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04110060 CITY OF CUPERTINO `�°"waba"v-A5d1.rr s €��az�a t resflts " BUILDING DIVISION PCRM� CONT.IUOMOR�INFORM ,N BUILDING ADDRESS: PERMIT NO. ARGONAUT WINDOW & DOOR 04110060 NtR' AMt. PERMIT ISEUE DATE PHONE: SANITARY N OL NO. (408) 996-9679 ARCHITECDENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LOo LICENSED CONTRACTOR'S\D'ECLARATION Job Description YwF 1 hereby,off no that I on licensed under OOAneolit of Chapter 9(commencing S;ry with 'on )of Division3of the Bminessaad PrOmasiuns C.dc.and my he.-.is ?�N in fullfom ndelfea ,t'I n-5 sya Lamm.elaae Lm,x WINDOW REPLACEMENT/STUCCO n F 0 Dam — 0— Contractor ARC nF1 SD LABNI0 �i I under Ian m all W se ublic'c da Jy Liccn 0 oris I ._ . OV TER-BUT DE ECLARATION +j I hereby affirm I am cxcmpt from dim Contractors License law(.r Linc i0 o following mason.(Scetion 7031.5,Business and Professions Code:Any city or county acro which retinues a permit to continues.alter improve,demolish.or repair any structure Fzy prior m its icsuana,ahortqums tWapplimm for such Permitm File a signed statement < that hu e is licensed pumuano the provisions of the Contractor's License Law(ChaPmr 9 Sq.Ft.Floor Area Val ¢�� (commencing withSection 7")of Division 3 of Ne B usimas and Proressmna Code)or i $ Bus he is exempt therefrom and Ilte basis fm the alleged exemption.Any violation of Section 7031.5 by any applicant for a Permit subjects the applicant o acivil Penalty ofhWatered3 gfpPF iju er0 0 Occupancy Type are dun five not Watered dollars 4500). 0 I,as owner of the property,in my employca with wages an their sole compensation. will do Ne work and dte strucwm is not intended or offered fmss4(Sim.7o .Business and Professors Code:The Conuactose rs LicenLaw dice:not apply M,n Owner Of Required Inspections property who buildsor improves Nercon,and who doessuch work himself.,through his - own employees,provided that such improvements art not intended or.ffered Waste.If. huilder,One Wilding or den of proving :the withinoneyear of completion.Ne owner- builder will have Ne burden of proving i Nat he did not Wild o,improve for purpose of salc1. ❑1,u.weerof the pee.7[P1.Bam exclusively confessions with:)Theed..nlluirS - O eonnam the canon(Sec.o an weer o.and nywh Professions Code:)The Conuxcmin,Li- whoc law does not apply c an owner.f property who W olds of improve thereon,and -who contracts for such projedt with acomm�.r(a)licensed pursuer.to the C.nfncfoh License law. ❑lent cxcmpt under Sec. ,Bin PC for this rtazon Dat WORKER'S COMPENSATION DECLARATION 1 heuby affmn under penalty of perjury one of the following dalantiona: 0 1 have and will maintain a Cer ificaeaof Conscm to self insom for Worker's Camper. nation,az provided for by Secdan 3700 of the Tatar Code.far the pmfmon.of do, were for which Nis permit is Wound. 0 1 hats and will maintain Workch Compcnaation Wuesnm..ai, retl by Sccuon 37W of the labor Code,for the performance or the wool,for which mi ,mit is issued. My orkcr Compensation Insurance carrier and Policy nu,Jbe ' Caa/� Poliy No.: RKERS i .. CERTIFICATE OF EXEM 1111 FROM WDR�KEn0.S' COMPENSATION INSURANCE (-d S (This senior need not be min,iread if the Permit is formic hundred dollars(SIM) or less.) I certify Nat in the performance of the work for which this Permit is issued,l shall not employ any Person in any manner so az to become subject to the Workeri Compenaxtion Laws of California.Dam Applicant NOTICE TO APPLICANT:If,aper making Nu Ccnircau,of Exemption,you should become subject to Ne Worker's Comperactum pnovisions of the tabor Cu c,you must .J O forthwith comply with such provisions or this permi(shall be deemed revoked. Z " CONSTRUCTION LENDING