Loading...
10080167 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10221 ADRIANA AVE CONTRACTOR:ARGONAUT WINDOW& PERMIT NO: 10080167 DOOR,INC ""'NER'S NAME: JUDITH&JOHN WEST 1901 S BASCOM AVE STE 800 DATE ISSUED:08/24/2010 t,vv'NER'S PHONE: 4088631373 CAMPBELL,CA 95008 PHONE NO:(408)378-4018 ❑ LICENSED CONTRACTOR'S ION. 1 Jli �v � BUILDING PERMIT INFO: BLDG F ELECT r PLUMB � License Class 6 Li,:;.# n �Q2fi1-/,� �/2�I/I� MECH F RESIDENTIAL r COMMERCIAL — Contractor & Date / I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REPLACE WINDOWS(34)/DOORS(8)LIKE FOR LIKE;FIRE (commencing with Section 7000)of Division 3 of the Business&Professions EGRESS CODE FOR BEDROOMS 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 Sq.Ft Floor Area: Valuation:$67000 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION APN r umber:32620051.00 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save 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 c consequence the 1710 DAYS FROM LAST CALLED INSPECTION. granting of this permit. Additionally,the applicant understands and will comply with all non-points rce gulat' ns per he Cupertino Municipal Code,Section 9.18. p Issued Date: 1Ay�0 S:-^ature Date ❑ OWNER-BUILDER DECLARATION RE-ROOFS: All roc fs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractors License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: I,as owner of the roe inspec'ion. property,rty,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Signat ire of Applicant: Date: Business&Professions Code) 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 I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by 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 maint tin compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. 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 Owner or a ized n . 2 become subject to the Worker's Compensation provisions of the Labor Code,I must Date: b,o 0 10 forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION, I here]wy affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for wl ich this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lend(r's Name to building construction,and hereby authorize representatives of this city to enter the above mentioned property for inspection purposes.(We)agree to save Lendcr's Address i mify 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 comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section I unde rstand 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: Lct: APN . . . . . . . . : 326200E1 .00 DATE ISSUED. . . . . . . : 08/24/ 010 RECEIPT #. . . . . . . . . : BS000021261 REFERENCE ID # • • . : 100801E7 SITE ADDRESS . . . . . : 10221 11)RIANA AVE SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER JUDITH & JOHN WEST ADDRESS 10221 I,DRIANA AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-1125 RECEIVED FROM . . . . : JOHN & JUDITH WEST CONTRACTOR . . . . . . . : CHRIS I;TTEMA LIC # 22820 COMPANY ARGONAUT WINDOW & DOOR, INC ADDRESS . . . . . . . . . . : 1901 S BASCOM AVE STE 800 CITY/STATE/ZIP . . . : CAMPBELL, CA 95008 TELEPHONE (408) 3"8-4018 FEE ID UNIT QUANTITY AMOMIT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ------ ---- ---------- ---------- ---------- 1BCBSC VALUATION 67, 000 . 00 3 .00 0. 00 3 .00 0.00 1BSEISMICR VALUATION 67, 000. 00 6 .70 0 .00 6 .70 0 .00 1WINREP EACH 8 40. 00 8£44 . 00 0 .00 884 . 00 0 .00 ----------- ---------- ---------- ---------- TOTAL PERMIT 893 .70 0.00 893 .70 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- --------------------- CHECK 893 .70 #3598 --------------- TOTAL RECEIPT 893 .70 r CITY OF CU13ERTINO CUPEKTINO GENERAL BUILDING PERMIT APPLICATION FORM APN# I Date: 2 L' Building Address: 16;,1 a I 7 , . ' 0-. L4 P-e r 1.