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10040059 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10200 MILLER AVE BLDG U1 CONTRACTOR:LEON CONSTRUCTION PERMIT NO: 10040059 OWNER'S NAME: CUPERTINO,CA 95014 PHONE NO:(408)209-1272 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r License Class Lic.)1 MECH r RESIDENTIAL r COMMERCIAL r Contractor Date 1 hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION: SEISMIC UPGRADE WINDOWS,GARAGE (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 penalty of perjury one of the following two declarations: have and will maintain a certificate of consent 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 Floor Area: Valuation:$200000 1 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 permit is issued. APN Number:37503005.BLDGUJ Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct.1 agree to comply with all city and county ordinances and state laws relating PERMIT EXPIRES IF WORK IS NOT STARTED to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 D S FROM AST CALLED INSPECTION. costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply /O with all non-point source regulations per the Cupertino Municipal Code,Section Issued by: / / V Date: 9.18. Signature Date RE-ROOFS: ❑ OWNER-BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being installed.If roof is installed without first obtaining an inspection,I agree to remove all new materials for 1 hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: 1,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: Date: will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). 1 hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& performance of the work for which this permit is issued. Safety Code,Section 25532(x)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,l shall Health&Safety Code,Sections 25505,25533,and 25534._ I not employ any person in any manner so as to become subject to the Worker's OteryOuthorized agent: Compensation laws of California. If,after making this certificate of exemption,I Date: GO l U become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.) I certify that I have read this application and slate that the above information is Lender's Name correct.I agree to comply with all city and county ordinances and state laws relating 10 building construction,and hereby authorize representatives of this city to enter Lender's Address upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Q Licensed Professional Signature t/v Date !J L 6 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10200 MILLER AVE BLDG I/J CONTRACTOR: LEON CONSTRUCTION PERMIT NO: 10040059 OWNER'S NAME: CUPERTINO,CA 95014 PHONE NO:(408)209-1272 ❑ y LICENSED CONTRACTOR'S DECLARATION r r r �� BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class � '�' I� Lic.q � . � � MECH r RESIDENTIAL r COMMERCIAL r Contractor " — Date a t 1 hereby affirm that I am licensed under the provisions of Chapter 9 .TOB DESCRIPTION:SEISMIC UPGRADE WINDOWS,GARAGE (commencing with Section 7000)of Division 3 of the Business&Professions 11/4/201 I-REVNI-REVISE GLASS WINDOWS AT LIVING& Code and that my license is in full force and effect. 11/4/201 I-REVtt l-REVISE GLASS WINDOWS AT LIVING&DINING AREAS, ENLARGE GLASS PICTURE WINDOW,SLIDING GLASS DOOR TO BE TEMPS-RED- hereby affirm under penalty of perjury one of the following two declarations: ISSUED 12/19/11 I have and will maintain a certificate of consent 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. I have and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$200000 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APPLICANT CERT'IFICA'TION APN Number:37503005.BI.DG1/J Occupancy"Type: 1 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 state laws relating to building construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,'Section 9.18. 1( r r Issued by: Date�/l�l�L, Signature Date ❑ OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is hereby affirm that I am exempt from Ilse Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for 1 the following two reasons: inspection. 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, Signature of Applicant: Date: Business&Professions Code) II,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS 7'O BE CLASS"A"OR Bli"1'1'IiR hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE I have and will maintain a Certificate of Consent to self-insure fog Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Ilealth&Safety Code,Sections 25505,25533,and 25534. 1 will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should 1 use equipment or devices which emit hazardous air contaminants as defined by the Bay Arca Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Ilealth&Safety Code,Sections 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,1 Own rqtrimligr, become subject to the Worker's Compensation provisions of the Labor Code,I must Date: forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's I certify that 1 have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct. I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date a CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10200 MILLER AVE BLDG I/J CONTRACTOR:LEON CONSTRUCTION PERMIT NO: 10040059 OWNER'S NAIVE: CUPERTINO.CA 95014 PHONE NO:(408)209-1272 11 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r License Class Lie.# MECH RESIDENTIAL COMMERCIAL r Contractor Date I hereby affirm that 1 ant licensed under the provisions of Chapter 9 JOB DESCRIPTION:SEISMIC UPGRADE WINDOWS,GARAGE (commencing with Section 7000)of Division 3 of the Business&Professions 1/24/2012-REV#2-REVISE MOMENT FRAME FOOTING AT FAMILY ROOM Code and(hat my license is in full force and effect. LOCATION(FEE ASSOC W/10040054)-REV#2 ISS'D 2/8/2012 1 hereby affirm under penalty of perjury,one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,ago provided for by Section 3700 of the Labor Code,for the performance of the work for which this pennit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of Ute work for which this Sq.Ft Floor Area: Valuation:$200000 pennit is issued. APPLICANT CERTIFICATION APN Number:37503005.BLDGI/J Occupancy Type: I certity that I have read this application and state that the above information is correct.I agree to conmply with all city and county ordinances and state 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. �ln Issued a Date: C� Signature Date OWNER-BUILDER DECLARATION RE-ROOFS: 1 hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS M1tATER1ALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the t have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should 1 store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by time Bay Area Air Quality Management District 1 will I certify that in the performance of the work for which this pennit is issued.I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making(his certificate of exemption,I become subject to the Worker's Compensation provisions of done Labor Code,I must Owner thorized agent: forthwith comply with such provisions or this permit shall be deemed revoked. Date: CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of murk's correct.I agree to comply with all city and county ordinances and state law's relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address costs,and expenses which may accrue against said Cit-in consequence of the granting of this pennit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point sour regulations per the Cupertino Municipal Code.Section 9.18. p y 1 understand my plans shall be used as public records. Signature Date�o w Licensed Professional CITY OF CUPERTINO FM_7 FEE ESTIMATOR - BUILDING DIVISION igADDRESS: 10200 miller ave. bidg #j DATE: 11/04/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY Multi -Family Dwelling USE: Buildina is 3 Stories 0 Yes Q No PENTAMATION 1GENRES PERMIT TYPE: WORK revise qlass windows at living and dining areas enlarge glass picture window, sliding lass door to be SCOPE tempered. ,:,.,,.r CC•;;:'%- '' r, i• rw r.i-, , n,., � P"�BC: -r f',: <'�, r' £'ITr:i• P'20" C1..'I1i'r =f ; •, tTrlie+r f�i�{rtl,'; lfrs/; �7f;uc, t=TcrC. htclzLi A ("' z fmp. Fc t:: 111u ;r(:- lux /;, t ; c': F,lec. lnw I'a•rt: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the nrelininary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS Lee Resolution 11-053 E . 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Q Yes © No $0.00 F__27 hours Plan Check, Hourly $260.00 1STPLNCK Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feel@ Reg. Q OT Q.Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Convtr•rf{'t1' i f,r 7C7,Y ,izltnd riyw,i iivee Fee: Q 0 Work Without Permit? 0 Yes (E) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 >'ravi:1FeG.y Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $260.00 TOTAL FEE: $260.00 Revised: 10/01 /2011