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09090204 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7685 NORMANDY WAY CONTRACTOR:ARGONAUT WINDOW& PERMIT NO:09090204 DOOR,INC (MI'NER'S NAME: LUTFUR KHUNDKAR&SUSAN FRAYNE TRUS 1901 S BASCOM AVE STE 800 DATE ISSUED:09/28/2009 .NER'S PHONE: 4082576277 CAMPBELL,CA 95008 PHONE NO:(408)3784018 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG f— ELECT f— PLUMB r License Class Lic.# MECH RESIDENTIAL COMMERCIAL Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REPLACE WINDOWS IN DWELLING LIKE FOR (commencing with Section 7000)of Division 3 of the Business&Professions LIKE 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. Sq.Ft Floor Area: Valuation:$6400 1 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. APN Number:36611167.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION. costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply_ r 2 F with all non-point source regulations per the Cupertino Municipal Code,Section Issued by: r Date 9.18. Signature Date RE-ROOFS: OWNER-BUILDER DECLARATION 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 I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: 1,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: Date: 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 contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). 1 hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this 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 permit is issued. Health&Safety Code,Sections 25505,25533,and 25534. 1 certify that in the performance of the work for which this permit is issued,1 shall not employ any person in any manner so as to become subject to the Worker's 0 er o thprized agent: Q� Compensation laws of California. If,after making this certificate of exemption,I .l ��{1,� � .. Date: 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.) I certify that I have read this application and state that the above information is Lender's Name 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 Lender's Address U' 'he above mentioned property for inspection purposes.(We)agree to save i. Jify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. C C Licensed Professional r— Signature� 4'( O� CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36611167 . 00 DATE ISSUED. . . . . . . : 09/28/2009 RECEIPT #. . . . . . . . . BS000008783 REFERENCE ID # . . . : 09090204 SITE ADDRESS . . . . . : 7685 NORMANDY WAY SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER LUTFUR KHUNDKAR & SUSAN FRAYNE ADDRESS 7685 NORMANDY WAY CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5252 RECEIVED FROM . . . . : LUTFUR R KHUNDKAR CONTRACTOR . . . . . . . : CHRIS ETTEMA LIC # 22820 COMPANY ARGONAUT WINDOW & DOOR, INC ADDRESS 1901 S BASCOM AVE STE 800 CITY/STATE/ZIP . . . : CAMPBELL, CA 95008 TELEPHONE . . . . . . . . : (408) 378-4018 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 6,400. 00 1 . 00 0 .00 1. 00 0 . 00 1BSEISMICR VALUATION 6,400 . 00 0 . 70 0. 00 0. 70 0 .00 1WINREP EACH 8 1 . 00 380 .00 0. 00 380. 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 381 .70 0 . 00 381. 70 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 381 .70 DISCOVER --------------- TOTAL RECEIPT 381 . 70 Z GO V'1 � C Q � ^ � r CV t` 00 N M AP140 M Ct IN ACCORDA'�' i ""1 i4 1 HE CITY OF CUPS HTlNO CODE' ANI,�1RDINANCE %*Akw nip DATE_ SIG�' NE This set of plans and specs<<cations fAUS be kept m the Sob at am ail ties and it is unlavrlul 4o make'a"y ' h;+`'yeti x alterations on same without - ltten permission from the HLAding Departr' _j Crty,-at Cupertino. The stampino c.>f thy, and spec rfications SHAL L NOT kip hel tr permit of to an N yl appvgval of the v�ol.rt�u�,of a� ,rout s of any City (;ilinar, r�ur ,,taste Lav U 00 BY N ^ �t O� cd in 3 � 00 cd .b d cd U OC O A t;( z 00 a� cd'00 � Q.) W Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CIT1f Of Fax(408)777-3333 XPEkTINO Building Department JOB ADDRESS: PERMIT # OWNER'S NAME: K*v N P- A-\j N 4-- 'C ek�s� PHONE # 4(5 2 5 7--6Z-7 GENERAL CONTRACTOR: rvaCq oQJ A-J T -Vb jv46 FAX# 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 Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature l3ate o 9 C) oma,y S-- CITY OF CUPERTINO CUPEf�TINO GENERAL BUILDING PERMIT APPLICATION FORM APN# cz, + �� M �� Date: Q 1.2 I f Building Address: Mailing Address (if different from building address): 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: UU-v (--U K Phone#: 4- 409-12(37-627 Contractor: Phone: 4 0� 7C- -4 Ol g P42610tti � Vel c\tpObv 9/ Fax: Contractor License#: <3 5,;�`6- 5 Cupertino Business License#: Contact: Phone: BUST iv ���'S7 Fax: Residential Commercial 11 Job Description: �Z L p L P-C E V J h"j ©fiNA T) V\J le 10: I\J G� Building Permit Info: Bldg D Elect ❑ Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: I-A, I-B ❑ II/III/V-A ❑ II/I1I B, IV-HT, V-B ®-- 3 Valuat;on: Square Footage: �c oo,o3 Project Size: Expresstandard ❑ Large ❑ Major ❑ 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.buflditgreen.org Revised 07/14/09 SIV� CITY OF CUPERTINO OF GENERAL BUILDING APPLICATION CUPEI�TINO 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 windows) 1 WINMEWSTR New Window-structural shear B wall/masonry(includes plan ck fee) 1 EPERMITFEE Electrical Permit Fee E 1 MPERMITFEE Mechanical Permit Fee M 1PPERMITFEE Plumbing Permit Fee P 1 ELCPLNCK Stand Alone Electric Pln Ck (hourly) E 1 MECPLNCK Stand Alone Mechanical Pln Ck(hrly) M 1PLMBLNCK Stand Alone Plumbing Pln Ck (hrly) P 1 STPLNCK-(3 Hr Min Standard Plan Check(when no E/M/P) B when not over counter) hourly-stand alone 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICR Seismic Residential B 1BSEISMICO Seismic Commercial B 1 TRAVDOC Travel & Documentation B 1BUSLIC Business License B 5 of 5 IAD/Health lVindoor Air ualiry an Finis es 1.Use lawlNo-voc Paint 1 IAQ/Health pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 3.Use Low/No VOCAdfesives 3 IAQ/Health 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 6IAQ/Health pts y=yes 0 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 7.Seal all�OsWP,arOdeboard or i 4 IAQ/Health. pts y=yes 0 B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0 10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 11io 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 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 1 1 1 Total Points Available: 1 1401 130 57 Total Points Project Received: 01 01 0 G:datalprogs/greenbuildngguidelineslremodelers/greenpointsfinal2.12.04proteoted.xls