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09110083 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7612 ELDERWOOD CT CONTRACTOR:SEARS HOME PERMIT NO:09110083 IMPROVEMENT P"'NER'S NAME: CARL DRESEL 1024 FLORIDA CENTRAL PKWY DATE ISSUED: 11/16/2009 U-NER'S PHONE: 4084463828 LONGWOOD,FL 32750 PHONE NO:(925)245-2000 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F ELECT r PLUMB F License Class A Lic.# 7_,;�/3 75 r I— ' MECH RESIDENTIAL COMMERCIAL Contractor � � �1V]�Date 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: INSTALL NEW KITCHEN COUNTER TOP/RECONNECT (commencing with Section 7000)of Division 3 of the Business&Professions SINK& FAUCET 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:$4425 permit is issued. APPLICANT CERTIFICATION APN Number:35929028.00 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, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all oint source regulations per the Cupertino Municipal Code,Section 9.18. _.__-----• // _ Issued b Datel�����5 c�� a e Dater ❑ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of 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, 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: 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. 1 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& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should 1 store or handle hazardous material. 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 1 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 r or authorize agent• forthwith comply with such provisions or this permit shall be deemed revoked. Dater — CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby 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 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 5 ITEMS OF 14 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35929028 . 00 DATE ISSUED. . . . . . . : 11/16/2009 RECEIPT #. . . . . . . . . : BS000009200 REFERENCE ID # . . . 09110083 SITE ADDRESS . . . . . : 7612 ELDERWOOD CT SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : CARL DRESEL ADDRESS . . . . . . . . . . : 7612 ELDERWOOD CT CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4327 RECEIVED FROM . . . . : TOWN & COUNTRY PERM CONTRACTOR . . . . . . . : ALFRED W NYMAN JR - ASST SEC LIC # 23097 COMPANY . . . . . . . . . . : SEARS HOME IMPROVEMENT ADDRESS . . . . . . . . . . : 1024 FLORIDA CENTRAL PKWY CITY/STATE/ZIP . . . : LONGWOOD, FL 32750 TELEPHONE . . . . . . . . : (925) 245-2000 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 4, 425. 00 1 . 00 0 . 00 1. 00 0 . 00 1BPTRAP NO OF TRAPS 1. 00 8 . 00 0 . 00 8 . 00 0 . 00 1BSEISMICR VALUATION 4, 425. 00 0 .50 0. 00 0 . 50 0 . 00 1PPERMITFE FLAT RATE 1. 00 42 . 00 0. 00 42 . 00 0 . 00 1TRAVDOC FLAT RATE 1. 00 42 . 00 0. 00 42 . 00 0 .00 ---------- ---------- ---------- ---------- TOTAL PERMIT 93 .50 0 . 00 93 . 50 0 . 00 CITY OF CITY OF CUPERTINO CUPEkTINO GENERAL BUILDING PERMIT APPLICATION FORM APN# �� v v Date: Building Address: jo4epl CAJOv� Mailing Address (if different from building address): Are Hazardous Materials being used as part of this project? . Yes LJ No HOA: Exterior work only) Yes ❑ No If es, rovide letter from HOA Owner's Name: Pho e#: -- � Contractor: Pone: Contractor License#: Cupertino Business License#: / Contact: Phone: Residential Commercial Job Description: /N57AL Building Permit Info: Bldg ❑ Elect ❑ Plumb Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ II/III/V-A ❑ IUIII B, IV-HT, V-B _ Valuation: Square Footage: Project Size: Express ❑ Major Green Building: Please complete relevant portion of the Green Building/LEED Checklist& attach it Points Achieved: to the application or if applicable, include in plan set& the sheet index. � _.. For help, contact Build it Green at www.buildit reen.or Revised 07/14/09 ti& CITY OF CUPERTINO CITY 'YOF GENERAL BUILDING APPLICATION CUPS TING FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1STUCOAP Stucco Applications (up to 400 sf) B 1GENCOM 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) I EPERMITFEE Electrical Permit Fee E 1 MPERMITFEE Mechanical Permit Fee M I PPERMITFEE 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 1QP / A4 5 of 5 M.Indoor Air Quality and Finishes 1.Use Low/No-V©C Paint 1 IAO/Health pts y=yes ID 2.Use Low VOC,Water-Based WoodFinishes 2 IAQ/Heaith pts y=yas 3.Use tmwINo TOC Adhesives 3 lAQ/Health pts y=yes 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y--yes D 