11010084 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10335 FINCH AVE CONTRACTOR:ARGONAUT WINDOW& PERMIT NO: 11010084
DOOR,INC
OWNER'S NAME: SREENATH SREEKANTHAM 1901 S BASCOM AVE STE 800 DATE ISSUED:01/14/2011
IER'S PHONE: 4085649194 CAMPBELL,CA 95008 PHONE NO:(408)378-4018
11LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB
License Class Lic./# d MECH r RESIDENTIAL r COMMERCIAL r
Contractor Q Date � JOB�
I hereby affirm tha01 t I am licensed under the provisions of Chapter 9 DOO,OREPLACE LIVING ROOM PATIO SLIDING GLASS
MERIPTION:
(commencing with Section 7000)of Division 3 of the Business&Professions STUCCO REMOVALIADDITION AROUND PATIO DOOR
Code and that my license is in full force and effect. 54-
I
aI 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 Sq.Ft Floor Area: Valuation:$3800
permit is issued.
APPLICANT CERTIFICATION APN Number:37543010.00 Occupancy Type:
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 PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point sou a regulations per the Cupertino Municipal Code,Section /
9.18. Issued by: Date:
Signatur Date or
L OWNER-BUILDER DECLARATION RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044, Date:
Business&Professions Code) Signature of Applicant:
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penalty of perjury one of the following three
declarations: HAZARDOUS MATERIALS DISCLOSURE
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 I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Safety Code,Section 25532(a)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Health&Safe Cod tions 25505,25533,and 25534.
Compensation laws of California. If,after making this certificate of exemption,I Owner o agent: I`Y�tl
become subject to the Worker's Compensation provisions of the Labor Code,I must Date:
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's
correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
'�mnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
s,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section
I understand my plans shall be used as public records.
9.18.
Signature Date Licensed Professional
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 37543010 .00
DATE ISSUED. . . . . . . : 01/14/2011
RECEIPT #. . . . . . . • • : BS000012487
REFERENCE ID # . . . : 11010084
SITE ADDRESS . . . . . : 10335 FINCH AVE
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER SREENATH SREEKANTHAM
ADDRESS 10335 FINCH AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM SREENATH SREEKANTHA
CONTRACTOR LIC # *OWNER*
COMPANY SREENATH SREEKANTHAM
ADDRESS 10335 FINCH AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
TELEPHONE . . . . . . . .
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -------------
---------- ---------- ----------
1BCBSC VALUATION 3, 800 . 00 1 .00 0.00 1.00 0 .00
1BSEISMICR VALUATION 3, 800 . 00 0 .50 0.00 0. 50 0 .00
1WINREP EACH 8 1. 00 380 .00 0 . 00 380 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 381 .50 0 .00 381.50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- -------
CREDIT CARD 381.50 VISA
---------------
TOTAL RECEIPT 381 .50
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 10335 finch ave. DATE: 01/14/2011 REVIEWED BY: bobs.
APN: IBP#: *VALUATION: 1$3,800
O-PERMITT'YPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY PENTAMATION 1GENRES
USE: SFD or Duplex PERMIT TYPE:
WORK replace living room patio sliding lass door.
SCOPE
k
Lfcch_ T,'On Che(`
�f eJt. Perm t F2<�_ ;'r`rtnab_ Pcam;�P"v.
Odle;,:1kch. InSP 010 l'kicf,, Imp,
tdck.la'p, F"o. Phold), h sty. 1"11c, tier lnp,
NOTE. These fees are based on the preliminairTy in ormation available and are only an estimate. Contact the Dept-for addn'l info.
FEE ITEMS (Fee Resolution 09-0SI EY. 717.-'I( FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 I 'J # Window/Sliding Glass Door
Suppl.PC Fee: (F) Reg. 0 OT 0.0 hrs $0.00 $380.00 IWINREP Replacement
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Fee-.0 Reg. 0 OT 0.0hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee:
(,'017.S11-11C[i07 7-(I.\-
Acoustical Fee: 0 Yes (E) No $0.00
Work Without Permit? 0 Yes 0 No $0.00
Planniny,Fee: $0.00
0
71-o el Doc loncntution Fees_ A
Strong;Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
BldgStds Commission Fee: IBCBSC $1.00
SUBTOTALS: $1.50 $380.00 " TOTAL FEE: $381.50
Revised: 01/03/2011
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: 3 NC V Pl;kVfVQ PERMIT#
OWNER'S NAME: SXeEkAArT14AM PHONE# —�
GENERAL CONTRACTOR: AR&0fVAQ7 BUSINESS LICENSE#
ADDRESS: 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.
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring/Carpeting
Linoleum /Wood
6+Vs / Glazing /A P\GQ NAA
Heating
Insulation
Landscaping
Lathing
Masonry
Painting/Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Cep+raetor Signature Date
CITY OF
CITY OF CUPERTINO
GENERAL BUILDING
CUPERTINO PERMIT APPLICATION FORM
APN# L L O r J Date: l / /,o O L
Building Address: !NL
10 , �- Av6- CupE2Tf Na, CA
Mailing Address (if different from building address):
Are Hazardous Materials being used as part of this project? Yes No
HOA: (Exterior work only) Yes ❑ No ❑ If yes, provide letter from HOA
If Residential.is house an Eichler? Yes ❑ No ❑ If yes, needs planning approval.
Owner's Name: Phone#:
Contractor: Phone:
AK& ONAUT Vq1 rV DON 9, n6D)IC, Fax:
Contractor License #: $ca OS
Cupertino Business License#: U o�
Contact: Phone:
S(�V� �0 BlnV Fax/e-mail:
Residential Commercial
Job Description: L- 1 Vt nGi /00M PATIO /VoR AS SHO W4 t1v
PtCzu2C WILL ge kepCACF1> WIT1,J IVF-&/ PA-71`0 D004C
5DM1 '5-rV(-00 MO�,Ac.f r�d0/7f0IVS� RRvunD "r�1E PAT(0 9004,
Building Permit Info:
Bldg ❑ Elect ❑ Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
1-A, 1-B 3' IUIII/V-A ❑ IUIII B, IV-HT, V-B ❑
ILL—_J
Valuation: Square Footage:
)C3, 900. 00
/ Project Size: Counter ❑ Express ❑ Standard ❑ Large ❑ Major ❑
Green Building: Please complete relevant portion of the Green Building/LEED Checklist & attach it
to the application or if applicable, include in plan set & the sheet index.
Points Achieved:
For help, contact Build it Green at www.buildit2reep.org
Revised 12/06/10