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10120046 e CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10439 MARY AVE CONTRACTOR:RAGHUPATHI SUBBIAH PERMIT NO: 10120046 OWNER'S NAME: RAGHUPATHI SUBBIAH 10439 MARY AVE DATE ISSUED: 12/08/2010 OWNER'S PHONE: 6508611162 CUPERTINO,CA 95014 PHONE NO: L LICENSED CONTRACTOR'S DECLARATIONF BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# MECH r RESIDENTIAL F COMMERCIAL Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: DUAL PANE LOWES DOORS,WINDOWS RETROFIT.TO (commencing with Section 7000)of Division 3 of the Business&Professions RETROFIT TWO PATIO DOORS(LIVING ROOM FIRST Code and that my license is in full force and effect. FLOOR),TO RETROFIT TWO FIXED WINDOWS(LIVING ROOM, 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 Sq.Ft Floor Area: Valuation:54250 permit is issued. APPLICANT CERTIFICATION APN Number:32652062.00 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 8 AYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAY M LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Issued by: `J Date: 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 become subject to the Worker's Compensation provisions of the Labor Code,I must Owner or and agent: forthwith comply with such provisions or this permit shall be deemed revoked. Date' 2 n 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 costs,and expenses which may accrue against said City in consequence of the ig of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION w Al non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature (Y Date I?Of 0 Licensed Professional CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10439 Mary Ave. DATE: 12/08/2010 REVIEWED BY: gs APN: BP#: *VALUATION: 1$4,250 P TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair Y V/ e PENTAMATION USE: SFD or Duplex €fr d PERMIT TYPE: 1 GENRES WORK SCOPE 1_,' Chck E}`•li'% .. ft.S'> t i, t, C)<„c.-£.;, LJ L ' ._ sr; 1, _ f',. tE,• i _ i,r = Jnr. i,. NOTE. Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'1 info, FEE ITEMS (Fee Resohitiofi 09-051 Eff. 7,," FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 ETI # Window/Sliding Glass Door Suppl. PC Fee: (F) Reg. 0 OT0.0 hrs $0.00 $380.00 1WINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee.0 Reg. 0 OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Collso-11"fion 7,ax F71 Acoustical Fee: 0 Yes (F) No $0.00 0 Work Without Permit? 0 Yes 0 No $0.00 E) Planning l;,ee: $0.00 Select a Non-Residential 0 1 i r�l l�c�c�l�rtttfrtinere,- Building or Structure 0 Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg;Stds Commission Fee: IBCBSC $1.00 _71 SUBTOTALS: 1 $1.501 $380.00 TOTAL FEE: $381.50 Revised: 12/07/2010 CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32652062 .00 DATE ISSUED. . . . . . . : 12/08/2010 RECEIPT #. . . . . . . . . : BS000012177 -REFERENCE ID # . . . : 10120046 SITE ADDRESS . . . . . : 10439 MARY AVE SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : RAGHUPATHI SUBBIAH ADDRESS . . . . . . . . . . : 10439 MARY AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : RAGHUPATHI SUBBIAH CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : RAGHUPATHI SUBBIAH ADDRESS . . . . . . . . . . : 10439 MARY AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE . . . . . . . . FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 4, 250. 00 1 .00 0 . 00 1. 00 0 . 00 1BSEISMICR VALUATION 4, 250 . 00 0 .50 0 .00 0 .50 0 . 00 1WINREP EACH 8 5 . 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 AMEX --------------- TOTAL RECEIPT 381.50 i Architecture Request Form j E Association Date j Casa 1>e AnzPr 'Atli (v uv -2-010 Name Home Phone (A-pa- h .h 1 -650 - 861 - 11bl_ Address Work Phone } 10*3 9 MaYJ Jive C&AftYtiYb (-,Or l -- 4.0 8 - 3 24 - 0 53 0 Descri tion/Dgaw-m—g--of Planned Improvement D Pam Lz W c Kkn,6 C>. Q2"O L- J� k av-m M a S to y gez(Yoaw► (0 �ee.��:t• S(�;d-��,y w��.t�bw (� Syy%at.c BedY-bvy►) AU 10 6- fla m at 4e DUAL ( O-M-e. Low 03 1 V N y L l The approval of your project's architectural compatibility with the Homeowners Association does not constitute or imply,that the Architectural Committee and/or-.the Association.Board of Directors-deem youit project as meeting City or County code.The approval is given contingent-upon you and/or your contractor's)obtaining the required construction permits and meeting all code requirements,if any. Homeowner Signature Association Use Only: Approved: IVI Denied: t�. :( `-FJV D B.Oard/Complittee Remarks: I Board/Architecture Committee Signature Date n Mail completed form with any attachments to: Community anagement Services, Inc 1935 Dry Creek Road, Ste. 203 Campbell, CA 95008 Ph-(408)559-1977 Fax:(408)559-1970 I i 5Ore q WoYk, 1Aj \"V.