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14050172 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11132 CLARKSTON AVE CONTRACTOR:FIVE STAR WINDOWS PERMIT NO: 14050172 OWNER'S NAME: KUO JAMES R AND MARY W 1450 DELL AVE STE C DATE ISSUED:05/30/2014 OWNER'S PHONE: 4084464683 CAMPBELL,CA 95008 PHONE NO:(408)370-3331 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL REMOVE AND REPLACE 11 WINDOWS AND 3 SLIDING License Class l U`� Lie..# C�?r�3 S DOORS Contractor N&%r W tn&d 7 Date TO MEET EGREES 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:$21000 viand will maintain Worker's Compensation Insurance,as provided for by ion 3700 of the Labor Code,for the performance of the work for which this APN Number:35620032.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIJEXP IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIF PERMIT ISSUA, CE OR to building construction,and hereby authorize representatives of this city to enterupon the above mentioned property for inspection purposes. (We)agree to save 180 DAAST CALLED INSP C ON. 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 source regulations per the Cupertino Municipal Code,Section I 4L 9 18. y, RE-ROOFS: Signature v Date �V 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 1,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 ons 25505, 5.3, d 2 534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: e: 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 9 18. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 its (408)777-3228• FAX(408)777-3333•bulldlnq(Ct7,Cupertlno.orq CUPERTINC7 ❑NEW CONST`RUCTIION /❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 1 I v77 / ,I�,/.G/.�n � APN# 5 tC �0 0 3� �r OWNS V,M,fr �' I l /�!/ v /V�1 7 PH ( ' V� E-MAIL STREET ADDRESS CITY, STATE,ZIP F CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑yyyO��WNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NA(�\J . �M r BUS.LIC# COMPANY NAME ' 1`I�J G/"'�' E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP - PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS c CITY,STATE,ZIP PHONE DESCRIPTION OF WORK I A I ^ 0 �,� /: �1.� ZS`td� ,dam, car, Y yww��J�1 , I- Qx-&ov%ffVJJ�r„I in400w J V,4 �fflm,<,t EXISTING USE PROPOSED USE CONSTRTYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NETAREA 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 RICEI ED "F` � - OT VALuA�I�J: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? []NO ru % (�� (vJ By my signature below,I certify to each of the following: I am the property owner or authorized agent to t on the property owner's behalf. I have read this application and the informatio 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 rel g to buildi onst ction. I authorize representatives of Cupertino to enter the ee-ide ified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAI INFORMATION REQ RED ; � ycicltjzrPE ; '1 ;.NRPUTiNc'; >P New SFD or Multifamily dwellings: Apply for demolition permit for R THE COUNTER x UII DING PLAN RE JIEW existing building(s). Demolition permit is required prior to issuance of building r permit for new building. r� EXP�� LArnvnvc�ANREv�w 3 r I s _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ��sTANJ)ARD r PUBLICWORICS form if any Hazardous Materials are being used as part of this project. IN s❑ � f _ ofApproval Letter or Meeting with prior to CoPlanning PYf A PP g h Plig pit � submittal of Building Permit application. `` i D.KENYIItONMEIVTAL.HEALTH , BldgApp_201 Ldoc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 11132 clarkston ave DATE: 05/30/2014 REVIEWED BY: Mendez APN: BP#: *VALUATION: $21,000 xPERMIT TYPE: Building PermitH2nd PLAN CHECK TYPE: Alteration / Repair PRIMARY nit? Yes No PENTAMATION1R3SFDREM USE: SFD or Duplex C1 Yes No PERMIT TYPE: A WORK remove and replace 11 windows and 3 sliding doors to meet agrees in bedrooms SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,111-B,IV,V-B 0 $0.00 $0.00 TOTALS: 0 $0.00 $0.00 MECH,,HOURLY o �P UMB HOURX.Y Yes. ''�.No XLEC,HOURLY ® Yes E)No ;�fcclr. t'lurf Er�:ck I'Irut�h. 1'lrrra{.rleck 1°:iec_1'pan<"I�crk t7;hrIIe� Vit. 7resp. Other Plumb oilier t k"( Irnp, �1 <h Pllarib. hrsp. Fee: 111"(. Imp, NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,eta). These fees are based on the prelimina information available and are only an estimate. Contact the Dept for addn I info. FEE ITEMS (Fee Resolution 11-053 La. 7/1/131 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 14 # Window/Sliding Glass Door Suppl. PC Fee: Reg. OT 0.0 hrs $0.00 $557.00 1 WIIVREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. Q OT ko.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 11 ,"oy),vroch on Tax: F 'IJInini.sir-rive Work Without Permit? ® Yes (E) No $0.00 L E) Advanced Plannin&Fee: $0.00 Select a Non-Residential E) Building or Structure 0 ?',cr.t'I Lit t.rf,2ct71c:zr ori.ees: Strong Motion Fee: IBSEISMICR $2.10 Select an Administrative Item BldgStds Commission Fee: 1BCBSC $1.00 $3.10, $557.00 TOTAL FEE: $560.10 Revised: 04/01/2014 Ivo ti t3z Ave, CPF- �J/t�r Pi"v CUPERTINO rtmeni Will Mee+ ar-eg7 (+4 Yew M)i hC65 MAY 3 0 2014 REVIEWED FOR GODE CoMPLIANCE Is Reviewed By: NNW Im AIL pa'a sff 0, F F 1C C Iq - E0 UP T 4 7-x+7 2-kit, ca- MASTER I L3.-C3 LI CX TE CD C) BATH o MASTER 0— co X Z;- . BEDROOM 15 0- 01 t� =A1 Y 721 co '.x IS' WALL C Ito& BEDROOM 2 BEDROOM 1 0 TIO BAT WALL E LAUNDRY KITCHEN BATH VALL B ROOM BREAKFAST OFFICE 7 a9 ROOM HALLWAY -7I)C4(7 GARAGE DINING LIVING ROOM ROOM ROOM 7 715 3 ENTRY law 141 4K 4m rt% -7 m58 * A 1(Vg5o —11 x978 Vq Z1(-4t, z la-6 of. WALL A vle dao 001'eori