14020166CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10982 SWEET OAK ST CONTRACTOR: PHILLIP ISAACS' PERMIT NO: 14020166
CONSTRUCTION INC
OWNER'S NAME: REGINA RUTLEDGE ( 7705 MOUNTAIN AVE I DATE ISSUED: 02/28/2014
OWNER'S PHONE: 4086213822
6 LICENSSE�D CONTRACTOR'S DECLARATION
,License Class CI / jj Li,. # 6Z74-7 7
/
Contractor �� � J 154-4-r—!5 Date
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
�erf cc of the work for which this permit is issued.
h a nd will maintain Worker's Compensation Insurance, as provided for by
io 3700 of the Labor Code, for the performance of the work for which this
ermi is issued.
APPLICANT CERTIFICATION
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,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands an5>ill comply
with all non -point source regulations per the Cupertino Muni Code, Section
9 18
Date 2
❑ OWNER- BiJILDER WLARATION
I hereby affirm that 1am pt from the Contractor's License Law for one of
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)
I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
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.
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
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
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
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,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9 18.
Signature Date_
ORANGEVALE, CA 95662 1 PHONE NO: (916) 852 -8132
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
REPLACE 5 WINDOWS & 3 SLIDING GLASS DOORS, LIKE
FOR LIKE. ALL WINDOWS/DOORS WILL MEET EGRESS &
BE
TEMPERED WHERE REQUIRED BY CODE
Sq. Ft Floor Area: I Valuation: $7286
APN Number: 32651057 00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 D IT ISSUANCE OR
180 DA OM LA ALLED INSPECTION.
d by: Date:
RE- ROOFS:
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.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter and
the Health & Safety Code, Sections 25505, 25533, an 534.
Owner or authorized agent:
Date;�
I hereby affirm that there is a construction lending agency for the performance of
work's for which this permit is issued (Sec. 3097, Civ C )
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Profess
CONSTRUCTION PERMIT APPLICATION O�
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 � P
(408) 777 -3228 • FAX (408) 777 -3333 • building0- cupertino.oro
CUPERTINO
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS � O � � `� 1 Q ^ -� C -•
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APN # -7
OWNER NAME 9C60 A A � Q 1 ) E V E
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STREET ADDRESS I /✓)� C�
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FAX
CONTACT NAME �i"'t
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STREET ADDRESS
10 Z 5 ,Jc ® 57.
CITY, STATE, ZIP
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FAX
❑ OWNER ❑ OWNER - BUILDER ❑ OWNER AGENT ❑ CONTRACTOR OkONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
ca`r ��a26Y 4',J vl�. St7.J.
LICENSE NUMBER
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BUS. LIC #
COMPANY NAME
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E -MAIL
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FAX
JV6,99 1 o
STREET ADDRESS
13 6 �IZ"C CCAPe,Z D12.
CITY, STATE, ZIP
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PHONE
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ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E -MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
r-e 7t'oX17 0(n1DaiJ.5 40 7 t4g-CC C&CAZe, - ,J o
5'--14S(- F Jr ,J ,)
5/-2-C N .
EXISTING USE
PROPOSED USE CONSTR.
TYPE
# STORIES
I
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 DECKIPORCH AREA
GARAGE AREA: LJ DETACH
❑ ATTACH
# DWELLING UNITS:
IS A SECOND UNIT OYES
SECOND STORY OYES
BEING ADDED? ONO
ADDITION? ONO
PRE - APPLICATION [:]YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
TOTAL VALUATION:
PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER
EICHLER HOME? ❑ NO
t",�
a
By my signature below, I certify to each of the following: I am the property owner or authorized agent to ac on the 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 accurate. I agree to comply with all applicable local
ordinances and state laws relating to building con rize representatives of Cupertino to enter the above - identified property for inspection purposes.
Signature of Applicant/Agent: Date: 2
SUPPLEMENTAL INFORMNT O D
PLAN CHECK TYPE
ROUTING SLIP
❑, OVER -THE- COUNTER
❑ BUILDING PLAN REVIEW
New SFD or Multifamily dwellings: or demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
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.
