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14060118CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10335 STERN AVE CONTRACTOR: JEMICO LLC DBA PERMIT NO: 14060118 RENEWAL BY ANDERSEN OWNER'S NAME: LEE DONGHUN AND YOU JINHE 30800 SANTANA ST DATE ISSUED: 06/18/2014 OWNER'S PHONE: 4088736030 HAYWARD, CA 94544 PHONE NO: (510) 263-3178 JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ LICENSED CONTRACTOR'S DECLARATION REMOVE AND REPLACE 11 WINDOWS LIKE FOR LIKE, License Class Lic.# CMTO MEET EGRESS IN BEDROOMS Contractor 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-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: $22783 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 37510051 00 Occupancy Type: c ion 3700 of the Labor Code, for the performance of the work for which this 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 180 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 ROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, City in consequence of the '' p �G/ costs, and expenses which may accrue against said Issued by: Date: �'�O • granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9 18. RE-ROOFS: l � Signatur Dater / 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 25505, 5533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized age Date: rUb 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 . J CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building a gwertino.orq �Aou 6I1 6 F1 NEW CONSTRUCTION M ADDITTON ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS. APN # OWNER NAME \� �� ) PHONE 3 E-MAIL STREET ADDRESS CTTY, STATE, ZIP FAX CONTACT NAME PHON JLO a{O,__3t 1p E-MAIL OMYI� MC> A�p. STREET ADDRESS CITY, STATE, ZIP& , Q � `�� ( PAX 5Co ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ^ _ _n ^ f�1(rj 1� LICENSE NUMBER n,�v­,� c LICENSE TYPE^ �Ct �j BUS. LIC # COMPANYNAME l �lcaoa� E-MAIL FAX 5Lp`Z6l' 53 7 STREET ADDRESS CITY, STATE, ZIP PHONE 5t�-ac,3-3t� ARCHITECT/ENGINEER NAME / ' lv LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORKfvi8, A,44 EXLSTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA BATHROOM REMODEL AREA XITCHEN REMODEL AREA OTHER REMODEL AREA PORCH AREA DECK AREA TOTAL DI CK/PORCH AREA GARAGE AREA DETACH ATTACH #DWELLINGUNrM ISA SECOND UNIT ❑YES BEING ADDED? ❑ NO SECONDSTORY ❑YES ADD N? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING ADPL 9 []NO PLANNING APPROVAL LEITER IS THE BLDG AN ❑ YES EICHLER HOME? ❑ NO RECEIVED BY: TOTAL VALUATION: I . -In ro By my signature below, I certify to each of the following: I am the property owner or authorized agent to a weer's behalf. I have read this application and -the information 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 relating to wilding construct n. I authorize rcoresentatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED _New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance ofbuilding permit for new building. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. PLANCHECKTVPE ROUTINGSLIP ❑ OVER_THIrCOUNTER ❑ EXPRESS 13STANDARD ❑ LARGE ❑ MAJOR El BUILDING PLAN REVMW ❑ PLANNINGPLANREVMW ElPUBLICWORKS ❑ FIRE DEPT ❑ SANITARY SEWER DISTRICT ❑ ENVIROPIMEPI'I'AL HEALTH BldgApp_201 Ldoe revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION t.)i'?er Aijr. cb. Iris/z. aec,a. 1tr..4;zr. f"ce: Plumb. Alm? €:1i€:r:z l'1remb. Persr a I"rye: € i er f'ir+r^rib Iris/3. 1't"wrb..Irrsrj. Fee: Eec. 1'r'€irr i.;irr<t: Le"", othf.'er MSP, £:?ec. /rrf�. Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l into, FEE ITEMS (Fee Resolution 11-053 E . 7/1113) 10335 STERN AVE DATE: 06/18/2014 REVIEWED BY: MENDEZ 11alADDRESS: APN: BP#: *VALUATION: 1$22,783 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: Suppl. PC Fee: 0 Reg. ® OT PENTAMATION 1 GENRE PERMIT TYPE: WORK REMOVE AND REPLACE 11 WINDOWS LIKE FOR LIKE TO MEET EGRESS IN BEDROOMS SCOPE t.)i'?er Aijr. cb. Iris/z. aec,a. 1tr..4;zr. f"ce: Plumb. Alm? €:1i€:r:z l'1remb. Persr a I"rye: € i er f'ir+r^rib Iris/3. 1't"wrb..Irrsrj. Fee: Eec. 1'r'€irr i.;irr<t: Le"", othf.'er MSP, £:?ec. /rrf�. Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l into, FEE ITEMS (Fee Resolution 11-053 E . 7/1113) FEE QTY/FEE I MISC ITEMS Plan Check Fee: $0.00 = # Window / Sliding Glass Door $557.00 IWINREP Replacement Suppl. PC Fee: 0 Reg. ® OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -0 Reg. ® OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C,oil.;tP'fLC'/lon ./ldx G) Work Without Permit? 0 Yes 0 No $0.00 Advanced Plannin& Fee: $0.00 Select a Non -Residential Building or Structure G 0 "nwel I r c°= r3. triicrPir z . r. r. s; Strong Motion Fee: 1BSEISMICR $2.28 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 k TES 8 $3.28 $557.00 TOTAL FEET` $560.28 Revised: 04/01/2014 T1 jol th Tt G' Lvo 61 s.� Mss.♦ fVLJ I b _ 141 _�,qx s f 'Project/Name: you r04 Address: /ass. N �jj......13 WINDbw. 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