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14090087 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21622 COLUMBUS AVE CONTRACTOR:THD AT-HOME PERMIT NO: 14090087 SERVICES,INC. OWNER'S NAME: REZAI-FAKHR M G ET AL 2690 CUMBERLAND PKWY STE 300 DATE ISSUED:09/15/2014 OWNER'S PHONE: 4082578684 ATLANTA,GA 30339-3913 PHONE NO:(510)731-1004 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL E] COMMERCIALE] REPLACE 11 (E)WINDOWS WITH(N),LIKE FOR LIKE. License Class 6--l ) Lic.# J��/2� WILL MEET EGRESS&BE TEMPERED WHERE �ff / REQUIRED BY Contractor7(�fD/f9 /'(cWC 5,�//cam DateS CODE I hereby affirm that I am licensed under the provisions of Chapte 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 erformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$13101 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:35618051 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 relatingkl� WITHIN 180 DA IT 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 save80 DA MLA ED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in cone ce of the Dae. granting of this permit. Additionally,the applicant and s and will comply with all non-point source regulations per the C no Municipal Code,Section 918. O RE-ROOFS: Signature Date ! �S 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. ❑ NER- LDER DECLARATION ' Signature of Applicant: Date: I hereby affir at 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. 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,Sections 25505,25533,and 25534�A­Date- Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: 4// 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 CONST N 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 Lll� COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O 10300TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•building(@.cupertino.org CUIPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS t& 71 j 3v /� ,! APN# �j�/ OWNER NAME/ [`eq 15-Z� /�Ep'T�.Z5- gol'?f (� E-MAILo JJ STREET DDRESS l• CI Y, TE,ZIP FAX 2-t �22 �CDwI t)5I �7r.,C7 CONTACT NAME JEFF RAINEY PHONE 510-427-4260 E-MAILJEFFREY.RAINEYQATT.NET STREET ADDRESS 1069 EDGEMERE LANE CITY,STATE,ZIP HAYWARD, CA 94545 FAX 510-783-1041 11OWNER 11OWNER-BUILDER13 `OWNER AGENT ❑ CONTRACTOR 1 CONTRACTOR AGENT ❑ ARyCHIHITECTT,E 11 ENGINEER 1:1 DEVELOPER 11 TENANT CONTRACTOR NAME LICENSE NUMBER 836021 '*,EC.S9 ft 3,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 1.J nSG r I�J-7 ' l�-5 ^ ��to 4) S _ QF ^tel/ EXISTING USE PROPOSED USE CONSTR.TYPE I #STORIES ��C USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODELAREA REMODELAREA REMODELAREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA I GARAGE AREA: DETACH ❑ATTACH #DWELLING UMTS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? []NO ADDITION? []NO PRE-APPLICATION ❑YES IFYES,PROVEDE COPY OF IS THE BLDG AN ❑YES Il CEl'11'E T TAL VALUATION: PLANNING APPL# []NO PLANNING APPROVAL LETTER EICHLER HOME? ❑N - / + By my signature below,I certify to each of the following: I am the property owner or au 'zed a owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of and vers it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I esen ' of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: I 1 SUPPL AL'INFORMATION " ROUTING SLIP _New SFD or Multifamily dwellings: A y for Rion permit for © O R THE COIINTEk ❑ BUILDING PLAN REVIEW existing building(s). Demolition permit' re prior to issuance of building emit for new building. P g• � EXPRESS ❑ PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. f LA);LG ❑ FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. Q MAJOR El SANITARY SEWER DISTRICT .EPSMQN:MENTAL:HEALTH... B1dgApp_2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 