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04110128Mail, SO, 2 is n6y Dto�— n_ru ;yC y 00, pC ym� FZa �F[ w�-S a 0 z F a W a r7 U W r F u CITY OF CUPFRTINO 4 """�� .A-,A �'� "'� �' �"' "��'`C CONRAC7,nRINFORM, ON: BUILDING DIVISION PERMIT : BOB.( Ss: THE WINDOW BROKER PERMITNOO 4 110 12 8 KEN ER'S NAME: PERMIT ISBUE DATE HANS T. SCHEELKE 2385 LINCOLN AYE ii/ic/onn/I SANITARY NO. CONTROL NO. PHONE: (800)639-4527 BUILDING PERMIT INFO ARCHITECTIENGINEER: BLDG ELECT PLUMB MECH LICENSED CONTRACTOR' DECLARATION lianxd unJcr$�rovisiomof,ICodo 9(mmmcncing f rmthtIa atme ondnll I affirm I fir undsSnJ lob De ar+�(I� 3 n I] y01 t uPxb ProfcssinnsCMcr9(Cor ofdmed $c 70001 is Ijtl`r•,', t19d1 \\WVplf(//^[}Y,LA\ f�i�y L n k1foate 1- etdme Ona erreq.- y �2 T WINDOW REPLACEMENT Lif t_ Lic.p Dau: 1 _ cantrecw t �--� JAN aD 2005 �d , my planRs hall 1W. JDns publie r mmis rates\jl pia n�lj Licensed Proportional OWNER -BUILDER DECLARATION I hereby affirm thatOW 1 ons exempt from the ATIOla(s License Law fm the ItI1{�[]It�jtYtjJ'I 'IL917 �� following reason. (Section 703 1.5, Business and Professions Code: Any city or eaunty 2 which rtqubes a permit In consnuct, alter, improve, dcronlish. tor repair any sructum Sq. Ft. FIOOT Area Valuation ! prior In its issuance.als. me.irronc. applicant farmph permit to file a signed stacerma Law 9 Nat he is licensed pursuant to the provisions of the Contractor's license (Chapter _ (commencing with Sued.. 70DIB or Division 3 of the Business and Professions Code) ar that he u exempt hcrefram and are basis for he alleged exemption. Any violation of erO 0 Occupancy Type Section 7031.5 by any applicant for a permit subjects Na applicant to a civil penalty Of not more than five hundred dollars ($5001, ❑hu owner of the pmpeny, Ora employees with wages az their sole compensation, Required Inspections 4 p w ll'Z,a woh, end the sRr le isnat intended or offered for sale(Stt. 7044, Business and Professions Cade: The Comencmts Liana Law docs not apply to in owner of pmpeny who builds or i reproves thereon, and who does such work himsell or through his own employees, provided that such improvements are not intended oraRercd fareale. If, however, the building or improvement is sold within one year of completion, the builder will has the bathe. of pmving Nal he did not build Or improve for purpose Of Ski.) 0 I. as Owner of the property. am exclusively contracting with licensed contractors to construct the project (Sec. 7044. Boniness and Prefouioru Cade:) The Contractor's Li Came law dors not apply to an owner of property who Wilds or improves thcmon, and who contracts for such pmjece, with a cormorants) licensed pursuant o the Conlnctor's xlaw. t e l am excmpl under Sm. ,B&PC far this mazon act Dal WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury ane of tM following dedaradans: 0 I has and will maintain a CeralfiCdlc of Consent to self -insure for Worker's Campem smfon, as provided for by Section 3700 of the labor Code, for rhe performance of the work for which this Permit is issued. 0 1 have and will maintain Wodcls Compensation Insurance, az required by Section 37W of rhe Labor Code, for the performance of Ne work far which this permit is issued. My Worcls Compensation lnsuTrzncc cjlricr and Policy numhcr am: !