AGENCY 'v'—t I hereby affirm Nat there is a construction lending agency for the Performance of xNe work fur which this permit is issmd(Sec.3097,Civ.C.) {LIQ Lenders NamegL _`.,_,_, Z) z lenders Adtlrrss U d 1 anify that I have read this application and sum Nat the about informauun is �. I,, correct.I agree to comply with all city and county ordinances and sum laws relating to ---- Q U Wilding consuuction.and hereby wtharix mpro em,tim of Nu city to enter upon the Ck1 above-mentioned Propeny(or inspection purposes. F4 (We)agum to save.indemnify and kcal,harmless NC City.1 Cupenio,against / h liabilida,judgments.cosy andaperoa which may in any way attiuc against said City U in consequence of the gaming of Ni{permit. '—' APPLICANT N ERS NDS ND WTLLtOMPLY WITH ALL NON-POINT Issued by: Date j 5 UL RCE L PIONS C / Re-roofs >Part fAp i y uacmr Dam HAZARDOUS MATERIALS DISCLOSURE Type Of ROOF Will pCutertu,futoni building e,Chaptstore er 9.12, handle Hcard.usm,teety as defined by the Cupertino Municipal Code.CTap¢r 9.11,antl the Health and Safety ode.Section 25532(01I�/ u All roofs shall be inspected prior to any roofing material being installed. C3 Yea fhN Will the applicant or future building oceupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants az dcfincd by the Bay Area Air Quality Management Disuict? all new materials for inspection. ❑Yes Nu Ihavcread Nehasad,m ,grialsuquimmenuundcr Chapmr6.95of Ne-Califon ria Hen Salary ade,Simtiona 115.15533 and 25534,1 understand Naz if the building docs not cuor a n,na tit is s 'vihilitymnoufy Ne.aupantorthe msni /t,./ ni mat .t n. c r Ccdr.am.racupany. Signature of Applicant Date wne,.a; m tied ag Da¢ All roof coverings to be Class "B"or better 0 • CITY OF CUPERTINO Item 1 of 1 PERMIT RECEIPT OPERATOR: conniew COPY # 3 Sec : Twp : Rng: Sub: Blk: Lot : APN 34245015 . 00 DATE ISSUED. . . . . . . : 11/10/2004 RECEIPT # . . . . . . . . . : 27720 REFERENCE ID # . . . : 04110060 SITE ADDRESS . . . . . : 10375 MELISSA CT SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER LARRY WONG ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : SARATOGA CA, 95070-5107 RECEIVED FROM . . . . : ARGONAUT WINDOW CONTRACTOR MARTIN ETTEMA LIC # 22820 COMPANY ARGONAUT WINDOW & DOOR ADDRESS 10624 S DEANZA BLVD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 • TELEPHONE . . . . . . . . : (408) 996-9670 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ---------- - - - ---------- ----- - -- - - ---------- --- - ------ ---------- BENERGY PERMIT FEE 288 . 36 138 . 41 0 . 00 138 . 41 0 . 00 BPERMFEE VALUATION 21, 000 . 00 288 . 36 0 . 00 288 . 36 0 . 00 BSEISMICRE VALUATION 21 , 000 . 00 2 . 10 0 . 00 2 . 10 0 . 00 BPLANCHK PERMIT FEE 288 . 36 384 . 82 0 . 00 384 . 82 0 . 00 TOTAL PERMIT 813 . 69 0 . 00 813 . 69 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER -- -- -------- - ---- ------- ----- - - CHECK 813 . 69 3224 TOTAL RECEIPT 813 . 69 • SCG CITY OF CUPERTINO� b CI PERMIT APPLICATION FORM • CUPEkTINO APN # Z[-2, x yl/ Date: Jv \ Building Address: Mailing Address (it di f Brent rm building address): /0-37- L SS X Q-T- Q up I=27lAM Q, 9 S-V ( Owner's Name: Phone#: -A42&q W f7 N Gi ¢a8• Z 5-3 • g i, m Contractor: License #: ,4aN,4vr /kC. G 0 +7 Contact: Phone: 468.63 f.4-3-FS- Cupertino Business License#: 7-YL IFF WI KF—k Fax: zlo8''3-7PO 9 Building Permit Info: Bld Elect ❑ Plumb ❑ Mech ❑ Job Description: � Residential A W/N40Wt( r-'<ACPHiS.vr S7-V--( 0 Cofm c a� Sq.Ft. Floor Area: $ q.Ft.: / Cost of Project: �I 66 Occupancy -11660, Group Type of Construction: Please check this box if the project is a second-stor addition: ❑ Project Size: Standard Large ❑ M�[:] Quandt Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1 