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13030053CITY OF CUPERTINO BUILDING PERMIT J BUILDING ADDRESS: 10649 FARALLONE DRI DCO �R:4BB IF8 E I PERMIT NO: 13030053 OWNER'S NAME: ALMA FARIAS I S5TA2 DATE ISSUED: 03/12/2013 OWNER'S PHONE: 4094108237, 11 ✓/ I PHONE NO: I i ❑ LICENSED CONTRACTOR'SDECLLARATION License Class_ LicA Contractor S - CAwAaa�f Date: I hereby affirm that I am licensed order 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 self4risure 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 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, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the7applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. signature l,� ,y/ a� h %6 - Drdeezda . ❑ OWNER -BUILDER DECLARATION. I hereby affirm that I am exempt .from$he Contractor's License Law for one of the following two reasons: 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 construct the project (SecJ044, 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 atter 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 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, costs, and expenses which may accme against said City in consequence of the granting of this permit. Additionallythe applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9,18. JOB DESCRIPTION: RESIDENTIAL REMOVE AND REPLACE 11 WINDOWS AND 2 PATIO DOORS, BEDROOM WINDOWS TO MEET EGRESS Sq. Ft Floor Area: I Valuation: $10000 APN Number: 36935003.00 I Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WIT8 DAYS OF PERMIT ISSUANCE OR 180 D ROM LAST CALLED INSPECTION. Issued by: Dat 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 I 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 505, 25533, and 25534. Owner or authorized agent: Date�� l 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 Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(c cuoertino.orG �19 B ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/ DEFERRED , ORIGINAL PRO ADD 5�+v MC. CD/ APN# J OWNER A;E PHONE /D` E-MAIL r STREETADDRESS CITY, STATE, ZIP ,}_ _( FAX CONTACT NAME FJ�tV t PHONE I -E.p(7DL" I _iA NF v � u 7� CJ 57 ADDRFjSS �G �� / � {� CITY, STATE, ZIP Gk Gvo FAX .� ❑ OWNER ❑ OwNEE-Innosa 13OwNFAAOFM V'CO/NTRACTOR ❑CONTRACTORAGINr ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME //r ` LICENSENUMBER LICENSETYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHTTECT/ENGINEERNAME WOENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK, 12 1 e ` / I EXISTING USE PROPOSEDUSE G.�Af a CONSTR TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTO NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KRCHEN OTHER REMODEL AREA REMODELAREA REMODELAREA PORCH AREA DECK AREA TOTALDECK/PORCH AREA OARAOEAREA: LIDETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT DYES SECONDSTORY ❑YES BEING ADDED? ONO ADDITION? ONO PRE,APPLICATION ❑YES IFYES,PROVIDECOPYOF IS THE BLDG AN ❑YESPEC H TOTAL. VALUATION: PLANNMOAPPL# ONO PLANIURGAPPROVALIErrFR EICHIRRHOME? ONO 000 By my signature below, I certify to each of the following: I am the property owner or antho ' age to act on the property owner's behalf I have read this application and the information I have provided is correcthave read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state taws relating to ilding constmetio . I authorize representatives of Cupertino to enter the above -i entified property for inspection purposes. Signature- Applicaut/Agenh Date: SUPPLEMENTAL INFORMATION REQUIRED PLA14 CHECK TYPE ROUTING SLIP _New SFDorMultifamily dwellings: Apply for demolition permit forOVER-TBE-COUNTER existing building(s). Demolition permit is required prior to issuance ofbuilding- BUILDING PLAN REVIEW permit for new building. ❑ EXPRESS PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS Tom 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 El SANITARY SEWER DISTRICT of Building Permit application. ❑ ENVIRONMENTAL HEALTH B(dgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO ruiv iverrri%4ArirnO—r2riri.TIINf_ DIViCi(1N beech: Plan Check :ble ch. Permil Fee:. Other .tlecch..lnsp.. I 1 .blade. Insp. Fee: �I NDTF: This estimate does n6 Plumb. Plun Check Plumb. Permit Fee. 011ier Plumb InxP. Phanb. bup. Fee: e to other Departments (ie Pla) �:1s~ klec. Plan Check Elec'. Pvrmh 111 Other Elco. Insp. face. Insp. Fea: Works, Fire, Sanitary Sewer District, School OISrrict ere FEE ITEMS (Fee Resolution 11-053 E . 712) ADDRESS: 10649 FARALLONE DR-- -- DATE: 03/12/2013 REVIEWED BY: MENDEZ APN: BP#: VALUATION: $10,000 "PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD Of DU 16X p 0.0 PENTAMATION 1GENRES PERMIT TYPE: USE: PME Plan Check: WORK REMOVE AND REPLACE 11 WINDOWS AND 2 PATIO DOORS LIKE FOR LIKE SCOPE $0.00 beech: Plan Check :ble ch. Permil Fee:. Other .tlecch..lnsp.. I 1 .blade. Insp. Fee: �I NDTF: This estimate does n6 Plumb. Plun Check Plumb. Permit Fee. 011ier Plumb InxP. Phanb. bup. Fee: e to other Departments (ie Pla) �:1s~ klec. Plan Check Elec'. Pvrmh 111 Other Elco. Insp. face. Insp. Fea: Works, Fire, Sanitary Sewer District, School OISrrict ere FEE ITEMS (Fee Resolution 11-053 E . 712) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F-1-37 # $533.00 Window/ Sliding Glass Door IWINREP Replacement Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -.0 Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax. Adin hiist•ative Fee: E) Work Without Permit? O Yes t'. No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 Trm,el Documentation Fees: Strong Motion Fee: - 1BSEISMICR $1.00 Select an Administrative Item Bldg Stds Commission Fee: I CBSC $1.00 ' $2.00 $533.00 TOTAL FEE:- $535.00 rtevisea: uvairzu-i,, O N AY Z(,a(API L� tag i,--iA-YZ�PoLLOA 8 U�- GuPbzjT 1740 � : a INC MAR 12 2013 eX.36 'b8!'ilsTiP 3ckTN �pl t ; APAUNIh DvELOPME C PE �� 6UILTING DIVISION' v S APPR , ns MUST be Vept s l e i oeanY Z> `�' � �nd speclflcatro NFLA °I co tons It is u iao ftlo dev ate ur''n9 tions on same,Wingottiglal. 6 0n . s�-a DUPP)dc. •ro�70 �t C7pICS I- r lcb n. s or altera the gw �Y �i c �'' rovaffrom gHALUt4OT thcr�.rom, with°ut aPP Ian and specifications violatio?i- mPin9 of this plan an aPProval of the p �, 1� or State Law'LL �7p permit or a, Oity Ordinance ovlslons of any J 0. CL f fig/ W V LZ LL=60 30 (. . pw Z O0rs �C PLOT PLANS CHECKED Di DATE (� 2J13 _ � PLANNING DEPT. DATE Ri,DC. DEPT. CUPERTINO •, r, Building Department '• City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST-,; JOB ADDRESS: PERMIT # OaCCb - OWNER'S NAME: PHONE # GENERAL CONTRACTOR BUSINESS LICENSE:' ADDRESS: CITY/ZIPCODE: ;`: ' . I *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)WII LI ;BE :SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBONTRACTORS VE OBTAINED :A'>CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signatu ate Please check applicable subcontractors and complete the following information: Owner / Contractor Signature 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