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13020064 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10181 BONNY DR CONTRACTOR:SGK HOME SOLUTIONS, PERMIT NO: 13020064 INC. OWNER'S NAME: LIN WEN J AND WEN-L 3801 CHARTER PARK CT STE B DATE ISSUED:02/132013 OWNER'S PHONE: 4086219375 SAN JOSE,CA 95136 PHONE NO:(408)264-6964 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL LJ COMMERCIAL License Class ? C Lica# REMOVE AND REPLACE 10 WINDOWS AND 4 DOORS, BEDROOMS TO MEET TO EGRESS Contractor Date //5 I hereby a rrm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000).of Division 3 of the Business&Professions Codeand that my license is in full force and effect. 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,as providedfor by Section 3700 of the Labor Code,for the performance of the workfor which this:permit is issued. Sq.Ft Floor Area: Valuation:$20837 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:35912030.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITIIIN 180 DAYS OF 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 DAYS LAST 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 /3 granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-poi source regulations per the Cupertino Municipal e,Section 9.18. RE-ROOFS: Signatu� Da All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION _ I hereby affirm that 1 am exempt from the Contractor's License Law for one of Signature of Applicant: Date: 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) 1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I 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(a)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 Cuperti o Municipal Code,Chapter 9. an I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sectio 55 25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Owner or authorized agent: D 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 most 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 cored.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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as 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 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 101$1 bonny dr DATE: O2/1 312 01 3 REVIEWED BY: mendez AEN: BP#: *VALUATION: 1$20,837 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY PENTAMATION USE: SFD Or Duplex PERMIT TYPE: 1GENRES WORK remove and replace 10 windows and 4 doors bedrooms to meet toegress SCOPE 77 J1MS.tJA �.31txi 1 11 ch. Plan Check PhunA Pkut Chock Eke(-Plan CYre,•,l. bleat./''v neil Fee:. I'hanb.Pei mil Pee: ller:..f'ernul Pce Ch -A-tech hr-`F'- Other 111unib ln.cp. Olber V,Insp. Li Mech.Map.-F,.°qc- Pluurb.Insp.Fee: L;[ec. lncp-!icer NOTE: This estimate does not include fees due to other Departments(Ie.Planning,Public Works,Fire,Sanitary Sewer District,School Dstrief etc). These fees are based on the prellmina in ormadon available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 14 # Window/Sliding Glass Door . Suppl.PC Feer Q Reg.. 0 OT 0.0 hos $0.00 $533.00 IWiNREP I Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.FeelD Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tarn: Achninistrative Fee: Q Work Without Permit? ® Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential Travel Documentation Fees; Building or Structure StronZ Motion Fee: IBSEISMICR $2.08 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 , $3.08 $533.00 , TOTAL I EE:; $536.08 Revised: 01/01/2013 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ^ 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)7773228•FAX(408)777-3333•building ftuoertino.org \ ❑NEW CONSTRUCTION ❑ ADDITION ALTERATio /TI ❑ REVISION/DEFERRED ORIGINAL PERMIT N PROJECT ADDRESS T V I �.j� TD1C APNA C C�1 OWNER NAME 1. I�N� L` ^r ,/ PHONE EMAB. STREET ADDRESS CITY,STATE,ZIP 'j / FAX � I!