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14080089 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 974 CANDLEWOOD DR CONTRACTOR:BROTHERS HOME PERMIT NO: 14080089 IMPROVEMENT OWNER'S NAME: ROBERT LEI 2510 DOUGLAS BLVD DATE ISSUED:08/13/2014 OWNER'S PHONE: 4088932410 ROSEVILLE,CA 95661 PHONE NO:(408)295-0680 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL //yy REPLACE 3(E)WINDOWS,LIKE FOR LIKE(ALL License Class C� ( LIC.# d� WINDOWS / WILL MEET EGRESS&BE TERMPERED WHERE REQ'RD Contractor l Date 3 BY I hereby affirm that I am licensed under the provisions of Chapter 9 CODE) (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 perfor ce of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$1815 ve 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:36919015 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 relatingO DAYS OF P T ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter 114[lif.1,11.11; '111 upon the above mentioned property for inspection purposes. (We)agree to save INSPECTION. 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: granting of this permit. Additionally,the applicant understands and will comply,.0 with all non-point source regulations per the Cupertino Municipal Code,Section 918. [/ may/ RE-ROOFS: Signature Date 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(Scc.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. 1 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,Sec" ns25505, 5 ,and 25534. / Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agen 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 Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY 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 �O CUPERTINO (408)777-3228• FAX(408)777-3333-building o—)cupertino.ong ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESSqlq ��• APN OWNER NAME ��111kobellf PHONE D /�3 �+� /�� EMAIL STREET ADDRESS �/ CITY,STATE,ZIP I_1 .'`�J !_/—G fes' / FAX CONTACT NAME L PHONE ` E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX UYOWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMELICENSE NUMBER O LICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS r CITY,STATE,ZIP 1j_ / �yJ HONE � ARCMTECr/ENGINEER NAME LICENSE NUMBER a/ BUS.LIC# (P COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK 2 n� EXISTING USE PROPOSED USE CONSTR_TYPE I #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 DECKIPORCH AREA GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY OYES BEING ADDED? ONO -ADDITION. ONO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES - _N TOT V ATION: PLANNING APPL# 0 N PLANNING APPROVAL LETTER EICHLER HOME? ❑NO - =^ _ L•�� By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is ect. 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 toping c ction. I authorize representatives of Cupertino to enter the above idgttified property for inspection purposes. Sip-nature ofApplicant/Agent: Date: T SUPPLEDfENT ION.REQUIRED � » R irirrc:_s`iiP � -i New SFD or MultifamilYwellin s: APP1Y for demolition permit for Y COIJ�TER existing building(s). Demolition permit is required prior to issuance of building permit for new building. P —Commercial Bldgs: Provide a completed Hazardous Materials Disclosure _ Axn. form if any Hazardous Materials are being used as part of this project. '� t>�O.y' ,iT, DEPT '-�� _• _Copy of Planning Approval Letter or Meeting with Planning prior to t° N'. Ol- � AIv YS M�DISTRICT submittal of Building Permit application. 7t S c-ERVIMONMAMENTAI BldgApp_201 1.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR— BUILDING DIVISION ADDRESS: 974 CANDLEWOOD DR DATE: 08/13/2014 REVIEWED BY: MELISSA APN: 369 19 015 BP#: *VALUATION: 1$1,815 xPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1 GENRE WORK �REPLACE 3 E WINDOWS LIKE FOR LIKE ALL WINDOWS WILL MEET EGRESS & BE SCOPE ERMPERED WHERE REQ'RD BY CODE) -�NOz' b t�• Ih ,w_ s � $�` � .�� ;lCtT4 Ct7£;{'b" a Icc, Man _aY1'C43 arar;t Fee: Odwr I'luinh 7rt:,tr. Li h3,,p, Fccc: Pha ibr /,�s3. Fees- Iy sp,I s : NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l in o. FEE ITEMS (&e Resolution 11-053 E . 711/13,1 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 0 # Window/Sliding Glass Door Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 $431.00 1WINREP Replacement J PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 es,;tt'YjtTltgai"c:�tts'?�'€?[:: Work Without Permit? 0 Yes No $0.00 E) Advanced Plannin 7�,Fee: $0.00 Select a Non-Residential Tr^ l I)r c t r czntratir rt Fees: Building or Structure i Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldy,Stds Commission.Fee: IBCBSC $1.00 U.r $1.50 $431.001 OTA TL,FEE: $432.50 Revised: 07/10/2014 l�9Xtii �X`�I N� �4 .17 CUPERTINO P=Lr Bonding Department CHE BY '-J F1 BATE � COMMUNITY DEVELOPMENT DEPARTMENT �� \11 �>`:' '! 'F-'--1R GODE COMPLIANCE PLANG EPT. BUILDING DIVISION-CUPERTINO Reviewed By: AP SROVL._® DATE This set of plans and specifications MUST be kept at the Job site during construction. It is unlawful to make any all DEPT. chances or alterations on same,or to deviate therefrom,without approval from the Building Official The stamping of this plan and ^ifications SHALL NOT (^b0© 0 be held to perm' 5M approval of the violation Z O of a mance or State Law. P � l�j7 C � DATE W/M)O w PERMIT NO. e U 8OU AUG 13 2014 BY