('ti c) C IT 9S-61(/ Mailing Address (if different from building address): Are Hazardous Materials being used as part of this pro-ect? Yes ❑ No HOA: (Exterior work only) Yes ❑ No If yes, provide letter from HOA Own Name: Ph ne#• o0►i � Ad� 7 u���t� I,��-s o � � - 13 -73 Contractor: Phone( qb�� 3 76--q01 Fax: Contractor License#r: Cupertino Business License#: Contact: I Phone: Fax: Residential Commercial ❑ ' ,n Job Description: RltpIctc�- Building Permit Info: ' Bldg Elect Plum) ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B Valuation: 4 �—/, oo Square Footage: Project Size: Express tandard ❑ Large ❑ Major ❑ Green Building: Please complete relevant portion of the Green Buitding/LEED Checklist& attach it to the application or if applicable, include in plan set& the sheet index. ?oints Achieved: d For help, contact Build it Green at www.buildit2reen.org Revised 07/14/09 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: I BP#: *VALUATION: 1$67,000 1 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Addition/Repair PRIMARY SFD or Duplex 11,. PENTAMATION 1GENRES USE: F/(A iii 4l; 1 PERMIT TYPE: WORK SCOPE Nt_ A- Phin I'ilof; 11, 1!, Owl ck Pllfwh Vc" LJ Li I Pcf- NOTE. These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn 7 info. FEE ITEMS (Fee Resolution 09-051 Eff. 7.1/101 FEE QTY/FEE I MISC ITEMS Plan Check Fee: $0.00 j 40 # Window Sliding Glass Door Suppl. PC Fee: E) Reg. 0 OT 1".0 hrs $0.00 $884.001 IWINREP I Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Feel 0 Reg. 0 OTF-6-.61 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 T4 Acoustical Fee: 0 Yes (F) No $0.00 0 Work Without Permit? 0 Yes E) No $0.00 E) Planning Fee: $0.00 Select a Non-Residential 0 lrw cl 1)(), rouuw(aioll Fces: Building or Structure 0 I A Strom Motion Fee: IBSEISMICR $6.70 Select an Administrative Item Bldv-Stds Commission Fee: IBCBSC $3.00 $893.70 ALS, Y, $884.00 $9.70 Revised: 8/17/2010 aD LQ<)-z U -1 9 kQ F7 0 Cj of X b 9 �d Uri° � Z to P o 0 a VX � uA --� G- nQD w� � �h �s Xa6 �ah rm J) —� /3 , �Olt. & APPROVED C� ^7 �c IN >t.0 ORDANCI WITH THE CITY Of V lJ� rT CUFF RTINO GOD AND ORDINANCES �' DATA_(� 2 C SIGNED- - j lL- tJy Fhrs yet M plans d s MUS? 72 � �J � be kept on the ob at all times and it is .; 7 unlaw`ul to make any changes or alterationF !<f.� ,r. -'C! I= on s ime without written permission from the P jilding Department, City of Cupertino. _4 �, The s amping of this plan and specifications OC :BHA Lt. NOT be held to permit or to be an appr oval of the violation of any provisions c siny City Ordindnr A or �;tatt-t-aw F y a LA o _ CWHIM M.Indoor Air Quality and Finishes 1.Use LowMo-VOC Paint 1 IACIHealth pis y--yes 0 2,Use Low VOC,Water-Based Wood Finishes 2 IACIHealth pis y=yes 0 3.Use Low/No VOC Adhesives 3 IAC/Health pts yeses 0 4.Use Salvaged Materials for Interior Finishes 3 Re;;ource pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 6IAC/Health pts y=yes 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAC/Health pts y--yes 0 7.Seal aft Exposed Partioleboard or M©F 4 IACiHealth pts y=yes 0 8,Use FSC Certified Materials for Interior Finish 4 Re;oource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Re;:ource pts y=yes 0 10.Install Whole House Vacuum System 31AO/Health pts y=yes 0 1 1 1 N.Flooring 1.Select FSC Certified Wood Flooring B Resource pts y=yes 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Rescvrce pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAC1 Health pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y--yes 0 1 1 1 Total Points Available:1 1401 1301 571 Total Points Project Received:1 4 01 01 01 G:da1alprogsfgreenbui1dncguidelinesl2modelerslgreenpointsfinal212 04protected.xls 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: 1 ()2� O " PERMIT#(Y6>8 ` Al/d? OWNER'S NAME: �p PHONE# 83`76—ylj GENERAL CONTRACT OOR' - BUSINESS LICENSE, f' ( o ADDRESS:�rvUF I//irk Iv�up►Y ILIA 1 S. �4.SC 1 AllP. CITY/ZIPCODE: CA 1f � rG *Our municipal cone requires alb 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 �BCONT CIRS HAVE OBTAINED A CITY OFCUPERTINO BUSINESS LICENSE. I am not using any subcontractors. Signatu re Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS DAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood l Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date