� i.a ISI G1 2,0 .CSm .i'in'C2 to ♦?w Is�...1 Policy No: CERTIFlCkTE OF PXEMPr10N FROM W 0RKERS' COMPENSATION INSLiRANCE (}Etas seelion need am lCeOmpleled If the perach i5 formas haadreddollars ($100) or less.) 1 in the work lot which this is issued. I shall out eenify that the performance of permit employ any person in any manner so as to become subject to the Workers Compensation lswa of California. Dale Applicant NOTICE TO APPLICANT. If, after making this CeniOcam of Exemption, you should Wcomc subject in the Worker's Compensation provisions of the Lallo Code, you must Z forthwith comply with such provisionsor this permit shall be deemedreveled. D j CONST RUCTION LENDING AGENCY .. 1 hereby affirm Nat there is a construction lending agency far the performance of > the work fur which this permit is issued (Sm. 3(197, Civ, C.) Undcss Name Undoes Address 1 Certify that 1 have read this application and sum th l rhe aWve informaliun is —' cored 1 agree to comply with all city and county ondman cs and sou laws relating to _ JWilding construction, and hereby authorise representatives of this <iry to cnmrupnnthe above mentioned property for Inspection purposes. nst y (We) agree m save, indemnify and keep harmless the City of Cupertino against liabilhies.judgntenu.cosn and .,a., which may in any way accent againstaxid City GGr Z inconsequence Of the granting of this permit. ^� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: DdIC SOURCE REOULWIONS Re -roofs Type of Roof Signalur fAppRanOCOmmclor Data HAZARDOUS MATERIALS DISCLOSURE/ Will the applicant or furore building occupanlstorc of handle haiarJous mmerial ,defined by IW Cupemina Munieipal Cock. Chapter 9.12, and, the Health and Safety _osa, Section 25532(a)76�a ,/ All roofs shall be inspected prior to any roofing material being installed. 0 Yes If a roof is installed without firs[ obtaining an inspection, I agree to remove Will the applicant of future building Occupant use, equipment at devices which emit hazardous air contaminants az defined by the Bay Area Air Quality Managcmonl all new materials for inspection. D'srriet7 o Yea y�Nu I have mad the hazardous materials requirements under Chapter 6.95 of the Carrot. Iia Health& Safety Cods, Smohn. 25515.25533 and 25534.1 undcrsund Na if the Wilding does not currently have a IcnanL that It is my respnnsihilily 41 noufy the tneupanl or the rcyuim nnmaatg,netpr;n�tprstaan=earacer;rcateorrxetrn•n=r /, Signature of Applicant Date All roof coverings to be Class "B" or better OKER FINAL MEASURE Y 2385 Lincoln Avenue, Hayward, CA 94545 DATE I — l r `fll ❑ 1871 So. Chris Lane, Anaheim; CA 92805 Phone (800) 639-4527 JOB If i'I'i j Fax (510) 723-5065 CA LICENSE N 785713 {{ 1 5� t�P' �z RES PHONE: DATE: I k'- I ix - Li OWNERS: . `T^C"t^S STREET: 1l /' `/ 1\e t"'`vyE' BUS PHONE: CODE -�� j � CITY: ^� rnTATE: 13(n�ltr' fn](fODE1�j1I0 �� ''`` �f �l�f n�l� �f ffj� ��FJ I� Bay Window 11;I atio�doochandle(s): Eave projection: (in.) 'b Single story: ❑ Wood siding: ❑ Wood windows . Two ❑ Vinyl siding: Q Aluminum windows: ❑ White ❑ Brass Roof type: ❑ Enclosed Cl story: ❑ d Stucco: ❑ Steel windows: , Inside trim: ❑ Slope Security bars - Re -install: ❑ Yes O No ❑ Stain grade ❑ Paint grade Angle: ❑ 30° ❑ 45° No. days ❑ Retrofit ❑ Pull frames ❑ Lawn sign okay Color: d White ❑ Almond NO. LOCATION TYPE APPROXIMATE SIZE TEMP e2 GLASS OPTIONS GRID' COMMENTS WIDTH HEIGHT - A_ NOV 13 2 3 Y' V 4 r. a V. 7 8 9 r � 05 ,oCEvWITHTTNECCP P.ERTI „ �u 2 t3 This'se-of M Fl� specifications m . Ile IOD at an _15PE5 Pow It uo 14 ul to In ike any changes or alteration on same w thout written perinlaslun uu. ,e 11'c'huildina Deot., City of Cupart'mo. The stamph g of this plan and specmcanons 16 aunt I NiTI hA held to Dei mit or to be ax +oprovol of the Violation of any provisions 17 11:11• n.e..,.nnn �. ♦.om law Instructions: Total U. I. �pecial Windows: Doors: The type and operation of each window have been fully explained and I accept the windows identified on this Bays: measure sneer as vany "„. Customer signature: .. 