12090193 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 8151 PARK VILLA CIR CONTRACTOR:ARGONAUT WINDOW& PERMITNO: 12090193
DOOR,INC
OWNER'S NAME': MARTIN WILLIAM 1 1901 S BASCOM AVE STE 800 DA'Z'E ISSUED:09212012
OWNER'S PHONE: 6509065838 CADIPRELL,CA 95008 PI IONF-NO:(408)37&4018
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDC r ELECT 1-1 PLUMB rl
License Class C-Vl Lie.# VZ g 2 J r r' r-
ynfwfi3�aW � MECFI RESIDENTIAL COMMERCIAL Contractor H ��ulJ� Date lZ ( 2
I herebv affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: REMOVE AND REPLACE(I)PATIO DOOR AND(5)
(commencing with Section 7000)of Division 3 of the Business&Professions WINDOWS.
Code and that my license is in full force and effect.
I hereby affirm under penalty of.perjury,one of the following too declarations
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.F1 Floor Area: Valuation:$9000
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued.
APN Number:35610043.00 Occupanc),T)pe:
APPLICANT CERTIFICATION
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 state Imus relating
to building construction,and hereby authorize represcntatives ofthis city oenter PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep hannlessthe City ofCupertino against liabilities,judgments, WITHIN Igo DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may acerae 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. Z Issued by: , JET/T/ /7ftT��f Date: 9 a/ •/�
Signature , `^u"1 1'Q Date I A
❑ OWNER-BUILDER DECLARATION RE-ROOFS:
All roofs shall be inspected prior to any roofing material beitg installed.If a roof is
hereby affirm that 1 am exempt from the Contractor's License Laws for one of installed without first obtaining an inspection.I agree to remove all new materials for
the following two reasons: inspection.
1,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)
1,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 BEITER
hereby affirm under penalty of perjury one of the following three
declarations: IIAZARDOUS MATE.RIAI S DISCLOSURE
I have and will maintain a Certificate of Consent to self-insure for Worker's 1 have read the hazardous materials requirements under Chapter 695 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Ileal th&Safety Code,Sections 25505,25533,and 25534. 1 wi11 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 I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality 5huuagement 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 die work for which this permit is issued,I shall Bealth&Softie Code,Sections 25505,'_5533,and 25534,
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of Califomia. If,after making this cenilicate of exemption.I Owner or authorized agent Z`
become subject to the Worker's Compensation provisions of the Labor Code,I must MS`- V\ Date G1/ A-I
forthwith comply with such provisions or this permit shall be deemed revoked '
CONSTRIICI'ION LENDING AGENCY.
APPLICANT-CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's
1 cenify that I have read this application moisture that the above information is Ibr wshich this permit is issued(Sec.3097,Civ C.)
correct.I agree to comply with all city and county ordinances and state Imus relating Lender's Niune
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
granting of this permit.Additionally,the applicant understands and will comply ARCIIITECI-S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section I understood my plans shall be used as public records.
9.18.
Licensed Professional
Signature Date
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 8151 Park Villa Circle DATE: 09/21/2012 REVIEWED BY: Sean
APN: BP#: 'VALUATION: $9,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair.
PRIMARY PENTAMATION
USE: SFD or Duplex PERTYPE: 1GENRES
WORK Remove and Replace 1patio door and.(5) windows.
SCOPE
Meth. Hon Check Plumb. Plan Check Elee.Plan Check
hlech. Permit Fee: Plumb.Permit Fec: rice. Permit Fee:
Other Hech.Insp. Other Plumb Insp. Other F:Ice. Insp.
,Neth.Insp.Fee: Plumb. Iwp.Fee: Elec.Insp.Fee:
NOTE: This estimate shies not includejees due to other Departments(i.e. Planning, Public ll'orks, Fire,Sanitary Sewer District,School
District, etc.). These fees are hosed on the prelindnan information available and are mile an estimate Contact the Dept for addn7 info.
