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13030054 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10307 MENHART LN CONTRACTOR:SEARS HOME PERMIT NO: 13030054 IMPROVEMENT OWNER'S NAME: PAM PIWEN HAWKINS 1074 FLORIDA CENTRAL PKWY DATE ISSUED:03/12/2013 OWNER'S PHONE: 4082422663 LONGWOOD,FL 32750 PHONE NO:(925)245-2000 C� LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class 3,L6 Cw 617Lic.# 7 -Li 3 77 REMOVE AND REPLACE 5 WINDOWS LIKE FOR LIKE, BEDROOM WINDOWS TO MEET EGRESS Contractor © E 'M' Date f Z I hereby affirm that I am licensed unde 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 perjuryone 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:$5704 1 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:37515034.00 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 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 D S 1�ROM LAST CALLED INSP CTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, // costs,and expenses which may accrue against said City in consequence of the Issued by: / -- granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Munici ode,Section 9.18. RE-ROOFS: Signature Date .3 I i 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. ❑ E ILDER DECLARATION Signature of Applicant: Date: I hereby f at I am exempt from the Contractor'aticense 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. 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(6)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: Date: IZ 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 CO ON LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a concoction 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 cityand 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 CONSTRUCTION PERMIT APPLICATION 065 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O�� 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 n— CUPERTINO (408)777-3228•FAX(408)777-3333•buildina .cuoertino.orO , ✓ na ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# ,r4 PROJECT ADDRESS 10307 9- I+Ag�T //J- APNN OWNER NAME F,A V I� � r/Wn� pH OB -� �- 2(9`� E-MAIL STREET ADDRESS 1_ CITY,STATE,ZIP V FAX 1030 7 �,J I+Az-r L� w CONTACT NAME LIZ GONZALES PHONE 916-830-3423 E-MAIL STREET ADDRESS 1200 DEL PASO RD y�(e, cITY,sTATE,zIPSACRAMENTO,CA 95834 FAX 11OwNER ❑ OwNER-aurmFR 13OWNBR AGSM L` coNTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANr CONTRACTOR NAME LICENSENUMBER 721379 LICENSE TYPE BUS.LICI Q Q6 C20 C39 CIO A 'SQA CAMME IMPROVEMENT PRODUCTS &MAIL FAX 407-551-3085 STREET ADDRESS 1200 DEL PASO RD CITY,STATE,ZIP SACRAMENTO,CA 95834 PHONE 916-830-3423 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANYNAME E-MAIL FAX STREET ADDRESS G CITY,STATE,ZIP PHONE DESCRIPTION OF WORK 1J\ -TA-1 t F IWJE c 1 f�l l7 l A Do �( N ._ - A)0 51 Gffi1-A)&C. 4 G EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES OFFICE USE 3NLY I — DOC, TYPE DESCRIPTION SOFT VALUATION EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA, NETAREA BATHROOM KITCHEN OTHER REMODELAREA REMODEL AREA REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA I GARAGEAREA:❑ DETACH ❑ ATTACH NIMFUTNGL'VITS ISASECQVnENR ❑YES SECONDSTULY [3 YM EE.GAVDM ❑NO I MORIDM ❑ro PRI:MPIJCATION ❑ YPS I DYES,PRGNDECCPYoP PIANNerSNAMR RECEIVED 'fOT PLIA1111GAPPLI ❑ \'O PLANMW APPRDVALIYTIFR 1. By my signature below,I certify to each of the following: I am the property owner or authorized agent to ilet 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 itis accurate. 