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13060179 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7855 CREEKLINE DR CONTRACTOR:SGK HOME SOLUTIONS, PERMIT NO:13060179 INC. OWNER'S NAME: SIMON HO 3801 CHARTER PARK CT STE B DATE ISSUED:06/21/2013 OWNER'S PHONE: 4083989116 SAN JOSE,CA 95136 PHONE NO:(408)264-6964 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIALS License Class Lic.# REMOVE&REPLACE 12(E)WINDOWS& 1(E)SLIDING DOOR,SAME SIZE&LOCATION(EGRESS&TEMPERED Contractor Date l� WHERE REQUIRED) I hereby affirm that I am li used under the provisions of Chapter 9 (commencing with Section 7 00)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 performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$12000 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:36217045.00 Occupancy Type: permit is issued. APPLICANT CERTH KATION 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 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 0 DAYS + ED 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. Add'ionally,the applicant understands and will comp I with all non-poin ourc r lations per the Cupertino Municipal Co ,Sect n 9.18. RE-ROOFS: Signature Date / / 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 License Law for one of the following two reasons: 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 permitis issued. will maintain compliance with the Cupertino Municipal Code,Cbapter9.1 nd I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sect' 5533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: 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 Worker's CONSTRUCTION LENDING AGENCY 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 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•building a�cupertino.org ❑NEW CONSTRUCTION ❑ AD ITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESSln APN# OWNER NAME p E-MAiL STREET ADDRESS CIT TATE,Z 6 �NTZYL � FAX CONTACT NAME P E-MAIL STREET ADDRESS / Olt— CrrY TA ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR qxpNIRACTORAGENT. ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTORA LIC SE LIC SE TYPE / BUS.LIC# COMPANY NAME - E- l FAX 10, STREET ADDRESS CITY�TA' ZPHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY STATE,ZIP PHONE DESCRIPTION OF WORK r ti EXISTING SE PROPOSED USE CONSTR TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA: DETACH ATTACH #DWELLING UNITS: IS A SECOND UNrr ❑YES SECOND STORY YES BEING ADDED? 0 ADDITION? ONO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES T VALUATI 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 authorized ageqKo act o property owner's behalf have read this application and the information I have yid i correct. I have read the Description of Work and ve s accurate. I agr to comp with all applicable local ordinances and state laws relating i nstruction. I authorize representatives of Cupertino to enter the above eft Ied grope�r spection purposes. Signature of Applicant/Agent: Date: SUPPLE ME TA L INFO TION REQUIRED _New SFD or Multifamily dwellings: Apply for demolition permit for oouNrEx Aft-DING pANi existing building(s). Demolition permit is required prior to issuance of building permit for new building. D''EJxEss LANNINCrPi AN RFYtEw _Commercial Bldgs: Provide a completed Hazardous Materials DisclosureSTANDQRD Cl PUBLIC woRxs form if any Hazardous Materials are being used as part of this project. �,ARGE � D FIRE DEPT '� _Copy of Planning Approval Letter or Meeting with Planning prior to CI MAJOR= SANITATt'YSEWERDISTRICT submittal of Building Permit application. EN tQlK11IEiVTAL BEALT11 ', $ B1dgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 7855 CREEKLINE DR DATE: 06/21/20137] REVIEWED BY: MELISSA ' APN: 362 17 045 BP#: -VALUATION: 1$12,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Duplex PENTAMATION 1GENRES USE: p PERMIT TYPE: A WORK REMOVE& REPLACE 12 E WINDOWS & 1 E SLIDING DOOR SAME SIZE & LOCATION SCOPE (EGRESS &TEMPERED WHERE REQUIRED) 0 01 WN MUM us kfa:h.flan Check E Plnnrb.Plan Check Elec.Plan Check 1,fech. Permit Fee: Plumb.Permit Fee: Elec. Permit Fee: FOther Alech.Insp. Other Plumb Insp. Other Elec.Insp �tdech.Insp.Fee: Plumb. Insp.Fee: Elcc.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These ees are based on the prelimina information.available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS(Fee Resolution 11-053 E,ff. 7/1/121 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 13 # Window/Sliding Glass Door Suppl.PC Feer (F) Reg. ® OT 0.0 hrs $0.00 $533.00 1WINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee-(E) Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tizx: Administrative:Fee: Work Without Permit? ®Yes (E) No $0.00 0 Advanced Planning Fee. $0.00 Select a Non-Residential 0 Building or Structure 0 Travel Documentation Fees: i Strong Motion Fee: 1BSEISMICR $1.20 Select an Administrative Item. Bldg Stds Commission Fee: 1BCBSC $1.00 $2.20 $533.00 $535.20 Revised: 04/29/2013 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/ SUBCONTRACTOR LIST 10, JOB ADDRESS: PERMIT# 0 OWNER'S NAME: 6 Q4PHONE# GENERAL CONTRACTOR: ABUSINESS LICENSE# ADDRESS: _ CITY/ZIPCODE *Our municipal code requires all businesses working in the city.to have a City.of Cupertinobusiness lieen NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE .SCHEDULED UNTIL THE. GENERAL CONTRACTOR AND ALL SUBCOVrRACTORS HAVE OBTAINED A..CITY OF C R O BUSINESS LICENSE. I am not using any subcontractors: ignature ate Please check applicable subcontractors and co plete the following information V 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 00 er/Co ractor Signature Date 1 . •1111 . �. _� pill,q kill 1111■q■■q■■q■■■■■■q■■q■■■■■■q■■ ■■q■.q■■■■■■q■■q■■q■/q■■■■■■1111■■q■■q■■q■■■ii■■��11lTi�11!e�y�■■■!■■ ■■q■■■i■■q■■■ 1111■q■■q■■q■■h■■q■■q■■q■■q■■ ■■q■■q■■q■■q■■q■■q■■■■■■■f■■q■■q■■q■■q■■q■■■iii�frii■lili�fi�■i■q■■ ■■q■■q■■q■■■ ■■■ ON ■■A■■q.■■■■■11■■■q■■■i■■E■■ ■■1111■■ mum.1111NN=Nm=mI ■ ■ ■■q■■ ■■■■■■■■■■ ■.q■■q ■■■i■■■ E N1n INI HM0a 11 ■■■ ■ ■■ ■ ■19■■ ■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ 1111 ■■ 1111 ■1111. 1111 1111 1111 1111 1111 1111 1111 ..q.. 1111 1111 1111. 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