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14100173 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22762 MAJESTIC OAK WAY CONTRACTOR:JEMICO LLC DBA PERMIT NO: 14100173 RENEWAL BY ANDERSEN OWNER'S NAME: HAYWARD,CA 94544 PHONE NO:(510)263-3178 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL REPLACE 2(E)WINDOWS& I (E)SLIDING GLASS DOOR, License Class Lic.# ?i7f SAME SIZE&LOCATIONS(WILL MEET EGRESS&BE {� �y s TEMPERED WHERE REQUIRED BY CODE) Contractor e/l e�✓Cpl Vel P -/Date `� l 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:$10846 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:34232118.00 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 10-DA-VS ERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to entery upon the above mentioned property for inspection.purposes. (We)agree to save S9� S CALLED 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 liss ate: e U A, _ granting of this permit. Additionally,the applicant uSdarstands and will comply with all non-point source regulations per the C mo Municipal Code,Section 9 18. RE-ROOFS: Signature Date � 7 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 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 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 Mu ' ipal C ,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code, 34. n / Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: ����1� r 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 I I e)(b I CONSTRUCTION PERMIT APPLICATION r11 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION V �J 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 �J CUPERTINO (408)777-3228•FAX(408)777-3333•building a4cupedino.org • \, NEW CONSTRUCTION ❑ ADDMON ALTERATION 1 TI ❑ REVISION 1 DEFERRED O�RIIGINAL PERMIT# PROJECT ADDRESS aaz�a 055 LZ APN# ? �Z ` 3 Z OWNER NAME /► _ ��� �✓� &MAIL STREET ADDRESS LTC S= ZIP Y PAX CONTACT NAME PHONE / 2 `� 2 `7 i� &MAD. CiU�lt.�5•�C-k 'Celli?W:4 q ( ,^Z ,ee'rl STREET ADDRESS 1 r 1 CITY,STATE,ZIP IU FAX ❑OWNER ❑OwNE•••RBUILDER 11owNERAGmT i Lco TRACTOR El CONTRACTOR AGENT ❑ ARCEMECT 11ENODJEBR 13 DEVELOPER 13 TENANT ,,,(��� CONTRACTOR NA:` �moA-A\4�n I 1C'NUMBER �j��']-�jO/I LICENSETYPE i BUS.LIC# COMPANY NAME x ieu-' A bi Anr,- E-AI FAX G\�l� • 7 SrRBET ADDRESS 1 Y,STATE,21P '� ^ L U�K PHONEv V tst ARCHrrECT ENOINBER NAME LICENSE NUMBER BUS.LIC 0 ' COMPANY NAME E-MAD. FAX STREET ADDRESS CITY.STATE,ZIP PHONE DESCRIPTION OF WORK GL. l EXISTING OSE PROPOSEDUSE CONSTR.T'YPE I #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTO NEW FLOOR Emo TOTAL. AREA AREA AREA NETAREA BATHROOM KITCHEN OTHER REMODELAREA REMODELAREA REMODEL AREA PORCH AREA I DECK AREA TOTAL DECKMORCH AREA I GARAGE AREA: DETACH ATTACH #DWELLWGUNITS ISASECONDUMT OYES SECONDSTORY ❑YES BEING ADDED? ❑NO ADDITION? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN 8 YES JjTOTAL VALUATION: PLANNINGAPPL# ONO PLANNING APPROVALLErTER ETCHLERHOME9 NO By my signature below,I certify to each of the following: [am the property owner*autho' gefitt act n t e property owners behalf I have read this 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 relatiny building ccoon_stru�ctiion. representatives 1 authorize of Cupertino to enter the above-identified property for inspection purposes. Signature of AppticanVAgent:_ `e3-�°� t/"`� Date: t --,1 SUPPLEMENTAL INFORMATION REQUIRED PLANCHRCHTYPIS ROUTINGSLE? _New SFD or Multifamily dwellings: Apply for demolition permit for © OVERTHE-COUNTER ❑ BIIIY.D Na PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building, ❑ Mims ❑ PLANNDNGPLANREVIEW _Commercial Bldgs Provide a completed hazardous Materials Disclosure 11STANDAPM ❑ PDBLIC WDREB form if any Hazardous Materials are being used as part of tris project, ❑ I A G]& ❑..FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. ❑ MAJOR SANITARY❑ ❑ ENVIROXRIENTAL MALTH BldgApp 2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION W'�:PERMIT DDRESS: 22762 MAJESTIC OAK WAY DATE: 10/28/2014 REVIEWED BY: MELISSA PN: 342 32 118 BP#: VALUATION: $10,846 PE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY PENTAMATION 1 GENRES USE: SFD or Duplex PERMIT TYPE: WORK REPLACE 2 E WINDOWS & 1 E SLIDING GLASS DOOR SAME SIZE & LOCATIONS WILL SCOPE MEET EGRESS & BE TEMPERED WHERE REQUIRED BY CODE) LI<<ar 1`,`s:art t li:t& Plrfrtrh. Pluta C'/1ec'P tiec.P<z '`?:,cck Lf>cl;. P_nnil Fee: Plumb. Pc"rmit Fke: t (,e Pe;��u Other Plump Frtsp. ED7-- We(,h,ings . F c I Plumb, Ins)). Tete: NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (lee Resolution 11-053 E f 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 L_Lj # Window/Sliding Glass Door Suppl. PC Fee: (D Reg. 0 OT0.0 hrs $0.00 $431.00 I WINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. ® OT ro.