1 agree to comply with all applicable local ordinances and state laws relating to building construction.jMthorize represen mo to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLE INFORMATI D PLAN CK TYPE ROUTING SLIP New SFD or Multifamily dwellings: A r demolifion pennit for OVER-THE-Co: R BUR, 1G PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ ExPREss PLANNINGPLAN REVIEW _Commercial Bldgs: Provide acompleted 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 application. ❑ ENVIRONMENTAL HEALTH BldgApp_201/.doc revised 03116/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10307 menhart In DATE: 03/12/2013 REVIEWED BY: MENDEZ APN: BP#: 'VALUATION: $5,704 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY PENTAMATION 1GENRES USE: SFD or Duplex PERMIT TYPE: WORK REMOVE AND REPLACE 5 WINDOWS BEDROOM WINDOWS TO MEET EGRESS SCOPE Meeh. Plan t('h�.ck Plumb, Plun Check Elea, Plan Cheek _ . Permil Fee: Plumb. Permil Fee: ln'lec. Permit Fee' Other Alec h. Insp. Other Plumb Insp. Other Met.Insp. Hoch.Insp. Fec. Plumb. hap. Fee: Elec. Insp. fee' NOTE:This estimate does not.include fees due to other Departments(de.Planning,Public Works,Fire,Sanitary Sewer District,School District etc.). These fees are based on the Preliminary information available and are only an estimate. Contact the De t for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff, 711112) FEE QTY/FEE I MISC ITEMS Plan Check Fee: $0.00 5 # Window/Sliding Glass Door Suppl.PC Fee: Q Reg. Q OT 0.0 his $0.00 $400.001 IWINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-.0 Reg. O OT 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tac. Administrative Fee: Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee: $O.OQ Select Non-Residential Building or Structure Travel Documentation Fees: o Strong_Motion Fee: 1BSEISMICR $.0.57 Select an Administrative Item _ Bldg Stds Commission Fee: 1ECBSC $1.00 $1.571 $400.001" 'TOT�ILFEE.�! $401.57 Revised: 01/01/2013 t ' 03/06/2013 09:39 19168303439 SHIPS PAGE 08 f ;6 . ram Pm j' I i I �. RpaanRleoY. •iI } i F.. : r I I I � I r. : . ... ...I IlMin9Poorrt Dlnlrig Room : : I Oor a 'I r :I ..._..,.. ..... ._.... .....L.... ___.1..... .... 1 - i i I i : LJ - , Hawkins Downsta DEPp,gT"vfENT ,BUILDING UIVISIU 'slob 1 d 1 UST be Kept at the t plans and speaiflcstions M rna,"e any O -5o7 �� �� L� This se of t ':icn. It is unlav,�ft to to I iq °r� �, r-o same,or to devl��. G/.� . cjj/ without 4pi=lov�l prom tno Buddjng Cfiicial. vL%rnJv� HALL NOT Tka s'zm"�"'q of this plan and specff�ly lO h ,,o,ation �,, prmnit or to I a ;n:-, tme Law. Ordinance or S "` LJ jg1ZA, f7 /6 ��7t�Y�'1 7 e; In"'provisions of an City IJ I J�� 5 - fns �--Inlil — A)O VIA 1 �777717mc Sf to C. PE�;NdTNo. .���� I !-S4 LlM1�f ♦♦q MM 1 ? 2013 ,6 ,\.�J:l_l.•sCi1 �^ �f%i�r:VJ�•r�lri�l�L PLOT PLANS e.'c •;ec 9y _t CHECKED 13Y co NNING DEPT. "� DATE Rrtx;. nRPm navme.a�.ne.oe vu a.r. 03/06/2013 09:39 19160303439 SHIPS PAGE 09 . I ', I '•�g1 i.• � I : .. . • i � 'E9maeV,Mdewisin BA-•'0;Eµ . 14 VW.ef . I AR ! i j . I i t. . I . i IHswklneUpabirs 151'3x1 pj$ r At ,/- a, 212 71201 3 112!!:00 PM 4 014 Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 CU P E RT I N O Telephone: 408-777-3228 Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: 10.30 7 ftj Z L PERMIT# -f D, OWNER'S NAME: A-rl A-1j I PHONE# lO ,_,2- GENERAL CONTRACTOR: opir BUSINESS LICENSE.# ADDRESS: E 7^ p CITY/ZIPCODE:. 7 S *Our municipal code requires all businesses working in the city to have a City of Cupertino business lice se. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(§) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE.QBT D•A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: 3 Si ture Date Please check applicable subcontracto omplete the following information: t/ SUBCONTRACTOR BUSINESS NAMEBUSINESS 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