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15010075 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11425 CHARSAN LN CONTRACTOR:THD AT-HOME PERMIT NO: 15010075 SERVICES,INC OWNER'S NAME: ATLANTA,GA 30339-3913 PHONE NO:(510)731-1004 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL E] INSTALL(2)RETROFIT WINDOWS(TO MEET EGREES IN License Class 9!f �C 1 ,( Lic.# 3G©� ( BEDROOMS) TPA f r I / � ow c- 5fl1' j- Date 1 ( 1310 1 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 PeFformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$1436 fe and will maintain Worker's Compensation Insurance,as provided for by tion 3700 of the Labor Code,for the performance of the work for which this p rmit is issued. APN Number:36210060 00 Occupancy Type: 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 D 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 DAYS FR AST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in cone e of the granting of this permit. Additionally,the applicant underst and will comply Issued by: Date: with all non-point source regulations per the Cuperti unicipal Code,Section 9 18. RE-ROOFS: Signature Date L 3 r 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. ❑ OWNE DER 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 1,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 hazar s Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management ' trict I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,C ter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 2 3 Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: 3 S 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 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 DIVISION1 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 ! �� CUPeRTIN4 (408)777-3228•FAX(408)777-3333•building0cuaertino.ora 111 ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS /I Lf 2-3 Gff 5 A J �A.j L7 7AN# 06(,0 OWNER NAME ' ' E-MAIL STREET ADDRESS � ,t ��� � /' �i CI Y, TATE,ZIP FAX CONTACT NAME JEFF RAINEY PHONE 510-427-4260 E-MAILJEFFREY.RAINEY@ATT.NET STREET ADDRESS 1069 EDGEMERE LANE CITY,STATE,ZIP HAYWARD, CA 94545 FAX 510-783-1041 11 OWNER 11 OWNER-BUILDER 11 OWNER AGENT ❑ CONTRACTOR RJ CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# 836021 B,C39,C13,C17 COMPANYNAME THD AT HOME SERVICES E-MAIL FAX 510-783-1041 STREETADDRESS 2456 VERNA COURT CITY,STATE,ZIP SAN LEANDRO,CA 94577 PHONE510-785-6340 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK ( 11 NI / l''�+ J r O 51�i v /I1/,f�C�j.� -C - EXISTING EXISTING USE PROPOSED USE CONSTR.TYPE #STOR 7tli 0 USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NETAREA BATHROOM KITCHEN OTHER REMODELAREA REMODEL AREA REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA: DETACH []ATTACH ATTACH #DWELLING UNITS: IS A SECOND UNIT [:]YES SECOND STORY []YES BEING ADDED? [:]NO ADDITION? []NO PRE-APPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES -It$CEtV•ED'BY: TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO `� C� By my signature below,I certify to each of the following: I am the property owner or authorized agent to ac on the property o er's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and veri agree to comply with all applicable local ordinances and state laws relating to building construction. epresentatives of o to toenter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: I qII S SUPPL L INFORMATION D AN;CHECK TYPE xouT>rrc sl>P New SFD or Multifamily dwellings: Appl tion permit for ovER T>�-couNrEa ❑ �ILANNINI LAN REVIEW existing building(s). Demolition permit is re Ired pKiorissuance of building permit for new building. `'❑ EXPRESS , - PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ sTANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. El LARGE` ❑ FME DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑.,ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 11425 charsan In DATE: REVIEWED BY: APN: BP#: "VALUATION: 1$1,436 YPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1GENRE WORK install 2 retrofit windows to meet agrees in bedrooms SCOPE t�tetr f','r:�t diEciz 1111w1h. 111an C'hecf 1 ce.P 1�? nra Fee: Plumh. Permit Iw_ Chin t'F, . hts'p OtherP;umT7 lrs,�. E3 oiher i, e s?. hoc z. jn.p. r Ce, 111111b, 117sp. Fee NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc . These ees are based on the relimina information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS (Fee Resolution 11-053 LE 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Window/Sliding Glass Door Suppl. PC Fee: Reg. ® OT 0.0 hrs $0.00 $431.00 1 WINREP Replacement 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? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential E) Building or Structure 7t'`Jt'c'l I�}{TC'tfdl'lc:tZf;d(7<1F? Fees: � Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 y h _ $1.50 $431.00 ,a: TOTAL FEE: $432.50 Revised: 01/06/2015 FF_LEGEND- SCOPE OF WORK:INSTALL(2)RETROFIT VINYL,DUALFJ = RETROFIT WINDOW/PATIO DOOR LOCATION GLAZED,LOW E WINDOWS.NO(N)CONSTRUCTION,= 1 PANEL HORIZONTAL SLIDER FRAMES WILL NOT BE DISTURBED.= PICTURE WINDOW LO NOTE;WINDOWS/PATIO DOORS; U-FACTOR =0.30 v o OFFICE SHGC =0.25 U(-D Q WINDOW(XO) w o�z� 71"w x 4711h/ROUGH OPENING w o 23.2 sq ft.ROUGH OPENING OFFICE BEDROOM 1c)>z QDw 33"w x 43"h/NET CLEAR =,O J 9.9 Sq ft.NET CLEAR ;;I- BATHROOM BATHROOM BATHROOM �4 CUPERTINO KITCHEN ! Building Department WINDOW(PW) 34U:f,l;'�'DE` E.. N7 DEP,�.RTffENT LIVING�OfI 59"w x 59"h BU11, C Dr�rlSiOF CUPERTINO � ,�,� 1 3 2015 m5 KITCHEN A;PPRO ® _ t: This sc lit pi ns and specificd�i ns MUST be kept at the �YE WED FOR CODE COMPLIANCE t is unlawful to make any pp I ENTRY changes Q( fait i 6i itj Q; �Me, O; t4 dvji;:a eviewed By., �° • tr r �ftD T1, v�it r:i �r—Plll ....ii f Im the Build ;:g Gi;i; "a 1. w "t Ps �!',1 „ 11 V rK4 'r _J a i= j= v PLOT PLANS CHECKED BY _�_. /3./ _ ~. y. ¢ N w • FIRST STORY - ���-� � -- (FRONT YARD) DATE FLOOR PLAN CHARSAN LANE 2 � �/ m o C\' CL LU ` NOTE: ,— =) '— U n:-r. 1).SMOKE DETECTORS:WHEN A BUILDING PERMIT IS REQUIRED,SMOKE DETECTORS SHALL BE INSTALLED;(a)IN EACH SLEEPING ROOM,(b)OUTSIDE EACH SEPARATE SLEEPING AREA IN THE IMMEDIATE VICINITY OF THE DATE t.lw.'` �� .s,., Y.r ... `b BEDROOMS,(c)ON EACH ADDITIONAL STORY OF THE DWELLING,INCLUDING BASEMENTS AND HABITABLE ATTICS BUT NOT INCLUDING CRAWL SPACES AND UNINHABITABLE ATTICS.(CRC 314) 01.07.15 DAlE 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 OPAx"eY 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 NTS EVERY LEVEL OF A DWELLING UNIT INCLUDING BASEMENTS.(CBC 420.4,CRC R315). (HOME OWNER TO PROVIDE BEFORE FINAL INSPECTION). 7955901 SHEET A-1