04070072 CITY OFCUPERTINO
BUILDING DIVISION PERMIT
BUB-DINGADDRESS: ARGONAUT WINDOW & DOOR 1111,11114904070072
OWNER'S NAME: PERMIT ISSUE DATE
J LEVENT & ANITA ERSOY 10621
sEo SANITARY N0. CONTROL N0.
(408) 996-9670
ARCHITELT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
40 LICENSED CONTRACTOR'S DECLARATION I e fl
1 hereby affirm that I am licensed under provisions of Chapter 9(commencing A 'Q�/r� Er y'
Uw with Section 7")of Division 3 of the Business and Professions Code,and my licenses F I'v�LG,
">m in mllto=and effen. REPLACE WINDOWS V
j L z Lkenm Class Lic.N
n_p
Data Contrutor
ya ARCHITECT-S DECLARATION
Y I understand my plans¢hall be used as public rernrJi OCT
®r 2004
�yU
3LL
LicensedProfessionalBUILDING
30 OWNER-BUILDER DECLARATION
<� I hmaso .('firm Net 1 a.1. exempt from Ne Caouns Co License Law for the
i O O following mason.(Section]1131.;Business and .,de um Code:Any city or county
+,$� which reyuira a Permit re cur s the¢Icer,improve,demolish,or repair any abadum
9- 0 prior to its issuance,purse requires the previsiappon of for such Corina tur's Licensele Law(ned Chamenl
< that heimingsed pursuant 700)of Division
of the eBuacmhnd Prollaw(C Code)or Sq.F .Floor Area Valuation
as O (cat he is amerash Section7000)ndth basis for
oftMeged exemption.
Any
Ca@)ser
$ Net he u exempt therefrom and du bmu for the alleged eumplion.Any violation of
Section 7031.5 by my applicant for a permit$objects the applicant to a civil penalty of aro 0 Occupancy Type
not mom Nen five hundred dollars(SW)). -
❑1,as owner offle property,or my employes with wage as their sole compensation.
will do the work.and dtesrucNo is nott0unded oreffered formle(Sec.7W,Business ns Required Inspections
and profaaions Code:The Cmutecmr's Lt..law does not apply to an owner of q p
property who builds or improves thereon,and who does such work himself or through his
ownemployees,provided that such improvements are notimmnded oroRered formic.If.
however.the Wilding or improvement is mid within one year of completion,the owner-
builder will have the unden of proving that he did nm Wild or improve for purpose of
sale.).
N1,as mvner of the property,am exclusively contracting with licensed ronwcu i to
,mmuntel the project(Sec.7004.Business and Professions Code:)The Conuacmr't Li-
cense law does not apply to an owner of properly who Wilds or improves thereon.and.
who contracts for such pmjecm with a contrecmra)licensed pursuant to be,Conuamrb
License law.
of ma
ae under Sec. Bk P C for this msson
0µ0)r. Dere 7 j1
/'/ WORK 'S OMPENSATION RATION
I hereby atm under penalty of perjury ane of dewing,declarations:
_ ave and will maintain a Cer iftam of Consent no self-insumforWorknesCompen-
an,m provided for by Section 3700 of the labor Code.for the perfmmanm of the
work for which this permit is issued.
❑I have and will maintain Worker)Compeasadon Insurance.as occulted by Section
3700 of Ne Labor Code,for the performance of the work fm which Nis permit is issued,
My Worker's Compensation Insurance arierand Policy number am: ,
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu aCCLIM need not Mcampleted if the permit is forms hundred dollars(SIM)
or less.)
1 cenffy,that in Ne perfmar.mc of the work for which this Permit is issued.l shall not
employ any person in any manner so as to become subjeel to Ne Workers'Compensation
Laws of Califomta.On
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
became subject to the Worker's Compensation provisions of Ne Labor Code•you most
O forthwith comply with such provisions or this permit shall he decreed revoked.
.Zi ti CONSTRUCTION LENDING AGENCY
[-r I hereby aRrm Nat there is a construction lending agency for to performance of
a 7 the work fur which this permit is issued(Sec.3097.Civ.C.)
W Q Lender's Name
=z Lender's Address
V Q 1 mnify that I have read this application and stem that the above information is
{L F comet.I agree to comply with all city and county ordinances and stale laws miming to
O U Wilding construction,and hereby summits repraenutives of this city to enter arson the
r W above-mentioned Property for inspection purposes.
G (We))gree to rove,indemnify and keep harathass
an the City of .gamin against ( /
U N ince consequence
nce of theeostsand expensesranting of ibismitch may in any way a<enu against mid City
V z t.
APPLICANT)UNDERSTANDStAND WILL COMPLY WITH ALL NON-POINT Issued by: Da
SOURCE ULA ONS.
