13020046CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19810 PORTAL PLZ CONTRACTOR: EMPIRE FLOORING &
DESIGN CENTER
OWNER'S NAME: ALLA ROZENVASSER 495 E BROKAW RD
OWNER'S PHONE: 4082534169 SAN JOSE, CA 95112
LICENSED CONTRACT'OR'S DECLARATION
License Class C Lie. #
06
Contractor 6 f r e F-100 ✓1 �5 Date Z 3
I hereby affirm that T 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.
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
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application arid state thatthe above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby author*= 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,
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
9.18.
Signature Date
❑ OWNER - BUILDER DECLARATION
JOB DESCRIPTION:
PERMIT NO: 13020046
DATE ISSUED: 02/11/2013
PHONE NO: (408) 213 -0996
REPLACE 2 (E) PATIO DOORS, SAME LOCATION & SIZE
IrSq. Ft Floor Area: I Valuation: $2000
1 APN Number: 36946042.00 Occupancy Type:
1 hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
1, w 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
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
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
Section 3700 of the labor Code, for the performance of the work for which this
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
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.
APPLICANT CERTIFICATION
I certify that have read this application and state that the above information is
correct. l 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 inspectionpurposes. (We) agree to save
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
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18..
Signature - Date
PERMIT EXPIRES IF WORK IS NOT STARTED.
WITHIN 180 DA PERMIT ISSUANCE OR
180 /DA 1 ST CALLED INSPECTION.
RE- ROOFS:
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. ...
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should 1 use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or authorized agent:
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
CUPERTINO
X6
CONSTRUCTION PERMIT APPLICATION �0�
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 n —D
(408) 777 -3228 • FAX (408) 777 -3333 • buildinGCG cuoertino.orG \ "/
❑ NEW CONSTRUCTION ❑ADDITION ®ALTERATION /TI ❑ REVISION /DEFERRED ORIGINALPERMIT#
PROJECT ADDRESS 199//J /fir �R /��
APNN / r r7
l�
A
_ L
OWNERNAME A�L /i /lOZE�f/l�i�SSEiP
PHONE /�R �,tZ_(/z
CC/UGPJC ✓R 7T
&MAIL`Q��NL�P� . /J
STREET ADDRESS /.98 /O PU.PT,4 L PLAZ,4
/YJ�t/D,
CITY, STATE, ZIP
CONTACT NAME
PHONE
E -MAIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
❑ OWNER ❑ OWNER.BUILDER ❑OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTORNAME
LICENSENUMBER �T�3 '1IS
LICENSETYPE5 /C
BUS. LICK
131c-
COMPANY NAME C
E -MAIL
FAX
G / O�
STREET ADDRESS _
CITY, STATE, ZIP woe n
PHONE
/— /��D
r�J (-
�y
ARCHITECVENGTNEER NAME
LICENSE NUMBER
BUS. LICA
COMPANY NAME
E -MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK 5Z11
_)11W .DOOMS
�E/�L�L'E�l €iJ✓T �/El+/ L•U�l /ST�PUCTjU�/
EXISTINGUSE
PROPOSED USE
CONSTRTYPE
ISTORTI
I
USE
TYPE
OCC.
SOFT.
VALUATION ($)
EXISTG
NEWFLOOR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOM MC13EN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
PoRCN AREA DECK AREA
TOTALDECKIPORCH AREA GARAGEAREA: UDETACH
ATTACH
9DWELWNGUNITS:
IS A SECOND UNIT OYES
SECOND STORY [3YES
BEING ADDED? []NO
ADDrr10N! []NO
PRE - APPLICATION ❑YES IF YES, PROVTOE COPY OF ISTHEBLDGAN TOT/OTION:
PLANNING APPLH []NO PLANNINGAPPROVALLETIER EICHLERHOME! O
By my signature below, I certify to each of the fol owing: 1 the property owner or a oriz d ag o act on t roperty owner's behalf. I have read this
application and the information 1 have provided correct. I ve r ad the Description of' ork and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to onsimcti . I au rim representatives of Cupertino to enter the above - identified property for inspection purposes.