1..11..,1.. ..... ,. 1 l CS Measured by: dZw ar I,� CCS CITY OF OCUPEkTINO i CITY OF CUPERTIN(O PERMIT APPLICATION FORM v�((°�"2-C� APN # 3C2 2 U Fee Description Fee Group Date: it _'9 -0t. Building Address: Mailing Address (if different from building address): 1010 K'evIo-,ree I Ck., A q5O N Owner's Name: Boiler> I OOK to 500K Btu MECHANICAL Phoe #: Boiler > 500K to 1M Btu MECHANICAL BBOILER4 TOO 293 - 2539 , BBOILER5 Boiler> 1.75M Btu MECHANICAL Contractor: Construction Tax BUILDING License #: 7 t19 3 Q ih o e✓ BUILDING BCONSTAXBQ Con. Tax for BQ Zone Contact: Phone: 510 331 S$ Ll Hotel and Motel Cupertino Business License#: C4 Q-v1sv, Fax: O 323•60G5 BUILDING BELEC1000 Building Permit Info: ELECTRICAL BELEC1001 Bldg [V Elect ❑ Plumb ❑ Mech ❑ ''Job Description: • nOW,S Residential /' ., �; �;� r ae 7 - 1 " Commercial El Sq.Ft. Floo Area: BUILDING BENERGYADD $/Sq.Ft.: 1 Cost of P oje 6 ' qZ , Investigation fee BUILDING Occupancy Gr #; if ype of Construe -on: / Please chec thi box if the 6Wject is a - second-stor ddi lon:;' ❑ E Project Size: Standard Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler> I OOK to 500K Btu MECHANICAL BBOILER3 Boiler > 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax - Resi/Mobile BUILDING BELEC1000 Elec 600V <= IOOOA ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING �tf- 27 �- 2d' 1 of 3 43F6 .7.i y�z Oa rcFF f- O�C � v �pC Kme Hi> Cog at 7 CITY OF 'CU � BmLrnnc DIVISION PERMIT WCQL�tTRAG�TQRINFORMATI®N awl BUILDING ADDRESS: THE ,WINDOW BROKER PERMIT "004110128 1010 KEN NAME: PERMIT ISSUE DATE �ER'S HANS T. SCHEELKE 2385 LINCOLN 4 PHONE: SANITARY NO. CONTROL NO. (800)639-4527 BUILDING PERMIT INFO ARCHITECTIENGINEER: BLDG ELECT PLUMB MECH 0 0 0 0 LICENSED CONTRACTOR' DECLARATION lob Description I hlrcby affirm Nat 1 am licenxd under ovuions of Chapmr 9 (commcncing wisp SCrnra7 011, of Di vision sinejs nd Professions Code. and my license is ------- - r fdme and effect •�' J3Z 1i WINDOW REPLACEMENT Lictnsc Clu_ �._ LIC D � Dau 1 4 Cortone 1 ARCHITECTS ECLARA3.TDN I dor and my plans shall M1e used as public mcnrds / J lel y Liccnscd Prommi... I OWNER -BUILDER DECLARATION 1 alarm that 11. cxcmpl from the Contraaoo Anyc Law for shy Code: Any city or county i followingnaso : ng reason. ]omnan Business and 86192 ve drinns which Peron t alter, improve m repair any slrvaure which a gamin m cores Vim` h Permit to priormiuiuuancc.alwrcquresthcapplicant for suchpermiuOBlcasigned statement its is the SQ Ft. Floor Area Valuation onotheprovisionsoftheConnector's6mouseLw(Chapter9 I Our he is licensedpursuu 1 (commencing with Seclian'"I of Division 3 of the Business and Professions Code)or that be is cxcmpl mono —and the basis for the alleged exemption. Any violation of er0 0 Occupancy Type Semon ]031.5 by iscrim lioant fora pesmil s inccu the applicannO a civil pcnalryof huned dollars (551101 nos more man fisc dr ❑ 1, as owner of the pmp.ny, or my employees with wages M their sole compensation, ._ — Required Inspections .. 