13020062 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 8145 PRESmI0 DR CONTRACTOR:JEMICO LLC DBA PERMIT NO: 13020062
RENEWAL BY ANDERSEN
OWNER'SNAME: CROWLEY JOHN K AND.PATRICIAN 30800 SANTANA ST DATE ISSUED:02/12/2013
OWNER'S PHONE: 4086911467 .. HAYWARD,CA 94544 PHONE NO:(510)263-3178 .
LICENSED WNTRA E ARATI N 30B DESCRIPTION: RESIDENTIAL COMMERCIAL
License Cla��ss77 C-:`r7 Lic.R. Z` REPLACE 2(E)WINDOWS& 1 SLIDING GLASS DOOR
Contracto'13g`al+'-` rs b to 24�
I hereby affirm than am licensed under the provisions of Chapter 9
(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:$12630
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 ofthe Labor Code,for the performance of the work for which this APN Number:35611085.00 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 MURK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 D ERART ISSUANCE OR
m building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection;purposes. (We)agree to save 180 DA AST CALLED INSPECTION.
indemnify and keepharmless 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 Issued Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
o — / RE-ROOFS:
Signature< /�N'"�"� Date 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 -
Signature ofApplicant: - Date:
I hereby affirm that I.am.exempt from:the Contractor's License Law for one of
the following two.reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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,
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). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. Iwill
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.pernit 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 � ,r-,�Q„- Zl
- Owner or authorized agent: 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 l 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 ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertmo'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
bn/
CONSTRUCTION PERMIT APPLICATION 00
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O�
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 ()_
CUPERTINO (408)777-3228•FAX(408)777-3333•buildinOC cupertino.OrO \ 'J
❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINALPERMIrTT# r\�
PROTECT ADDRESS V Y✓ �` d tom-k APN# / I I O r+ J
OWNERNAME ::560V—
}_(•D Li,�1 /fO I PHONE qo%_ 11_ tqg -7 &MAIL
STREET ADDRESSU t LtS 1 af`�V S SYJ;O (' 1�,,(CQL CITY,STATE,�{�O b G -{qb FAX
CONTACT NAME20 LC_0 �S ti^ PHONES10 263
STREET ADDRESS�JO Oa &L�k C` CITY',S TE,ZIP C� �,�yy FAX
❑OWNER ❑ OWNER-BIRLDER ❑ OWNERAGENT OCCONTRACTOR ❑CONIRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
c"ACTO NAME LICENSE NUMBER a LICENSEL� BUS.LIC#
COMPANY NAME,T �O� '^�"1e E-MAIL F 6 7,�'j S 311?
STREET ADDRESS.2,Q�V,� 5a�1_4 (`I ` CIN STATE,ZIP n RY �y.,� PHa%US-3f7
SJ3 Jf7
ARCHITECT/ENGINEER NAME ,t LICENSE NUMBER l- J T BUS.LIC# I/
COMPANY NAME E-MAIL FAX
STREET ADDRESS CRY,STATE,ZIP PHONE
DESCRIPTION OF WORK � � 11
&AakW1�+� 4F'1� S�' (qc$ Ot' G� -5f J
ExTIN
6GUSE PROPOSED USE CONS TYPE #STORffS
G �t ( �ll �(M y ! USE TYPE OCC. SQ.FT. VALUATION(S)
EXLSTG N FLOOR /h+ DEMO TOTAL
AREA AREA AREA NETAREA
BATHROOM KITCHEN OTHER
REMODELAREA REMODELAREA REMODELAREA
PORCHAREA DECKAREA TOTALDECKIPORCH AREA GARAGEAREA: DETACH
ATTACH
p DWELLING UNITS: ISASECONDUKIT []YES SECONDSTORY ❑YES
BEMGADDEDt []NO ADDITION? []NO
PRE-APPLICATION []YES IF YES,PROVIDE COPY OF ISTHEBLDGAN LI YES RE TOTAL VALUATION:
PI.ANNINGAPPL# []NO PLANNING APPROVAL LETTER EICHLERHOME? ❑NO lI V
*3 X
By my signature below,I certify to each of the following: I am the property owner or authoriz gefflto act dathrrrperty owner's behalf. Ihave read this
application and 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 laws relating to building co tinction. IIauthorize representatives of Cupertino to enter the above-identified property for inspection purposes.
