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12040103 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10766 CARVER DR CONTRACTOR:THD AT-HOME PERMI-1 NO: 12040103 SERVICES, INC. OWNER'S NANIE: MACAULAY MARK 2690 CUMBERLAND PKWY STE 301 DA IT, ISSUED:04/18/2012 OWNER'SPHONE: 4089969239 ATLANTA, GA 30339-3913 PHONE NO:(510)731-1004 IEI LICENSED CONTRACTOR'S DECLARATION r r r ��O Z ' BUILDING PERMITINFO: uLDG t:Lt:CI' PLUMB License Class G1 7 Lie.0 '? r r r —r 1 I �( NIECII RESIDENTIAL COMMERCIAL Contractor I�� /f-7 YTOVx'1F Datc —1/��I� hereby affirm that I nm licensed under the provisions or Chapter 9 JOB DESCRIPTION: INS'I'At.[.2 RET110171'I"WINDOWS& I PA 1'10 DOOR (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. 1 hereby affirm under penally of perjury one of the following two declarations: I have and will maintain a certificate of'consenl to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Flour Area: Valuation:53982 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APV Number:37532007.00 Occupaney'Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and slate that the above rmation PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances stoic laws rely WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives f Ihis city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS_FR" LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of they/ granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-point source regulations per the Cupertino Munici a1 Code,Section 9.18. / RE:ROOFS: Signature - Date T / All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection. I agree to remove all new materials for inspection. 131'NE:R-B11I1.UE:R DECLARATION ' I hereby affirm that l am exempt from the Contractor's license Law for one of Signature of Applicant: Date the following two reasons: ALI,ROOF COVERINGS TO BE CLASS"A"OR BE:ITER I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to IIAZARDOUS NIATERIALS DISCLOSURE: construct the project(Sce.7044,Business&Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California llealth&Safely Code,Sections 25505,25533,and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: llealth&Safety(:ode,Section 25532(x)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued, will maintain compliance with the Cupertino 3lunieipal Code,Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance,as provided for by the llealth&Safety Code,Sections 25505.25533,and 25534. ` Section 3700 of the labor Code,for the performance of the work for which this Owner or authorized agent: Date: 4 A / permit is issued, I certify than in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of Colil'omia. If,after making this certificate of exemption,1 C -(" ON I'ENDIN('A('E'N(.1 become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec 3097,Civ C.) Lender's Name APPLICAN'I'CER'I'IFICA'TION Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and stale laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ARCIII'I'F:Ca"S DF.CL,yR,VfION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which mayaccrue against said City in consequence of the I understand my plans shall be used as public records, granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date CITY OF CUPERTINO 3 ITEMS OF 12 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 37532007. 00 DATE ISSUED. . . . . . . : 04/18/2012 RECEIPT # . . . . . . . . . : BS000016570 REFERENCE ID # . . . : 12040103 SITE ADDRESS . . . . . : 10766 CARVER DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : MACAULAY MARK ADDRESS . . . . . . . . . . : 10766 CARVER DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : PERMIT SERVICES INC CONTRACTOR . . . . . . . : FRANCES BLAKE LIC # 29818 COMPANY . . . . . . . . . . : THD AT-HOME SERVICES, INC. ADDRESS . . . . . . . . . . : 2690 CUMBERLAND PKWY STE 300 CITY/STATE/ZIP . . . : ATLANTA, GA 30339-3913 TELEPHONE . . . . . . . . : (510) 731-1004 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---- ---------- - -- ---------- ---------- - - 1BCBSC VALUATION 3, 982 . 00 1 . 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 3, 982 .00 0 . 50 0 . 00 0 . 50 _ 0 . 00 1WINREP EACH 8 3 . 00 392 . 00 0 . 00 392 . 00 0 . 00 -------- -- ---------- ---- - -- -- -- TOTAL PERMIT 393 . 50 0 . 00 393 . 50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- -------- ------- -- - --------- -------- CHECK 1, 784 . 