Loading...
12100110 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRFSS: 7559NORAIANDY WAY CONTRACTOR:JEMICO LLC DBA PERMITNO: 12100110 RENEWAL BY ANDERSEN OWNER'S NAME: SALTER STUART M AND MARILYN F TRUST 30800 SANTANA ST DATE ISSUED: 10/152012 OWN1:R'SPIIONIi: 4082579008 IL\YN'ARD,CA 94544 PHONE NO:(510)263-3178 RD LICFNSIiD CON`fRAC`VOR'S�DIiCLARATION BUILDING PERMIT INFO: BLDG I✓ ELECT r2 PLUMB 1- a]` License Class ICcin Lie.q "ll Z f7 0 Z— FW— JR VOt 1'�Y�_ I\IECIIr RESIDEN'PL\Lr COMMERCIAL C-11 Contractor J'Cv`e^^` � Date b 1 hereby affirm that 1 am licensed under the provisions of Chapter 9 .JOB DESCRIPTION:REPLACE FIVE(5)WINDOWS LIRE FOR LIRE (commencing with Section 7000)of Division 3 of the Business S Professions Code and thin mylicense is in full force and effect. 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,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.FI Floor Area: Valuation:$9897 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:36611154.00 Occupancy Type: APPLICANTCERTIFICATION I certify that I have read this application and state that the above inl'orrmation is correct.l 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 10 save WITHIN 180 DAN'S OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertinougainst liabilities,judgments, 180 DAYS 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 with all non-point source regulations per the Cupertino Municipal Code,Section Issued Its: Date: 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 nets materials for hereby affirm that I am exempt from the Contractor's License Low for one of inspection. the following two reasons: I,as owner of the propeity,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 d Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO RIS CLASS"A"OR RF,'I-I'ER construct the project(Sec.7044,Business B Professions Code). 1 hereby affirm under penalty of.perjury one of the following three HAZARDOUS\IA1'F.RIALS 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 Ilcalth S Sailers.Code,Sections 25505,25533,and 25534. I will maintain Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino dlunicfpal Code.Chapter 9.12 and the Health& performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,its 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 Ray Area Air Quality Management District l will permit i5 issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the P Ilealih&Snfety Code.Sections 25505,25533,and 25534. 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 Worker's O}11�r or authorized agent: Compensation law's of California. If,after making this certificate of exemption.I 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 constriction lending agency for the performance of work's A I'll LICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.) I cenif-v that I have read this application and stale that the above information is Lender's Name correct.I agree to comply with all city and county ordinances and state Imes relating to building construction,mid hereby authorize representatives ol'this city to enter Lender's Address upon the above mentioned property for inspection purposes.(We)agree to she indemnify and keep harmless the City of Cupertino against liabilities,judgments, ,\RCIII'I'I{f-1'•S DECLARATIONcosts,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply 1 understand my plans shall be used as public records. