BLD-2024-0549_Construction Permit applicationCONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • permitcenter@cupertino.org PERMIT #B - -
CUPERTINO I REV # DEF #
M MFW C 0NSTRT IC'TTC)M n AmrrTON n AT.TF.RATION n T I_ n MF.P M RE -ROOF n SWIMMING POOL/SPA
PROJECT ADDRESS
APN #
7375 Rollin Dell Drive,
OWNER NAME PHONE
Kav Sasaki
14D% 24 A dSZ
E-MAIL,
STREET ADDRE
11, � 1\
CITY, STATE, ZIP
C u +�w� G
7 37.5
l CONTRACTOR NAME ❑ OWNER -BUILDER COMPA\S
NANTC
LICENSE NUMBER
LICENSE TYPE
Andrew King �Newpanexom
782072 �C-17
STREET ADDRESS
CITY, STATE, ZIP
340 Industrial Way # T
Dixon, CA 95620
E-MAIL
PHONE
BUS. LIC h
andrew@newpane.com
800 614 7263
(3� CIt� ► `{ j
❑ARCHITECT ❑OWNER ❑OWNERAGENT I] CONTRACTOR AGENT ❑ENGINEER❑DEVELOPER❑TENANT
CONTACT NAME
E-MAIL
Andrew King
Andrew@rlewpane.com
STREET ADDRESS
CITY, STATE, ZIP
PHONE
1800
340 Industrial Way # T
Dixon, CA 95620
614 7263
DESCRIPTON
e la a Aluminum windows only for Buildin s 1.2,6.,'7.10 & 11 for new Mil and White vinyl windows. total windows t
be replaced is 160.
TOTAL VALUATION:
197,500.00
❑SINGLE-FAMILY/DUPLEX ❑x MULTI -FAMILY ❑ INDUSTRIAL ❑ COMMERCIAL
USE
TYPE
OCC
SQ.FT.
VALUATION ($)
EXISTING USE
I EXISTING IF
NEW FLOOR IF
I PORCH
IF I DECK IF
I DEMO IF
STORIES I
TOTAL NET SF
REMODEL
REMODEL KITCHEN
REMODEL OTHR
GARAGE ❑ ATTACHED
BATHROOM IF
IF
IF
IF ❑ DETACHED
EXISWG ❑ YES
FIRE SPRINKLERS ❑ NO
EICHLER ❑ YTS
❑ NO
SECOND STORY ADDITION ❑ YES
❑ NO
DWELLING
SECOND DWELLING ❑YES ❑ ATTACHED ❑DETACHED OTHER
UNITS R
I
UNIT ADDITON: ❑ NO S F I
POOLS
❑ FIBERGLASS ❑ VINYL -LINED ❑ GUNITE ❑ PREFABRICATED
POOL - SF SPA - SF I SPA ATTACHED 13YES ❑ NO I TOTAL - SF
RECEIVED BY:
ComntuvrcW or Multi FamR B�Xs a ith PuNk Swimming Pools requires Dnyarhnotof Environmental Heath ahyroval
RE -ROOF
EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES[] WOOD SHAKES ❑
WOOD SHINGLES ❑ TILE OTHER (SPECIFY)
REMOVE /REPLACE ❑ NO
TF NO
PLYWOOD ❑❑ 3/8"
PLYWOOD TYPE:
PITCH: q
ROOF CLASS
[]YES
# OF LAYERS
I
THICKNESS ❑ 5/8" OTHER
j
❑OSB ❑ CDX OTHER
'12
A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ 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 wledge and authorize all information contained on this application form
to be made available for public record.
Z- 2 3
2:Z_i
Signature of Applicant/Agent: Date: -
SUPPLEMENTAL INFORMATION REQUIRED
*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.
*BOA -Provide a letter of approval from the Home Owner's Association
BldgApp_2017.doe revised 01101121