M 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 flee 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD I Energy Add Multi BUILDING BINVESTIGA Investi anon fee BUILDING z77� 1 of SM *CITY OF CUPERTINCO CITY OF PERMIT APPLICATION FORM CUPEI�TINO Quantity Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE PbIg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace > I OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2 of 3 �} CITY OF CUPERTINA °TY°F PERMIT APPLICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM -Temporary Bldg Permit BUILDING BTEMPSVCS Tem Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elee Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING • 3 of 3 E C x4 G �` CITU Of -2'' .{i+Yw•_1.�T4-,`��y.arv--.,.,� !.^a+�Tx i<v�"', �" 'l '�^xF 'iz. +i.5:ca +k .a�'``t�^ Y ",x`a';- . +_ �� CUPERTINO Assessor's Parcel Number: Name of owner. i�NOV 0 9 2004 Project address. BY'—�-- Contact person. Phone. Fax. (�1 (� (�nn�/� Net square footage of lot. " ` U moII � �I-I' `II J�% �b "ti . .w " Exi stip e Proposed Square footage: First floor: /,3 S:-Z1 3 SZ3 Second floor: g `/2 '�'72 Garage: 6 3 $ 6 7 9 TOTAL: L 3'L 2 2 3 2-14 • Are there at least two 10 foot by 20 foot clear spaces inside the garage? G N Is privacy protection planting required for the project? Y On what floor(s) is work being done? ! 2- Brief description of work. RENO V& RF_7'41 cr- W/NAaV/S - DO d�S 2tdt°vE 4RFP4C9 5:7VC-044T7kyl' Code editions: 2001 CBC (Y - N)2001 CFC (Y - N)2001 CMC (YEN) 2001 CPC (Y -N)2001 NEC (Y - N) FRbv TM�pity,�0 Effective 11/1/02 ,peciticadonsVt is a114 �: sS Ga°.��at all times and tna 'an y as on aftereitnm �`y Lut syr lien c�pe�po _ r City °t and specncCedon9 lttleto be at, b L tz,- j si Platt�n to Pe[Mrt or two 01 altv POD, • f ane Plan Review Process Work Book Page-8-Revised 4/28/04 00 t T3 U J i• U 1 �� NOV 0 9 2004 lul w � 141 o x w 3 _ ',5'Q .a Lj- G p\ ; IU UA .2t q r i p .I � 1' o L1. O I'�'., ,yy. � �y ✓ Ig• i� � '1— p�/ ;y _ V- t - �; 4' ell CJ I W j la _--- CA tO0 9 2004 Y By 0 P :cj 4 Y ly r, ,n 0 ? y 7�-,7" f • \ 1 V 11 l O 'F ? \\ v W1 0 14Q r\ y` ---- -------- v .� ----------------------------------------- k'AU IV ii i rI n It = _� -4 Q N5V 0 9 2004 w � _ FEE COPY L 4U � I v � 1 J • 3 l �� I CITY OF CUPERTINO BUILDING DIVISION PERMIT " - ;p.0}O,NTRA.CTQRxiNF,OORMA'CIQN - - - BUILDING ADDRESS: PERMIT NO. ARGONAUT WINDOW & DOOR 04110060 O N R'S AfvPERMIT ISSUE DATE NE: SANITARY OL NO. ARCHITEC'VENGINEER: BUILDING PERMR INFO .. _ BLDG ELECr PLUMB MECH uoo LICENSED CON'rRACIOR'S DECLARATION YmF I hereby drum that I am ficanxd ander p.,W ns of Chapmr Y(commencing Job Description <Zt�f with )of DivWon]of We BualnesaZal PfafetslansCode.and myliceaxb _ ^�N in full fa delta. I'' I- f ucer�x- %I /fie. uc.a WINDOW REPLACEMENT/STUCCO 'Fp Dam - m- 4 '1�Conlra� rAf I uncle an m ARC all x D li c Ods JyU ;�� Licen d fes' 1 . 3 O\ ER- UI DE ECLARATION .� y I Wmhy olrfm 1 am e.. in from tW Contamofs License Law for llc 0 o following mason.(Section 7031.5,Business and Professions Code:Any city or county x m which wifuines a permit to comomet.After,improve.demo)lah,at mpair any acetum AA prior in its iatamum.shot oxine ithe applitanl for such permit to Neo signed namment �< that he is licensed pursuant to the provisions of the COmmcmr's Umnx law(Chapmr 9 Sq.Ft. Floor Area Y 1 H$ (commencing with Section 7")of Division 3 of tm Business and Professions Code)w / dw he is eampt tmmfrom and We basis for Um alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not roam that,five hundred dollars($M 3 4V4t*4# O 0 c,up ype 1,u owns of the properly,army employers with wages u Ilmv sole compenutlon, `C1 will do t e