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11060066 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22940 CRICKET HILL RD CONTRACTOR:SILICON VALLEY PERMIT NO: 11060066 BUILDERS GROUP OWNER'S NAME: MARC TAKAHASHI 1961 OLD MIDDLEFIELD WAY DATE ISSUED:06/09/2011 r R'S PHONE: 4082556453 MOUNTAIN VIEW,CA 94043 PHONE NO:(408)627-4177 LICENSED CONTRACTOR'S DECLARATION /,/ BUILDING PERMIT INFO: BLDG� ELECT PLUMB F License Class ?_ Lic.# �y/�V _ /n MECH r RESIDENTIAL COMMERCIAL r Contractor�J� Date I hereby affirm that I am licensed under the provisions of C apter 9 JOB DESCRIPTION:SIDING REPAIRS TO REPLACE SIDING DAMAGED BY (commencing with Section 7000)of Division 3 of the Business&Professions DRY Code and that my license is in full force and effect. ROT PRIOR TO PAINTING COMPLEX 427SQFT 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. Sq.Ft Floor Area: Valuation:$1334 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:34235006.00 Occupancy Type: 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, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the a plicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-point source regulations per a Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signatu Dat ` Issued by: Date: Li OW R-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS: the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date: construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sectio 25505,25533,and 25534. 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. Owner or a orized ent: Date 4�v APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of Hork's to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.) upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name i' nify and keep harmless the City of Cupertino against liabilities,judgments, c and expenses which may accrue against said City in consequence of the Lender's Address 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. ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 24 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 34235006. 00 DATE ISSUED. . . . . . . : 06/09/2011 RECEIPT #. . . . . . . . . : BS000013702 REFERENCE ID # . . . : 11060066 SITE ADDRESS . . . . . : 22940 CRICKET HILL RD SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : MARC TAKAHASHI ADDRESS . . . . . . . . . . : 22940 CRICKET HILL RD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : MICHAEL INOUYE CONTRACTOR . . . . . . . : FRANCISCO BERRUETA LIC # 30850 COMPANY . . . . . . . . . . : SILICON VALLEY BUILDERS GROUP ADDRESS . . . . . . . . . . : 1961 OLD MIDDLEFIELD WAY CITY/STATE/ZIP . . . : MOUNTAIN VIEW, CA 94043 TELEPHONE . . . . . . . . : (408) 627-4177 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 1, 334 . 00 1. 00 0 . 00 1 .00 0. 00 1BSEISMICR VALUATION 1, 334 . 00 0.50 0 . 00 0 .50 0. 00 1SIDEOTHER SQ FEET 427. 00 570. 00 0. 00 570 .00 0 .00 ---------- ---------- ---------- ---------- TOTAL PERMIT 571. 50 0. 00 571.50 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 3, 812 . 00 MC --------------- TOTAL RECEIPT 3, 812 . 00 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 22940 cricket hill rd. bldg#1 DATE: 06/08/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: 1$1,334 °PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1 GENRES USE: PERMIT TYPE: woRK re lace siding due to dryrot damage. SCOPE ...... Li NOTE: Thesefees are based on the prelindnary information available and are only an estimate. Contact the De t or addn'l info, FEE ITEMS(lee Resolution 09-05I I ff 7-1.;"10) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. Siding Suppl.PC Fee: E) Reg. 0 OT 0.0 hrs $0.00 $570.00 ISIDEOTHER I All Other PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Acoustical Fee: 0 Yes G No $0.00 0 Work Without Permit? 0 Yes E) No $0.00 Planning;Fee: $0.00 Select a Non-Residential Building or Structure Strong Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $1.50 $570.00 TOTAL FEE: $571.50 Revised: 04/29/2011 = COMMUNITY MANAGEMENT SERVICES,INCORPORATED May 27,2011 Silicon Valley Builders Group Re: DeAnza Oaks Homeowners Association Dear Sirs: Please pull permits for siding repairs on the units indicated on attached site maps Sincerely, Commu ty M ;gementces, Inc. Bill bbar ,Assager DeAnza aks Hosociation BH/st cc: Board of Directors 1935 Dry Creek Road, Suite 203 Campbell CA 95008-3631 voice (408) 559-1977 u fax (408) 559-1970 I o o l,o CONSTRUCTION PERMIT APPLICATION- COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333•building(Mcupertino.ord CU ERTINO ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS ��-1 L K�� V I L�. �Z� �/ T I WO APN# �i/_� OWNERNAME � �ItSK S N PQ = ,4S:1 -1 STREET ADDRESS CITY, STATE,ZIPFAX ZZ.414D CR,•ctc61 1V J Gb gS �c, ,�L�. c��c,�-�,uu _di CONTACT NAMEPHONEE-MAIL s(J !�dIIHI►S 72'7 • �G• is 14,4 t L_ :iOvv�' CYo7JS9V-�3i E- STREET ADDRESS CITY,STATE, ZIP5Gs C�S' O 7 -2 Z R� Y 1 ,� 6k A43 4.1 ❑OWNER ❑ OWNER-BURDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# 0 sCrcc„ro ��-Ij" 6 g�lvo� ! 3 COWANYNAME E-MAIL F C�Sa $Y 7'2 ZZY S/L�c.arc l/A6-�� 3�vXf. �rw�n s bc.�ldrrs roU Hca STREET ADDRESS ,/ CITY,STATE ZIPS��I/ �(vs / J L Z r/7/ P bd'�� 91,4�Z (.&A/J �cll�(./�(.�(, rJJ Lf{ ARCHITECT/ENGINEER NAME 1 v/ LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE iSCRIPTION OF WORKle / 4>/�G `PA `A. ` x EXISTING USE PROPOSED USE7MTNE #STORIES EXISTG NEW FLOOR AREA AREA EA BATHROOM KTT'� +: REMODEL AREA REMODEL ARE4. PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑ DETACH ❑ ATTACH 3 gv a : #DWELLING UNITS: D A SECOND UNIT ❑YES SECOND STORY ❑YES i BEING ADDED' ❑NO ADDITION' ❑NO } PRE-APPLICATION ❑ YES ff YES,PROVIDE C OF PLANNER'S NAME: $$C$tS B PLANNING ADPL# ❑ NO PLANNING APPRO LETTER By my signature below,I certify to each a following: I the pro owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have pided is correct. I e rea Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relatin g construction. autho ' e resentatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date SUPPLEMENTAL INFTION RE U1RE p New SFD or Multifamily02 ZA11$ dwellings: Apply for olition ermit for existing building(s). Demolition permit is required pno ce of building z�N Dermit for new building. 8, KENN a _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure fos �n rm if any Hazardous Materials are being used as part of this project. _Copy of Planning Approval Letter or Meeting with Planning prior to 77 submittal of Building Permit application. 77 x ,fids , B1dgApp 2011.doc revised 03116111