13060141CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10413 NOEL AVE
CONTRACTOR: FIVE STAR WINDOWS
PERMIT NO: 13060141
OWNER'S NAME: HANNA STEPHEN J AND CASSIE
1450 DELL AVE STE C
DATE ISSUED: 06/1.8/2013
OWNER'S PHONE: 4088354250
CAMPBELL, CA 95008
PHONE NO: (408)370-3331
JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIALE]
LICENSED CONTRACTOR'S DECLARATION
License Class1`3l Lic. # f
REPLACE 4 (E) WINDOWS ON 2ND STORY, LIKE FOR
v
LIKE,
Contractor`— k Date I 3
SAME SIZE AND LOCATIONS
I hereby affirm that I am li ensed ander the provisions of Chapter 9
(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: $3985
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: 32647063.00
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. I agree to comply with all city and county ordinances and state laws relating
WITIiIN 180 DA T 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 DAY M LA LLED 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 ' Additionally, the applicant understands and will comply
Is
with all no rut gulations per the Cupertino Municipal Code, Section
9.18.
g /3
RE-ROOFS:
Sign re ate G`
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
inspection.
OWNER-BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's LicensejLaw for one of
the following two reasons: i
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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 (Sec.7044,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business &Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 25532(a) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's
material. Additionally, should I use equipment or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
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
the Health & Safety Code, Section 5533 25 4.
/I
Owner or authorized ag Date:
permit is issued.
I certify that in the performance of the work for which this permit is ;issued, I shall
not employ any person in any manner so as to become subject to the I Worker's
Compensation laws of California. If, after making this certificate oflexemption, I
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I must
I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked.
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
APPLICANT CERTIFICATION
Lender's Address
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
indemnify 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
I understand my plans shall be used as public records.
granting of this permit. Additionally, the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
9.18.
Signature Date
CUPERTINO
CONSTRUCTION.. PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408)' 777-3333 - building@cgoertino.org
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT #
PROJECTADDRESS t t , ^ O� __TAPN#
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OWNERNAME � (
PHONE
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E-MAIL
STREET ADDRESSCITY
t ol-} 13 �l
TATE, ZIP
_\ n 5D t
FAX
CONTACT NAME
PHONE
E-MAIL
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37v-333
STREET ADDRESS
�LASC)
C STATE, ZE'
FAX
❑ OWNER ❑ OWNER •BUILDER ❑ OwNERAGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME � 7 % % tc(CC^�
LICENSE NUMBER
LICENSE TYPE
BUS. LIC #
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Bl C. -A-1
_
COMPANY NAME �r--i
�;
E-MAIL
FAX
�_
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STREET ADDRESS
CTfY STATE, ZIP
Cw
PHONE
ARCHrrECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
EMAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
2 O nr- oS` J Uv
EXISTING USE
PROPOSED USE
CONSTR TYPE
# STORIES
USE
TYPE
OCC.
SQ.FT.
VALUATION ($)
EXISTG
NEW FLOOR
DEMO
TOTAL
__.......
AREA
AREA
AREA
NET AREA
BATHROOM
KITCBEN. .OTHER.
REMODEL AREA
REMODEL AREA REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECKMORCH AREA
GARAGEAREA:
HDLrAcH
ATTACH
I
# DWELLING UNITS: IS A SECOND UNIT ❑YES
SECOND STORY ❑YES
BEINGADDED? ❑NO
ADDITION? ONO
PRE -APPLICATION ❑YES I YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
" " TOTAL VALUATION:
PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER-
EICHLER HOME? ❑ NO
„ _..
By my signature below, I certify to each of the following: I am the property owner or authoriz agent to act on tp6perty owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and verify it is affurate. I agree to comply with all applicable local
ordinances and state laws relating to on. I authorize represe of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant) Date: 3
SUPP O UIRED
PLAN_CHECK TYPE
ROUTING SLIP,
New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition.permit is required.prior to issuance of building
OVER -THE COUNTER
UIIDING PLAN REVIEW
permit for new building.
❑ EXPRESS
PLANNING PLAN REVIEW
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
❑ STANDARD
❑ PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project.
❑ LARGE
❑ FntE DEPT
Copy of Planning Approval Letter or Meeting with Planning prior to
0 MAJOR
❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
BldgApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
WE FEE ESTIMATOR — BUILDING DIVISION
IlaADDRESS:
10413 NOEL AVE DATE: 06/18/2013
APN: 326 47 063 BP#:
REVIEWED BY: MELISSA
*VALUATION: 1$3,985
^PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY
USE: SFD or Duplex
® # Window / Sliding Glass Door
$400.00 1WINREP I Replacement
PENTAMATION
PERMIT TYPE: 1 GENRE
WORK
REPLACE 4 E WINDOWS ON 2ND STORY, LIKE FOR LIKE SAME SIZE AND LOCATIONS
SCOPE
PME Plan Check:
i,h"("' z. 'r'caa: Glwck
PIF%mb. 111ad P C7Ti;E:.li..
Nter-?n. llerrrlid T'--.
Cirher PfFT,rnd,
1 hor,,b. bt7,ip, Fee:
NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.). l hese.jees are based on the preliminary information avatiaDle and are onty an estimate. contact the Uept.jor aaan -i tufo.
FEE ITEMS (Fee Resolution 11-053 E . 711112)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
® # Window / Sliding Glass Door
$400.00 1WINREP I Replacement
Suppl. PC Fee: (F) Reg. ® OT
0.0
1 hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee -0 Reg. 0 OT
10.01hrs
$0.00
PME Unit Fee:
$0.00
Permit Fee:
$0.00
//PME
l.i€3T71ir"i Ti.t �{iT� /3 ti,f✓.•
E)
Work Without Permit? 0 Yes (F) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential E)
Building or Structure 0
Strom Motion Fee: IBSEISMICR
$0.50
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
v:
ABT( SLS
$1.50
�TOTAL
$400.00 FEE:
$401.50
Revised: 04/29/2013
Building Department
City Of Cupertino
Lo 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: IOL+(,3 noel
PERMIT
OWNER'S NAME:
PHONE #
GENERAL CONTRACTOR:
BUSINESS LICENSE #
ADDRESS: t -S D � L Qs� v� C
CITY/ZIPCODE:
*Our municipal code requires all businesses working in the city to have a City Lof Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS 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 A.
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
caner / C ur Date
Shining Above The Competition
Family Owned and Operated Since 1983
a 1450 Dell Avenue, Suite C, Campbell, CA 95008
Te1408-370-3331 Fax 408-370-31.10 L' 628383.
WwwfivesL
DATE: 3®B NAME:
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ANNING DEPT.
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Never Promising More Than We Can Deliver. Striving To Deliver More Than'0,/e Promise.
Never Promising More Than We Can Deliver. Striving To Deliver More Than We Promise.