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10120099 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1590 JAMES TOWN DR CONTRACTOR:BAY CITY WINDOWS PERMIT NO: 10120099 OWNER'S NAME: RAMAN ANIL AND VYJAYANTHI 3030 OSGOOD CT DATE ISSUED: 12/15/2010 OVINER'S PHONE: 4083090681 FREMONT,CA 94539 PHONE NO:(510)353-1600 CI LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r— PLUMB License Class—C I / Lic.,# �91R' Rh d ) MECH F RESIDENTIAL r— COMMERCIAL� Contractor J C�� )+^ L�-S Date /Z I S 6 I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REPLACE 5 WINDOWS,REPLACE 5 PATIO DOORS, (commencing with Section 7000)of Division 3 of the Business&Professions REPLACE TWO WINDOWS AND CUT DOWN TO MEET EGRESS Code and that my license is in full force and effect. 1 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:$6600 permit is issued. APPLICANT CERTIFICATION APN Number:36610070.00 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, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regula' ns per the Cupertino Municipal Code,Section 9.18. Issued Date-./' " b�'"�'�---- ��' Signature ������•••✓✓✓ Date ` 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, Business&Professions Code) Signature of Applicant: Date: 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& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. 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&Safety Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I t agent: J J J� become subject to the Worker's Compensation provisions of the Labor Code,Imust Owner or authorized /� forthwith comply with such provisions or this permit shall be deemed revoked. Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address and expenses which may accrue against said City in consequence of the mg 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 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: TraciC COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36610070 . 00 DATE ISSUED. . . . . . . : 12/15/2010 RECEIPT #. . . . . . . . . : BS000012251 REFERENCE ID # . . . : 10120099 SITE ADDRESS . . . . . : 1590 JAMES TOWN DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : RAMAN ANIL AND VYJAYANTHI ADDRESS . . . . . . . . . . : 1590 JAMES TOWN DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : BAY CITY WINDOWS 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 ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 6, 600 .00 1. 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 6, 600 . 00 0 .66 0 .00 0 . 66 0 . 00 1WINREP EACH 8 9 . 00 506 . 00 0 .00 506 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 507 . 66 0 .00 507 . 66 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 507 . 66 6255 --------------- TOTAL RECEIPT 507.66 CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: TraciC COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36610070 . 00 DATE ISSUED. . . . . . . : 12/15/2010 RECEIPT #. . . . . . . . . BS000012251 REFERENCE ID # . . . : 10120099 SITE ADDRESS . . . . . : 1590 JAMES TOWN DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER RAMAN ANIL AND VYJAYANTHI ADDRESS 1590 JAMES TOWN DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : BAY CITY WINDOWS 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 ---------- ------------- ---------- ---------- ---------- ---------- ---------- VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 100 FOOTINGS 101 FOUNDATION 102 PIERS 103 UFER 104 REBAR 105 ANCHOR BOLTS 106 SEWER & WATER 107 POOL/BONDING 108 PAD SETBACK CERTIFICATION 109 BLOCKWALL 110 RETAINING WALL ill, CONCRETE WALL 112 WATER PROOFING 113 SLAB 114 PLUMBING UNDERGROUND 115 ELECTRICAL UNDERGROUND 202 UNDERFLOOR PLUMBING 203 UNDERFLOOR MECHANICAL 204 UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION 301 ROUGH PLUMBING 302 TUB & OR SHOWER 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 305 FRAME 306 HOLDOWNS 307 INSULATION 308 SHEETROCK CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 1590 james town dr. DATE: 12/15/2010 REVIEWED BY: bobs. APN: j(p(�, - j0- BP#: t o 1j *VALUATION: 1$6,600 xPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY 3 r PENTAMATION 1 GENRES USE: SFD or Duplex .� �t' ={�t , PERMIT TYPE: WORK SCOPE NOTE. These ees are based on the relimina in ormation available and are only an estimate. Contact the Dept-for addn 7 info. FEE ITEMS (Fee Resolution 09-051 E('. -1:70) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 9 # Window/Sliding Glass Door Suppl. PC Fee: E) Reg. 0 OT 0.0 hrs $0.00 $506.00 1 WINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feed Reg. 0 OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Acoustical Fee: 0 Yes G No $0.00 Work Without Permit? 0 Yes 0 No $0.00 Plann tingE: $0.00 l3"i!i'i't 1.4)C Ioi "'11I£!a it1`c"�`.�_ Strong Motion Fee: IBSEISMICR $0.66 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $1.66 $506.00 TOTAL FEE: 1 $507.66 Revised: 12/07/2010 Building Department City Of Cupertino Lm ' 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: 1,510 Py PERMIT# d OWNER'S NAME: A ti' h vravN PHONE# Y)61- 353— 6 e o GENERAL CONTRACTOR: eV, n'-'f14 BUSINESS LICENSE# 4 a 3 59 ADDRESS: . 36 eC' A; (. -rl CITY/ZIPCODE: q �S *Our municipal code requir s 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 SUBCONTRAC ORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. 1 am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 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 mc,,.14 XIX clot• L.vi✓1� l vin[ 4.VIrlC yo 44;- sSXss SS-�Ss 5„ Gv � 7 s•'� k 40 j,J 6 r r o �( 9 S S�3i xJ L�XtiLI SC e O w0ck 1 - W ; ndowS � 5� � � IP75 PGl CITY OF CITY OF CUPERTINO CPA GENERAL BUILDING CUPERTINO PERMIT APPLICATION FORM APN# Date: 30(P - 10-0-3fD /2 Building Address: j 5q D 5�yr"5 y0w r Pr. Mailing Address (if different from building address): Are Hazardous Materials being used as part oft 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#: 40� 3M 6691 Contractor: Phone: 5(0-- Fax: Contractor Licens #: Cupertino Business License#: Contact: / Phone: y►'1/ ���'►� � Fax/e-mail: ResidentiaVX Commercial ❑ Job Description: Building Permit Info: Bldg n_- Elect ❑ Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B Ej,--. Q Valuation: 162 0 La 6 K) 0Square Footage: , Project Size: Counter ©fix ress ❑ Standard ❑ Lar e ❑ 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.buildittireen.org Revised 12/06/10