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Licensed Professional Signature Date CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 7559 Normandy Way DATE: 10/15/2012 REVIEWED BY: jsg APN: BP#: VALUATION: FL *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMA"PION 1GENRES USE: PERM IT Tl'PE: WORK a lace 5 windows like for like SCOPE bk•ch. Plan Check Phonb.Plan Cheek F.lec.Plan Check hlech.Permit Fve: Plumb.Permit Fec: Elec.Peron Fee: Other Much.Imp. Other Plumb Insp. Ll I Other Elce.hup. Pble.ch.Insp. Fee.' Plumb. hrsp.Fee: Elec.Insp.Fee: NOTE: This estimate does not includejees due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School District,etc.). These eas are baser/on the preliminan•information available and are onh'an estimate. Contact the Detrifor addn'I info. FEE ITEMS (Fee Resolution 11-053 Bff 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Window/Sliding Glass Door Suppl. PC Fee: 0 Reg. Q OT 0.0 hrs $0.00 $400.00IIVINRPP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT O,p 11rs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax. Administrative Fee: Q Work Without Permit? O Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential 0 Travel Documentation Fees: Building or Structure 0 Soong Motion Fee $0.00 .`l Select an Administrative Item q q Bide Stds Commission Fee: $8.06 1, 00 `"101. SUBTOTALS: 1 $0.00 $400.00 TOTAL FEE: 1 $4 0 Revised: 10/01/2012 f2- i ��; ' I � CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228• FAX (408) 777-3333 • buildingpcuoertino.org ❑ NEW CONSTRUCPION ❑ ADDITION ALTERATION 1-1-1 ❑ REVISION/DL'PERRED ORIGINALPERMITM PROJECT ADDRESS APNq WC, OWNERNANIE 1 PHONE Mr�1� r S-4v�-1- Sq 'ler yup-2 7-q�o� STREET ADDRESSCITY, STATE,ZIP _ / I OO��'l� FAX C's «I(OJv-e_ CONTACT NAME PHONE_Cd L633(�� F.-MAIL �,^ S n fCr1C,;.4IU [reef•C STREET ADDRESS _,, C ' CTY.STATE. ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT 01CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENA.NT CONTRACTOR dl LICENSE NUMBER Z 7()L LICENSE TVP i �L( BUS.LIC d COMPANY NAME` 1 ' 1^ E-MAIL FAX STREET ADDRESS 2-,I�� 1C�6 J'F C1 cA 6 , 1 Y,ST ZIP �t-`,� PHONErJ,)763306 ARCHITECT/ENGINEER NAME: AI/A\ LICENSENUMBER I `� BUS.LICb COMPANYNAME /`j E41AIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE /} DESCRIPTION OFWORK(�t . � S Wlt 1 1 .I -(" (Z!,4 ` ` fIG Y 04 BVI t 'Na 1 Cc -1 l ;idl, eweSS G\ISTINGUSE PROPOSED USE CggqNSTR.T 'PE bST RIES ^ a USE TYPE OCC. SQ.Ff. VALUATION(S) EXISTG 1` NEW FLOORC DEMO TOTAL AREA AREA AREA NLT AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTALDECKMORCHARHA GARAGEARG: DETACH ❑ATTACH N DWELLING UNI S: ISASECONDUNIr ❑YES SF.CON'DSTORY ❑YES DF.I\O.AODf:U• �.:0 ADDITION! :gNO PRE-APPLICATION El YM IF YES,PROVIDE COPYOF IS THE DLDG AN ❑YES RECEIVED BY: TO�THA�LVALUATION: PLANNING APPL0 C]NO PLANNING APPROVAL LETTE0. EICII LER I IOMF.'. �NO W q7� 1)0 By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. 1 have read this application mid the information I have provided is correct. I have read the Description of Work and verify it is accurate. 1 agree to comply with all applicable local ordinances and state Ines relating to building cons ruction. I authorize representatives of Cupertino to enter the abab{ove-identified property for inspection purposes. Signature of Applicant/Agent: Vd� DDate: `1?,de112 SUP PLENIENTAL INFORNIATION REQUIRED PAN CIIECK'1Y14: ROIDIN'C SLIP New SPD or Multifamily dwellings: Apply for demolition permit for ❑ DYER-rur:couN-n:R ❑ atuLDIN'c PLAN REVIEW existingbuilding(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ P1.\N\INC PIA\REVIEW _Commercial.Bldgs: Provide a completed Hazardous Materials Disclosure ElSPAN'DARD ❑ PHBLICNVORKS Tori if any Hazardous Materials are being used as pan of this project. ❑ n ARCS ❑ F-IRT:herr _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ ,NI A.IOR ❑ SAN]TARY SEWER DISTRICT submittal of Building Pcrmifapplication. ❑ T:\rlxoNau:\r.u.uE,u:rn Bldgilpp_2011.doc revised 06/21/11 wArtdersen. mw INS ,• W1606W AEPIACEMENT m?A,eknen(;:itmryny ' Dxc �N 1030xp T[eafelyd (o ) c o+-d - a ' ! •.'- : V40 6CP,40FpX-p�+ - .- 3) /�tTU•(�^rJ ` (!OZ) `l r `4 �.'T ,{ai < `t •.v`1 'Q7�. Z QOM 1 tl�i ll`t rq u •� A✓UPE R , NC s BUiICInti L]C{)dnfI1G; 1 V � � F t OCT 15 2012 0E ('.OIN�'_i/aI�CF REVIEWED FO ( , t,€I<"' .],„ `;. '< , f ' - Reviewed By: 5� FEri�ir, $lx - s rt S gZ�CEIVFID CE. COPY , - :OCT 15 2012 A BY: 5 MONSOn t�:..