9 p will do the work, and me structure is not intended or offered for nal. (See .]D14, Business and Proplex. s Code: The Cmuccomr's License Law docs not apply to as Owner of ' property who builds or improves thereon. and who does such wutk himself or through his Own employees, provided that such improvements are not intended .,offered forsels. If. however, the building or improvement is sold within one year of completion, the owner -- builder will leve me burden of proving that he did not build or improve for purpose of sale.). ❑ L as Owner of the property, am exelasively contracting with licensed contractors no onstrecl the project (Sec. 7Ba4, Business and Professions Code:) no Contractor's Li - came taw does not apply no an owner of property who hands or improves Nemon, and who contracts for such pmjecm with a contractol(s) licensed pursuant to the Conuaaafs -.. .. License Law. I am exempt under sec. . B & P C for this reason tier Date WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty Of perjury one of the fallowing declarations: I have and will maintain aCorricateof Consent to self -insure for Worker scompcn- svnion, as provided for by Section 3700 of the labor Codc, for me performenm Of the work for which this permit is issued. 1 have and will maintain Worces Compensation Ltsttrancc, as required by section 3]00 Of the Labor Code, for the rformof the work for which this permit is issued. pekance My or cls Co. pesmation Insurance c Hier and Policy numMr aa: Cam 'tre C ?•+ a Policy No: ISI CERTIFlCATE OF EXEMPTION FROM WORKERS* COMPENSADON-INStRANCE (This section nccJ nm M1c cumplctcd if the p.rmit is roronc hundred Jnllars (Ilfgp in, lysx) 1 1 croons, con in the performance of the work for which this permit is issued. l shall out employ any person in any manner sn as to become subject o the Workers Compensation Laws of California. Date Applicant _ NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Worker's Compensation provisions Of the Labor Cade, you must Z furthwi in comply with such prnvisions .ar this permll shall be deemed evoked. CONSTRUCTION LENDING AGENCY . 1 hereby that mire is 3(y lending agency for the perfurmana of whalltrm 7 the work for which Ibis permit is issued (Sec. J(5], Civ. C.) s ed (Sec. aI-codin's Nam. , 'LcadMcr's Address Z Q I notify mat 1 have read this application and mute mat the above information is correct. 1 agree to comply with all city and county on inarmse and state laws relating to r upon building ce)agreean,oand V siry andOu eppuenmtives Of this of nu cm.no agathe ,indehereby above mentioned progeny for Wolverton proposes. W and keep harmless the City of Cupertino against 6. (Wq agree m marc, and expenses which may in any way accrue against said City t,lZ liabilities,judgments,fthecommand exam S4t(2� of this oftheRSTAN or this permit ,`Z A APPLICANT t-" APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date SOURCE REOUME01,11 `i"��! �c,�r� ;rIO,✓'/af Re -roofs Type Of Roof Sig nam rAppricaraCnntraaor Date HAZARDOUS MATERIALS DISCLOyRtif Will the applicant or future building Occupant store or handle havardous material as defined by the Cupenlnn Municipal Code. Chapter 9.12, and the Health and Safety ode. 25532(a)? All roofs shall be inspected prior to any roofing material being installed. OYees Ian If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or furore building Occupant use equipment or devices which min homtdous air contaminants az defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes YNu I have read the havardous materials onnimments under Chapter 6.95 done Califon, - nia Health &Safety Code, Sccdom25505, 25533 and 25534.1 understand than if the building Jots not of sly have tenant mat it is my resporomilisy to notify the —or-' of the (occupancy Date myui¢ met, tpnn toissnanunfaceNfieatey ' Signature of Applicant .� All roof coverings to be Class "B" or better