Re-roofs
JoIllimare of ApplsanUContrumU Da eof Roof
ff Z ROD SMATERIALS I LOSURE Typ
Will the applicant or future building occupan erre or handle havardaus material
as defined by the Cupertino Municipal Code.Chapur 9.12,and the Health and Safety
Cade.Seem.15531(a)] All roofs shall be inspected prior to any roofing material being installed.
C]Yes 24.
Will the applicant m future building occupant use equipment or devices which
If a roof is installed without first obtaining an inspection,I agree to remove
harardnus air conmminants as dcfncd by Ne Bay Arca Air Quality Management all new materials for inspection.
n?
❑Yes
1 have mad the ha anka s mau uorequioments under Chap er6.95 of the Califor-
me Health do SafetyCo ic.Sections 8505.15533 and 35534.1 umlersmnd thalif Ne building
seas not carte ray have a mount,that it u my ramonsibility m notify tM oecupmt of the
req immcn ichmu Mot nut a )oI Certiram afaapanay Signature of Applicant Date
n)r ar aathorizea.gent ate All roof coverings to be Class"B"or better
CITY OF CUPERTINO � 7
BUILDING DIVISION PE`u' "n
BUILDING ADDRESS: ARGONAUT WINDOW & DOOR PERMITN904070072
J -;20 PRIMROSE Wy PERMITLSSUB DATE
OWNER'S NAME:
LEVENT & ANITA
SANITARY N0. CONTROL NO.
P E:
(408) 996-9670
BUILDING PERMIT INFO
A HI'IECT/BNGINEER:
BLDG ELECT PLUMB MECH
0 0 0 0
D0 LICENSED CONTRACTOR'S DECLARATION
m Job Description
1 hereby ancon that 1 am fthe Businessea and Profeasiuns Code.and my licence is
1¢full fm¢eandeffWL REPLACE WINDOWS
License Clan Lie.N
Da¢ Comraemr
ARC all W used
DECLARATION O
1 understand my plane shall M used npublic mcards
CLARATION
Licensed Pmfenional
OWNER-BUILDER DECLARATION
a O 1 reason,
(Stat Nal 11. exempt from the Contractor's :License Law for the
IfD followinguires.permit
7031.3.Business and Profession Cade:Any city or rounry
Z(L which its requires n pormit re conmrms ahea impmw,demodish permit t ore antlered
my structure
iy Upoor tondheIBcensedpursuace.also mquimalMaisionoftheCnt for chpermi',Lices Law(Chater9 S Ft.Floor Area Valuation
0 thatmecing wait pursuantinof Division
of theeBuacsorsnd Professions
Code)
q•
$ (est he is
(commencing Secfoen and the
handis far of me alleged
cseontl on,Any
Gtion Of
�.. slut he r 31.5 b therefrom and Ne beer for the alleged e¢mptioro Any violation of
not oa than by try applicant fora 00). subjects the applicant m a civil penalty of er0 O Occupancy Type
not mom than five hundred dollars(5300). r. '
❑I,n owner of Ne property,army employee with wage u Meir sole compmsa0on,
will do the.&and thesmucture is not intended m offered fmsale(Sec.70".Business Required Inspections
cad Profeuions Codes The Contractor's U.Law does oro apply be an owner of 9 p
property who builds ar im proem Nemon,and who does such work himself ar through his
own employee,provided Nat such improvements are naUnusded oro@cad for We.If,
however,the Wilding or improw rant issold within am year of completion,the owmr.
Wilder WIN haw the burden of proving that he did not build or improve for purpose of
sale.).
It i,as own,,of the properly.sm exclusively convecting with liccnaed contractors to
pfinstruct the pmject(See.7060.Business and Prnfecrons Code:)The Containers Li.
come Law docs not apply an an owner of property who builds or improve thereon,and,
who contracts for such projects withacomracmr(s)licensed pursuant In do Comractoh
License law.
❑tem axe under Sec. .B&P C for thr.a•.on
ow�egf
�(J WORK 'S MPENSAT ONO RATION
1 hereby affirm under penalty of perjury ane of OlOwng declarations:
Raw and Will maintain a CeNBeate of Consenuo self4rume for WorkersCompen-
,ss provided far by Section 3700 of the labor Code.in,the perfarmanm of the
for which this permit is issued.
❑I haw and will maintain Wark¢r'a Compensation Insurance,as required by Section
3700 of the Labor Cottle,for the performance of the work for which this permit is mond.
My Workers Campenntion Insurance carrier and Policy number am:
Comte, Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thr section need not Mcompleted if tbepemril is foramhummodollara(SIM)
Or less.)