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Health pts y=yes D 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes D 7.Sad ail } iDW%rd Qr MDF _ 4 IAQ/Health_pis - as _ D B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes D 9.Use Finger-Jointed or Recyclad-Content Trim 1 Resource pts y=yes D 10.Install Whole House Vacuum System 3 IAO/Health pts y=yesl ID 1 1 D N.Flooring 7 1.Select FSC Certified Wood Flooring B Resource pts y=yes 0 Z Use RapidfyRenewable Flooring.Materials 4 Resource pts y=yes D 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes D 4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Haalth pts y=yes D 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts yeses 0 1 i � Total Points Availaale. I 140 130 57 Total Paints Pro'ect Received: 0 0 0 d=lersl reen ointsnnal2.12.D4 rotected_xts G:datalprogslgreenbuildingguidelm,shemo _ g p p Community Development 10300 Torre Avenue '€ Cupertino CA 95014 Telephone(408)777-3228 C)T1f OF �UPE�TINO Fax(408)777-3333 Building Department JOB ADDRESS: PERMIT # /2 EC 0C--4 ,.fuu OWNER'S NAME: CA L .9R-C--S& PHONE # GENERAL CONTRACTOR:S FAX # I am not using any subcontractors: n 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 Date CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21422 ELM CT CONTRACTOR:FIVE STAR WINDOWS PERMIT NO:09110025 OWNER'S NAME: SANJOY DAS 1450 DELL AVE STE C DATE ISSUED: 11/05/2009 OWNER'S PHONE: 4088737210 CAMPBELL,CA 95008 PHONE NO:(408)370-3331 L LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT (_ PLUMB License Class 'I�> Lic.# MECH RESIDENTIAL COMMERCIAL Contractor Date \ 51 11 I hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION:WINDOW REPLACEMENT (commencing with Section 7000)of Division 3 of the Business&Professions 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 Sq.Ft Floor Area: Valuation:$14300 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 APN Number:36201014.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.1 agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify 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 Issued by .� ,r/'i- Date://— with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Signature ,l Date // S C RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is OWNER-BUILD ECLARATION installed without first obtaining an inspection,I agree to remove all new materials for inspection. I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: Signature of Applicant: Date: I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(See.7044, ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). HAZARDOUS MATERIALS DISCLOSURE I hereby affirm under penalty of perjury one of the following three I have read the hazardous materials requirements under Chapter 6.95 of the declarations: California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain a Certificate of Consent to self-insure for Worker's compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Compensation,as provided for by Section 3700 of the Labor Code,for the Safety Code,Section 25532(a)should I store or handle hazardous material. performance of the work for which this permit is issued. Additionally,should I use equipment or devices which emit hazardous air I have and will maintain Worker's Compensation Insurance,as provided for by 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 Section 3700 of the Labor Code,for the performance of the work for which this Health&Safety Code,Sections 25505,25533,and 25534. permit is issued. I certify that in the performance of the work for which this permit is issued,1 shall Owner-6r utho ' n : (( not employ any person in any manner so as to become subject to the Worker's Date: Compensation laws of California, If,after making this certificate of exemption,I r` become subject to the Worker's Compensation provisions of the Labor Code,I must CONSTRUCTION LENDING AGENCY forthwith comply with such provisions or this permit shall be deemed revoked. I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued(Sec.3097,Civ C.) APPLICANT CERTIFICATION Lender's Name 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 Lender's Address to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, C, and expenses which may accrue against said City in consequence of the [understand my plans shall be used as public records. I !g of this permit.Additionally,the applicant understands and will comply wun all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date