07050117 CITY OF CUPERTINO
NFOR
BUILDING DIVISION PERMIT ' '
BUILDN DD ESS: PERMIT NO.
���0� MARY AV AVERY CONSTRUCTION 07050117
4ER'S NAME: PERMIT ISSUE DATE
GLENBROOK APTS 130 EliST DANA ST 05/15/2007
NE: SANITARY NO. CONTROL NO.
ARCHITECTIENGiNEER: BUILDING PERMIT INFO
REPLACI: 270 WINDOWS LIKE FOR BLDG ELECT PLUMB MECH
o o LICENSED CONTRACTOR'S DECLARATION lob Description
W(: I hereby affirm that I am licensed under provisions of Chapter 9(commencing
Z with Section 7000)of Division 3 of the Business and Professions Code,and my license is
m y in full force andeffsct
License Class uc•g
M Date Contractor �"� n i
ARCHITECTS DECLARATION
i a< 1 understand my plans shall be used as public records
)WU
U.
H Licensed Professional
V3 11 OWNER-BUILDER DECLARATION
'> 1 hereby affirm that 1 am exempt from the Contractor's License Law for the
jp o following reason.(Section 7031.5,Business and Professions Code:Any city or county
$ which requires a permit to construct,alter,improve,demolish,or repair any swcutre
Z; prior to its issuance,also requires the applicant for such permit to file a signed statement
I;q.Ft. Floor Area Valuation
_ that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 .rq
Q t-$ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or
L that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not more than five hundred dollars(5500).
❑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 Required Inspections
and Professions Code:The Contractor's License Law does sot apply to an owner of q
property who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improvements are not intended or offered for sale.If,
however,the building or improvement is sold within one year of completion,the owner-
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
❑1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li.
cense Law docs not apply to an owner of property who builds or improves thereon,and
who contracts for such projects with a contractor(s)licensed pursuant to the contractor's
License Law.
C]I am exempt under Sec B&P C for this reason
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's Compen-
sation,as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑1 have and will maintain Worker's Compensation Insurance,as required by Section
3700 of the Labor Code,for the performance of the work for which this permit is issued.
My Worker's Compensation insurance carrier and Policy number are:
e
Cartier. Policy No.: Z-C r Lr-rif-G j
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars($100)
or less.)
I certify that 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 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 Codc,you must
Oforthwith comply with such provisions or this permit shall be deemed revoked.
Z r CONSTRUCTION LENDING AGENCY
(--,CA 1 hereby affirm that there is a construction lending agency for the performance of
> the work for which this permit is issued(See.3097,Civ.C.)
raw.Q Lender's Name
Z Lender's Address
U 0 1 certify that I have read this application and state that the above information is
L1+ r- correct.1 agree to comply with all city and county ordinances and state laws relating to
C U building construction,and hereb authorise representatives of this city to enter upon the
W above-mentioned property f spection purposes.
91� (We)agree to sav m cmnify and keep harmless the City of Cupertino against
liabilities,judgments,c and expenses which may in any way accrue against said City
tJ Z in consequence of
tin of this permit. Date
APPLICANT U DS A17D ]LL COMPLY WITH ALL NON-POINT Issued by:
.�
SOURC ONS.
�y
Re-roofs
Signature of Applicant/Conuactor Date
HAZARDOUS MATERIALS DISCLOSURE Type of R)of
Will the applicant or future building occupant store or handle hazardous material
as defined by the Cupertino Munici al Code.Chapter 9.12,and the Health and Safety
Code,Section 25532(a)? All roofs:;hall be inspected prior to any roofing material being installed.
❑Yes o
0YIf a roof i:;installed without first obtaining an inspection,I agree to remove
Will the applicant or future building occupant use equipment or devices which
emit hazardous air contaminants aR defined by the Bay Area Air Quality Management all new m iterials for inspection.
District?
Q Ycc
1 have read the h rdous materials requirements under Chapter 6.95 of the Califor-
nia Health&SafctyC 533 and 25534.1 understand that ifthe building
does not cu nil a tenant,that it is my nsibility to notify the occupant of the
requ' m ,ch ust melpriorwiss nfaCertifcateofOccupancy. Signature Df Applicant Date
1) -&7 All roof coverings to be Class"B"or better
Owner or authorized agent Date
oz
gg
IWE
I SED ITT
CUf kTINO : .. .
Assessor's Parcel Number: —
Name of owner.
Project address.
�
t o Phone.
—
Contact person. V , ! S
Fax.
Net square footage of lot-
EX-Ji giag Proposed
Square footage: First floor:
Second floor:
Garage:
TOTAL:
Are there at least two 10 foot by 20 foot clear sF aces inside the garage? --Y�
ing required for the project?
Is privacy protection plant
On what floor(s) is work being done? T
Brief description of work.
Code editions: 2001 CBC D -N)2001 CFC; (Y -N)2001 CMC (Y-N)
2001 CPC (Y -1)2001 NEt: (Y -N)
EffectiVA MMANCC 411TH I'Nr
0U."ERTIN0 CODEG L;
)AJ)=n...�. .� _..__ ._. _. An
This s6t ci fI�•
laMd to
Copy
The siarlpirg I i;i;S ;
SHALL NOT be he"d tc.
3OProu81 of the vi fati,:=i a� r
Plan Review Process Work Book Page-8-Revi3ed 4/28/04
Community Development
10300 Torre Avenue
Cupertino CA 95014
ClTelephone(408) 777-3228
"U PE �IN ` Fax(408)777-3333
Building Department
All Cupertino building permits must meet certain conditions related to maintaining
environmental quality and public peace and safety. The two most common
conditions are described below.
STORMWATER POLLUTION CONTROL
State law requires that Cupertino, 12 other Silicon Valley cities, Santa Clara County and
the Santa Clara Valley Water District control stormwater pollution. Educating local
residents and businesses and enforcing stormwater pollution control laws are key parts
of the City's compliance efforts.
Stormwater pollution prevention: It's up to us
In northern Santa Clara Valley, storm drains flow directly to local creeks and San
Francisco Bay, with no treatment. Stormwater pollution is a serious problem for wildlife
dependent on our waterways, for people living near streams and baylands, and for the
local water supply. Common sources of stormwater pollution include:
• Dripped oil, fuel, and antifreeze from vehicles and heavy equipment;
• Construction debris, including dirt, concrete and paint;
• Landscaping runoff containing pes:icides or weed killers; and
• Any material dumped or spilled into streets or storm drains
The property owner and the contractor share ultimate responsibility for activities
occurring at a construction site and will b,2 held responsible for any environmental
damage caused by subcontractors or employees.
For more information on construction-relE ted stormwater requirements, see the
Stormwater Quality Regulations section of the City of Cupertino web site at:
http://www.cupertino.org/city goNrernment/departments and offices/
environmental services
COMMUNITY NOISE CONTROL
The basic noise control requirements for construction sites are as follows:
• Typical construction work hours are:
- Weekdays - 7 a.m. to 8 p.m.
- Weekends - 9 a.m. to 6 p.m.
• Construction other than street construction is prohibited on holidays.
• Residential daytime noise levels frim complaint site - 60 dBA
• Nonresidential daytime noise levels from complaint site - 65 dBA
For more information on noise control, please see Chapter 10.48 of the Cupertino
Municipal Code, which can be accessed at http://www.amlegal.com/cupertino ca/
Greg Casteel
Building Official