10020041 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7909 BELKNAP DR CONTRACTOR:ARGONAUT WINDOW& PERMIT NO: 10020041
DOOR,INC
VER'S NAME: MURAMOTO EDWIN E AND SALLIE R 1901 S BASCOM AVE STE 800 DATE ISSUED:02/08/2010
OWNER'S PHONE: 4082531401 i:AMPBELL,CA 95008 PHONE NO:(408)378-4018
❑ LICENSED CONTRACTOR'S DECLARATION 311JILDING PERMIT INFO: BLDG[— ELECT r— PLUMB r
License Class Lic.# MECH r RESIDENTIAL F COMMERCIAL
Contractor Date
FOB DESCRIPTION:REPLACEMENT BATHROOM WINDOWS&REPLACE
I hereby affirm that I am licensed under the provisions of Chapter 9
3EDROOM
(commencing with Section 7000)of Division 3 of the Business&Professions NINDOW W/SLIDING GLASS DOOR;NO STRUCTURAL;WINDOWS
Code and that my license is in full force and effect. AKE FOR LIKE
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
5q.Ft Floor Area: Valuation:$1100
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:36208039.00 Occupancy Type:
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
indemnify and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
S' zture Date Issued by: Date:
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Code)
Signature of Applicant: Date:
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:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
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 read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
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.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I must Own o auth ized agent:
forthwith comply with such provisions or this permit shall be deemed revoked. 4k"- j� Date.
6� �' E
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
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 I hereby affirm that there is a construction lending agency for the performance of work's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
'he above mentioned property for inspection purposes.(We)agree to save Lender's Name
nify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
9.18.
c/ I understand my plans shall be used as public records.
Signature �w`�' 214,4 j-'L Date Y d LO
Licensed Professional
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 3E208039. 00
DATE ISSUED. . . . . . . : 02 /08/2010
RECEIPT # . . . . . . . . . BE000009706
REFERENCE ID # . . . : 1( 020041
SITE ADDRESS 75,09 BELKNAP DR
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER MURAMOTO EDWIN E AND SALLIE R
ADDRESS 7309 BELKNAP DR
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4973
RECEIVED FROM . . . . : EDWIN E MURAMOTO
CONTRACTOR CHRIS ETTEMA LIC # 22820
COMPANY ARGONAUT WINDOW & DOOR, INC
ADDRESS 1:)01 S BASCOM AVE STE 800
CITY/STATE/ZIP . . . : CAMPBELL, CA 95008
TELEPHONE (,608) 378-4018
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 1, 100 . 00 1 . 00 0 .00 1 . 00 0 . 00
1BSEISMICR VALUATION 1, 100 . 00 0 . 50 0 . 00 0 .50 0. 00
1WINREP EACH 8 1 . 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
IR CITY OF C'UPERTINO
CUPEi�TiNO GENERAL BUILDING
PERMIT APPLICATION FORM
Date: o
Building Address: � 6� � � i\ � ..� � j
Mailing Address (if different from building address):
Are Hazardous Materials being used as part of this project? Yes No
HOA: (Exterior work on Yes ❑ No ❑ If yes, provide letter from HOA
Owner's Name: Phone#:
Contractor: 1 Phone:
/`42,/,6 Wlv-�C Fax: - C-e,8 -
Contractor License#: 8$6 D 5,b
Cupertino Business License#:
Contact: Phone:
GjAAi--)Nt-1,3 pj' - MARS Fax:
Residential Commercial
Job Description: LACC -[:�f�,-CV ZO w t t-' VO-W s
-T t-}
u D/ Q4 Gi CA
1--t K-C- FOP- `-L r
Building Permit Info:
BI d 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 E],,
Valuation: Square Footage:
U C/
Project Size: Ex ress ❑ Standard ❑ Large ❑ Ma or ❑
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.
Points Achieved:
For help, contact Build it Green at www.builditureen.or
Revised 07/14/09
CITY OF CUPERTINO
In of GENERAL BUILD[NG APPLICATION
CUPEI�TINO FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1STUCOAP Stucco Ar plications (up to 400 sf) B
additional stucco application
1 WINREP Replacem int windows/sliding glass B
0 door (ea 8 windows)
1WINMEWSTR New Window-structural shear B
wall/masc my(includes plan ck fee)
1 EPERMITFEE Electrical Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
IPPERMITFEE PlumbinE Permit Fee P
1 ELCPLNCK Stand Alone Electric Pln Ck(hourly) E
1MECPLNCK Stand Alone Mechanical Pln Ck(hrly) M
1 PLMBLNCK Stand Al ane Plumbing Pln Ck(hrly) P
1 STPLNCK-(3 Hr•Min Standard Plan Check(when no E/M/P) B
when not over counter) hourl -s'.and alone
1BCBSC Cal Bldg;Standards Commission Fee B ALL PERMIT
TYPES
1BSEISMICR Seismic Residential B
1BSEISMICO Seismic Commercial qB
1TRAVDOC Travel &Documentation
1BUSLIC Business License B
5 of 5
M.Indoor Air QuaI4 and Finishes
1.Use LowNo-VOC Paint 1 IADJHealth pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQJHealth pts y=yes 0
3.Use LowlNo VOC Adhesives 3 IAQIHealth pts yeses 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts Y--yes
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQMealth pts y=yes
6.Use Exterior Grade Plywood for Interior Uses 1 IAQIHealth pts y=yes
7.Ssal ail EkppsW_i'Wiblebaard or MDF _ 4 IAQ/Health. pts Y:-:Yes
B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes D
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 3 IAQMealth pts y=yes
N.Flooring
1.Select FSC Certified Wood Flooring 6 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 D
4.Install Natural Linoleum in Place of Vinyl 5 IAQ/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
Total Points Available: 1401 1301 57
Total Points Project Received: 0 61 0
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