21622 COLUMBUS AVE DATE: 09/15/2014 REVIEWED BY: MELISSA APN: 356 18 051 BP#: *VALUATION: 1$13,101 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Du lex PENTAMATION 1GENRES USE: p PERMIT TYPE: WORK REPLACE 11 E WINDOWS WITH N LIKE FOR LIKE. WILL MEET EGRESS & BE TEMPERED SCOPE WHERE REQUIRED BY CODE ry llccJr, TIG,, {�I;t«k 11111ttb.11kin Cheek Alec.t''i«fa Check lle:;t.Pz?iuit i ee: Ph4mb.Permit Fee: T ':e Pa°rrrazt f°t-E t:)rlrcr lcc b, Trr,vrr Other Numb Iran. ED tither L u'c.Insp, {'Itsntb, hasp. Fee; 1 tecifs i'�cz; NOTE.This estimate does not include fees due to other Departments(i.e.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./or addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Window/Sliding Glass Door Suppl. PC Fee: Q Reg. ® OT 0.0 hrs $0.00 $574.00 IWINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. ® OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 -tion 0 Work Without Permit? ®Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential E) Travel1)r>cz,+tzntrxdirtrr Fees., Building or Structure � i Strong Motion Fee: IBSEISMICR $1.70 Select an Administrative Item Bldg Stds Commission Fee:' IBCBSC $1.00 $2.70 $574.00 TOTAL FEE:' $576.70 Revised: 08/20/2014 LEGEND' SCOPE OF WORK:INSTALL(11)RETROFIT VINYL&VINYL, z ® = RETROFIT WINDOW/PATIO DOOR LOCATION DUAL GLAZED,LOW E WINDOWS&(2)PATIO DOORS.NO(N) CONSTRUCTION,FRAMES WILL NOT BE DISTURBED. In) = 1 PANEL HORIZONTAL SLIDERLO ti NOTE;WINDOWS/PATIO DOORS; C/) rn BEDROOM U-FACTOR=0.30 v p Q PATIO DOOR SHGC =0.25 U U 95"w x 80"h z BEDROOM Lu BATHROOM PATIO DOOR Q 95"w x 80"h O= J COMMUNi f n-244 OPMENT DEPARTMENT WINDOW(XO) BEDROOMBUILDING DI iS1uN-CUPERTINO BATHROOM „� � 35"w x 23"h WINDOW(XO) ¢BATHROOMN c¢i� A4 P"R 0 L� 35"w x 23"h BATHROOM Cn(TEMPERED) This ,t of plans and specifications MUST be kept at the BEDROOM BASEMENT tc during construction. It is unlawful to make any WINDOW(XO) BEDROOM WINDOW(XO) hanras or alto;ations on same,or to deviate 47"w x 47"h (2)BEDROOM 32"w x 17"h t1. rom,without approval from the Building Official. XO BASEMENT WINDOWS (XO) BASEMENT o '° 71"w x 47"h/ROUGH OPENING N = i^roping of this plan and specifications SHALL NOT 23.2 sq ft.ROUGH OPENING WINDOW(XO) �d to permit o apor al of the violation 33"w x 43"h/NET CLEAR 32"w x 17"h o y pr ns of an a or State Law. DINING ROOM DINING ROOM m r>8 BEDROOM 9.9 sq ft.NET CLEAR _ . WINDOW(XO) A BEDROOM ENTRY WINDOW(XO) > 71"w x 40"h LIVING ROOM 71"w x 47"h O WINDOW(XO) PE T NO. 71"w x 47"h LIVING ROOM GARAGE LU LO WINDOW(XO) ¢ rn 35"wx47"h a �- --- - CUPERTINO ca :2 F 4 Suildina Department (FRONT YARD) W O O I COLOMBUS AVENUE RECEIVED ¢ o .� = U LU LU ,I A FLOOR PLANSEP 15 2014 � = PEl11 1( ED F.O€�CODE: COMPLIANCE `UJ TU IME: cv L�evlewea ey I-SMOKE DETECTORS:WHEN A BUILDING PERMIT IS REQUIRED,SMOKE DETECTORS SHALL BE INSTALLED;(a)IN EACH SLEEPING ROOM,(b)OUTSIDE EACH SEPARATE SLEEPING AREA IVITtE IMMEDIATE VICINITY OF THE BAh 09.06.14 RDROOMS,(c)ON EACH ADDITIONAL STORY OF THE DWELLING,INCLUDING BASEMENTS AND HABITABLE ATTICS BUT NOT INCLUDING CRAWL SPACES AND UNINHABITABLE ATTICS.(CRC 31 SME NTS 2-CARBON MONOXIDE ALARMS:WHERE A PERMIT IS REQUIRED FOR ALTERATIONS,REPAIRS OR ADDITIONS EXCEEDING$1,000.00,EXISTING DWELLINGS OR SLEEPING UNITS THAT HAVE ATTACHED GARAGES OR FUEL BURNING BBAWNBY DKw APPLIANCES SHALL BE PROVIDED WITH A CARBON MONOXIDE ALARM IN THE FOLLOWING LOCATIONS;(a)OUTSIDE OF EACH SEPARATE DWELLING UNIT SLEEPING AREA IN THE IMMEDIATE VICINITY OF THE BEDROOM(S),(b)ON FIERY LEVEL OF A DWELLING UNIT INCLUDING BASEMENTS.(CBC 420.4,CRC R315). 5 ICE COPY 00ME OWNER TO PROVIDE BEFORE FINAL INSPECTION). 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