Signature ofApplicanVAgenC Date: .2.
SUPPLEME ORMATION REQUIRED
t ' Ia "' ' - '
s. x"*.. .1•f;ANcC79EC$TYP1'
;� `
m ..ii•ROU77NGSLTP fia'""•.
New SFD or Multifamily dwellings: Apply for demolition permit for
_
existing building(s). Demolition permit is required prior to issuance of building
"I :oR TaP,coVNTER
eun.Dtric PLANREVIEW
permit for new building.
a�I>'i- '
Prarmmc PY.ANREYIEw �i-
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
s/'ANn'n8iila s u� .�
O
fl:rlq ptiuucwoxxs �f
_
Tom if any Hazardous Materials are being used as part of this project.
�•O'emEDEr`r
_ Copy of Planning Approval Letter or Meeting with Planning prior to
.. r F }
'^`I,
SEWERPLSTRiCT
❑ SANiT,ARY `.:
submittal of Building Permit application.
�❑�/vIhJOR`
. + 4s.
�MENVIR'OCIMEN7hT-}IEAGTH 5
BldgApp_201 Ldoc revised 06121111
F=
�� N CITY OF CUPERTINO
OWN 1PRU F.CTiMATnR — RITII,DING DIVISION
. �i^�N4r.iuUl+.l I'�1�?y •� ... + .il... � #. ,.� ,J' r.. ' .:; 7, r,. d..'
;Wech. Plan Check Phoub. Plum Check F.lec. Plan Check
mech. Permit Fee: Plumb. Permit Fee: Elec, Permit Fee:
Other Afech. Insp. Other Plumb Insp, Other Elec. Insp. Li
,Wech. Insp. Fee I Plumb. Gasp. Fee: Elec. Insp. Fee:
NOTE: This estimate does not include fees due to other Departments.(l.e. Planning, Public Works, Fire, Sanitary Sewer District, School
FEE ITEMS (Fee Resolution 11 -053 Eff 711112)
ADDRESS: 19810 portal plz -- -
DATE: 02/07/2013
REVIEWED BY: Mendez
APN:
BP#:
'VALUATION:
$2,000
*PERMIT TYPE: Building :Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
0.0
PENTAMATION 1GENRES
PERMIT TYPE:
USE:
PME Plan Check:
$0.00
WORK
remove and replace 2 patio doors
Permit Fee:
$0.00
SCOPE
0,0
. �i^�N4r.iuUl+.l I'�1�?y •� ... + .il... � #. ,.� ,J' r.. ' .:; 7, r,. d..'
;Wech. Plan Check Phoub. Plum Check F.lec. Plan Check
mech. Permit Fee: Plumb. Permit Fee: Elec, Permit Fee:
Other Afech. Insp. Other Plumb Insp, Other Elec. Insp. Li
,Wech. Insp. Fee I Plumb. Gasp. Fee: Elec. Insp. Fee:
NOTE: This estimate does not include fees due to other Departments.(l.e. Planning, Public Works, Fire, Sanitary Sewer District, School
FEE ITEMS (Fee Resolution 11 -053 Eff 711112)
FEE
QTY/FEE
--
MISC ITEMS
Plan Check Fee:
$0.00
F-27 #
$400.00
Window / Sliding Glass Door
1WINREP Replacement
Suppl. PC Fee: Q Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. FeelD Reg: 0 OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax:
Administrative Fee:
O
0
Work Without Permit? 0 Yes 0 No
$0.00
Advanced Planning Fee:.