-6a✓� P N $' o CONTACT NAME 1/nt4rd C- PHONfi (� 20 jl EMAIL,-MA STREET ADDRESS •1- CITY,STAT$ZIPJ Q�^ FAX.2 �/ ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGPNr l] CONTRACTOR CIORAGENT ❑ ARCHITECT 13 ENGINEER ❑ DEVELOPER ❑TENANT 101 Ah¢ u �d LICENSE ER LICE*TYPE BUS.LIC# E-MAIL FAX STREET ADDRESS ,STATE,ZIP PHONE 2- ARCHITECT/ENGINEER NAME G- LICENSE NUMBER BUS.LICA Y' COMPANY NAME E-NAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK �lst.r r_c- itir G✓T d IV A/' A ,Doo¢S t,t t'. EMSTIIGUSE PROPOSEDUSE CONSTRTYPE I #STRIPS USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEWFLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER` REMODEL AREA REMODEL AREA REMODELAREA PORCH AREA DECKAREA TOTALDECKIPORCHAREA GARAOEAREA, H DETACH ATTACH #DWELLMGUNITS: WASECONDUNTT OYBS SECOND STORY 0 YES BEINGADDEbt []NO ADDITION[ ONO PRE-APPLICATION OYES WYES,PROVEDECOPYOP ISTHEaLDGAN OYES $y TOTAL VALUATION: PLANNING ADPL# [3NO PLANNINGAPPROVALLEITPR EICHLERHOME7 E]NO '9-0Cy-7 By my signature below,I certify to each of follow' g: I am the property owner or authorized agent act on the property o is be . I have readd this application and the information I have E _ L I have read the Description of Wock and ven it is accurate. I agree o comp with all applicable local ordinances and state laws relating ro b coon. I authorize representatives of Cupertino to enter the a vo-i 'fi f ion purposes. Signature of ApplicantlAgent: Date. SUPPLEMENTAL INFO TI N REQUIRED PLAN CH TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit forOVER-TRECOUNTER I1D.DRiG PLAN REVIEW building(s). Demolition permit is required prior to issuance of building permit for new building. - ❑ EXPRESSM WG PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project ❑ LARGE ❑ FiRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit appfication. ❑ ENVIRONMENTALHEALTH BldgApp_2011.doc revised 06/21/11 Building Department City Of Cupertino 10300 Tone Avenue Cupertino, CA 95014-3255 C U P E RT I N O Telephone: 408-777-3228 Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: Allyl PERMIT# U UCS OWNER'S.NAME: PHONE# GENERAL CONTRACTOR: rUSINESS LICENSE# ADDRESS: / c CITY/ZIPCODE: *Our municipal code requires all business s working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL•.00CUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. /7 /3� I am not using any subcontractors: Sighature 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 • 8■■®■■N■■®■■■11■■■L^7■■■EJ■■®■■■f�■■■ii■■■■■■■■I■■■■■■■i�■■■■■■■■ii■■■[ii■■■Pi■■N■■■ILIMEMM ' o nor. imunju SESSIONS= M ONION MMMMMMMMffM MENEM sommo W&WEN no Ems ■■■ Fz iifeJ�- ova" man ■Niumi■n■o ilii ■�■iinnnnME nii■i■N■MMMM Boni ■■■.�J■■1 117 till■!119 a'I I,N■■N■■N_=i%■■■M■■N■■IN■■N■■M■■N■■N■\N1.1■�■■■M■■■ '� "I Ems AMEM Own—MMNlI1MMMMMMM IMA Sir WE m ■■■N■■ on ■■I■■ ■■lN■■ ■■ ■■N■■N■ad A MoH109do\�■■ ■■N■■N■■N■■■ _■N■■■ 1.N..�' miie: � "mii�im� '` iiii� � cai: ii �iie .. i�ii�iiwi ii . ��aia�: :a : ::: ■■■N■■�■■N■■N�■N■■■GfirNCJ��■■rf■■N■■N■\` ■■■n■■N■■N■■N■1�■■i,■�■■��■■■■■ ■■■ ■■ ■■N■■A■■ ■■Flomilom �.��11■Ii;uN■■ :m�������N���li■■■Il■■� in N EIRIO:1S� E E ■■■ no ■■ ■■► ■■ ■■ ■ M ■■ ■■ ■■0■■■■t.■0■■0■■ ■■OI►�!!�■�,■■■■ ■■■ ■■ ■■N►.�N■■ri■I■■ ME q IEEE ■■N■■N■■N■■■ [�■N■■N■■N■■N■■■1:�■l`■■■■ i:i 0: �i i i�11 ■�i �i ■�i ii �i�i ■�i X11 ■�i ���■�i►� �i ■�i �ii��:�l�'!'��:i� �" 41111 1 No EMMINEr014110 fig, Edam loom ■■■■f■■\■��.7�EM/MMMMMM�Aa�■■IN��N M�R511ii■,3■1 ►�'�ls 4�i■14R �: N�►.N■■■fL■�:C7�■■��■ .r i1"..�iri _W34W Fro ■7ii�iir�o.ri��o■■o■■■�i���� " �i�■'I�i�i�■�::�_�_��■�i�' " ' ' � NAME r■& 11FRICA■■■ \\t■■■■■■■0■■■■■► pppddr.�Fla ■■ra ■■■ce■okl■■ ■■RV mom on i■■ ■■■ No i■■■ MIR ME&PA■:�■■■ ■■ ■■Ma■/A■om .. ; ...��: ......_-,. .. ■■••■■x■■ .. .p .■=■■=■■ ■■MMMM0E ,_M■■. 1■4 ■rD�SGw■ A■■�N■Ilei■_ ■i■�\._.Ca\■. 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