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14050027 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7625 WEST HILL LN CONTRACTOR:BROTHERS HOME PERMIT NO:14050027 IMPROVEMENT OWNER'S NAME: VAIRAVAN VALLIAMMAI AND PALANIAPPAN 2510 DOUGLAS BLVD DATE ISSUED:05/05/2014 OWNER'S PHONE: 4083759401 ROSEVILLE,CA 95661 PHONE NO:(408)295-0680 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL r� Q /�,, REMOVE AND REPLACE 7 WINDOWS, 1 PATIO DOOR TO License Class 1'� r/ <<-Zic.# u/� MEET Contractor #06t Date /e—/ EGRESS IN BEDROOMS 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:$6000 I have and will maintain Worker's Compensation Insurance,as provided for by ection 3700 of the Labor Code,for the performance of the work for which this APN Number:36227027.00 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 1A0 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 DAY M LAST CALLED INSP CTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, Q� costs,and expenses which may accrue against said City in consequence of the Issued by:_ Date ) granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 918. RE-ROOFS: Signa Date l 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 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,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 Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Se 5505 3,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: r 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 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 2* (408)777-3228• FAX(408)777-3333•buildingP—cupertino.orc �� CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ❑ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 7APN 0 3`„n r�-7 02,1 OWNER NAME PHONE ^� ' !.� E-MAIL tuy ` STREET ADDRESS CITY,STATE,ZIP q O'4 1 FAX dftha OA CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR RrC-'ON1RACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME A LICENSE NUMBER o LICENSE TYPE BUS.LIC k COMPANY NAME !71' �/ E-MAIL (� FAX STREET ADDRESS CITY,STATE,ZIP PHONE Lori ARCHITECTIENGINEER NAME LICENSE NUMBER BUS.LIC#. COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK -tff&4' 40 4a545 -70 EXISTING USE PROPOSED USE CONSTR.TYPE 9 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 GARAGE AREA: DETACH ❑ATTACH S DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY []YES BEING ADDED? []NO -ADDITION? ❑NO PRE-APPLICATION ❑YES 1F YES,PROVIDE COPY OF IS THE BLDG AN El YES --RECEIVE- a'- ',til �� rV;� TOTAL YALLUUATITION: B PLANNING APPL ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO - � a, By my signature below,I certify to each of the following: I am the property owner or authorized agent tona...,ate perty owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work an Ify iI agree to comply with all applicable local ordinances and state laws relating in const Ion. thorize representatives of Cupert' tifle property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEDIE TI . QUIRED `` rcx tea_ ozlT�csy �' � New SFD or Multifamily gs: Apply for demolition permit for m a `s ` OYER-_H1<COUNTER BUII DING P1 AIS REVIEVE existing building(s). Demolition permit is required prior to issuance of buildin 4 permit for new building. +� aPR'Ess ` -E� PI:AI�I�•INGPI,ANT2EVIEw�'��_ I,. rustle � ' _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure voRI] sTnIVDARD� form if any Hazardous Materials are being used as part of this projects I D fi - _Copy of Planning Approval Letter or Meeting with Planning prior to z submittal of Building Permit application. ' n sox � �: >srTAtSE)u Ra RI , .�� M�';> i© ENVTROTS'111EIVTAIr=FIEALTAI�:»��s�.j".:. B1dgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION W....�PERMIT DDRESS: 7625 west hill In DATE: 05/05/2014 REVIEWED BY: mendez PN: BP#: EVALUATION: $6,000 PE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1GENRES USE: PERMIT TYPE: WORK remove and replace 7 windows 1 patio door to meet egress in bedrooms SCOPE L "JI, Plu:,E;e<;cr< t'.�ur�h.I'/urr Check t'ec. i'r ti' ;c7 Wcc b' P rniil Fee: /P iib.Peermil Pee; C?tltE r Afc fJ'j. Ms Other Plumb Trt.p. C 1he-1,L ter.hzv :41cr;1Ir�sP, i, <, F'lzzrrtb. Irrsd�. T'es €`iec.Ini}r tae: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These fees are based on the prefimina information available and are only an estimate. Contact the De t or addn I info. FEE ITEMS (Fee Resolution 11-053 Eff. 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 ® # Window/Sliding Glass Door Suppl. PC Fee: (F) Reg. 0 OT0.0 hr's $0.00 $418.00 IWINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Feer Reg. 0 OT 0,0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 t"c}a:so'll iio "I tr: Work Without Permit? 0 Yes (E) No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential r< >zl�)txarrtic�✓tftr(it>n Fees: Building or Structure 0 Strong Motion Fee: 1BSEISMICR $0.60 Select an Administrative Item Bldp,Stds Commission Fee: 1BCBSC $1.00 $1.60 $418.00 TOTAL FEE: $419.60 Revised: 04/01;2014 k? fi (Ctq�JNPFJ � , 1 IUAz-c� l/A� a t, 6te Aja g G �. Qx F 0i ei3 u3 adz t r. A �y ZZA)?h tt "R I"PA,^TM ENT it w uni4;R.f aI to make any to d ev l Le '" U4"fl `-he Building Official. �® V �.jfiF.7741 eRG Q R h ;oval ofvic;'a'don < ? ,7.t,Law. f1,40500 Cz rl IP e+ quilI'dling Il c lli}�ti14 VI'D FOR C O' DE COMPLIANCE 0