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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 Y 3 i i CITY OF CvPERTI QWcDiN� DFPAP NQ l3ao ?r mrose_ l� 20.EE�IT ' RlrnoJ� a-144 Y I&C t. e,wlSn L�ltndotJs. I v copy 40 talo googol A ILI 10 oat Woo F 17! 1 acilto *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� 1 of3 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 2 of 3 %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 3of3