10060144 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7968 FOLKESTONE DR CONTRACTOR:CUSTOM EXTERIORS INC. PERMIT NO: 10060144
OWNER'S NAME:JENG-TZONG WANG 440 19OULDER CT STE 400 DATE ISSUED:06/22/2010
TIER'S PHONE: 4082573430 PLE kSANTON,CA 94566 PHONE NO:(925)249-2280
Qvl_ LICENSED CONTRACTOR'S
DECLARATION BUILDING PERMIT INFO: BLDG ELECT r— PLUMB r
License Class C' Lic.# O MECH F RESIDENTIAL r— COMMERCIAL r
Contractor Date 2 Z
I hereby oprmthat I am licensed under the provisions of Chapter 9 JOE.DESCRIPTION: REPLACE 12 WINDOWS,2 SLIDING PATIO DOORS,NAIL
FIN]4EW CONSTRUCTION INSTALL,CHANGES TO EXISTING
(commencing with Section 7000)of Division 3 of the Business&Professions OPE DINGS,3 CUTDOWNS TO MEET EGRESS
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
perfonnance 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 hid Sq. Tt Floor Area: Valuation:$7500
permit is issued. Z__
APPLICANT CERTIFICATION APPI Number:36211003.00 Occupancy Type:
I certify that I have read this application and state that the above inf ation 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, WITHIN 180 DAYS 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 DAYS FROM LAST CALLED INSPECTION.
with all non-po o egulations per the Cupertino Municipal Code,Section
,..LLa
9.18. Issued by: ---- Dater
Signature Date
OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All -oofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: instilled without first obtaining an inspection,I agree to remove all new materials for
1,as owner of the property,or my employees with wages as their sole compensation, insl ection.
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Sig Nature 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
Compensation,as provided for by Section 3700 of the Labor Code,for the I h;rve read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. Ca ifornia Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by coy rpliance 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 Ad 3itionally,should I use equipment or devices which emit hazardous air
permit is issued. coy tarninants 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 o t ed agent:
Date:
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I h
I certify that I have read this application and state that the above information is reby 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, Leader's Address
and expenses which may accrue against said City in consequence of the
.ulg of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
v�,:h all non-point source regulations per the Cupertino Municipal Code,Section
9.18. 1 u rderstand my plans shall be used as public records.
Signature Date Li sensed Professional
CITY OF CUPERTI
NO
CUPEkTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN # Date:
Building Address:
Mailing Address (if different from building address):
Are Hazardous Materials being used as part of this pr eject? Yes No
HOA: (Exterior work onlD Yes ❑ No If yes, provide letter from HOA
Owner's Name:--- Phone#:
Contractor: ` Phone:
Fax:
Contractor License#: G r3 C l
Cupertino Business License#:
Phone:
Contact: e��_ A e.,7 A Fax:
Residential Commercial El
Job Description: / �_ w '� U LAJ 2 ��
CJ-, e-J-1 7Z
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Building Permit Info:
Bldg 0./ Elect ❑ Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
/3
1-A 1-B II/III/V-A ElII/III B, IV-HT, V-B [–+—
–
Valuation: Square Footage:
�S7�
Project Size: Express Standard ❑ Large ❑ Major ❑
Green Building: Please complete relevant portion of i he Green Building/LEED Checklist & attach it
to the application or if applicable, n►clude in plan set & the sheet index.
Points Achieved:
For help, contact Build it Green at www.builditgreen.or
Revised 07/14/09
slt,� CITY OF CUPERTINO
C U
CITY
OF O GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1STUCOAP Stucco Applications (up to 400 sf) B
additional stucco application
1 WINREP Replacement windows/sliding glass B
door (ea 8 w indows)
1 WINMEWSTR New Window-structural shear B
wall/masonry(includes plan ck fee)
IEPERMITFEE Electrical Permit Fee E
1 MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit Fee P
1 ELCPLNCK Stand Alone Electric Pin Ck(hourly) E
1 MECPLNCK Stand Alone Mechanical Pin Ck (hrly) M
1 PLMBLNCK Stand Alone Plumbing Pin Ck (hrly) P
1 STPLNCK-(3 Hr Min Standard Plai Check (when no E/M/P) B
when not over counter) hourly-stand alone
1BCBSC Cal Bldg Staldards Commission Fee B ALL PERMIT
TYPES
1BSEISMICR Seismic Residential B
1BSEISMICO Seismic Corranercial B
1 TRAVDOC Travel &Do mmentation B
1BUSLIC Business Lic--nse B
5of5
M.Indoor Air Quality and Finishes
1.Use Low/No-VOC Paint 1 IACJHealth pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAC JHealth pts y=yes 0
3.Use Low/No VOC Adhesives 3 IAC JHealth pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61A(JHealth pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAO/Health pts y=yes 0
7.Seal all Exposed Particleboard or MDF 4 IA(VHealth. pts y=yes 0
B.Use FSC Certified Materials for Interior Finish 4 RE3ource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Re source pts y=yes 0
10.Install Whole House Vacuum System 3 IAXHealth 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 Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IACJHealth pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Re;ource pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Res ource pts y=yes 0
1 1 1
Total Points Available: 1 14OF 1301 57
Total Points Project Received: 01 01 0
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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 / SUB(_"ONTRACTOR LIST
JOB ADDRESS: �- U �Z 5 �� r PERMIT# 01 0 d 111-f
OWNER'S NAME: /VN.- v,Jam- PHONE# I L- 6-7 �S_- T-1 3 6'
GENERAL CONTRACTOR: eL- erj)r 3 BUSINESS LICENSE # 0
ADDRESS: U C_7X qui er4j,-t-o^ CITY/ZIPCODE: Cc- 9 Lf
*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 SUBCO TRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I 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
Date
Owner/Contractor Signature