SignatureofApplicanOAgent: Date: 2-14 Q;'4 Lf)
SUPPLEMENTAL INFORMATION REQUIRED PLANCHECKTYPE ROUTINGSLIP
_New SFD or Multifamily dwellings: Apply for demolition permit for DOVER-THE-COUNTER WBUHAING PLAN REVIEW
existing building(s). Demolition permit is required prior to issuance of building j
permit for new building. ❑ EXPRESS LANNING PLAN REVIEW
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 11 STANDARD ❑ PUBLIC WORKS
Toif 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 ❑ SANrrARY SE WER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
B1dgApp_2011.doc revised 06121/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 8145 PRESIDIO DR DATE: 02/12/2013 REVIEWED BY: MELISSA
APN: 3561/ 085 1 BP#: EVALUATION: $12,630
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY SFD or DU lex PENTAMATION 1GENRES
USE: p PERMIT TYPE:
WORK REPLACE 2 E WINDOWS & 1 SLIDING GLASS DOOR
SCOPE
`k4ii,R 1[ �6� � 1PP r37's .a✓ +y� 1 f"t ro�"um , '�A arc,
1fech.Plan Check Phunb.Plan Check Elec.Plan Check
Mech. Peron Fee: Plumb. Permit Fee: Flee.Permit Fete
Other.bfech. Insp. - Other Plumb Insp. 0/her Elec.Insp.
Li I
,ldech. Insp. Fee: Plumb. Lisp.Fee: Elec.Insp. Fee:
NOTE:.This estimate does not include fees due to other Departments(le.Planning,Public Works,Fire,Sanitary Sewer District,School
District eta). These ees are based on the relimina in ormation available and are only an estimate. Contact the Dent for addn 4 info.
FEE ITEMS Fee Resolution 11-053 E . 7/1/12 FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 3 # Window/Sliding Glass Door
Suppl.PC Fee: 0 Reg. 0 OT0.0 hrs $0.00 $400.00 FWINREP Replacement
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.FeelD Reg. 0 OT 0,0 1 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
C'ansimelion Tax:
Administrative Fee: O
Work Without Permit? : 0 Yes 0 No $0.00 0
Advanced Planning Fee: $0.00 Select a Non-Residential 0 .
Travel Docaonentarion Fees: Building or Structure 0
A.
Strong Motion-Fee: IBSEISMICR $1.26 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
$2.26 $400.0014. $402.26
�w\ Revised: 01/01/2013
PROJECT NAME: Crowley, Kevin and Patricia,City: Cupertino
8145 Presi$io Dr. �'h `
Rear elevation/Backyard
0
5040 XO 5068 SGD 5040 XO
103 102 101
Dining room Living room
entry
PLOT PIANS
CHECKED BY
DATE Z '3 70�.
PLANNIN DEPT.
DATE
RI1N;. DF.V'P:
Street elevation/Front yard
Presibio Dr
�Y
OF
ICFCOP
12 X013
Building Department
City Of Cupertino I
10300 Torre Avenue
Telephone: 408-777-3228
C U PE RTI N O Fax:408-777-3333
CONTRACTOR/SUBCONTRACTOR LIST
JOB ADDRESS: Q ffa5i. u —1�, PERMIT#
OWNER'S NAME: Jok-, ( ra-A e,,4 PHONE# Po Z4 3 3 h
GENERAL CONTRACTOR: ., .)qL of cr BUSINESS LICENSE#
ADDRESS: 3oQod S. S�.- CITY/ZIPCODE: 5vc.4r G-fcl Y Y
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINALrOR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE. ; 2
I am not using any subcontractors: - T—
Signature Date
Please check applicable subcontractors and complete the following information:
V 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