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13020016 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10407 VISTA KNOLL BLVD CONTRACTOR:ARGONAUT WINDOW& PERMIT NO: 13020016 DOOR,INC OWNER'S NAME: PATRICIA MCCARTHAY 1901 S BASCOM AVE STE 800 DATE ISSUED:02/052013 OWNER'S PHONE: 4083687202 CAMPBELL,CA 95008 PHONE NO:(408)378-4018 ❑ LICENSED CONTRACT OR'SD LARAT N JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class C Lic.k S REPLACE 10(E)WINDOWS& 1 (E)PATIO DOOR.SAME ` SIZE,NO STRUCTURAL CHANGES. EGRESS&TEMP. Contractor Ar'12t'4 4 WI� Date a 5 3 WHERE I hereby affirm that I am licensed under the provisions of Chapter 9 REQUIRED.STUCCO EXT TO MATCH (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I 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.Ft Floor Area: Valuation:$12800 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 APN Number:32613035.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES 1[WORK IS NOT STARTED correct.l agree to comply with all city and county ordinances and state laws relating WITHIN 180 D F PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAY T CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accme against said City in consequence of the Z Iss Date: 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. ,•/I_ J,1 ��/ �/ 14ar 1/V Y l f_IG�I'�C.! V'/�/�'3 RE-ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed.If a roof is �� installed without first obtaining an inspection,1 agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: [hereby affirm that 1 am exempt from the Contractor's License Lew for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will 1 hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,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 I 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 Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&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: * V1/hl T! u-AW-Date: permit is issued. 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 Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY 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 APPLICANT CERTIFICATION 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 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used w 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 CONSTRUCTION PERMIT APPLICATION O\�j COMMUNITY.DEVELOPMENT DEPARTMENT•BUILDING DIVISION V O 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINC (408)777-3228•FAX(408)777-3333•buildino(ftupertino.org �t ❑NEW CONSTRUCTION ❑ ADDITION TERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# 'k PROJECT ADDRESS J-0 Vy ,S-- �y �/ oLL LUQ / # C� O XOWNERNAME I4 Jl� 1�l'IL l//�gLf P �U '7J-7ao�- &MAD STREET ADDRESS `'�� YIsT s+ Kv l -k I CITY, STATE,ZIP I � ..\ /lA/1_ FAX CONTACT NAME 666��... PHONE STREETADDRESS CITY,STATE,ZIP FAX 6L OWNER ❑ OWNER-BUDDER ❑ OWNERAGENT XONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBERLICENSE TYPE BUS.LIC# 22.E 20 COMPANY NAMET EMAIL FAX 14 gA014 ac ! tw@ _G.auFtAv,Co GMg-6 8 -o SS STREET ADDRESS S Q Q:5 fcd CITY,ST E,ZIP 'e va e,4-5�oe PHONEvFC-376 ARCHTTECT/EN'GWEER NAME •� LICENSENUMBER BUS.LIC# COMPANY NAME EMAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK P �O lG�dDt/Q ' TL k�UOIZ SAD1� 8 �/+! s 7U l t1E2c c�2 74-7-�70' 70 Mk EXLSTWO USE PROPOSED USE CONSTATYPE I #STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NEC AREA BATHROOM FHCHEN OTHER REMODELAREA REMODEL AREA REMODELAREA PORCH AREA DECKAREA TCTALDECK/PORCHAREA GARAGEAREA: LJDZrACR' ❑ATTACH #DWELLINGUNIIS: ISASECONDUNIT []YES SECOND STORY YES BEINGADDFD? []NO ADDITION? []NO PRE-APPLICATION AYES DYES,PROVIDECOPYOF ISTHEBLDGAN ❑YES TOTAL VALUATION: PLANNN`GAPPL# []NO PLANNINGAPPROVALLETTER EICDL6 ERHOME? ANO