0 LARGE
❑ FIRE 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_201 Ldoc revised 06121111
F1
CITY OF CUPERTINO
FFF FSTIMATOR — BUILDING DIVISION
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District eta). These fees are based on the prelimina information available and are on1v an estimate. Contact the Dept or addn'1 info.
FEE ITEMS (Fee Resolution 11 -053 f{•. 711113)
10982 SWEET OAK ST
DATE: 02/28/2014
REVIEWED BY: MELISSA
JimADDRESS:
APN: 326 51 057
BP #:
*VALUATION: 1$7,286
*PERMIT TYPE: . Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE: p
h_• t_
PENTAMATION 1GENRE
PERMIT TYPE:
WORK
REPLACE 5 WINDOWS & 3 SLIDING GLASS DOORS LIKE FOR LIKE. ALL WINDOWS /DOORS
SCOPE
WILL MEET EGRESS & BE TEMPERED WHERE REQUIRED BY CODE
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District eta). These fees are based on the prelimina information available and are on1v an estimate. Contact the Dept or addn'1 info.
FEE ITEMS (Fee Resolution 11 -053 f{•. 711113)
FEE
• 4 .> t
MISC ITEMS
Plan Check Fee:
$0.00
® # Window / Sliding Glass Door
$418.00 IWINREP Replacement
Suppl. PC Fee: Reg. C) OT
r 070
hrs
$0.00
h_• t_
<'z >,rraFee"
Phimb. Pa mflT," .
I :r. F >t.;; f 1, ,L,.
Suppl. Insp. Fee: Reg. ® OT
�fic?: <. '�.��P
1 hrs
$0.00
Orirc>f Ply?7lns >.
01;7rs 1 tc S[).
$0.00
1"0.",
$0.00
F'7xrn11. lisf). Fee:
1Eec. Ins"), Fcc
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District eta). These fees are based on the prelimina information available and are on1v an estimate. Contact the Dept or addn'1 info.
FEE ITEMS (Fee Resolution 11 -053 f{•. 711113)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
® # Window / Sliding Glass Door
$418.00 IWINREP Replacement
Suppl. PC Fee: Reg. C) OT
r 070
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee: Reg. ® OT
0.0
1 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
E)
Work Without Permit? 0 Yes 0 No
$0.00
Advanced Planning Fee:
$0.00
Select a Non - Residential E)
Building or Structure 0
�
�}E�C FtiFix'YdtC%r(f�Y� l'e,F',�'.
Strong Motion Fee: IBSEISMICR
$0.73
Select an Administrative Item
1
Bldg Stds Commission Fee: IBCBSC
$1.001
A zSiB[LSms
$1.73
$418.00 TOTAL'FEE:
$419.73 T
Revised: 01/15/2014
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SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
(408) 777 -3228 • FAX (408) 777 -3333 • building aecupertino.on:
FILE'
PURPOSE
This affidavit is a self - certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC Section R314,2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for
inspections are required.
GENERAL INFORMATION
Existing single- family and multi- family dwellings shall be provided with Smoke Alarms and Carbon
Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds
$1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and /or Carbon
Monoxide Alarms be installed in the following locations:
AREA
SMOKE ALARM
CO ALARM.
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s)
X
X
On every level of a dwelling unit including basements
X
X
Within each sleeping room
X
Carbon Monoxide alarms are not required in dwellings which do not contain fuel- burning appliances and that
do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with
CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal.
Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated.
In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do
not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl
space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for
alarms which must be connected to the building wiring.
As owner of the above - referenced property, I hereby certify that the alarm(s) referenced above has/have been
installed in accordance with the manufacturer's instructions and in compliance with the California Building
and California Residential Codes. The alarms have been tested and are operational, as of the date signed
below.
I have read and agree to comaly with the terms and conditions of this statement
O ner (or Owner A nt's) Nam
Si natu . . ...1.
Contractor Name:
Signature.................................... ............................... Licl ....... ............................... Date: ...................
Smoke and COform.doc revised 03118114