14070023 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19181 PHIL LN CONTRACTOR:THD AT-HOME PERMIT NO: 14070023
SERVICES,INC.
OWNER'S NAME: WILBER&CAROLYN LA RUE 2690 CUMBERLAND PKWY STE 300 DATE ISSUED:07/08/2014
OWNER'S PHONE: 4082553658 ATLANTA,GA 30339-3913 PHONE NO:(510)731-1004
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑
�j REMOVE AND REPLACE(1)EXISTING WINDOW IN
License Class c1�7 ��( Lic.# Z5 Z- OFFICE
Contractor� `/ A-7 I I�t"'I� .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:$501
lo-have and will maintain Worker's Compensation Insurance,as provided for by
r4ti n 3700 of the Labor Code,for the performance of the work for which this APN Number:37540042.00 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 1 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 DVM LAST CALLED INSP CTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the
D
granting of this permit. Additionally,the applicant understands and will comply Issued by: ate:
with all non-point source regulations per the Cupertino ipal Code,Section
9 18.
RE-ROOFS:
Signature Date 7 f 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.
❑ O - UILDER 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 25505,25533,a7%ate�:
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: 7
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 CONSTRUC LENDING AGENCY
become subject to the Worker's Compensation provis}ons 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 �U
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228•FAX(408)777-3333•build ingna cupertino.org
❑NEW CONSTRUCTION ADDITION ❑ ALTERATION/TI ❑ REVISION/�DtEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS I f lf4i /� AA)JE APN# 3-7 5 J t 0,t-9 iSU
OWNERNAME �1 l:l`--". / ^�oE (J PHONE ^J .� // E-MAIL�V
STREET ADDRESS ' I fJ t r GC�STCiZ�I/.�0 G ^Gj n�� FAX
CONTACT NAME JEFF RAIN1EY 1 PHONE 510-427-426'09 `� E-MAILJEFFREY.RAINEY@ATT.NET
STREET ADDRESS 1069 EDGEMERE LANE CITY,STATE,ZIP HAYWARD, CA 94545 TF—AX 510-783-1041
El OWNER 11OWNER-BUILDER13 OWNER AGENT 11 CONTRACTOR YJ CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME LICENSENUMBER 836021 Lf�E Ya3,C17 BUS.LIC#
COMPANYNAME THD AT HOME SERVICES E-MAIL FAX 510-783-1041
STREET ADDRESS 2456 VERNA COURT CITY,STATE,ZIP SAN LEANDRO,CA 94577 PHONE 510-7 8 5-6 3 4 0
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP \ PHONE
DESCRIPTION OF WORK t(Ll
&cev
EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES
-TJ USE TYPE OCC. SQ.FT. VALUATION($)
EXISTG NEW FLOOR DEMO TOTAL
AREA AREA AREA NET AREA
BATHROOM KITCHEN OTHER
REMODELAREA REMODELAREA REMODEL AREA
PORCH AREA DECK AREA 1 TOTAL DECK/PORCH AREA I GARAGE AREA: DETACH
❑ATTACH
#DWELLING UMTS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES
BEING ADDED? ONO ADDITION? ONO
PRE-APPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES fttCEIVE151"BY 'r TALVALUATION:
PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NOo
By my signature below,I certify to each of the following: I am the property owner or authorized agen o act on tie—property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and ven IIs accurate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I authorize representatives of Cupertino tA&nLcLtbp above-identified property for inspection purposes.
Signature of Applicant/Agent: Date: 6 I-O
SUPPLE25NTAI INFORMATION REQ '-'
PLe�IY,,;CHECk,T':YPE ROUTING SLIP
_New SFD or Multifamily dwellings: Apply*1de`V1C9on permit for p OVEIi TA0OJJNTER O BUIIDING PLAN REVIEWexisting building(s). Demolition permit is require prior to issuance of building ,
permit for new building. ❑<PLANNING PLAN REVIEW
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure :. sTaNDAxD` ❑ PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project.
LARGE. FIRE DEPT
_Copy of Planning Approval Letter or Meeting with Planning prior to P,,MAJOR ❑ sANITARv SEWER DISTRICT
submittal of Building Permit application. "
ENVIRONMENTAL.HEALTH
BldgApp_2011.doc revised 06121111
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 19181 Phil In DATE: 07/08/2014 REVIEWED BY: Mendez
APN: BP#: *VALUATION: $501
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY PENTAMATION
USE: SFD or Duplex PERMIT TYPE: 1GENRE
WORK remove and replace 1 existing window in office
SCOPE
.m, xx ii � ea
1'!"rentb. Plan(:'hecAl't rn(.'heck
t;fnhf't m:t Fee: 1_7:
Jrlt� ic',zR. t;., t)lieer 1 r'a l)Iftse:e
NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . Theseees are based on the prelimina information available and are only an estimate. Contact the Dept./or addn'1 info,
FEE ITEMS (Fee Resolution 11-053 Eff.' 711113) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 = # Window/Sliding Glass Door
Suppl. PC Fee: (F) Reg. 0 OT 0,0hrs $0.00 $431.00 IWINREP Replacement J
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Feer Reg. ® OT0 0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Work Without Permit? ® Yes No $0.00 1 E)
Advanced Planning Fee. $0.00 Select a Non-Residential
Building or Structure
I7"U ea
Rr.)L)C tet7'1L'r' (t`11tFt? Fe(,"y:,S: A
Strom Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
Mv, S� AL $1.50 $431.00 TOTAL FEE: $432.50
Revised: 07/07/2014
LEGEND: _
® = RETROFIT WINDOW/PATIO DOOR LOCATION C Ab' Aft Py C:)�
(XO) = 1 PANEL HORIZONTAL SLIDER0 ru kov
ti
w�CY)
UOQ
U U
w Q O
OFFICE �°C
WINDOW(XO) WWO
47"w x 37"h
CD co w
COMMUNITY DEVELOPME14T DEP
ARTMERlT Q N
BUILDING DfASION-CUPERTINO , U)
APPROVED OFFICE
This set of plans and specifications MUST be kept at the ~
job site during construction. It is unlawful to make any $
changes or alterations on SaMP4 or to deviate �U
therefrom, without approval from the Building Official.
The Stamping of this plan and specifications SHALL.NOT
be held toit or to be an approval of the violation
of any pr Is Of any City Ordinance or State Law.
> >
m ?elx
BY °
DA
TE7 Z
GARAGE PERMIT NO. /O7
d-
ENTRY w Z w o
� rn
C
W �—
m r z
CUPER f INN O° '—
� Mw
PL T PLANS Building Defaartmeni �
(FR YA
CHC ED BY PH y rt Q $ 2014 U
DA E
K f NOTE;WINDOWS/PATIO DOORS; 06.19.14
FIRST LEVEL REVIEWED FOR CGDE COMPLIANCE u-FAcroR=a.3o SCALE NTS
SHGC = 0.30 DRAWN By
PL I G DEPT. FLOOR PLAN Reviewed $Y. s 717�, DKW
SCOPE OF WORK:INSTALL(1)RETROFIT VINYL,DUAL ,oB
7467106
GLAZED,LOW E WINDOW.NO(N)CONSTRUCTION, sNE�r
GATE FRAMES WILL NOT BE DISTURBED. A-1
BLDG. DEPT.