$0.00
Select a Non- Residential
Building or Structure
(D
0
Travel Doc umentaiion Fees:
Strong Motion Fee: 1BSE1SMICR
$0.50
Select an Administrative Item
Bldg Std s Commission Fee: 1BCBSC
$1.00
�
5 0
$40000
1 14
bE:
$401.50
Revised: 01/01/2013
PORTAL PLAZA HOMEOWNERS ASSOCIATION
C/O M & C ASSOCIATION MANAGEMENT SERVICES, INC
4305 HACIENDA DRIVE, SUITE 180
PLEASANTON, CA 94588
OFFICE 925.460.8890 OR 800.843.3351 FAx 925.460.889)
January 18, 2013
Alla Rozenvasser
19810 Portal Plaza
Cupertino, CA 95014
RE: 19810 Portal Plaza/00134 -1179
Dear Alla Rozenvasser,
** ARCHITECTURAL CHANGE APPROVAL **
Your Architectural Change Request has been reviewed by Portal Plaza Homeowners Association. They
rendered the following decision:
Window Replacement
This is to let you know that your request for window replacement, as submitted, has been approved.
Attached please find a copy of the signed Guidelines for Window Replacement.
You are responsible for obtaining any building or other permits which may be required by the city and/or
county for complying with all codes, permits, and regulations which may apply.
The Association would like to express its appreciation for your cooperation in submitting your
Architectural Change Request. If you have any questions, please contact the management office.
Sincerely,
h
Grant Shetron, CMCA, AMS, PCAM
Community Association Manager
As Agent for
Portal Plaza Homeowners Association
cc: Unit File
SA -03
Portal Plaza Homeowners Association
Guidelines for Window Replacement
The following guidelines cover the replacement of windows and sliding glass doors. These guidelines
have been established in order to maintain a uniform external appearance throughout the property of
Portal Plaza, and the integrity of each building.
These provisions do not concern the mechanical or thermal performance, cost, durability, or internal
appearance of window units. While the Board recognizes the Importance of these characteristics to the
Homeowner, they do not affect the common interests of the Association.
1. It is at the discretion of the Board of Directors to make the ultimate decision to approve or deny
any particular design of replacement windows and sliding glass doors.
2. An Architectural Request for Modification Form (ARMF) must be submitted to the Architectural
Control Committee prior to any work. The Architectural Control Committee and the Board of
Directors must approve the Request in writing.
3. The ARMF must include detailed descriptions of the modification and include the name of the
vendor and of the installer.
4. Installers must be licensed, bonded and insured contractors with the State of California.
5. Any damage to the structure of the building or any degradation in the installation's appearance
over time is solely the responsibility of the Homeowner
6. The new windows and doors must slide open in the exact manner in which the original window or
door did. The window screens must be in the same position as the original ones.
7. If the glass doors facing the patio are being replaced, all glass door units facing the patio must be
replaced at the same time.
8. All windows, which are part of the outside wall, must be replaced at the same time. This includes
the window in the master bedroom, the window in the second bedroom, and the window in the
living room. Exclusion: Replacement of a single broken window.
9. The replacement windows must conform to the following Specifications
A: Windows surrounded by Wood (most living room and bedroom windows)
Homeowners can install Dark Bronze Mercer 800 slimline brand windows or any window
complying to the following Specifications:
.Color: Must be Dark Bronze or closely match existing color
ii. PANES: The number of panes should be same as the window being replaced
ii. Measurement: (See attached picture for definitions)
a. Width of any one side of the exterior of a window frame MUST NOT EXCEED 3 inches
when measured from the exterior glass outward to the edge of the frame touching the
exterior enclosure
b. Outer Frame Width MUST NOT EXCEED 1.75 inches
o I I I L 94''/2, I
c. Inner Frame Width MUST NOT EXCEED 1.25 inches
d. Middle bar MUST NOT EXCEED 1.75 inches
B. Windows surrounded by Stucco
i. Color: Must be Dark Bronze or closely match existing color
ii. PANES: The number of panes should be same as the window being replaced
iii. Measurement: Must be IDENTICAL to existing windows.