FEE ITEMS (Fee Resolution II-053 F_Tf 7/1//11 FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 = # Window/'Sliding Glass Door
Suppl. PC Fee: Q Reg. Q OT 0.0 Thrs $0.00 $400.00 11I7VREP Replacement
PME Plan Check: $0.00
Permit Fee: $0.00
SuppI. Insp. Fee Q'Reg. Q OT F0 0hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Construction Tnr:
fl ininistrative Fee: O
Work Without Permi(? Yes Q No $0.00 E)
Advanced Planning Fee: $0.00 Select Non-Residential
Travel IJocumentwinn Fees: Building or Structure 0
Strong Motion Fee: 1RSEISMICR $0.90 Select an Administrative Item
Bldg Sids Commission Fee: 1RCBSC $1.00
SUBTOTALS: $1.90 $400.001 TOTAL FEE-,T $401.90
Revised: 07/01/2012
❑�.`� � � i�--<. job+ = _ � .r _ _ `_-rC �.- � _ __ _.,. <"'�. x. ._^ _ .�'.c _-_ _.
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
CONTRACTOR [SUBCONTRACTOR LIST
JOBADDRESS: `S Partk V (It, . ; rCI�, L` ERMIT# /.;2-1
OWNER'S NAME: 1A/ iI1 nrH, K1 LtPHONE# • U0� — 6 �1— 0757
GENERAL CONTRACTOR: Ayn0c,-HCl LritiCJRcv5 BUSINESS LICENSE #
ADDRESS: In t,( ) (�nJA, � , C)1 f ..nr.trind CITY/ZIPCODE: GSU
*Our municipal code.reyuires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL'OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
1 am not using any subcontractors: ! t U L� t e �I C
Signature Date
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing /
Electrical
Excavation
Fencing
Flooring/ Carpeting
Linoleum / Wood
Glass/Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
72--I,� o q3
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO.CA 95014-3255
(408)777-3228• FAX(408)777-3333•buildina(acuoertino.orD
CUPERTINO
❑ NEW CONSTRUCTION ❑ ADDITION IX ALTERATION/TI ❑ REVISION/DEFERRED ORIGINALPCRNUTN '
PRaecrADDRESS1 �6- 5 Park I/l;1( 6 CI (CIP 1 ,4A(�PNrI/,, -Jy. ty1 4
OWNER NAME VV IIlry�l USI"\ M/1(�-WI I PHONEr y,_..IQV - U�U L'SIAIIIL WVI�.t \ Qk00'c
STRF.ETADDRFSS(JiICI \PA VjjlD mm-WI
Cm', STATFb.21PUCLL �7t�Irj0 CAq t0//I FAX /V !�(
CONTACT NAME oD JJ meyl co pled ei ros PHONE �In�ll_• _ /1-1111L / perco(Pa ego wio,C L,
STREETADDRCSS l OW2- 1C'- Do An-,( I�I,.-I- CITY,STATT:. ZIP c -^,�„ ,._,lro CAC('5-ln( FAX lL -4S!
