14050042 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10413 MARY AVE CONTRACTOR:PRO-CRAFT BUILDERS PERMIT NO: 14050042
OWNER'S NAME: ZDENA PIPKOVA 669 COMMERCIAL ST DATE ISSUED:05/06/2014
OW/4R'S PHONE: 4085591977 SAN JOSE,CA 95112 PHONE NO:(408)293-1411
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL 0
REMOVE&REPLACE(E)BEAM(4X6XI6'),LIKE FOR LIKE
License Class iLi-cl.# ?665V AT ENTRY WAY OVERHANG FROM 2ND FLR
Contractor go-CV,Aw`
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
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$1500
l 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:32652049 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 WITB N 180 DAYS O SUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned prope for inspection purposes. (We)agree to save 180 DAYS F ED INSPECTION.
indemnify and keep harmless th ity of Cupertino against liabilities,judgments,
costs,and expenses which m ccrue against said City in consequence of the Da
granting of this permit. Ad i' nally,the applicant understands and will comply ss
with all non-point sourc ulations per the Cupertino Municipal Code,Secti
9 18.
RE-ROOFS:
Signature i Date 4'� All roofs shall be inspected prior to any roofing material being installed.If a roof is
ox 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: i 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 o 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 Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with the Cupe ti unicipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 2 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
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 0�
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228• FAX(408) -3333•building(c)-cupertino.org \
❑NEW CONSTRUCTION ❑ ADDITION �ALTERATION/Tl ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRES` MAPN# r7 �� �T 7/� r
IoqI3 ai AV
OWNER NAME 2 D�r Ar F 1 f � , f /� PHONE �� � � E-MAIL
STREET ADDRESS ,04//3 f x v rf CITY,STATE P FAX
/ Ge �
CONTACT NAME PHONE E-MAIL
l5 J�` )I✓A,+'��
STREET ADDRESS CITY,STATE,ZIPM FAX
❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAML. ` LICENSE NUMBER�� ' LICENSE TYPE,!? BUS.LIC#
COMPANY NAM E-MAIL J� F
rRo_C d .T . 1 .
STREET ADDRESS CITY,STA ,ZIP PH
(001- C�QXMIWCjAL r 4f -
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK,
jV4( F1
EXISTING USE PROPOSED USE CONSTR-TYPE #STORIES
USE TYPE OCC. SQ.FT. VALUATION(S)
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: DDETACH
❑ATTACH
#DV,TLLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES
BEING ADDED? NO ADDITION? ANO
PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN - N
VALUATION:
PLANNING APPL# r-1NOPLANNING APPROVAL LETTER EICHLER HOM V � x �� pb
By my signature below;I certify to each of the ]lowing: I am the property owner or authorized agent to aceisoacate.
perry ov< s behalf. I have read this
application and the information I have i d is correct. I have read the Description of Work and verify itI a to comply v ith all applicable Iota]
ordinances and state laws relating to g const etion. I authorize representatives of Cupertino to enter le property for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEUeSITAL INFORMATION.REQUIRED1111
!ROUT3NG?SLIPu ani.. ;
New SFD or Multifamily dwellings: Apply for demolition permit for
VER=`1'H7<COU TE 2 m" 12J—BUMI)ING PE! RES'IEFY' z �r
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. EaP sial, miGrialifzv w �_
_ x
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
form if any Hazardous Materials are being used as part of this project. ® DErT ��
_Copy of Planning Approval Letter or Meeting with Planning prior to � �`
$ATTfARY�EISRD7S�RICTx €
submittal of Building Permit application.
B— a �E_�'F�IROl�T114ENTAL''FiEALTH��pg�:�=
E1dgApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10413 MARY AVE DATE: 05/06/2014 REVIEWED BY: MELISSA
APN: 326 52 049 BP#: *VALUATION: $1,500
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY SFD or Duplex PENTAMATION 1GENRES
USE: p PERMIT TYPE: A
WORK REMOVE & REPLACE E BEAM 4X6X16' LIKE FOR LIKE AT ENTRY WAY OVERHANG FROM
SCOPE 12ND FLR
ry ;
10
7'errnf Fee:
C}r'Irc r : FcTt.
frisp. Other t'IarmbIrsp. ET-1- Olhui�1��:c.Msp'
adach Inst.f>e: Phial!). Insp. Fee: f:`lec.�.?nf . 1°:<
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,eta). Theseees are based on the prelimina information available and are only an estimate Contact the Dept for addn'Z info.
FEE ITEMS(Fee Resolution 11-053 Eff. 7/1/13) FEE QTY/FEE MISC ITEMS
Plan Check Fee: Hourly Only? 0 Yes No $0.00 hours Plan Check,Hourly
Suppl. PC Fee: Reg. 0 OT 0.0s $0.00 $139.00 ISTPLNCK
PME Plan Check: $0.00
Permit Fee: Hourly Only? 0 Yes •) No $0.00
Suppl. Insp. Fee.-(E) Reg. Q OT 0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
("onsIr trcPion T7'v.' F-1
Work Without Permit? ® Yes (E) No $0.00 G
Advanced Planning Fee: $0.00 Select a Non-Residential E)
Building or Structure
Tr avc4 Dcacmnent aiton Fees: I A
Strong Motion.Fee: IBSEISMICR $0.50 1.0 hrs Inspections
Blda Stds Commission Fee: IBCBSC $1.00 $139.00 ISTINSP Inspection,Hourly
ry $1.50 $278.00 TOTAL FEE: $279.50
Revised: 04/01/2014
COMMUNITY MANAGEMENT SERVICES
February 27 2014
Re: Casa De Anza Homeowners Association
To Whom.It May Concern:
I am writing;of behalf of neies Association. Pro Craft Builders
the Ca �e�A�� �,w
will be completing wood repairx, 400,01 r o the 'buildings. They are starting with
the building which houses units l:`Dl -1(129 Mazy Ave.
If you have any questions or concerns please contact me at(408)559-1977.
Sincerely,
Dustin Mannina;
Community Management-Services,Inc.
Association Manager=
Casa de Anza Homeowners Association
1935 Dry Creek Road,Suiten2b3■Campbell,CA■95008-3631 ■voice (408)559-1977■fax(408) 559-1970
10483
Casa De Anza ,0481
10453 10479
10477
Condominiums 10455 10475
10457 10473
T
Cupertino, Calif
Q ao\ 10459 10471
10461 104691 1
Qi iiowr
10463 10465
Play O 6�
Hre �J�r h� 10353
10355 L.4
—
�ff M
nri�s
CIO, $ "�' � `�L' g Vi n_ $
3 0 •» r o r v v
�g 10359 r r T r r T 0 0
10349 10361
�103471 1 1 110363
10365
10343 110367
10319 10341
10321 10369LI
10339 - _ 10371_ _ _ ° o o; rn o 0
,0323 - - M �-%- a s M * O o o
10337 0 0 eCOn r o� •-
10325 10373 0 4. o, C31r
10327 10335 10375
56317F 103331 1 10377
10315 10329 10331 10379
. Mary Avenue