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11070008I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 20261 REINELL PL I CONTRACTOR: BAY CITY WINDOWS I PERMIT NO: 11070008 1 OWNER'S NAME: QUINN ROSS A ET AL ( 3030 OSGOOD CT I DATE ISSUED: 07/01/2011 OVhMFR'S PHONE: 6509616911 1� LICENSED CONTRACTOR'S DECLARATION License Class C 11 Lic. # $ Z ZS eG Contractor Q e_ C (,.► ; n d o w, Date _24LL_ I hereby affirm that I 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 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, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature 6A Date L OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the 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 (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 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, C ind expenses which may accrue against said City in consequence of the g. ig 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 FREMONT, CA 94539 PHONE NO: (510) 353-1600 BUILDING PERMIT INFO: BLDG ELECT F PLUMB f— MECH f— RESIDENTIAL r— COMMERCIAL I— JOB DESCRIPTION: SFD, 10 WINDOW & DOOR REPLACEMENT, NON- STRUCTURAL, BEDROOMS TO MEET EMERGENCY RESCUE REQUIREMENTS PER 2010 CBC Sq. Ft Floor Area: I Valuation: $8250 APN Number: 31642014.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued byy -�—� Date: 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 25505, 25533, and 25534. Owner or au i ed gent: Dater 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 4 ITEMS OF 8 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 31642014.00 DATE ISSUED.......: 07/01/2011 RECEIPT #......... BS000013951 REFERENCE ID # ...: 11070008 SITE ADDRESS .....: 20261 REINELL PL SUBDIVISION ...... CITY CUPERTINO IMPACT AREA ...... OPERATOR: TraciC COPY # : 1 OWNER ............: QUINN ROSS A ET AL ADDRESS .......... CITY/STATE/ZIP ...: CUPERTINO CA, 95014-2221 RECEIVED FROM ....: DAVID MORKIN CONTRACTOR ROBERT BENTLEY LIC # 27371 COMPANY BAY CITY WINDOWS ADDRESS 3030 OSGOOD CT CITY/STATE/ZIP ...: FREMONT, CA 94539 TELEPHONE (510) 353-1600 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC ---------- NEW BAL ---------- ----------------------- -ADMIN HOURS ---------- 1.00 -------------------- 41.00 0.00 41.00 0.00 1BCBSC VALUATION 8,250.00 1.00 0.00 1.00 0.00 1BSEISMICR VALUATION 8,250.00 0.83 0.00 0.83 0.00 1WINREP EACH 8 10.00 522.00 ---------- 0.00 522.00 ---------- 0.00 ---------- TOTAL PERMIT ---------- 564.83 0.00 564.83 0.00 METHOD OF PAYMENT AMOUNT REFERENCE -------------------- NUMBER ----------------- --------------- CREDIT CARD 999.52 VISA 01349D --------------- TOTAL RECEIPT 999.52 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: I � Z L� Re,'% r, ( k of PERMIT # 0(::�(J OWNER'S NAME: V/ �N PHONE # 5 10') 3 S 3-) L.6>0 GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS:3o -3 p .o6 LT 1=re-rn, C4gg5 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 INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. -1( '[ () 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 t ^F 3 � a c d J � � IE c O 3IL � ( nV v . t ^F d v IE v m 0)m s �+ iN o Q 3 �. 3 p o o oN�v m 4 C <-�� o C)n� -;cc ai rZ C Nis oo� p- 8 0 S�l m -=`oO -0<m p� Q s o n r V m a W co n�S O W 0 O D Z s owe -a o =ho e i M m 3 W a CD o z 'm'm ma c - m m c: ( v 4 W W c�'n o W o c'U'i _a z� f a� v, Qoo Om 2 CD CD 7 ZN: 0 o = uoz t o Jnr :v= 1 y r•J Tc 77 2 � _ "—a v r _n CITY OF CUPERTINO W -W FEE ESTIMATOR - BUILDING DIVISION imlADDRESS. 20261 reinell place. __7DATE: 07/01/2011 REVIEW D BY: bobs. APN: BP#: 'VALUATION: 1$8,250 y�PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: PENTAMATION 1GENRES PERMIT TYPE: woRK sfd 10 window and door replacement non structural bedrooms to meet ernerqency rescue requirements SCOPE per 2010 CBC. A/nTC. Tb,...n nn n .. /a.nnil nr, i/,n n:nli,,,ir,nru itsFnrrafnfinN nvnilnhlo nrsd nrn ori/v nn nc/imnfo_ ('nnfaet /hv Dont for addn'i info. FEE ITEMS (1�'ee Resolution 09-051 11L ' /.-'1(7) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 =# $506.00 Window / Sliding Glass Door iwINREP Replacement Suppl. PC Fee: E) Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -.0 Reg. 0 OT Fo .0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Acoustical Fee: 0 Yes E) No $0.00 0 E) Work Without Permit? 0 Yes 0 No $0.00 Plannitng Fee: $0.00 Select a Non -Residential Building or Structure Q i Stronjz Motion Fee: 1BSEISMICR $0.83 0.5 hrs $39.00 Admin./Clerical Fee ]ADMIN Bidgy Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: j $1.83 $545.00 TOTAL FEE: $54 3 , (�� Revised: 04/ /2011 (�`• b CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buildingCo)cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS P APN #� 1 OI O e, y-, C C OWNER NAME l j� �© PHONE Ck t f E-MAIL ,` (a to I STREET ADDRESS Same CITY, STATE, ZIP Cv °l�cl FAX 0. 5 p15�✓C CONTACT NAMEPHONE . V (c� Mor 5(0 3 s'3- I (moo v E-MAIL STREET ADDRESS 30 o 0S c'�oc1 C I- CITY, STATE, - Q C G, C Ll ^ �� = rhon� ""4 lJ FAX J ) - / / ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ONTRACTOR AGENT ❑ ARCHITECT, ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME, C LICENSE NUMBER �y n s , b C. LICENSE TYPE i ^ BUS. LIC # I f COMPANY NAME E-MAIL FAX STREET ADDRESS I CITY, STATE, ZIP n PHONE Q M on) ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK A 1Yl Y'{ 1G+CP rn -e Ur Vu IU J ', 2 2 n Gj c, 11 N e� - 1 // EXISTING USE ,f 1 `4 PROPOSED USE CONSTR. �F- TYPE .0 # STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA 1pb � `u via y -J BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH I []ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? []NO ADDITION? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # []NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ AS EICHLER HOME? O RECEIVED BY:� TOTAL VALUATION: !!0 2-L_6-! t By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the pr_rperty owner's behalf. I fiave read this application and the information I have provided is corre . 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 cons n. I authorize representatives of Cupertino to enter the above -ide tifie property for inspection purposes. Signature of Applicant/Agent: �\ Date: SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP _ New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ElSTANDARD ❑ PUBLIC WORKS fo_rm 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 El MAJOR 1-1 SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11