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B-2017-1995 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1995 10886 NORTHRIDGE SQ CUPERTINO,CA 95014-0528(316 36 018) DELUXE WINDOWS AND DOORS SAN MATEO,CA 94403 OWNER'S NAME: MOGHTADER JOHN TRUSTEE DATE ISSUED: 11/17/2017 • OWNER'S PHONE:650-380-6148 PHONE NO:(650)461-4446 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B.C-17 Lic.#695262 Contractor DELUXE WINDOWS AND DOORS Date 09/30/2019 X BLDG _ELECT _PLUMB MECH X RESIDENTIAL_COMMERCIAL 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. JOB DESCRIPTION: • REPLACE WINDOW(2);REPLACE SLIDING DOOORS(3);LIKE FOR I hereby affirm under penalty of perjury one of the following two declarations: LIKE TO MEET EGRESS 1. 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 17; l Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$7800.00 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 316 36 018 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. ature Date 11/17/2017 Issued by:Jasmine Archbold �I} • Date: 11/17/2017 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. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date: 11/17/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. 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. HAZARDOUS MATERIALS DISCLOSURE 2. 'I 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. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. ner or authorized agent: • APPLICANT CERTIFICATION itiate: 11/17/2017 I certifythat I have read this application and state that the above information is CONSTRUCTION LENDIN AGENCY PP 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. I understand my plans shall be used as public records. Signature Date 11/17/2017 Licensed Professional CONSTRUCTION PERMIT APPLICATION t� COMMUNITY DEVELOPMENT DEPARTMENT ® BUILDING DIVISION - 10300 TORRE AVENUE ® CUPERTINO, CA 95014-3255 *"-° ' (408) 777-3228 ® building@cupertin.o.org PEMIT#B- 2O l - l q et 5 CUPERTINO REV# DEF# ❑ NEW CONSTRUCTION ❑ADDITION "❑X ALTERATION ❑T.I. ❑MEP ❑RE-ROOF ❑SWIMMING POOL/SPA PROJECT ADDRESS APN# � � � _ �� - Q 10886 Northridge Sa 01.8 OWNER NAME PHONE E-MAIL • John Moghtader 650 380 6148 jmoghtader@gmail.com STREET ADDRESS CITY,STATE,ZIP 10886 Northridge Sq Cupertino,CA ❑CONTRACTOR NAME ❑OWNER-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE Yanek Poryes DELUXE WINDOWS 695262 B,C-17 ISTREET ADDRESS CITY,STATE, ZIP I 105 22ND AVENUE SAN MATEO,CA 94403 E-MAIL PHONE BUS.LIC# info@deluxewindows.com 650-461-4446 Li 0 6(6 ❑ARCHITECT ❑OWNER ❑OWNER AGENT ❑CONTRACTOR AGENT ENGINEER❑DEVELOPER 0 TENANT CONTACT NAME, E-MAIL STREET ADDRESS Li I Y,STATE,ZIP PHONE DESCRIPTON Replace 2 windows and 3 sliding doors.New exterior trim. same size and location. ❑SINGLE-FAMILY/DUPLEX 0 MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL I EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES# TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION($) REMODEL REMODEL KITCHEN REMODEL OTHR GARAGE ❑ATTACHED BATHROOM SF SF SF SF 0 DETACHED EXISING ❑YES EICHLER ❑YES SECOND STORY ADDITION ❑❑ ES FIRE SPRINKLERS.❑.NO ❑ NO DWELLING SECOND DWELLING ❑YES ❑ATTACHED❑DETACHED OTHER UNITS if UNIT ADDITON: ❑NO S F POOLS! 0 FIBERGLASS 0 VINYL-LINED ❑GUNITE 0 PREFABRICATED , POOL-SF SPA-SF SPA ATTACHED❑YES 0 NO TOTAL-SF RECEIVED BY: TOTAL VALUATION: • Commercial or Multi-Family Buildings with Public Swimming Pools requires Department of Environmental Heath approval 7800 RE-ROOF!EXISTING ROOF TYPE: ❑BUILT-UP ROOF❑ASPHALT SHINGLES❑WOOD SHAKES❑WOOD SHINGLES❑TILE OTHER(SPECIFY) REMOVE/REPLACE 0 NO IF NO PLYWOOD ❑'A ❑3/8" PLYWOOD TYPE: PITCH: ROOF CLASS 0 yES I #OF LAYERS THICKNESS❑5/8" OTHER ❑OSB ❑CDX OTHER .12 A PROPOSED ROOF TYPE:❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES❑WOOD SHINGLES 0 OTHER • • 'Provide a signed copy of the Cupertino's Tear-Off Policy SF #of SQUARES By my signature below I certify to each of the following: I am the property owner or authorized agent to act on the-property 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.construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. I acknowledge and authorize all information contained on this application form to be made available for public record. Signature of Applicant/Agent: AI I ' Date: t 1 111-I to i t SUPPLEMENTAL INFORMATION REQUIRED 61 *New SFD/Second Dwelling Units/Multifamily Dwellings:A Demolition.permit is'required prior to issuance of a building permit for all new construction. . *Commercial Buildings: 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 submittal of Building Permit application. *HOA-Provide a letter of approval from the Home Owner's Association BldgApp_2017.doc revised 08/01/17 Northpoint HOrnieo ners Association 10880 Nortfipa'intWay,Cupertino,CA 95015 November 16,'2017 John Moghtader 10886 Northridge Square Cupertino,CA 95014 RE:10886 Northridge Square Dear Mr. Moghtader, The Northpoint HOA has reviewed your property modification request to replace 2 windows and 3• y sliding glass doors. They must be the same size aperture and location of existing window or sliding door. The structure of the building may not be altered and/or jf any part of the installation requires a permit, then the HOA requires a copy of the permit for their records. On behalf of the Northpoint.HOA, Za General Manger Northpoint HOA 10880 NorthpointWajr Cupertino,CA 95014 Office:408-996 3734 Fax:408-996-0226 email:martager@northpointhcia.com a.corrt_ 10800 Northpoint Wav,Cupertino,CA 9501 rrz,inaveRal Sll airithOa.etitn:.