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14060021CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 802 CANDLEWOOD DR CONTRACTOR:'rSD--TO-BE PERMIT NO: 14060021 IIID OWNER'S NAME: BARBARA RUDD A!n le Cul DATE ISSUED: 06/05/2014 OWNER'S PHONE: 4088591289 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ REMOVE WINDOW IN M.SUITE AND REPLACE WITH License Class Lic. # SLIDING rr GLASS DOOR Contractor < (�` fJX 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-insuie 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: $3480 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: 36919033 00 Occupancy Type: permit is issued.i�'/,G/_l�_�� 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 to WITHIN 10 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DALY,FJkOM LAST CALLED INSPETIQN. indemnify and keep harmless the City of Cupertino against liabilities, judgments, and expenses which may accrue against said City in consequence of the 1 Q �, costs, "" 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 RE -ROOFS: 9 18. j�,-_ Signature Date �fl 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, Sections 555533, 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 CONSTRUCTION LENDING AGENCY 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 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 918. Signature Date CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • build ingna cupertino.org ❑ ❑ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # ❑ NEW CONSTRUu i iuN ADDITION (� 7 PROJECT ADDRESS `q C! APN # r ^ 657 OWNERNAMEZ^fid/` p/ ` PHO���n�j' STREET ADDRESS j , /Q� // ® j 7C`. CITY, STATE, ZIP•,f/�/_. 70 %-�,.� �fd� FAX C ",' r// CONTACT NAME PHONE E-MAILJ STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRALTO _ AME /?� (�/ / LICENSE NUMBE p)�te7 � LICENSE TYPE BUS. LIC F � y;} !? rS /7�J COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP - PHONE ,l DESCRIPTION OF WORK /® Lc,. / dole.? EXISTING USE PROPOSED USE CONSTR TYPE #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: DETACH []ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY []YES BEING ADDED? []NO ADDITION? [:]NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES ° ' -- T UATION: RECEAM� PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? []NO E.`. By my signature below, I certify to each of the following: I am the property owner or authorized agent to act t e property owner's behalf. I have read this application and the information I have provi is co ect. I have read the Description of Work and verify iturate. I agree to comply with all applicable local ordinances and state laws relating to b ildi con cti la e r sentatives of Cupertino to enter the above)i1entifyd property for inspection purposes. S' L' Signature of Applicant/Agent: Date: - SUPPLEMENTAL INFORMATION REQUIRED K;rE„ :, ,.Iioiriirresilr. New SFD or Multifamily dwellings: Apply for demolition permit for z�ourTx �' D'B LDING PLAN Ev1Ew _ - existing building(s). Demolition permit is required prior to issuance of building , r� ar` permit for new building. > x> ss �pLANNitvGiA7v>vrEw �� � � 3 �" PUBLIC WORKS Commercial Bldgs: Provide a completed Hazardous Materials Disclosure L7. TaNnaxD -� form if any Hazardous Materials are being used as part of this project. s' Y Ci FII2E DEPT, _ Copy of Planning Approval Letter or Meeting with Planning prior toDi atilt' ©ANITARYSEwERDISTRrcT submittal of Building Permit application. PnEli N IItONMENTAL ISEAI;TH ; ..< BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO Im FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 802 candlewood dr DATE: 06/05/2014 REVIEWED BY: Mendez IPA APN: BP#: *VALUATION: 1$3,480 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: Window / Sliding Glass Door IWINREP Replacement PENTAMATION 1GENRE PERMIT TYPE: i WORK remove window in m.suite and replace with sliding lass door SCOPE $0.00 Fee: {J�t7C -1 7L -;z'61. IYtSt'. NOTE: This estimate does not include P(rrtttb. I'l'an Choc i'; Plumb, Perm"", 1`£'E: other Pivmb lnsP /'/lurui. hrsp, Fee: I It sp!"?c.' due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School nio*r:nt -,',I Th000 font n o hncod nn tho ..1,*—i.nru iwfnrs»ntinn nvnilnhlo ""d nra nnl) nn octimato rnntart tho Dont fnr addn'I infer FEE ITEMS (Fee Resolution 11-053 E . 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 # $418.00 Window / Sliding Glass Door IWINREP Replacement Suppl. PC Fee: (F) Reg. () OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. ® OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Colz.Stlwc�ion 711x: ��FP2ftPt�Ci',:7Lft'' I`e,'E; E) Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) 0 1'rav l I)c>c°rirrr orl a zr,rt 1 <>es. Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 $1.50 $418.00 ', TOTAL FEE: $419.50 Revised: 04/01/2014 COMIALIN,ITY Cnr,-,��L !r;!; MEN -7 DEPARTiv«'T BUILDING DIVS110N - CUP=ERTINO APPROVED r �ARY�Rf�� This set of plans and sprcifica�tions MUST be kept at the0FC E C ug"Po"" � � CFt�1>LW1)0T D, job site during construction. It is unlawful to make any � Y(21A?eP,-T) 0 C>) Cs� 1)sQ14 changes or alterations on same, or to deviate therefrom, without approval from the Building Official. The Stamping of this plan and specifications SHALL NOT b^ heold to pormit or to be an approval of t";e violation V cions of any City OAinance or State Law. fic avu sB;T Pa'J. Noto' i N qR' I I I I I --3) a ►l — z ExiZ>Tt0%�nj`,N170 �©os� C.aniave��N 'Ialh" oAT:f -- CUpERTIN r3uildin,, r,,�aqrer.. .SUN 0 5 2014 REVIEWED FOR CODE CO(Lf " Reviewed By;; yf-G I f I # --3) a ►l — z ExiZ>Tt0%�nj`,N170 �©os� C.aniave��N 'Ialh" oAT:f -- CUpERTIN r3uildin,, r,,�aqrer.. .SUN 0 5 2014 REVIEWED FOR CODE CO(Lf " Reviewed By;; yf-G k A S 10( VV -1 113, � 11 - - -- --- � AR&AR A:RtAT;V 90-4 CANbLew000-De CLAPeRT100 )CA 95D)q f 13 m21 V C:,-1 - I .C- <i -I 1/:2, 11 - I, L-