XOO ( By my signature below,I certify to each of the following: I am the property owner or authorize `nt to act on the 1folierty owner's behalf. I have read this application and the information I have provided is correct d have read the Description of Work and verify it is accuette. I agree to comply with all applicable local ordinances and state laws relating to uil ' 'on. I tho' r resentatives of Cupertino to enter the above-iden fled p9operty for inspection purposes. Signature of Applicant/Agend Date: 2` 5 SUPPLEP(!NM WTMAUbN REQUIRED ,, G eCK WP ° Rai�T vc si`P M� New SFD or Multifamily dwellings: Apply for demolition permit for V HT HECOONTBR y ,"BU DAG LM RBNEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. � xPRSs �' i` $0-P mcP" -AN RavIFcY _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure �,�,sT ;� puBLic woRlYs form if any Hazardous Materials are being used as part of this project _Copy of Planning Approval Letter or Meeting with Planning prior toPit submittal of Building Permit application. ?Dg " sAN Y E\VER D 5 nP T#�a+ENVHiONMENT�L HEALTH.. BldgApp_2011.doe revised 06121/11 Feb 04 2013 7: 39PM HP LASERJET FAX P- 1 COMtll i NTY CFya-I rl';17,!11- -_nn^-r:i-igr OU�LDINO DIV::=!(,iJ- GiiPr-H lii�U Thi^set of pian-.and sppc[f[cci tinny: ml Q,T he Icspiat the io! sl._I du -.i,� cons ;,cation. It �ar, l ro n any C'r;;nc=s oi alb- on s.-:�w3, or 4o r.,v.�..-_: tLcr�Jh'cm, v,'J Out approv .I horn the i;,:ik!bna Oifioial. Tli. .t ..mpir.. � this p1mi nc' L NOT ;-,L-!d Pto F ;fW0� ��_• CEOVb ' an o i C O ainanr,,, cr 5?o�tTw. st tr4)1 a DATE PERh4IT NO. 0 7— /.� ,��.��_�...,��•L v� Live iww,lol Sal MWMNWA Kits vo�o slido.- ! 4037 SC.d a` y5 br F1xQ� %aQ 6040 CS�Ke� WIG N g � Cupe VistaKnoll Blvd. g rid yn r.fi Cupertino, Ca. 95014 ` OFFICE COPV� ��T FEB 0 5 2013 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10407 VISTA KNOLL BLVD DATE: REVIEWED BY: MELISSA APN: 326 13 035 BP#: 'VALUATION: $12,800 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Duplex PENTAMATION 1GENRES USE: PERMIT TYPE: WORK REPLACE 10 E WINDOWS & 1 E PATIO DOOR. SAME SIZE NO STRUCTURAL CHANGES. SCOPE EGRESS &TEMP.WHERE REQUIRED. STUCCO EXT TO MATCH F,RU -- ;blech. Plan Check Plumb.Plan Check Dec. Plan Check klech. Permit Fee: Plumb.Permit Fee: Elec. Permit Fee: Other Meeh.Insp. Other Plumb Insp. Other Dec.Insp. Lj Alech.Insp. Fee: Plumb. htsp.Fee: 6lce.Insp.Fee.' NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary SewerDistrict,School District,etc.). These ees are based on the preflomdin in ormadon available and are only an estimate Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 11-053 E . 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F-1T-1 # Window/Sliding Glass Door Suppl. PC Fee: Q Reg. Q OT 0:0 hrs $0.00 $533.00 IWINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp:Fee:Q Reg.. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consiniclion Tax: Administrative Fee.: O Work Without Permit? O Yes O No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential Q Travel Documentation Fees: Building or Structure 0A Strong Motion Fee: 1BSEISMICR $1.28 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 $2.281 $533.001-,— m2p,uu Titi1?4kUFEfZ' $535.28 Revised: 01/01/2013 N\ � Building Department City Of Cupertino 10300 Torre Avenue Telephone: 408-777-3228 C U PE RTI N O Fax: 408-777-3333 CONTRACTOR(SUBPN RACTOR LIST JOB ADDRESS: IDW7. ( N01V PERMIT# O Z 00 1 6 OWNER'S NAME:M A ! rI41A I i(G Gt f' PHONE# GENERAL CONTRACTOR: j" O i? BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires 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. I am not using any subcontractors: 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 —771 Tile Owner f Contractor Signature Date