❑OWNER O OWRLR-RUILULR D OWNERn0EN'r XCON'LRACTOR EICONTRACTO`R-AAGGEW`TTXJI-El ARCHITECT CI ENGINEER C1 DEVELOPER ❑TENANT
CON, ACTORNAMF. WndotaS LICENSF,N NI�F.O � LICENSE TYPE./' I� RIIS.LICR n•7 �` "1 O
Ay. ciao l C G o OC
COMPANY NAME J E-MAIL
r [o ) ��5y 1EOarg6WIV).COf11 FAX 0� 0�
STREE'rAUURF_SS 062. 7. p(� 11zL1 Ud. ern'.srATE.ziP �lnO, Cn q�lu PHONE — CG 30 -J 3S
—b -o '7
ARCHITF.CrIENGINF.FR NAME V LICE\SENUMBER 11BUS.LIC# �/A
COMPANYNAME I VE-PIAIL ( FAX /A
STREET ADDRESS n// CITY,STATE.ZIP N /^ PHONE
DESCRIPTION OF WORK T Ky-ID A O 1A. I !(-0-- `1 Ae R C (/u
(\- oL 1
i e -�oY toe )I c1(c x)
F.XI9TN-USF. PRu�D US CUNSTR. '•F. e6T1 IFS
USE TYPE OCC. SQ.FT. VALUATION(S)
F.XISTG NEW FLOOR DEMO TOTAL
AREA AREA AREA NCT AREA
BATHROOM KITCHEN OTHER
REMODLLARI"A RCAIODLLAREA JUa IOUCLAREA
PORCHAREA UECKAREA TOTALULCKIPORCHANEA GARAGLARIL\: IIETACH
❑ATTACH
u DWELLING(NITS: IS A SFCUNn U.N'nEl YFS SECUFn LTURr MYFS
REISC.AnnED': ONO "IBBl'ION' ONO
PREAPPUCATION DYES IF VES.PROVIDE COPT'OF ISTIIEOIAGAN Ol'ES RECEIV' BY: TOT VALUATION:
AN'N
PIINGAPPLR ONO PLANNING APPROVAL LETTER FACRLF.R110Mr:' ONO
By my signature below,I ecrtifv to each of the following: [.,at the property Owner or authorized agent to act an the property owner's behalf. 1 have mad this
application and the infuonation I ave provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and slate laws rung to bu ing conslmetion. 1 onze representatives of Cupertino to enter thea uve-identified property for inspection purposes.
Signature of ApplicandAgchl: Date: � ( ly � (
SUPPLEMENT A 1 \NATION RIiQUIRED PIAN curr.K1VN: ROMINGSI.IP
_New SFD or Multifamily dwellings: Apply for demolition permit for OVER-TUE-CousrER yt,BUILDING 1,110REVIEW
existing building(s). Demolition permit is required prior to issuance of building /
permit for new building. ❑ Exrur'ss ❑ rLSN:vn'r.PLAN REVIEW
Commercial Bldgs: Provide a completed I lazardous Matenals Disclosure 11STAN'1111411 ElPuHLlc\YORKs
far_m if any Hazardous Nlauctials are being used as IxOt of this project.
❑ LAuch ❑ F'ute Dl:rr
_Copy of Planning Approval Leuci of Mceling with Planning prior to
submittal of Building Pennil application. El aLtauH El s.SNn'AxY SF:e'Eu uLCI'xta
❑ F:NS'IRONXII!SI',\I.IIt:n Cl'll
B1dgApp_2011.doc revised 06121/11
-rrm
FTM/71 V "�/C,
a t IFCETVE
13V2 SEP 21 2012
BY:
Ov,/ �dtict0(,J
W l R1 do-
CAM BUILDING DIJISIONECUPERTNT INO E�
APPROVED
� This set of plans and specifications MUST be kept at the
04 fob site during ns alterations ontsame is ao fto devul to iatemak
�y
changes royal from the Building Official'
(� O therefrom,without app
v IFi in of this plan and specifications SHALL NOT
IL-11 The stamping it or to be an approval of the violation
T be held to permit Clty Ordinance or State Law*
of any provisions of arty
BY
�\ DATE
J\ PERMIT NO-
N
O
,)FFICE COPY,
21 September 2012
10612 S. De Anza Blvd.,
Cupertino, CA 95014
Phone:408.639740.7 (D757
email: AmericoCdargowin.com
Fax: 408 688 0576
Re:Appointment of Agent for Cupertino Building Construction Permit Application
Dan Fz),c)
I,Ame6co-Mederies-make Maggie Lin my agent to apply for and receive a city building permit for 8151
Park Villa Circle,Cupertino, CA 95014.
,—Ace-A4edeic pan F o Y d S Q I e s