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13040031CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7471 BOLLINGER RD CONTRACTOR: THD AT-HOME PERMIT NO: 13040031 SERVICES, INC. OWNER'S NAME:. BROWN JAMES W 2690 CUMBERLAND PKWY STE 300 DATE ISSUED: 04/64/2013 OWNER'S PHONE: 4805400634 ATLANTA, GA 30339-3913 PHONE NO: (510) 731-1004 JOB DESCRIPTION: RESIDENTIAL COMMERCIALE] LICENSED CONTRACTOR'S DECLARATION C (% ?f 3 6 O Z INSTALL 6 (N) RETROFIT WINDOWS AND 1 (N) SLIDING License Class Li.. # q11-7� �jj % GLASS � DOOR IN KIND, NO SIZE CHANGES Contractor I f-1 l�i C9 1'►o WI F ,�1?J4t � Date / / I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7C )0) of Division 3 of the Business & Professions Code and that my license is it 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: $2652 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 35923024.00 Occupancy Type: 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 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 uponthe above mentioned property for inspection purposes. (We) agree to save 180 D ST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, r costs, and expenses which may accrue against said City in consequence of the Iss Date: b-3granting of this permit. Additionally,' the applicant understands !Pd -Will comply with all non -point source regulations per the Cupertino pal Code, Section RE -ROOFS: 9.18. ` Signatur 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. 0 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 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.(2 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 Cupertino Municipal Code, Cha 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by for this the Health & Safety Code, S�25533, 2553 _rl 4permit Section 3700 of the Labor Code, for the performance of the work which or authorized ageDate: is issued.Owner 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 CONSTRUCTION LENDING AGENCY 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 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 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 Date CUP RTINO CONSTRUCTION PERMIT APPLICATION dO COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 `►� (408)777-3228 • FAX (408) 777-3333 • building a(�cuoertino.ora ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS J % I � � � � I + __7 APN # CJ OWNER NAME Pq E-MAIL STREET ADDRESS ���� dllf.�� 2� CI Y, STATE, ZIP P&)Z-,t,Ja C14 9soZ3 FFA. CONTACT NAME JEFF RAINEY PHONE 510-42 7-4260 E-MAILJEFFREY.RAINEY@ATT. NET STREET ADDRESS 1069 EDGEMERE LANE CITY, STATE, ZIP HAYWARD , CA 94545 FAX 510-783-1041 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR 11 CONTRACTOR AGENT ❑ ARCHITECT 1:1 ENGINEER ❑ DEVELOPER 11 TENANT CONTRACTOR NAME LICENSE NUMBER 836021 Lf It l YH 3, C 17 BUS. LIC # COMPANY NAME THD AT HOME SERVICES F -MAIL FAX 510-783-1041 STREET ADDRESS 2456 VERNA COURT CITY, STATE, ZIP SAN LEANDRO , CA 94577 PHONE 510 - 7 8 5 - 6 3 4 0 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK--726`�) l -_)/N1 1D07J _ /AJ I D— /v O �. 512-C t -t A -A/ F Grr%ti EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODELAREA REMODELAREA REMODELAREA PORCH AREA DECK AREA . TOTAL DECK/PORCH AREA GARAGE AREA: DETACH []ATTACH I # DWELLING UNITS: IS A SECOND UNIT []YES SECOND STORY []YES BEING ADDED? ONO ADDITION? []NO ' PRE -APPLICATION O YES IF YES, PROVIDE COPY OF IS THE BLDG AN ; : TOTAL VALUATION: PLANNING APPL # NO PLANNING APPROVAL LETTER OYES EICHLER HOME? By my signature below, I certify to each of the following: I am the property owner or authorized agent n the property owner's behalf. I have read this application and the information Ihave 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 -identified property for inspection purposes. Signature of Applicant/Agent: Date: � J Z / I J SUPPLEMENTAL INFOUIRED PLAN CHECK TYPE, ROUTING SLIP 4, New SFD or Multifamily d .pply for demolition permit for _ existing building(s). Demolition permit is required prior to issuance of building ovER TED CGUNTERsuu :, nuvG PIAN REVIEW t` Q permit for new building. ;'0. EXPRESS PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ElsTANDARD ElPUBLIC WORKS form if any Hazardous Materials are being used as part of this project.El LARGE ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to 0. MAJOR, , -.- ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. �OPIMENTAL L3EALTH BldgApp_2011.doc revised 06121111 CITY OF CUPERTINO V1V1V 1 Q9P1X4 A rF'nR _ RITIT .DINE DIVISION lfech. Plan Check Phimb. Plan Check Elec. Plan Check Afec-h. Peril it Fee: Plumb. Permit Fee: Elec. Permit Fee: Other Afech. Insp. Cather Plumb Insp. Other Elec. Insp. E]� llech. Insp. Fee: Plumb. Ixsp. I i e: Elec. Insp. FCC: NOTE: This estimate does not inctuaejees aue to otner vepartments (ie. -tun"Ing, lUUL[G rr u,n.,, . w , �w•w.w•y -•- _r____ rnntart tho Dont for addn'l info. FEE ITEMS (Fee Resolution 11-053 E . 711/12) ADDRESS: 7471 BOLLINGER RD DATE: 04/04/2013 REVIEWED BY: MELISSA APN: 359 23 024 BP#: *VALUATION: 1$2,652 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex 0.0 PENTAMATION 1GENRES PERMIT TYPE: i USE: PME Plan Check: WORK INSTALL 6 N RETROFIT WINDOWS AND 1 N SLIDING GLASS DOOR IN KIND NO SIZE SCOPE I CHANGES lfech. Plan Check Phimb. Plan Check Elec. Plan Check Afec-h. Peril it Fee: Plumb. Permit Fee: Elec. Permit Fee: Other Afech. Insp. Cather Plumb Insp. Other Elec. Insp. E]� llech. Insp. Fee: Plumb. Ixsp. I i e: Elec. Insp. FCC: NOTE: This estimate does not inctuaejees aue to otner vepartments (ie. -tun"Ing, lUUL[G rr u,n.,, . w , �w•w.w•y -•- _r____ rnntart tho Dont for addn'l info. FEE ITEMS (Fee Resolution 11-053 E . 711/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 0 # $400.00 Window / Sliding Glass Door IWINREP Replacement Suppl. PC Fee: (F) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee.0 Reg. ® OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C:onso-action :Tax: ,lr./tninistrative Fee: Work Without Permit? ® Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure I t ave/ Documentation Fees: Strong Motion Fee: IBSEISMICR $0.50 $400.00 Select an Administrative Item A $401.50 Bldg Stds Commission Fee: 1BCBSC $1.00 $1.50 Revi%eh: 04/01/2013 DINING ROOM WINDOW 93 x 47 LIVING ROOM BEDROOM BEDROOM PATIO DOOR WINDOW WINDOW 99 x 70 6905 35 69 x 35 LIVING ROOM BEDROOM BEDROOM DINING ROOM BATHROOM BEDROOM (E) FRONT DOOR BATHROOM BEDROOM GARAGE KITCHEN WINDOW WINDOW 42 x 36 42 x 36 KITCHEN 410 WINDOW 31 x34 BOLLINGER ROAD FRONTYARD �'Ts1Lti'R A� C C In7�c FLOOR PLAN Rc� VTvf 046- r ->/r --7f0 -b6Z`T - n1 0 517- C -(A4 n!D 6— •`JQ'itl _ —' HiNG �I S � UVA XVCSK""�amn NOTE: RETROM V1� A14D (1) PATIO DOOR ONLY NO NEW CONSTRUCTION _ CUPERTINO o r Building C7eParrtment LOAPR p 4 2013 U-1= c.-�, o `t REVIEWED FOR CODE COMPLIANCE C/) � � Reviewed By: LLJ LU CZ) COQ O CO UJ COM' ".. Hi `T, y =':?� R TI�1=NT N Z bLiiLDING DI i >1Cri`! - CJ EHTiNO = T,, s set of plans and sPecifications MIDST be kept at the cp?1StruCili41. It is unlawful to ?ll_ike any �`is? 'ice OY aIt'r tions on same, or to deviate L r©'rom, without approval from the Building Official. stamping of this plan and specifications SHALL NOT sill" held to pr be an approval of the violation ual ovisio ny City Ordinance or State Law. W BE IT NO. Q d- Z�rn LIJ C:) C'3 U mzp Z JZ LU �_ tiC-3 'A'E 03.28.13 SCAE NTS DmwNsr DKW " 6778752 SKEV A-1 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: 7 4f -7/ 3o/11Ajo-< PERMIT# 'f 0 � / OWNER'S NAME: ,j 3P -6W PHONE*q'?0- 37qO, 06.3 q GENERAL CONTRACTOR: THP A-7 BUSINESS LICENSE # -6 -A -10 c� 4S 77 ADDRESS: 2-4s e-7 CITY/ZIPC,,ODE:...5A-/ Lt� -Aj>j *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),-WILL .B-E�7�SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTO-RS"--,"VE OBTADT D -A CITY OF CUPERTINO BUSINESS LICENSE. l&4 e4 // 3 I am not using any subcontractors: Date Please check applicable subcontractors and co 4 rete the following iii -formation-, 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