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14050060 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10450 N PORTAL AVE CONTRACTOR:SGK HOME SOLUTIONS, PERMIT NO: 14050060 INC. OWNER'S NAME: KLEIN PETER A AND WOON SANDRA 3801 CHARTER PARK CT STE B DATE ISSUED:05/08/2014 OWNER'S PHONE: 4087252544 SAN JOSE,CA 95136 PHONE NO:(408)264-6964 ICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL F] Q 5" REMOVE AND REPLACE 11 WINDOWS TO MEET EGRESS License Class ~�( � Lic.# SC/ 0 IN BEDROOMS Contractor Date I hereby affirm thatam lic used under the provisions of Chapte 9 (commencing with S ction 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:$11400 I have and will maintain Worker's Compensation Insurance,as provided for by Oatn 3700 of the Labor Code,for the performance of the work for which this APN Number:31629014 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 F AST CALLED INSPE TION. 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 Issued by: Date: with all non-point s urce regulations per the Cupertino Municipal Code, ection 9 18, RE-ROOFS: Signature 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. ❑ OWNER-B ILDER 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 unicipal Code,Chapter 9.12 an I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sec' S0 533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Dat 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 GUPERTINQ (408)777-3228•FAX(408)777-3333•buildinga-cupertino.org \� NEW CONSTRUCTION ❑ ADDITION 9 AJTERA`flON/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS Avo d APN# 5/ n ./')q ON OWNERNAME Pirft, L�F-2� / E-MAIL STREET ADDRESS CITY,STATE,ZIP ,7 FAX CONTACT NAME / � P / E-MAIL G�%7" c1 /ew Ire-2— U� STREET ADDRESS CrrY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BPLDER ❑ OWNER AGENT ❑ CONTRACTOR CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME e LICENSE NUMBE LICEN E BUS.LIC# COMPANY NAME E-MAII FAX I STREET ADDRESS CITY,STATE,ZIP ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK N ' �f' < r EXISTING USE PROPOSED USE CONSIX TYPE I #STORIES 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 DECK/PORCH AREA GARAGE AREA: 0 DETACH ❑ATTACH #DWELLINGUNITS: IS A SECOND UNrr []YES STORY []YESBEINGADDED? ❑NO ADDITION? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES 'RECEIVED BY: TO V PLANNING APPL# ❑NO PLANNING APPROVAL r ETTER EICHLER HOME? ❑NO By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I hay rovided correct. I have read the Description of Work and verify it is accurate. I agreeto /.ply with all applicable local ordinances and state laws relatin b nstruction. I authorize representatives of Cupertino to enter the above-i nt p Pr inspection purposes. Signature of Applic.VAgent: Date: / SUPPLEMENTAL ORMA 11 N REQUIRED PL, � TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for ,OVER-THE coUNTER ❑ BUILDING PLAN REVIEW 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 woRics form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FmE DEPT _Copy Of Planning Approval Letter or Meeting With Planning piior t0 ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH B1dgApp 2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION W�PERMIT DDRESS: 10450 n portal ave DATE: 05/08/2014 REVIEWED BY: Mendez BP#: *VALUATION: $11,400 PE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Du lex PENTAMATION 1GENRES USE: p PERMIT TYPE: WORK remove and replace 11 windows to meet egress in bedrooms SCOPE p' 4ac/1 Plan Ou_ck I'luolb,Plan Cjt(,'ck Ile:. Phan Check Llt> t.a'<rratFllec>.. 1'ltf3nh. 11erm;lFee: 1,1C . Other Phi rib Iny'r'. (Jlfrct1 ire Itast�. 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 prelimina information available and are onl an estimate Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 ff. 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Window/Sliding Glass Door Suppl. PC Fee: (j) Reg. ® OT 0.0 hrs $0.00 $557.00 IWINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-.(j) Reg. Q OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 t:'onslivc=iior, 'I'V1' Idmillisfraliv Fee: Work Without Permit? 0 Yes (j) No $0.00 0 Advanced Planning Fee: $0.00 Select a Non-Residential fi~<a i t)c}c: r¢t r/ra;ic;ra f'rc=s': Building or Structure 0 Strom Motion Fee: IBSEISMICR $1.14 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 A $2.14 $557.0011 - TOTAL TEE:", $559.14 y �4 I Revised: 04/01/2014 'MEN'��'ii"oERMI' ME No 'o iiON iiMi"ii"E 'C�mii SEE ME No ME ME No MMEMINE No ME No ON ME ME ONO SEEN �au=iiii�i�mii 'u' w iiiMii�.iiiiMiawiBiu' prMEMEMISM 0 SEEM '::oaou_o:o= 4'0N':.:.'0M':."o".:eiCC'o':o momilmmoom limmir.v:1mmmesmo�MMWEMMMMMMMUMM ME P�se�i No �ee��esr ��a�o: ��e�eeenNo �r�eEm�i,�em� No No ° MEN No MEMEOMMUME ME No ME MMINIUMNIMUME MINSIME10% 1.10 MEN ��7m��3N�. ��e�ii�e°a'si°see�� mommmmmsmommm No ME MENNEN MENNEN NNE�xex:r��o e'se:eommommo Ell I No ON No I so mea�m�in�e;mage;u,meer�i MuaoEVionE oiCimCroMEonrnmruNmINN No ME ME INIMMUMIN No No ME Ism ENE ��E ME �� :s. :: eli�meE ME Nil No ON No 111MUMMEM MemS lummunimPmoomm MEN Wo" .mMmIMMa% ME WEmm �; 6� iINKNIA"Iml NEW E�� :: lmlmhl!OIN, M�9�,anaeBiiec ��:e:��es�aa�e:�es�e�: -