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B-2016-2460 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2460 10166 BONNY DR CUPERTINO,CA 95014-2904(359 11 048) SENO CONSTRUCTION INC ANTIOCH,CA 94531 OWNER'S NAME: LEWIS MARILYN M TRUSTEE DATE ISSUED:08/04/2016 OWNER'S PHONE:408-761-4014 PHONE NO:(925)584-1245 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic.#896482 Contractor SENO CONSTRUCTION INCDate 05/31/2017 X BLDG _ELECT —PLUMB _ _ I hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH X RESIDENTIAL COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: REPLACE WINDOW(10)-LIKE FOR LIKE TO MEET I hereby affirm under penalty of perjury one of the following two declarations: EGRESS/TEMPERED PER CODE;REPLACE PATIO DOORS(2); 2. I have and will maintain a certificate of consent to self-insure for Worker's REPLACE FRONT DOOR Compensation,as provided for by Section 3700 of the Labor Code,for the /,'performance of the work for which this permit is issued, z./ ave and will maintain Worker's Compensation Insurance,as provided for by ction 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$3400.00 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 359 11 048 representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. -' Signature Date 8/4/2016 Issued by:Abby A,eti nde Date:08/04/2016 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. I,as owner of the property,or my employees with wages as their,sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the,work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) 2. 1,as owner of the property,am exclusively contracting with licensed Signature ofApplicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:8/4/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. 1 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. HAZARDOUS MATERIALS DISCLOSURE 2. 1 have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this , California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534. i Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked, /Owner or authorizedagent: APPLICANT CERTIFICATION J Date:8/4/2016 i certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 8/4/2016 Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 r—UPI"RT1N0 1 (408)777-3228•FAX(408)777-3333•buildingCcDcupertino.orc ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS ,6 f 4�- / � APN# v �L yryF OWNERNAME ! (p / d�Y.A/ 7e-1E-MATT STREETA RESSS P11k, STATE,ZIP�fJ FAX F T NAME �1 PHONE E-MAIL R - 143 CI TS%STAGE'ZIPS/ �y-7 FAX ❑OWNER ❑. OWNER-BUILDER -IOWNERAGENT ❑ CONTRACTOR 1:1 CONTRACTOR AGENT ❑ ARCHITECT ®❑-ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME r [ E-MAIL FAX STREET ADDRESSCITY,STATE,ZI ( PHONE arc-✓ ��s �i� �G� �, -� 72-5'.S96lz ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK ll x EXISTING USE PROPOSED USE CONSTR TYPE #STORLES USE TYPE OCC. SQ.FT. VALUATION($) EXLSTG 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: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES - - - BEING ADDED? ❑NO ADDITION? ❑NO PRE-APPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES [RE Prypp By, ' T T VALUATION: PLANNING APPL# NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the prop-hy owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building e.. Eauthorize representatives of Cupertino to enter the above-identi ee pro errty for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFION-IZ �- G IRED " � r,.,PLANCRECI�TY EHb[7TING'St New SFD or Multifamily dwellings: Apply for demolition permit for ❑ 9YE[2"THE -COUNTEII El BUIY DING PLAN REVIEW existing building(s). Demolition permit Is required prior to Issuance of building i permit for new building. ❑ EXREss �PLeVNNINGPLANI2EViE,l1S, Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ PUBLICO x� ` form if any Hazardous Materials are being used as part of this project. s LARGE - � ❑ Ems.DTP1` ' c Copy of Planning Approval Letter or Meeting with Planning prior to r; submittal of Building Permit application. AaoR MEW'- ❑��ANrrAizY _wrRvrsTlitcT HEALTx�<f, B1dgf4pp_2011.doc revised 06121111 d �Q Z_ ` 4. .. F 1,C P-Y Y:v er�A Al, ar' —^i�M"�a4 < /"/1.-7' vy�,4L L��Wr r "^ (E)WALL i ... n TO DEMO .... (N)WALL , kyr Il�h Q9 , PLOT PLAN C . l '� CKED R�° r ` DATE ►<< ' G PLA NINE DEPT CUPERTINO - COMMUNITY Y OEVELOP rrlT,IOEPARTNI IST EU1D(N, DIVISION CUP€RTINC) APPROV D C � his set of.pians end Ssp"Ifi atio� :. GL,A Eel L/ - ;ob sate d firing cor,str n. it fs unia. l 'n make CIL I' .7,,�� ,�!. � 5s changes or alterat, �s on sail Wto delviate therefrom; without approval from the Building Official. The Stam�ing of this plan and specifiGatlons SHALL NOT be held to permit or to be an approval of th6 violation a77, of any pr visions o any City Ordinance or State Law. _ DATE II �,wry/ 6 f-7AA..C7� ,4 : r ��- /�. ,{`V✓t�� vIG PERMIT # ' y �4:1Jt✓1". '�4.�'°�� _ :.. 7 z.,.5_ s- 161416 O 6 / 416aN -Y I`VE, jPER-rINO C. 1 '�`-1 Thursday July 27,2076;