10090062 CITY OF CUPERTI140 BUILDING PERMIT
BUILDING ADDRESS: 10735 FARALLONE DR CONTRACTOR:ARGONAUT WINDOW& PERMIT NO: 10090062
DOOR,INC
INER'S NAME: YU-LIN CHAO 1901 S BASCOM AVE STE 800 DATE ISSUED:09/09/2010
v*VNER'S PHONE: 4086363211 CAMPBELL,CA 95008 1 PHONE NO:(408)3784018
B, LICENSED CONTRACTyOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT PLUMB
License Class C Lic.# �l �d'S 616;9 r
WCydpt� ,1 MECH RESIDENTIAL COMMERCIAL�
Contractor �� .�hn t) t�t 0'r Date �{ CI U
� 0 JOB DESCRIPTION:WINDOW REPLACEMENT FULL NAIL ON RETROFIT,LIKE
I hereby affirm that I am licensed under the provisions of Chapter 9 FOR
(commencing with Section 7000)of Division 3 of the Business&Professions LIKE,2 BEDROOMS DROPPED FOR EGRESS NON-STRUCTURAL
Code and that my license is in full force and effect.
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:$9072
permit is issued.
APPLICANT CERTIFICATION APN Number:36935016.00 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, WITy1AYS 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 DM LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
ra' /
9.18. �" r—/ d Date:
--
q-1� Issued by:
+ature Date
❑ OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one 01' 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,
Signature of Applicant: Date:
Business&Professions Code)
I,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&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 mug t Own r or autho ' 1 ager. D
Date:
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I hereby a
I certify that I have read this application and state that the above information is 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
the above mentioned property for inspection purposes.(We)agree to save
-mify 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
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
n I understand my plans shall be used as public records.
9.18.
Signature Date n— —�� Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR BUILDING DIVISION
ADDRESS: DATE: 09/09/2010 REVIEWED BY: gs
APN: BP#: "VALUATION: 1$9,072
*PERMIT TYPE: Building Permit PL ,N CHECK TYPE: Alteration /Addition / Repair
PRIMARY SFD or Duplex I01?L PENTAMATION 1GENRES
USE: r Ot)R .� tt£r: PERMIT TYPE:
WORK
SCOPE
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1 rt(_,tech IYc,°. f rurr Cn
-fe.lr. P, it L'.���. I'Tftr;h, f'c;r»ziI 1<`t: L71 r_ P, rt%it 1,�,
O'tx'r tic<:Fr. Iftc,3F-1 _L_ Othr.'r 1,11117217/rlv C)ihr t,7cr.C;zsf,
tl -h MAI) 1 e: I'hrttrh. h1.ip. Peer lwq). Fcc.
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 Resolution 09-05I a. 74/10) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $).00 = # Window/Sliding Glass Door
Suppl. PC Fee: (F) Reg. 0 OT 0.0 hrs $).00 $506.00 1 WINREP Replacement
PME Plan Check: $).00
Permit Fee: $100
Suppl. Insp.Fee-.0 Reg. 0 OT 0.0 hrs $).00
PME Unit Fee: $).00
PME Permit Fee: $).00
C'orzllr ucfion Tnr F]
Acoustical Fee: 0 Yes (F) No $).00 0
Work Without Permit? 0 Yes E) No $).00 E)
Planning Fee: $).00 Select a Non-Residential 0
Building or Structure 0
7i-irrtl t)ocrrrrrc�rrtutir�rr F`c�es: �
Strong Motion Fee: IBSEISMICR $3.91 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: r $1.91 $506.00 TOTAL FEE $507.91
Revised: 9/01/2010
RESIDENTIAL PROJECT COVER SHEET
Assessor's Parcel Number:
Name of owner. �V tti 'Viva h
Project address. to-73S- V cW(` e- Vr d
Contact person. Ualh YV1 t1�S�G` P zone. Inq--
F ix.
Net square footage of lot.
Existiniz Proposed
Square footage: First floor:
Second floor:
Garage:
TOTAL:
Are there at least two 10 foot by 20 foot clear spaces i aside the garage? Y N
Is privacy protection planting required for the project' Y N
Build it Green Total Points [-==
On what floor(s) is work being done?
Brief description of work. t&(Xd W awdODd� i4- Iy "
Code editions: 2007 CBC Y N)2007 CFC N)2007 CMC (Y-N)
2007 CPC -N)2007 NEC ( -N)
IN NE: t_;I1Y i T
cut-, ,t �ANt ( MDINANCES
Effective 1/1/08 04n-
SIGNED
thss set of plan nd sa!p It tj-ztttons Mus
be kept tin th �b at 1 -�Ys,end�t
;snlav til to make any charnjes or alteration`
or. .ame without wrMet`permission trer+t
the I Building Department i;Ety >f Cupertrnt,
>W!tamping o this pian and 5pecikattons
'SN kL.L NOT be lteliI r;>permit or to be.an
>t roval of the OIX, provistons
.,r •
any Gi4Y(�rct+^;,�nc.e or , ,
Plan Review Process Work Book Page-8-Revised 8/05,08
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CITY OF CUPERTINO
OF
CUPEkT1NO GENERAL BUILDING
PERMIT APPLICATION FORM
APN# Date:
Building Address:
�O73S 'Fa,r<:1�k 0 14 F.
Mailing Address (if different from building address): 266y � i� ' l br 5ckMN�(x CA
Are Hazardous Materials being used as part of this project? Yes No
HOA: (Exterior work only) Yes ❑ No If yes, provide letter from HOA
Owner's Name: r 1_ Phone#: c kSWQCk5k\ 1*06 32i 1
1�"l1W Cll�a�
Contractor: Phone: YoF 3 7G
Q 54 1 `f0 k
Contractor License 0,S g'
Cupertino Business License#:
Phone: 6.50•
Contact: 1).. �rd 2-0(4 - I`f0
U
Fax: '�o� -b
Residential Commercial
`
� ��
Job Description: LJ'\k& L CC1µeK� �D(k Nux Oti
2 13ed wts cAte tr ed --6 r• eject 2 s Wo LA -St S U C_to a
Building Permit Info:
' Bldg Q 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 L�---
Valuation*A 10-72,"" Square Footage:
Project Size: Express ❑ Standard ❑ Large ❑ Major ❑
Green Building: Please complete relevant portion of the Green B ' ding/LEED Checklist & attach it
to the application or if applicab..e, include in plan set& the sheet index.
'oints Achieved:
For help, contact Build it Green at www.builditj-een.or
Revised 07/14/09
3