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15030183 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20571 SUNRISE DR CONTRACTOR:JEMICO LLC DBA PERMIT NO:15030183 RENEWAL BY ANDERSEN OWNER'S NAME: BLANCO MANUEL AND DOROTHY M 30800 SANTANA ST DATE ISSUED:03/30/2015 OWNER'S PHONE: 4082526160 HAYWARD,CA 94544 PHONE NO:(510)263-3178 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL E] REPLACE 1 (E)SLIDING GLASS DOOR,LIKE FOR LIKE. License Class ("/7 Lic.# �6� (WILL MEET EGRESS&BE TEMPERED WHERE j REQUIRED BY Contractor Date CODE) I hereby affirm that I censed 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:$5005 have and will maintain Worker's Compensation Insurance,as provided for by ection 3700 of the Labor Code,for the performance of the work for which this APN Number:35910017.00 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 T 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 + ALLED 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 ed Date: O / 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. RE-ROOFS- Signature Date 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. ❑ 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,and 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 918. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildina�a cupertino.ora NEW CONSTRUCTION ❑ ADDITION ALTERATION!n ❑ REVISION I DEFERRED ORIGINAL PERMIT# PROTECT ADDRESS (j'I ,^ C APN Il 9 _ 1 0 _ 0 OwNERNAME �/l.h ,/' J PHONE EMAIL •� •,( STREET ADDRESS ,© 51 • �V, QTY,STATE,ZIP `a pL,A, y6* 1IL �U[✓�C�V[PCONTACrNAME/ R PHON � 23b�� a�GIV STREET ADDRESS CITY,STATE,ZIP fFAX CI OWNER ❑OWN,,,,FRBUB,DER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT 13 ARCHITECT 13 ENGINEER 13 DEVELOPER ❑TENANT CONTRACTORNA:" (4 A�Irtra'x� (CBNSENUMBER �j�.�I--�O/J LICENSETYPE l BUS.LIC N COMPANY NAME ,eLoa,\ E-MAIL FAX 7s A C— A LCb)U? STREET ADDRESS ,STATR,ZIP PHONE a �- A q . 17 ARCPBTECT/ENOINEERNAME LICENSENUMBER BUS.LIC 0 ' COMPANY NAME EMAIL FAX STREET ADDRESS CITY,STATE,ZIP ( /J PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE OONSTR TYPE STO U56 TYPE OCC. SQFT. VALUATION($) RX!STG NEW FLOOR DEMO TOTAL AREA AREA AREA NETAREA BATHROOM MCHEN OTHER REMODEL AREA REMODEL ARBA REMODEL AREA PORCH AREA I DECK AREA70TAL DECKlPORCH AREA GARAGE AREA: DETACH ❑ATTACH #DWELLING UPBTB IS A SECOND UNIT ❑YES SECOND STORY []YES BEING ADDED? ❑NO ADDITION? (:]No PR&APPLICATION El YES IF YES,PROVIDE COPY OF IS THE BLDG AN 13 YES RECEIVED BY: Fd1L VALUATION: PLANNING APPL q NO PLANNING APPROVAL LETTER EICHI.ERHOME4 NO S wv, f 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 comet. 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 co�nstru�ct`ion. ----------- uthorize representatives of Cupertino to enter the abov Itle 'fled p p for inspection purposes. Signature of Applicant/Agont: j•e3--� ,1"v ` `-- Date; © 15 SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROITFINGSLM New SFD or Multifamily dwellings: Apply for demolition permit for THE-COUNTER 13BDILDINGPLANItEVEEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 1:1STANDARD ❑ PUBLIC WORES Form if any Hazardous Materials are being used as part of this project, ❑ LARGE ❑-I=DEPr _Copy of Planning Approval Letter or Meeting with Planning prior to E-1 sANITARxsEwRRDrsTRICT submittal of Building Permit application. ❑ MA�oR ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 001/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 20571 SUNRISE DR DATE: 03/30/2015 REVIEWED BY: MELISSA 191 APN: 35910 017 BP#: *VALUATION: 1$5,005 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Repair PRIMARY SFD or Duplex PENTAMATION 1 GENRES USE: p PERMIT TYPE: WORK REPLACE 1 E SLIDING GLASS DOOR LIKE FOR LIKE. WILL MEET EGRESS & BE TEMPERED SCOPE WHERE REQUIRED BY CODE) ,t9ech. Plan Check Plumb. Plan Check Elec.Plan(:heck Meeh. Permit flee: Plumb.Permit Fee., Gle.c, Permit Fee: F 'Tech. Insp- Other Plumb Insp. Othe��L Cec.Insp. Lj Insp. Fee: Pluinb. Inst. Fee: L lec.Insp. Fee: 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 prelimina information available and are only an estimate. Contact the Dept for 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: (j) Reg. ® OT 0.0 fns $0.00 $431.0011 WINREP 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 Consiruction TOO: Administrative Fee: Work Without Permit? ® Yes (F) No $0.00 0 Advanced Planning Fee: $0.00 Select a Non-Residential 0 Building or Structure 0 TrUvel Docurnenlalion Fees: i Strong Motion Fee: IBSEISMICR $0.65 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 $1.65 $431.00FE-E 7 $432.65 Revised: 02/14/2015 Project name: Dorothy Blanco Backyard/Re,arSetback 40FT R�>rlewal Sul/) ( .� _ Andersen C e114?00 6%o x6/a 101 NLG D' �. f{fu� Rrir�r� J BAR 3 Npa'tment FT ® ZU�J S back 10FT ��� r� ` V, Q4 p C0 PLIANCE +U C \ Ca "� ��O\�a�y-\ru+O dJ�� G�.Z.p`fin:• �"J. �f G �5 �� �Q 0 K�TC~HEN )40( GARGAE `e�n�s TRne� �Gn � � ` F ti. AM �( G "/Front Setback 30FT 040 O :( Q v PIaOjP 1490KID ®'Y Scope of work: 1EA FULL FRAME PATIO_ DOOR LIKE FOR LIKE ' DATt WOOD SIDING ING EPT CUPERTINO