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential Building or Structure Strom Motion Fee: IBSEISMICR $1.41 Select an Administrative Item Bld,z Stds Commission Fee: IBCBSC $1.00 ( � K $2.41 $431.00 TOTAL FEE: $433.41 Revised: 08/20/2014 Prescriptive Certificate of Compliance; Fenestration CF-1 R-ALT-Fenestration Project Address: Climate Zone Permit# Enforcement Agency: Date: Building Type)?Single Family U Multi Family Circle the Front Orientation:N,E,S,W,or degrees Conditioned Floor Area(CFA): FENESTRATION PROPOSED AREAS )9 Replacing window alone-Replacement windows shall meet the U-Factor and SHGC value requirements of Component Package D in Table 151-C(see reverse side). The Total Fenestration and West-facing Area requirements are not applicable, ❑Adding 50fe or less ofwlndow area-Newly installed windows shall meet the U-Factor and SHGC Value requirements of Component Package D in Table 459-C(see reverse side). 0 Adding more than 50fe of window area- Newly installed windows shall meet the U-Faotor and SHGC Value and the Fenestration Area requirements of Component Package D in Table 451-C(see reverse side). Complete the Altered Fenestration Allowed Area Table on Page 2 of the CF-IR-ALT Orientation Fenestration Type and Frame (North,East, PropsedAreal Maximum maximum NFRC or Default ( IMe- -1-ma nnnror G hill South,West (ft) U-facto?'3 SHGC2.3,4 Value6 k49 Lcv -242 9. Fenestration area is the area of total glazed product(i.e.glass plus frame). Exception:When a door is less then 50%glass,the fenestration area may be the glass area plus a 7 inch frame"around the glass. 2. . Eater value from Component Package A Requirements in Table 151-C. 3. Actual fanestratlon products Installed and as Indicated in CF-6R ENV Foma shall be equivalent to or have a lower U-factor andlor a lower SHGC value than that Wooffled on the CF-1R ALT Form. 4. Submit a completed WS-3R Form if a reduced SHGC is cafoulated with exterior shading. 5. If @pp#cable at this sta a enter'NFRC°for NFRC Certified windows or are CEO'Defaulf values found in Table 11 S-A or B. ALTERED FENESTRATION ALLOWED AREAS(Complete if more than 50W of fenestration is added A B C D E F G Allowed Existing Fenestration Total Area CFA of Entire %of Fenestration Area Fenestration Allowed Proposed Area Dwelling CFA Area Removed Area Added A x B) (E-D)+C Total Fens ation Area �0 West Fenestration Area (Required in 0 5 > CZ's 2,4&7-15 1. West Fenestration Area includes west-sloping skylights and any skylights with a pitch less than 1:12. 2. West facing glazing area removed cannot be°counted"twice,"In order to distribute the west glazing area removed to the other orientations,input the west glazing area removed in the Total Fenestration Area row,column D. 3. Include the Proposed Area of the West facing fenestration in both Area columns above. 4. To meet compliance,the Proposed Area must be less than or equal to the Total Allowed Area for BOTH the Total and West Fenestration Areas. Declaration Statement • Ice"under penalty of perjury,under ttte laws of the State of California,the information provided on this form Is accurate and complete. it I certify that the energy features and performance specifications Identified on this Certificate of Compliance conform to the requirements of Title 24,Parts 1 and 8 of the Callfornla Rode of Re ulations. Name: Yew Signature: Company: a°iLL Date: Address: License; v. City/State2ip: 5 r l Phone:bU>-X,, ,3-3 t. For assistance or hitesdons regarding the Energy Standards,contact the Energy Hotline at: 1-800-772-3300. Project: Setback Address 22762 Majestic Oak Wy rhrs setY e ,c Cit Cupertino i b siloto S. ' �' . � � p �han �urir��, i 0 1 .` .. /�r/N� 'VT 9es be�,`St`'mf u)w �` 't`1 pns o� ,r Ce ked;,�`th �tiJrp S�?r ;.: �el t0 Pc �h�s�43� �� fir��� 1; fo dto ike nY 0,14 804417-# o &or S,,;te aivn P/D Setback �—SetbZi� master living bed 1 93X55 69X44 XOX entry X t �5 `)U--Setback Front/Street DATE pLANNtNG I?EpT, i Scope of work: `� �-✓�✓(Gt d4,) OFFICE COPY-----