C. Patio Windows and Sliding Doors
Homeowners can Install Dark Bronze or WHITE "Mercer 850" Sliding Doors or any sliding doors
complying to the following Specifications
i. Color: Must be Dark Bronze or WHITE
ii. Measurement:
a. Width of any one side of the exterior of a window frame MUST NOT EXCEED 5 inches
when measured from the exterior glass outward to the edge of the frame touching the
exterior enclosure
b. Outer Frame Width MUST NOT EXCEED 2.5 inches-
c. Inner Frame Width MUST NOT EXCEED 2.5 inches
d. Middle bar MUST NOT EXCEED 2.5 inches
Agreement:
1. Any damage to the structure of the building or any degradation in the installation's
appearance overtime is solely the responsibility of the Homeowner
2. Any new window not conforming to the specifications as submitted and approved must be
removed immediately at the owner's expense. Failure to do so will result in a fine of
$500.00 per calendar month
3. 1 have reaadd the above Guidelines and agree to abide by them.
I the owner of unit IWO agree that by replacing the windows or sliding glass doors of my unit, I will be
responsible for ANY leaks or wdampagge caused by the new windows or sliding glass doors.
Print Namehah MENVA S %6 ZL Unit Number A/�
Signatur� Date 8c�0�
fIj- �o��ti(/�4�scZ
/9y/O /0012-74-1- i°z yZA
0 0041f7t-1 410, C-A 9� /y
35"
00
b
v
vto X)
0Y a
G�� 12,0 \`✓
PATIO
0
(V
203"
SLIDING KITCHEN
DOOR
TO BE
REPLACED
i
11 I /z"
v
FRONT DOOR
19" v
70" 57"
SLIDING L
DOOR
TO BE
REPLACED
OFFICE COPY
98"
LIVING
ROOM
STAIRSTO
THE SECOND
FLOOR
rn
REc- 1-,.71_I,?7
FEB 11 2013
RY:-,�-
CUPERTINO
Building Department
City Of Cupertino
10300 Tone Avenue
Cupertino, CA 95014 -3255
Telephone: 408 - 777 -3228
Fax: 408-777-3333
CONTRACTOR / SUBCONTRACTOR LIST
JOB ADDRESS: 19 k/0 0 / Fw
PERMIT # 3 -0 2.0 0 Lf
OWNER'S NAME: n
PHONE #
GENERAL CONTRACTOR: C
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 INSPECTIONS) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINEW A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information::
Owner / Contractor Signature
Date
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
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19810 PORTAL PLZ
CONTRACTOR: THE SCREEN SHOP
PERMIT NO: 13020046
OWNER'S NAME: ALLA ROZENVASSER
601 HAMLINE ST
DATE ISSUED: 02/11/2013
OWNER'S PHONE:. 4082534169
SAN JOSE, CA 95110
PHONE NO: (408)295 -7384
❑ - LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL U COMMERCIAL
`6 1 `r/" g �K
REPLACE 2 (E) PATIO DOORS, SAME LOCATION & SIZE
License Class Liicc. ##
Contractor ��✓'-eZA �r pp Date Z L (3
I hereby affirm that 1 am licensed under the provisions of Chapter 9
_
(commencing with Section 7000) of Division 3 o 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: $2000
1 have and will maintain Worker's Compensation Insurance, m provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
APN Number: 36946042.00
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
WITHIN 180 DAYS 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 DAYS FJbQ5KAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
Issue , Z
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.
RE- ROOFS:
Signature Date Z Z
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 of Applicant: 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
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. 1 will
I hereby affirm under penalty of perjury one otthe following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 25532(a) should 1 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 1
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: LOA% OJV -/ (,C7 Date: 2 2L
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 1 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 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 Rate
CUPERTINO
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10306 TORRE AVENUE • CUPERTINO, CA 95014 -3255
(408).777 -3228 • FAX (408) 777 -3333 • building Ocuoertino.om
F] NEW CONSTRUCTION nADDITION Fl ALTERATION /TI n REVISION/ DEFERRED ORIGINALPERMIT#
IM]
PROTECT ADDRESS /yg/O PD,eT/I Z 1,9Z4 Z'4
APN
OWNERNAME ZL/1 ROZFIVVft SS 7P
PH°'"E(�i0�
/•/
STREET ADDRESS PLAzA
CITY, STATE, ZIPCUPfRT /NO, �Zf'950ir
EA']r
CONTACT NAME �//L /E A. 17142TL F'y
PH °NE /�j/O// �Vr 73B
/sue
E- MAILJUL /6 �TyESC,PEE,t/,S,�pp?
