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13100167 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18860 NEWSOM AVE CONTRACTOR:IC HOME DESIGN PERMIT NO:13100167 OWNER'S NAME: DRAGOS LUNGEANU 248 RED OAK DR E STE E DATE ISSUED: 10/24/2013 OWNER'S PHONE: 4085078673 SUNNYVALE,CA 94086 PHONE NO:(408)718-7036 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL I� Lic.# L G ENLARGE 2 WINDOW OPENING IN LIVING ROOM, License Class REMOVE Contractor �0 r 14 C A) �ry�►�ate �C z � � � AND REPLACE 1 WINDOW IN DINNING ROOM I hereby affirm that I am licensed under 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 Valuation:$6000 performance of the work for which this permit is issued. Sq.Ft Floor Area: 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:37530021.00 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 80 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 DA F/�M LAST CALLED MSPECTIO . indemnify and keep harmless the City of Cupertino against liabilities,judgments, / 1012,1 G�y costs,and expenses which may accrue against said City in consequence of the Issued by: ll�� Date: / If granting of this permit. Additionally,the applicant understands and will comply with all non-point source reulations per the Cupertino Municipal Code,Section 9.18. C RE-ROOFS: Signature `� Date /CI 2 4 ' 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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER the following two reasons: 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) HAZARDOUS MATERIALS DISCLOSURE I,as owner of the property,am exclusively contracting with licensed contractors to 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 Management District I will main aio compliance with the Cupertino Municipalnts as defined by the Bay Area Air niCod ,Chapter 9.12 and performance of the work for which this permit is issued. the Health&Safety Code,Sections 255 ,25533,and 25534. 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 Owner or authorized agent: Date: 2 (C)" ' 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 at become subject to the Worker's Compensation provisions of the Labor Code,I must hereby �k b fof which thispermitis ere is a issued(Secnstruction,3097,Civ ending agency for the performance of rm th forthwith comply with such provisions or this permit shall be deemed revoked. 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 A COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION b�(Q 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 \� CUPERTINO (408)777-3228• FAX(408)777-3333•building cDcupertino.orq \� ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/Ti ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESSSI R eco / f ww O / VF APN# "?-1 5 OWNERNAME ` WSLuAJ6FAOU PHONE6R N04 6 E-MAIL STREET ADDRESSASO CITY, STATE, ZIP P, FAX CONTACT NAME /V ( PHONE ` JE'-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT P CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHTTECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME 6 n I /� `� )d/J A- .�1 LICENSE NUMBER l �) 2 ` LICENSE TYPE i� BUS.LIC# COMPANY NAME ` I��/�I- v 'c� ��✓�'� E-MAIL/ V�IC G� Wb'SNl ISS FAX C�L�'� STREET ADDRESS r Cry ^ (Q TY,STATE,ZIP /\+t �I L E l n PHONE ARC HITECT/ENGINEER NAME LICENSE NUMBER (/1 BUS.LIC## I Jp COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WOjtts ^ r� t/J ` G / EXISTING USE PROPOSED USE CONSTR.TYPE #STORIE S USE TYPE OCC. SQ.FT. VALUATION($) F.XISTG 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 GARAGE AREA. DETACH ATTACH N DWELLING UNITS. IS A SECOND UNIT ❑YES SECONDSTORY ❑YES BEING ADDED? �NO ADDITION? NO PRE APPLICATION [I YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RE 'D BY: TOTAL VAJUATION: PLANNING APPL# []NO PLANNING APPROVAL LETTER EICHLER HOME? 14 NO (/p O By my signature below,I certify to each of the followi : I am the property owner or authorized agent to act On the property owner's behalf. I have read this application and the information 1 have provided is corr I have re a Deription Of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building cons uc ion I rize r resensctatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: (6 • 2 '1 • I SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for OVER-THE-COUNTER LDtNg PLAN REVIEW existing building(s). Demolition permit is required prior to issuance ofbuildin 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 ❑'FIREDEPT _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. MAJOR DISTRICT ❑(SANITARY SEWER ENVIRONMENTAL HEALTH BldgApp_201 1.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 18860 NEWSOM AVE I DATE: 10/24/2013 REVIEWED BY: MENDEZ APN: BP#: 13020034 "VALUATION: $6,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY PENTAMATION 1GENRES USE: SFD or Duplex PERMIT TYPE: WORK ENLARGE 2 WINDOW OPENING IN LIVING ROOM REMOVE AND REPLACE 1 WINDOW IN SCOPE DINNING ROOM i�lG't It. t'i`UYt t Ltc�!i 11honh. IPcut ChccA f��c�t'. i'h�n t.seck Lt>ut. Permit I`or 6hmrh_ Permit hoc. f:(Er. Prrn�i�h°cr O,hcT 1(P'17. Irts'r" Otiac� Pharnb IrsUtlrcrlfec_Ir�st�_ Ph�rrrh_ hup. h . [�lec.Inst. Fie: 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 preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1,13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 3 # Window/Sliding Glass Door Suppl.PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 $418.00 1 WINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee.0 Reg. 0 OT Q,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 t'orzstrurtion Tax: 0 zIdmirrisfr�ativ Fec+: Work Without Permit? 0 Yes Q No $0.00 • Select a Non-Residential 0 Advanced Planning Fee: $0.00 Building or Structure 0 Travel 0oul"inc litution Fees: Strong Motion Fee: IBSEISMICR $0.60 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 77= SUBTOTALS:' $1.60 $418.001 TOTAL FEE: $419.60 Revised: 10/01/2013 6o l_ uNGEAkA) 13860 /JE4' sOM AVE FLooRFL4fi cu PE 1itjo � cA , 544 E � ISS INfi W►N �GvuS All A. �6u A) 80�► H PATio 461, IAJ L. r ARE A SlWNG SL J�JN6 A OO Q SM. v4�rNbc�tz JAR PLOT PLANS , CHECKED BY F Pi. L.ANNNI OATtr fo ►s" 2� �s" 2 1�r� ► s'' ZM4 ► SU A C k YAR ,& � KA6oS LUNGEANO 18860 9EWSOM AVE FLooRFL4W CUPERirj�jb / ,CA ) 0014 NEW WWNovJS gnu � 80"K PA i!0 �r6" N Llvlm6 AREA SIikiNs SWIN6 . �rorz� POOR w1t4ow �► tJ � E s 12 �ErtPERE� (N) t2 i EnPERE). (NEWS 1 � YARD Sc � y u L�rnlrnlc R,y Sl�o' FA4o VI