I certify that in the performance of the Work for which this permit is issued.I shall not '
employ anyperaon in any menacme n an became subject m the Worker'Compensation
I.of California.Dam
Applicant
NOTICE TO APPLICANT:If.other making this Comfrcate of Exemption,you Mould
become subject to the Workers Compensation provisions of me Labor Code.you mum
O fard with comply with such provisions or this Novell shall W deemed raveled.
tiCONSTRUCTION LENDING AGENCY
I hnmhy airum that t ere is a construction lending it may far the perfur main.of -
Y, the work for which this permit is issued(Sec.3097,Civ.C.)
i)O Isnticr's Name
2W Lattices Address
Q 1 wnify that 1 haw mad this application and sure met the show information is
y Fconey 1 agree an comply with all city and county ordinances and sum how relating to
building consuvetion.and hereby authodm repmnnus se,or this city to error upon the
is above-mentioned property for impaction purposes n
r G w.ju agree to mw,indemnify and keep hay in an the City of against id City I/
yart
y liabilities.judgments,coati indemnify
map
in any the Cacmueegalnmmid City
J,Z In coruegwnee of the licensing of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Da
SOURCE ULA ONS.. -
Re-roofsC7 L
tum of ApplicanUConuectar De 'Type of Roof
HAZARDOUS MATERIALS I LOSURE
Will use applicant or future building occuirm tom or handle hanadom nodanad a
as defined by the Cupertino Municipal Cade.Chapter 9.12.and the Health and Safety
Code.Seetian 25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑
Y. 24.
Will the applicant or future building occupant use,equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
it hanu
rasds air conmadnanu at defined by me Bay Arm Air Quality Management all new materials for inspection.
uin1 _/
❑Yes tj)mV�
1 bane rend the Incautious materiae requirements under Chapter 6.95 or the Califar-
nia HUM&SefmyCode,Sactlons 25505,25533 and 25534.1 undersand Weirdo building
does not carte t haw a mnam.Nat it is my responsibility to notify tie c cupent or the
req
immcn ich as Menet ren' a cera e¢rtifmte or Oe¢npmey.. Signature of Applicant Date
14, agent ter All roof coverings to be Class "B" or better
car or aam
f
A ACCORDANCE WITH THE CITY .. _
dUPERTINO CODES AND DRDINANC[.
i
SATE
>IGNED b f Sb
wopy
ihis set of pans and specifications Mt;,,
oe kept on the job at all times and it is m
lawful to make any changes or alteration
on same without mitten permission frorr. +_+
the building Dept., City of Cupertino.
The stamping of this plan and specifications tPLOT
SHALL NOT be held to permit of to be aC
+pproval of the violation of any PIN) i010
r any city Or UWM as Nats Lam
' j !
V
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CITY OF CvPERTI
QWcDiN� DFPAP NQ
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RlrnoJ� a-144 Y I&C t. e,wlSn L�ltndotJs.
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*CITY OF CUPERTINO*CU 7 NO PERMIT APPLICATION FORM ��
�APN# 36 / �&y /4- )04
Building Address: Mailing Address (if different from building address):
3 pr'Irnr0
Owner's Name: Phone#:
L 0 ? - 416 -313f-
Con ct a 6 � �d o � U License#:
Contact: Phone: Cupertino Business License#:
Fax:
Building Permit Info:
- . Bldg ❑ Elect ❑ Plumb ❑ Mech ❑
Job Description: te &(.A Some 0 e)(15 ',n 1z*tr\ ou1S
Residential Er Commercial ❑
Sq.Ft. Floor Area: $/Sq.Ft.:
Cost of Project: 9/ 000 . 00 Occupancy Group:
Type of Construction: Please check this box if the project is a
second-story addition: ❑
Pro'ect Size: Standard ❑ Laze ❑ Major ❑
Quantity 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 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 <= 1000A ELECTRICAL
BELEC1001 Elec 600V> 1000A ELECTRICAL
BELEC200 Elec Svcs 600V<=200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi 7 . BUILDING
BINVESTIGA Investigation fee BUILDING
D3�
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I
*CITY OF CUPERTINA
CUPEI�TINO PERMIT APPLICATION FORM
QuantityFee 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 Pblg Fixture PLUMBING
BPGAS Gas Piping System Fee PLUMBING
BPINI'ERCEP 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 rinklerBackflo 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 clip MECHANICAL
BREMAHUiAN 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> l 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
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%ITY OF CUPERTINO
CUPEt�TINO PERMIT APPLICATION FORM
QuantityFee 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
C
NSYS Ventilation S stems MECHANICAL
VD Scb S ecific Plan BUILDING
COM Seismic CommercialBUILDING
ICRE Seismic Fee Res BUILDING
IAL S ecial Ins ection BUILDING
M Swimmin Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Temporary Bldg Permit BUILDING.
BTEMPSVCS Temp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING.
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
ND IFEE Mechanicals . foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbin2 Permit Issue PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
ZADDCHG Address Chane BUILDING
t
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