STATE, 25 � : P i0> (\ / ARCIBTECT/ NGNEER NAME LICENSE ?\�iJ?� BER BUS. LIC-,' COMP -W NA?1,_, E-NLUL I F?-: STREET ADDRESS I CITY, STATE, ZIP I PHONE USE or- i7 or DUPLEX ❑ brULTI-F.Affi-Y PROJECT N WITJLf1NTD ❑ YFS PROJECT LN ❑ YES IS THE BLDG AN ❑ YES BUM DP.G: C01+9,' -- .CIAT U3RB/?1 L\1 -EP -?.CE,' -RFA ❑ 2,10 I FLOOD ZONE ❑ 1\'0 I EICFLERHO1✓B7 ❑ I 0 DESCRIPTION OF WORK , D Lz/--�5 z1v l//�G• TOTAL VkLUATI01 : � 3 By my signature below, I certicy to each of the If owing- grope_: ty owner or authorized agent to act on the propery owner's behalf. I have read this scription of'Wm-k - d -veru it is accurate. I agree to comply ith all applicable local application and the Lnfor-nation I have provide torr ct. rea�Yepresenta` ordinances and smote laws relatL g to building o ctio horizupe tiro to enter the zbov - rieOpe ror inspection purposes. Siscmatnre ofApplicant/.?gent: Date: !/ 1^ , T SU -PPL 1t l AI. L��ORvIATIOI� �QULRED ._s;Y x; s ;, Y :,� � :-'at;y.. .'a':i_': ="': i--`^.- =`;€'=_ v � � �OF.FZCESLSEO�LIF1 vx� MKT 4 ? ❑ :r LR t f -A,fEP ,isc,,4vp_?011. doc remised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School llic}rim} aim 1 Thaca faac nra hacad nn fha nraliminary infnrmatinn avai/ah/a and are nnly an estimate_ Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 E{f'. 7/1/13} ADDRESS: 10668/10670 Hale PL DATE: 12/09/2015 REVIEWED BY: Sean APN: BP#: *VALUATION: 1$12,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY USE: SFD or Duplex PENTAMATION FPERMIT TYPE: 1GENRE ; WORK Remove and replace 2 doors and 10 windows in duplex. SCOPE NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School llic}rim} aim 1 Thaca faac nra hacad nn fha nraliminary infnrmatinn avai/ah/a and are nnly an estimate_ Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 E{f'. 7/1/13} FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 12 # $574.00 Window / Sliding Glass Door 1 WINREP Replacement Suppl. PC Fee: (j) Reg. 0 OT0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0,0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 ("'O i:N11°uefion ./Ltd-: F7 G Work Without Permit? Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) 0 i I* ir(di)el.I)ociiiitei,itotion Fees: Strong Motion Fee: IBSEISMICR $1.56 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS:_ $2.56 $574.00 TOTAL FEE:: $576.56 Revised: 10/01/2015 10670 Hale pl - Google Maps Page 1 of 1 t rt 10670 Hale PI Cupertino, CA 95014 CUPERTINO wilding Depatnent 19 201.5 REVIEWED FUR CODE COMPLIANCE R600va� B9.- �k �� 5: D $ yt FICE COP"4Y https://www.google. comlmaps/place/ 10670+Hale+Pl,+Cupertino,+CA+95014/@3 7.3 2695... 12/7/2015 From: paulboewer <paulboewer@yahoo.com> To: paulboewer <paulboewer@aol.com> Date: Mon, Dec 7, 2015 2:23 pm Attachments: IMG_0193.JPG (156K), IMG_0194.JPG (151K), IMG_0195.JPG (127K), IMG_0196.JPG (129K) Sent from my iPhone 4 Attached Images Page 1 of 2 https://mail.aol.com/webmail-std/en-us/PrintMessage 12/7/2015 https://mail.aol.com/webmail-std/en-us[PrintMessage / b �.� <�' Page 2 of 3 12/7/2015 i. J Page 2 of 2 https://mail.aol.com/webmail-std/en-us/PrintMessage 12/7/2015