work end tm stuctarc u notinmMed uoRemA rosea(Sec.yOa4,Busirost a and Professions Cade:The Commences Liceme Law docs not apply in an owner of _ Required Inspections JC property who builds or improves 0 tar on.and who doessuch workhimselfortloaugh his Own employers,provided matauch improvements me not intended uolfesed for sale If. - however.We building or improvement is sold within one year of completion,the ownor- W ilde'will lave We burden of proving that he did not Mid or improve for purpose of sok.). ❑1,u Owner of be property,am exclusively contracting with lhainsed contaco rs to constmcl the project(Sec 90".Business and Prosiblons Cada)Tim Com acbri U. cerise taw docs not apply to an owner of property,who Wilds or improvrs Wmon,and who contacts for such projects with acontrauOKs)licemed pursuant to We Contractors License law. ❑l am tempt under Sec. ,B k P C far this mason - Owar Data WORKERS COMPENSATION DECLARATION I hereby affirm under penalty of perjury ane of We following declarations: 737W.f have and will maintain aCenitcam of Consent to self-insum for WoracesCompen- n,u provided for by Section 3'!00 of the LAW,Code,for the performance of the k for which this permit is iuucd. love and will maintain Warkels Compensation Imuana,.y}_tt��syyrea by Section the tabor Code,far Ue performmce of Ne woh for whic�.thiypermit is issued. orker Campemation Imumnce carrier and Policy n� UI PolicyNo.CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE }e ' IG-f'CS Mos inion need not W complemdiftha hundred permit is foranc hundred dNlars(510(1) nr lens) I mri fy Out in the performance of We work for which this permit is issued.I shall not employ any Pinson many manner sec as in become subject to thc Wo wW Compcwtion Laws of Celifomiw Dam Applicant NOTICE TO APPLICANT:If,afar making thb Ccniram of Excmplian.you should -- - Wcome subject m the Worker's Compensation previsions of W tabor Code,you must .,O foMwim amply with such provisinm Of this immot.hail be deemed revoked.Z'.. CONMUCiON LENDING AGENCY F"�' l hemby affirm Nat than is a construction lendingfar the performance of a.) 2' the work for which Nis permit b iuucd(Sec.3097,Cl,C.) 6w. Q lender's Name :D z Lcnderi Address ...�•�— U Q 1 cenify Nat I have rend Nis application and sum Nat the above informatiun is ^ :L f"' correct.1 agree to comply wit all city and county ordinances and saw laws relating an 0U Wilding construction.and hereby authorim mproxnlatircs of this city to cnmr upon the above-mentioned property for inspection purpmes - y (We)agree an ave,indemnify and Imp harmless We City of Cupertino against liabilita,judgments,costs and expenses which may in any way seem against said City UZ in consequence of did granting of permit. '-' APPLICANT N ER NDS p WILL OMPLY WITH ALL NON-POINT Issued b S URCE R IONS ( L_\, \ y Date I / �1 —� Re-roofs / m A m H FOCUS MATERIALS DISCLOSURE Dam Type of Roof Will pplicant or future Wilding occupant nom or handle ha�ous material r As derncd by tm Cupertino Municipal Code,Cbapmr 9.13,and We Health and Safety Code.Section sss3z(a)+ All roofs shall be inspected prior to any roofing material being installed. Yu Will the applicant or future Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove 'mit hanrdous air contaminants u dc0ncd by the Bay Area Air Quality Managemem all new materials for inspection. District? ❑Yes No I have mad the banrdous nab requirements under Chapter 6.95ofthe CAirm- niaflalth&Safety ode,Semons 5,25533an 25534.1un&nm,dlbmirthc Wilding Ones not curt w y nano t it u ra mihility 0 nodfy tW occupant of thc to mea h f Certi0camofOcapancy. Signature of Applicant Date I/iO-YI All roof coverings to be Class"B"or better wnu'or N iced Dam t