10100148CITY OF CUPERT
BUILDING ADDRESS: 1200 BUBB RD
-VNER'S NAME: CRAIG LITTLE
vWNER'S PHONE: 4088739456
❑■
License Class
Contractor
LICENSED CONTRACTOR'S DECLARATION
Lic. #
Date
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.
INO BUILDING PERMIT
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 ente
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgment:,
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, Sectior
9.18.
Date
El OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for oiie of
the following two reasons:
I, as owner of the property, or my employees with wages as their sole compens� tion,
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
1, as owner of the property, am exclusively contracting with licensed contractor: 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 st all
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 re ating
to building construction, and hereby authorize representatives of this city to en er
n the above mentioned property for inspection purposes. (We) agree to save
.mnify 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 compl
with all non -point source regulations per the Cupertino Municipal Code, Sectic n
9.18.
Signature '
Date y l Z)
CONTRACTOR: ARGONAUT WINDOW &I PERMIT NO: 10100148
DOOR, INC
1901 S BASCOM AVE STE 800
CAMPBELL, CA 95008
DATE ISSUED: 10/20/2010
PHONE NO: (408)378-4018
JOB DESCRIPTION: RESIDENTIAL LJ COMMERCIAL
REPLACE 1 WINDOW IN LIVING ROOM
Sq. Ft Floor Area: I Valuation: $3849
APN Number: 36211056.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: 1 ✓ 6— Date: w w�o
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 Appl
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. 1 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 authorized agent: Date: 1 ��
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 Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
CITY OF CUPERTINO
rm-7, FEE ESTIMATOR —BUILDING DIVISION
NOTE: These fees are based on the vreliminary informatio n available and are only an estimate_ Contart tho Dont far addn'1 infa
FEE ITEMS (Fee Resolution 09-05I Eff T1/10)
ADDRESS: 1200 Bubb Rd. 77DATE:
10/20/2010
REVIEWED BY: jsg
APN:
BP#:
*VALUATION: 1$3,849
xPERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY
SFD or Duplex
USE:
hr1?
i t 0 11' �ts':.��:
PENTAMATION
PERMIT TYPE: 1GENRES
WORK
$0.00
SCOPE
NOTE: These fees are based on the vreliminary informatio n available and are only an estimate_ Contart tho Dont far addn'1 infa
FEE ITEMS (Fee Resolution 09-05I Eff T1/10)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
[= #
$380.00
Window / Sliding Glass Door
1 WINREP Replacement
Suppl. PC Fee: 0 Reg. 0 OT
0.0
I hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Feer Reg. 0 OT
0.0
1 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
C�`c�ta.�f� rr< ri � 1"n-
F
Acoustical Fee: 0 Yes (F) No
$0.00
0
Work Without Permit? 0 Yes (E) No
$0.00
Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
0
0
%rcr���1 f)f�c rrtrl�xttctlinr� I.:�F�s
Strong Motion Fee: IBSEISMICR
$0.50
Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC
$1.00
SUBTOTALS:
$1.50
$380.00
TOTAL FEE:
$381.50
Revised: 10/17/2010
i
CM OF
CUPS T1NO
CITY 01 CUPERTINO
GENE1UL BUILDING
PERNIIT APPLICATION FORM
lnlcoNep
APN #
00
Date:
Building Address:
12 Uv 66,6,3 Po b4 Wr'Io f y
Mailing Address (if different from building address):
S ec,
Are Hazardous Materials being used as part of this project? Yes El No
HOA:(Exterior work only) Yes ❑ No ❑ (f es, rovide letter from HOA
Owner's Name: (� Q i Lx T 1' t -- Phone
L4_
Contractor: Phone: H U,T) 3 7 6' 0
ARv0 T [A/Z.N �,1p Fax:
o 12 Ow ypg 8 _05 qZ
Contractor License #: y�� 0 j y
Cupertino Business License #:
Contact: Phone: (fid F) 6 - 05 9.�
SiIAiV�JUN
Fax: qo 6 �g-05x3
Residential Commercial ❑
Job Description:
ticr1ALt r, �v►n�vw in �� ri Hoorn
Building Permit Info:
'Bldg Elect ❑ Plumb ❑ Mech ❑
Type of Construction (Usage Class):
Occupancy Type:
1-A, 1-B ❑ U/UIN-A ❑ 1T/III B, IV -HT, V- B
Square Footage:
Valuation:4S-3
3-3 17
Project Size: Express ❑ Standard ❑ Lame Maior I—I
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.
pints Achieved:
L For help, contact Build it Green at www.builditgr en.or
Revised 07/14/09