\d-o-w Y--ef ku- (� v--Q-- to U,kz Two p:x-,� w� 4�z-e WFIL(W ftCv-/ Patio Door Patio Door n� Fixed Window edftrlpy LivingOFFI M BedRoom P 0 4 Dining Stairs M o Bath Stairs Kitchen .5 Bath Entryf: I -� 16.0' BedRoom First Floor 16.0' Sliding Window Second Floor C 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: 10y3q 10y3MAY Ave— YKz,o C-P,9%-D)q PERMIT# OWNER'SNAME: RGG. �k f} SU60,1Pf R PHONE# GENERAL CONTRACTOR: S(j )L c ktUJ� BUSINESS LICENSE# ADDRESS: go 164-Ay -c4 &44,-- L- B sc✓r,J041- to I51 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 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 Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile �COA�� ,z1 og � , o O er/ on actor Signature Date WINDOW REPLACEMENT REQUIREMENTS COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildinq(d)cupertino.orq PURPOSE The purpose of this guideline is to clarify the minimum building code requirements when repairing, replacing or adding windows in a residential building. Structural plans and calculations may be required if window/door openings are added to an existing lateral resisting element(shearwall). PLAN REQUIREMENTS 1. Provide a completed building permit application. 2. Provide three sets on minimum 8-1/2"x 11" sheets of completely dimensioned floor plans showing the size, type and/or location of all new or replacement/repaired windows. Floor plan shall specify the use of all existing rooms. 3. Owner-Builder Disclosure Form(for property owners applying for their own building permit) 4. Provide structural plans and calculations if window/door opening is (are)being added to an existing shearwall and the overall design does not meet the conventional construction requirements of the California Building Code. GENERAL INFORMATION—EMERGENCY ESCAPE AND RESCUE OPENINGS • Per Section 1029 of the 2010 California Building Code,provis ade for emergency escape and rescue in Group R occupancies. This al �t replacement windows per 2010 CBC Section 3407. 4 `b 711, • Every sleeping room shall have at least one exterior a enncy,� nrescue opening or exterior door approved for egress or rescue. • All emergency escape and rescue openings from sleeping rooms shall have a net clear opening of 5.7 square feet, except that the minimum net clear opening for emergency escape and rescue grade- floor openings shall be 5 square feet. • The minimum net clear opening height shall be 24 inc s. um net clear opening width shall be 20 inches. am I US • Emergency escape and rescue sQa e the ottom of the clear opening not greater than 44 inches measured from the floor. • Bars, grills, grates or any similar devices are permitted to be placed over emergency escape and rescue openings provided the minimum net clear opening size complies with the opening requirements of the egress window and such device shall be releasable or removable from the inside without the use of a key,tool, special knowledge or effort or force greater than that which is required for normal operation of the escape and rescue opening. • Bars, grills, grates or any similar devices shall be equipped with an approved exterior release device for use by the fire department. WindowReplacePolicy.doc revised 11108/10 1VIIN. WIDTH/HEIGHT EMERGENCY ESCAPE AND RESCUE WINDOWS (5 SQ. FT.) [Specify WIDTH to calculate minimum HEIGHT] WIDTH: 20.0 inches (20"minimum) HEIGHT: 36.0 inches MINIMUM NET CLEAR OPENING OF C7 5.7 SQ.FT. / (EXCEPTION: GRADE-FLOOR MIN. WIDTH/HEIGHT EMERGENCY ESCAPE z WINDOW OF AND RESCUE WINDOWS (5.7 SQ. FT.) 5.0 SQ.FT.) N [Specify WIDTH to calculate minimum HEIGHT] 120"MIN. WIDTH WIDTH: 20.0 inches (20"minimum) HEIGHT: 41.0 inches 'v v FLOOR FEE ESTIMATE FOR WINDOW AND/OR SLID ING„GLASS DOOR(,EW OR REPLACEMENT): The calculated fees are only an estimate. Contact the Bldg beet for ddditiortal info. *SCOPE OF WORK: Replacement Permit Fee $0.00 *VALUATION: $0 Strong Motion Fee $0.00 *#OF WINDOWS AND0 Bldg Stds Commission Fee $0.00 SLIDING DOORS: TOTAL $0.00 WindowReplacePolicy.doc revised 11/08/10 OWNER-BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333• buildin4(a)cupertino.org Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SITE ADDRESSM��O I Ave— APN BP# �'Il /L L1�- OWNER NAME Q '-t' OWNERADDRESS DESCRIPTION OF WORK: w c kXV\.r � We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed,and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you,the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS:Please read and initial each statement below to signify you understand or verify this information.) �. I understand a frequent practice of unlicensed persons is to have the property owner obtain an"Owner- Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. 1, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. �3. 1 understand as an"Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. . I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an"employer'under state and federal law. `LP�Gli understand if I am considered an"employer" under state and federal law, I must register with the state and federal government,withhold payroll taxes, provide workers'compensation disability insurance, and contribute to unemployment compensation for each"employee." I also understand my failure to abide by these laws may subject me to serious financial risk. 7. 1 understand under California Contractors'State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s)that result from any latent construction defects in the workmanship or materials. OwnerBuilderFornt 2010.doc revised 04114/10 -9: I understand I may obtain more information regarding my obligations as an"employer"from the Internal Revenue Service,.the United States Small Business Administration,the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors'State License Board(CSLB)at 1-800-321-CSLB (2752)or www.csib.ca.gov for more information about licensed dco�n"tractors. I am aware of and consent to an Owner-Builder building permit applied for in my name,and understand that I 1, - am the party legally and financially responsible for proposed construction activity at the site address listed above. V 11. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. "12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors'State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint.Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property,you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors,you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers'compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS:Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued,this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note:A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: - -- ---------- --------------- -- ----- --------------- ------ -- ------------------ --- -'----------------------------------------------- (NOTE: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner,the execution of which I understand is my personal responsibility, I hereby authorize the following person(s)to act as my agent(s)to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project(or Description of Work): Project Location or Address: Name of Authorized Agent: Tel No Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note:A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: o OwnerBuilderForm 2010.doc revised 04114110 Jo `f CITY OF CUPERTINO CM OF CUPS TINO GENERAL BUILDING PERMIT APPLICATION FORM APN # ,-� � ��- -� ! � Date: Building Address: V Cp Mailing Address (if different from building address): Are Hazardous Materials being used as part of this project? Yes ❑ No HOA: (Exterior work only) Yes K]/No ❑ H yes, provide letter from HOA / Owner's Name:�G�� y►��a��1 � 5 �� .c� i� Phone#: �- Contractor: Phone: ;, Z q E �r C y �1 -�- 5 Fax: 16- 1 2- Contractor Contractor License Cupertino Business License#: 4 Contact: Phone: Fax: esidential Commercial ❑ `)kc+ t2_� ��;��; ovw h;-k,:t Lu-5 R-cvyrn } I-yyY F--Vul Job Description: imp iZ�r'Q t- I 76 <-C-A-y'3�--A►' 1+.� � w� G' •i, ( L `' v� t�c�rrn I ,(,V- F-�c ) dt-L Ll-:'j w° �- Y Building Permit Info: Bldg Elect ❑ Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ E/=-A ❑ II/III B, IV-HT, V-B E4 S Valuation: Square Footage: 2-- Project Project Size: Express ❑ Standard ❑ Large ❑ Major ❑ Green Building: Please complete relevant portion of the Green BTuilding/LEED Checklist & attach it to the application or if applicable, include in plan set& the sheet index. Points Achieved: )r help, contact Build it Green at www.buRditueen.org Revised 07/14/09 3