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13120140
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20727 GARDEN CREST CT CONTRACTOR:AMERICAN VISION PERMIT NO: 13120140 WINDOWS INC OWNER'S NAME: SANTA CLARA,CA 95050 PHONE NO:(408)617-0901 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL REPLACE 7(E)WINDOWS& 1 SLIDING GLASS DOOR.ALL License Class_ Lie.# �� 32� WINDOWS/DOORS WILL MEET EGRESS&BE TEMPERED ContractorAMW1 M Jt9e,4 W%,MWS Date 1Z1t-2WHERE011 3 REQUIRED BY CODE I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 pf the Business&Professions Code and that my license is in full force aud'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 the1abor Code,for the pe an of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$4744 have and will maintain Worker's Compensation Insurance,as provided for by terinit ction 3700 of the Labor Code,for the performance of the work for which this APN Number:36230058.00 Occupancy Type: 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 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 FR LED INSPECTION. indemnify and keep harml the City of Cupertino against liabilities,judgments, costs,and expenses, h c ay accrue against said City in consequence of the 1 a e Z granting of this permit. dditionally,the applicant understands and will comply with all non-point Cupertino Municipal Code,Sectio 918. RE-ROOFS: Signature 1 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. ❑ O -B ILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am x mpt from the Contractor's Lieense 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,shoJSectionsM lent or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as definea Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance wo Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code, 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 CONSTRUC I L ING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construeNSec97, ing 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 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 918. Signature Date _ l CONSTRUCTION PERMIT APPLICATION V COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 Nor CUPERTINO (408)777-3228• FAX(408)777-3333•building cDcupetno.org \ ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 2.07/,,71 GoWtW CSj (29-I 1APN, 3I 2- - *3 O OWNER NAME -� 1 MAIL STREET ADDRESS( CCITY, TAPTE, ❑ OWNER ❑ OWNER-BUIIAER ❑ OWWNER' AGENT ycoNrRAcToR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑)DEVELOPER -❑ TENANT COW=AM w 1LA-4,�V" T• fA •6+91 LICENSE NUMBER 111B.37 � LICENSE TYPE Q BUS.LIC WT,7 oMPANY NAME V I�IEa�J E-MAIL� 1rael�a,Jd�or►Wi,J Z—9`iI�I STREET ADDRESS CITY,STATE ZIP OI�E ARCHITECT/ENGMER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK f 4�"r__frt vis �Pt'Q o l I.I Kms' EXISTING USE PROPOSED USE CONSTR TYPE ;r STZORIES St,�(.vl:c MILy USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODELAREA REMODEL AREA REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA: ETACH TTACH 4 DWELLNG UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? )<No ADDITION? ONO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY//'''c iS THE BLDG AN S �, -Y�, ;x- -� �, TOTAL VALUATION: PLANNING APPL k E]NO PLANNING APPROVAL ETTER EICHLER HOME? � op a By my signature below,I certify to each of th foll ing: I am the prop owner or autbol' ent to ct e property owner's behalf. I have read this application and the information I have rovi d is rect. I have read the Description of Work and veriit is accurate. I agree to comply with all applicable local ordinances and state laws relatino ui in con tion. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature ofApplicanUAgent: Date: SUPPLEMENTAL PL ,CHE�K=TYPE,, �f-;��.RODTIIGSLIP� , _New SFD or Multifamily dwe lin s: ppl for demolition permit for n R OYE THE COIINTER © BUS DI\G'PLAA REIIEZ!' existing building(s). Demolition perm t i q red prior to issuance of building permit for new building. yl gaPREss � n PZAiinil�GriAt`tREv�tiv X _Commercial Bldgs: Provide a completed Hazardous Materials DisclosuresTAnmtrsLrc�aRxs form if any Hazardous Materials are being used as part of this project. �. �s ; _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. snLrr YSEi4 RDISTRIc3�ro� �= BldgApp_2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 20727 GARDEN CREST CT DATE: 12/18/2013 REVIEWED BY: MELISSA APN: 362 30 058 BP#: "VALUATION: 1$4,744 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1GENRE i WORK REPLACE 7 E WINDOWS &.1 SLIDING GLASS DOOR. ALL WINDOWS/DOORS WILL MEET SCOPE EGRESS & BE TEMPERED WHERE REQUIRED BY CODE NONt56 wn khxh. Plan Check Phu b.Plan Cheek Elec.Plan Check rLlech.Permit Fee: Plumb. Permit Fee: Elec.Permit Fee: Other Alecrh.Insp. Other Plumb Insp. Other Elec.Insp. F-1 Rlech. Inds.Fee: Plumb, hap.Fee: 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 ees are based on the preffinWdna information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS(Fee Resolution 11-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 8 # Window/Sliding Glass Door Suppl.PC Fee: (j) Reg. ® OT 0.0 hrs $0.00 $418.00 1 WINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Feer Reg. ®OT Fo,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consirztt.-tion :Tax: Administrative Fee: Work Without Permit? ® Yes 0 No $0.00 Advanced Planning Fee- $0.00 Select a Non-Residential E Tavel Documentation Fees: Building or Structure i Strong Motion.Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 $1.50 $418.00 $419.50 Revised: 10/01/2013 YO xFoffo Dbut 3 � f" COM !fit C �C�,v;..�.ri �-rr;fit BUtLL)iN t' 'swl - OF E-Krifq-, lJ r A OVEr This of plans an ications ML ST be kept at the l.lv�nl1gM ` job site wring c struction. t is unlg wful to make any chan alterations on e, i r to deviate therefrom ' hout approval om the ding"'iciaf.7 ing of is p and SPecifica ions SHAT. NOT be Id to permit I rovai of the violation 'r � panor State Law, 5 TE I �P 1 ft iJ V i"E Rt t N() i ding [�epprtmp'm A D1 REVIEIN�.L, �r � C� t 'joDE 4d C)tvlf'Lff- NC<E Re A� JWpIr Jpc, Liu L)ATS .. (,(Kv- FOR- U W-C SAwIv,-•,:Si? ANO Lo 9t;ur%T& OEC j(j 2013 c-AV'kTJu\1 cq,�-T a, cofwwo CA 9,To-lq l3Y 402 � JID . )- (O 57)(457 I � , YD (al Y- CUPERTINO LAdina Department. REVIEWED F-OR jai DE CQfVtF't_IANCE keviewed By y (� T