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14080045 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 8159 PARK VILLA CIR CONTRACTOR:JEMICO LLC DBA PERMIT NO: 14080045 RENEWAL BY ANDERSEN OWNER'S NAME: XIAOCHUAN NN 30800 SANTANA ST DATE ISSUED:08/07/2014 OWNER'S PHONE: 4086017518 HAYWARD,CA 94544 PHONE NO:(510)263-3178 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL E] COMMERCIAL E] t.-„0 REPLACE 3(E)WINDOWS,LIKE FOR LIKE(WILL MEET License Class Lie.# �- EGRESS&BE TEMPERED WHERE REQUIRED BY CODE) Contractor Kee\ al ate �d 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:$5417 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:35610039 00 Occupancy Type: 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 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 + LAS ALLED INSPE TIO . indemnify and keep harmless the City of Cupertino against liabilities,judgments, / costs,and expenses which may accrue against said City in consequence of the Date: F� / 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. Q� RE-ROOFS: Signature Date O — t 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 25505,25533 nd 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Dater 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 �O COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228-FAX(408)777-3333•building aa)-cuoertinO.oM NEW CONSTRUCTION 0 ADDITION ALTERATION/TI El REVISION/DEFERRED ORIGINAL PERMIT# PROTECT ADDRESS .� 1 K p ` „ v,kk0.^` APN9 2 C v O OWNERNAME `„t• c,., n l �j, PHONE fvr"COt+-Z/J`Ctr E•MAE, STREETADDRESS P v\� CITY,STATE ZIP '}hooIK FAX CONTACTNAMEL6-15m " C6' 1A sA G/lam momrl0 2.6.3 J 1 /C &C` J�/tn�•[�:R '(��1w':� 4 4.^Z ccrv� STREET ADDRESS,2 a U'u w k ` CITY,STATE,ZIP G J 7 C y LJ FAX ❑OWNER ❑OWNER-BUILDBR ❑OWNERAGENT IiI CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NA:" -I�, x (CENSE NUMBER ('j •1.�1--T�777FTYPF t BUS.LIC 0 COMPANY NAME J '�J f-b(1e`k&T- Cr O tIoc�/ PAX b)u' y SrRBET ADDRESS STATE,Z[F, .0 PHONE • L ARCFHTECTIENO[NEERNAME LICENSENUMBER EU9.LIC N ' COMPANY NAME E-MAIL FAX STREET ADDRESS CRR,STATE,ZIP PHONE DESCRIPTION OF WORK r ` �1 ` o� E20TWO USE PROPOSED USE Comm TYPE STORIES USE TYPE UCC. SQFT. VALUATION($) EXISTG NEW FLOOR DING TOTAL AREA AREA AREA NErAREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKMORCH AREA I C ARAGE AREA eDErACH ATTACH #DWELLING UNITS ISASECONDUMT ❑YRS SECONDSTORY ❑YES BEINGADORDP ONO ADDITION? []NO PRE-APPLICATION ❑YES IFVas,PROVIDECOPYOF IS THE BLDGAN TOTALVALUATION: PLANNING APPLN ONO PLANNING APPROVAL LETTER EICHLERHOINE NO '{ 1-7 O� By my signature below,I certify to each of the following: [am the property cwrrer or authorized agent to act afiAwfproperty owner's behalf. I have read phis 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 relatin building construedom authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent:�V"v T Date; V i[ I(`'I SUPPLEMENTAL INFORMATION REQUIRED PLANCRECKTYM ROUTING" _New SFD or Multifamily dwellings: Apply for demolition permit for r6&C:ourfm ❑ BUILDING PLAN RRVMW existing building(s). Demolition permit is required prior to issuance of building permit for new building, ❑ ERPAE99 ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 11 STANDARD ❑ PUBLIC WOAIM _ form if any Hazardous Materials are being used as part of this project, ❑ LARGE ❑..FMS _Copy of Planning Approval Letter or Meeting with planning prior to ❑ M�oR 11 sANiTARYSEwEHDrsTrucT submittal of Building Pemnit application. ❑ ENVHtOMWdVTALHEALTH B1dgApp_2011.doe revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION W�;PERMIT DDRESS: 8159 park villa cir DATE: 08/07/2014 REVIEWED BY: MELISSA PN: 356 10 039 BP#: *VALUATION: $5,417 PE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1GENRES USE: p PERMIT TYPE: WORK REPLACE 3 E WINDOWS LIKE FOR LIKE WILL MEET EGRESS & BE TEMPERED WHERE SCOPE REQUIRED BY CODE) IM Pi1j,ni) Tc tnr,Fee: f �. P, Other Plu"11"lyes", 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 inormation available and are onlyan estimate. Contact the Det or addn7 info. FEE ITEMS (Fee Resolution 11-053 Eff. 711/131 FEE QTY/FEE I. MISC ITEMS Plan Check Fee: $0.00 0 # Window/Sliding Glass Door Suppl. PC Fee: Reg. ® OT Fo.0 hrs $0.00 $431.00 IWINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee: Reg. C) OT p 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (,'c;,,,.v°w,fion Tax: F L Fee: 0 Work Without Permit? ® Yes (E) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential Building or Structure 0 7,r-rr��1 1.,'r�t_rftr<�rtfutir>rt I��ce.s`: � Strom Motion.Fee: IBSEISMICR $0.70 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 $1.70 $431.00 TOTAL FEE: $432.70 Revised: 07/10/2014 Project name: Xiaochuan Niu Renewal S a r K V) l(o► C 1 it bmAndersen_ Backyard/Rear Setback .�✓ S h J 0'-- ' r 2 P GLC, 102 GL 45X40 W.MOOW 4 LCEYEI.T %rte ��✓ �_ _ KITCHEN 103 AW 32X20 ' BATH LIVING ROOM 101 GL 58X56 Setback Setback Comment ENTRY Street/Front Setback COMMUNITYD DEVELOPMENT ENT BUILDINGp31CUERT APPROVED This set of plans and specifications MUST be kept at the job site during construction. It is unlawful to make any changes or alterations en same, or to deviate ' therefrom without approval from the Building Official. UCa pF Rrwo The Stamping of this plan an ecifications SMALL PJOT PQa"finent be held to o be a pproval of the violation k� rovisions of ity Ordinance or State Law. p Rev,-ev' By-G�� 6Y N cOPv1PLIAWCE PERMIT NO. 0 PLOT PLANS Scope of work: CHECKED BY DATE2 4 *NNINGDE T DATE BLDG. DEPT.