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13090012 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10217 COLD HARBOR AVE CONTRACTOR:SGK HOME SOLUTIONS, PERMIT NO:13090012 INC. OWNER'S NAME: BOON 3801 CHARTER PARK CT STE B DATE ISSUED:09/04/2013 OWNER'S PHONE: 4088326052 SAN JOSE,CA 95136 PHONE NO:(408)264-6964 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL License Class C ic.# REMOVE&REPLACE(E)7(E)WINDOWS&2(E)PATIO / DOORS,LIKE FOR LIKE(NO SIZE CHANGE).WILL MEET Contractor Date EGRESS&BE TEMPEPED WHERE REQUIRED BY CODE I hereby affi m that I am licens d under the provisi ns 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 performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$7150 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:36909023.00 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 WITHIN 180 DAYS O + SSUANCE 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 F 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 b granting of this permit. Additionally,the applicant understands and will comply Date: with all non-po' t urce r gulations per the Cupertino Municipal Cod ,Se 'on 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 ail 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. 1 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 qupertino Municipal Code,Chapter 9.1 an I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sect' n 2550 5339 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 Compensation laws of California. If,after making this certificate of exemption,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 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 111 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•building(cDcupertino.org ❑NEW CONSTRUCTION ❑ ADDITION ❑ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS APNQ�KA&1� &-e-- # % 7 /1 OWNERNAME �� "/—/lQ/_ A� J PHONE F79^ ® EMAIL STREET ADDRESS � CITY,STATE,ZIPFAX CONTACT NAME � PHOIV��o �/' f// E-MAIL STREET ADDRESS CITY,STATE,ZIP (�kj FAX ❑OwNER ❑ OwNER-BUIIAER ❑ owNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTORNAME / LICENSE NUMBER LICENSE-ME /7 ICENSE E / BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS Q�/ CITY,STATE,ZIP �i- / P ONE C ARCHITECT/ENGINEER NAME LICENSE NUMBER '_��/ BUS.LIC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR.TYPE I #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODELAREA REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEINGADDED? ONO ADDTTTON? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES TOT =TJQN-- J'1 PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME! ❑NO - �✓`1(vim r By my signature below,I certify to eac f the following: I am the property owner or authorized ent the property owner's behal. I have read this application and the information I hav pmvid d' correct. I have read the Description of Work and it is accurate. I agree o co ly with all applicable local ordinances and state laws relating "construction. I authorize representatives of Cupertino to enter the above-id fi pr rty for inspection purposes. Signature of Applicant/Age Date: SUPPLEMENTAL NFO"TION REQUIRED r.LAiv c�I cTc TYPE RovTTNc New SFD or Multifamily dwellings: Apply for demolition permit for ( ovEx THVcourriER 4 BUILDING PLAN REvmw existing building(s). Demolition permit is required prior to issuance of building - permit for new building. F1PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDD- ❑ PUBLIC woRxs form if any Hazardous Materials are being used as part of this project. Q LARGE ❑,;FIRE DEPT 77 _Copy of Planning Approval Letter or Meeting with Planning prior to tKAJOR; SANITARY SEWER DSTRICT submittal of Building Permit application ;❑ ENVIRONNIMAL HEALTH BldgApp 2011.doc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10217 COLD HARBOR AVE DATE: 09/04/2013 REVIEWED BY: MELISSA APN: 369 09 023 BP#: "VALUATION: 1$7,150 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY PENTAMATION 1GENRES USE: SFD or Duplex PERMIT TYPE: WORK REMOVE & REPLACE E 7 E WINDOWS &2 E PATIO DOORS LIKE FOR LIKE NO SIZE SCOPE CHANGE). WILL MEET EGRESS & BE TEMPEPED WHERE REQUIRED BY CODE a, Lfech. Flan Check Phemb. Plan Check Elec.Plan(.,'heck iLliu;h. 11erwit Fee: Plumb.Permit Fee: I Elec. Permit Fee: Other Afech.Inv.?. Cather Plumb Insp. Other Elec.Insp. M!ch,Insp. Fee: Plumb. hlsp.ree: Elec.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 fees are based on the prefintina information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 11-053 LE 711/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 9 # Window/Sliding Glass Door Suppl.PC Fee: (E) Reg. Q OT 0.0 hrs $0.00 $557.00 1WINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-0 Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax. Administrative Fee: Work Without Permit? ® Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential Building or Structure Travel Documentation Fees: Strong Motion Fee: 1BSEISMICR $0.72 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 5 $1.72 $557.00 $558.72 e_ . Revised: 07/01/2013 PLAvs CHECKED PNi �vc L4rG cATR �,.f�.�-od�,✓l ;lra OEM 2 Name: C,��L e� ��nb•r� �--. Address: l0 2/� C'�c- �l 80g- Email: cJ?�c�T�k-o �'rS Phone: 3 2-- �o�� HOME— SOLUTIONS 0 1 2t 3• 4 sI 6 7 8I 91 10= 11# 12I 13r 14 Y § d E I I t # § 1 I » ..11r I ?11 s § # 6 - i E E - I I q¢ ? F I Y f f F 88 # 3 t f i t d e t ¢ ¢ Y # F z 9 I 8 � I � 7 a f ¢ Y # ¢ # Y gAI A .... t P F Y t y f $} 8 6 t 12 L_ s .�� _ - vL— i 13 f t 14 r p p R M N S _ _ is 3 � OUR il e < ,- ept t e U ORM tr Cl9 It ia.. n6a fu fo mak a y - t .._._ -- 0,:-- ho _ . ra e E t 1 t # { r m Wiling ria. } 1F; ... .._#. ...._ ._..._esstm in eft is.. I t _ "iC�in� t - tidat' h n AEt NOT... w ..} 8 6ZI&Q- Off: vwm 17 408-264-6964 www.sgkhomesolutions.com Fax: 408-264-6126