STREET ADDRESS G/d/ H/-1 �9L /NF S'T/lE
CITY. STATE, ZIP�D� ,r,`yl
FAx
❑ OWNER ❑ OWNER - BUILDER ❑ OWNERAGENT ® CONrRACrOR ❑ CON[RACTORAGENr ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME -
edge sew" 5&�6
LICENSENUMBER �^�
1 I
LICENSE TYPE
C' 10 T D�'L
BUS. 1I11 l Cq
7 I
COMPANY NA%D1 Hamlin Sf. —Ph. 408 298-7384
B -MAIL I! TVK SC %eh5
00
FAX
STREET ADDRESS a0 JOS98 LAW. 96110
CITY, STATE, ZIP
PHONE
ARCHITECT/ENOINEER NAME
LICENSE NUMBER
BUS. LIC 9
COMPANY NAME
E -MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
EXISTING USE
PROPOSED USE
CONSTRTYPE
MSTORB;S
USE
TYPE
OCC.
SQ.FT.
VALUATION (S)
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NETAREA
BATHROOM KRCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
PoRCH AREA DECKAREA
TOTALDECKMORCH AREA GARAGE AREA: DETACH
❑ ATTACH
O DWELLING UNITS:
ISASECONDUNIT ❑YES
SECONDSTORY []YES
BEING ADDED? ❑NO
ADDITION? []NO
PRE - APPLICATION ❑YES IF YES, PROVIDE COPY OF
ISTHEBLDGAN ❑YES
P VM
TOTAL VALUATION:
PLANNING APPLM [3 NO PLANNINGAPPROVALLFTTER
EICHLER HOAfE? ❑NO
By my signature below, I certify to each of the following: 1 am the property owner or authorized agent to act on the property owner's behalf I have read this
application and the information I have 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 state laws relating to building construction. I authorize representatives of Cupertino to enter the above -ide ified p operty for inspection purposes.
Signature of Applicant/Agent: /101191- Qfl-I r-ILle o- Date: Z 2-1
SUPPLEMENTAL INFORMATION REQUIRED
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BldgApp_2011.doc revised 06121111
7JrEj
To: Whom It May Concern
City of Cupertino
Community Development Department, Building Division
10300 Torre Avenue
Cupertino, CA 95014 -3255
From: JoAnn Salamida Merhige
The Screen Shop
601 Hamline Street
San Jose, CA 95110
(408) 295 -7384
Re: Construction Permit Application
Dear Sir or Madam,
With this letter we authorize Alla Rozenvasser to be our agent in obtaining the Construction
Permit from the City of Cupertino for the following project: replacing two existing sliding doors
with the new ones of the same size and type, and without any structural changes. The work is to
be done at the following address: 19810 Portal Plaza, Cupertino, CA 95014. The properly filled
and signed Construction Permit Application form is attached.
If you need any additional information please do not hesitate to contact us.
Sincerely,
JoAnn Salamida Merhige
The Screen Shop
ffw seW," .5080
601 Hamline Sf. —Ph. (400) 296.7384
San Jose, Calif. 96110
21,
To: Whom It May Concern
City of Cupertino
Community Development Department, Building Division
10300 Torre Avenue
Cupertino, CA 95014 -3255
From: JoAnn Salamida Merhige
The Screen Shop
601 Hamline Street
San Jose, CA 95110
(408) 295 -7384
Re: Construction Permit Application
Dear Sir or Madam,
With this letter we authorize Boris Panitch to be our agent in obtaining the Construction Permit
from the City of Cupertino for the following project: replacing two existing sliding doors with
the new ones of the same size and type, and without any structural changes. The work is to be
done at the following address: 19810 Portal Plaza, Cupertino, CA 95014. The properly filled and
signed Construction Permit Application form is attached.
If you need any additional information please do not hesitate to contact us.
Sincerely,
21, 2013
9—JO--X Sal da Merhige