90 43427 ---- ----------- TOTAL RECEIPT 1, 784 . 90 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•building cuoertino.orG I q.6103 ❑NEW CONSI"RUCTION El ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINALPERMUP PROIECI ADDRESS 10 APNo 5—L57 Or\ll OWNER NA N( b L ` PIIONIi li">f,111. 1/T A C A v I.°I o G9 sTRher nonarss lO / t CITY. STAI 19 C � 61 FAN CONTACT NAME l L PIloV -IO `h�, (�/p IS MAIL Ii 11RliT,ADDRESS 1061 /q L�� � VO ST CITYATX ( /(,�V CLl ( FAX 13O\\'NER 11Oull'NNIIiR"BUIfIDER ❑ OWNER AGENT ® CONETACTOR ❑CONTRACTOR AGENT `❑ ARCIIITECT ❑ECC,INEItR ❑ DIt\i OPER ❑ TENANT CONTRACIOR SAME LICENSE NUMBER LICENSIi TYPE BUS LICv 836021 B,C39,C13,C17 COMPANY NAME E-.NAIL FAX THD © HOME SERVICES 510-783-1041 S TRRFT ADDRESS CITY.STATE.ZIP PHONE 2456 VERNA STREET SAN LEANDRO,CA 94577 510-877-4550 ARCI IITECTIESGINEER NAME: LICENSE NUMBER BUS LIC v COMPANINAME E-MAIL FAX S IRFET ADDRESS CITY.STATE.ZIP PHONE DESCRIPTION OF\YORK -1� I� IT� o = /'D GJ I,J Oc� /i ,.,}/ O .J e_— /1 -110 A -110 2 - �o S/zE CI (gAIGe 1 I LISTING USE PROPOSED USE CONSTR.TYPE NSTORIES OFFICE JISF,IN I Y- D N Fr VAL ATI N c ESISTG NEW FLOOR DEMO TOTAL QCC TYPE AREA ARE,\ AREA NET AREA I'Vn IROO11 KITCHEN OIHER REMODELAREA REMODELAREA REMODELAREA PORCH AREA DECK AR fA TOTALDECK?ORCHAREA GARAGEAREY. ❑ DETACH ❑ ATTACH -111111111.1\U1 IS A SECOND O4T 01'1'F SECONOSTORI' ❑YYS 9EINGAURCD' ❑\'O ADDIT1OM ❑\U Il r.11ll'alm ❑ \In a wl 'IxO'IUIIIUYVOr YInN�Lx'sNn?ns RECEIVED BY: TOT VAVON �� II \I 1'1•I,� F] \ YI.\'.I.r V•Yx()\'N-I'.1UA A Z 13%,my signature below,I certify to each of the following: lam the property owner Gr authorized agent io act on the property owner's behRlE I have read this application and the information I have provided is eortect. 1 have mad the Description of Work and verify it is accurate I agree to comply withal]applicable local ordinances and state laws relating to building con. Drize lcpresentativcs Dl'Cu ino to enter the ahovc-idcnlilic(d ') Crty lilr inspection pulposcs. Signature of Applicanl/AgcnG Dave: Lll I �C / I Z SUPPLEMENTAL INF ION REQMED PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVERTIIECOUNTF.R ❑ BUILDING PIAN HY.t'I t;\\' existing building(s). Demolition permit is required prior to issuance of building pennit for new building. ❑ EXPRESS ❑ PLANNING PIAN RF;\'IF.11' o— Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD Cl PUBLIC w'ORKS Dorm if any Hazardous Materials arc being used as part of this project ❑ LARGE ❑ FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to RICI Submittal of Building Permit application. nlnaoR ❑ EN11R NNIRY SE"AL HE LI'll �f ❑ ENVIRONAl1:NTAI.IIEALTII Rldgdpp_2011_doe rrridcrl031161ll PROJECT INFORMATION TABLE OF CONTENTS -� OWNER INFO PROJECT ADDRESS T-I TITLE SHEET V- 0 MARK MAGAULAY I0166 CARVER DR. A-I FOOTPRINT Z 10166 CARVER DR. GUPERTINO, GA 65014N r__ GUPERTINO, GA 65014 PHONE: 408-69(b-9239 a) U0 CONTRACTOR PROD. #: (o196"1102 Nr LEGEND ? a) THD @ Home Services (North) (510) 81-7-4550 N Q 2456 Verna Gt. W01150 San Leandro, GA 94511 N U Field Inspector - ERIK HERNANDEZ ® New Window E O Drown b - SuzyRpine (510) 185-6340 = C -0 SCOPE OF WORK WINDOW STYLESQ N CU Installation of 2) In-Kind replacement windows and (1) patio. , >J door. 3PNL - 3 PANEL SLIDER In C (5EE LIST BELOVO PD - PATIO DOOR H N U IPNL - I PANEL SLIDER WINDOW SPECIFICATION SHEET ®✓ EXISTING NEW • MEETS # LOCATION WIDTH HEIGHT # LOCATION FLR. STYLE WIDTH HEIGHT EGRESS I MBEDRM 69 40 _ 1 MBEDRM I 3PNL 6G 40 Y 2 MBEDRM 96 80 2 MBEDRM I PD 96 80 Y 3 MEATH 10 33 3 MEATH I -. l0 33 NA BUILDING DIVISION-CUPERTINOLID _ APPROVED 0) rn This set of plans and specifications MUST be kept at the J '� Q job site during construction. It is unlawful to make any U changes oralteiations on same,'oi to deviate RFc IVFD Q ; therefrom,without approval from the Building Official. APR 18 202 _ Q X Z The stamping of this plan and specifications SHALL NOT < U be held to permit or to be an approval of the violation �� Q' of any provisio f any City Ordinance or State Law. CD Wa BY '� C) V DATE F PEWITNO. F I vie 196110 F TITLE SHEET T-I O z F G� � rn �1 3 �M rn za A O A r7s 3 O urn F U D a of 3 7. z t S � O 3 z; D Z> z = r= s ` MARK MACAULAY THD - At Home Services (North) y P z 10766 CARVER DR. o N a 2456 Verna Ct. — g CVPF-RTINQ, OA 06014 San Leanc]fo, GA 94577 t� o N 4�I