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15040148 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 887 ALDERBROOK LN CONTRACTOR:JEMICO LLC DBA PERMIT NO: 15040148 RENEWAL BY ANDERSEN OWNER'S NAME: WILSON EVA F 30800 SANTANA ST DATE ISSUED:04/21/2015 OWNER'S PHONE: 4082536662 HAYWARD,CA 94544 PHONE NO:(510)263-3178 LICENSED CONTRACTOR'S DECLARATIONX JOB DESCRIPTION:RESIDENTIAL COMMERCIAL REPLACE 2(E)WINDOWS& 1 (E)SLIDING GLASS DOOR License Class( Lic.# (LIKE FOR LIKE) Contractor�4g,61 `RR 7 40-y�.D/ate 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:$10444 I 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:36920007 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 WIT�IIN 180 DAYS OF P SUANCE 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 F ST 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 granting of this permit. Additionally,the applicant understands and will co Da e: with all non-point source regulations per the Cupertino ►cipal Code,Section 9 18. 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 I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: 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 hazargous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality agement District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Munici ode,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sectio 505 553 nd 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 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 918. Signature Date v` V /1\ CONSTRUCTION PERMIT APPLICATION A COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•building aC7,cuDertino.org \ NEW CONSTRUCTIQid ///❑ N/ADDITION ALTERATIOn El REVISION/DEFERRED ORIGINAL PERMIT# PROTECT ADDRESS Q07-7 dtv (/00k, v.. 4N APN# '31 O -10 O OWNER NAME �, ; 1 PHONE q ti S 3 46 EMAIL . STREET ADDRESS 941 " ( (t Vwv CrrY,STATE,ZIP �v e� /A qA O FAX CONTACT NAME `�b� PHONE" I VZ.I� 3/ �� a E C�"j(�`Iu�1•�i A Celle W<cA 2 4:Z C v tq STRBETADDRESS, r /� CITY,STATE'JZIP /` J q�5-yy FAX ❑OWNER ❑oWN,rFABUILDER ❑ OWNER AGENT �CON7RACTOR ❑CONTRACTOR AGENT 13ARaarxcT 13 ENGINEER 13 DEVELOPER 10TENANT CONTRACTGRNA; `{ �nr�`x 10ENSEHUMe13ER (j /I LICENSETYPE i BUS.LICA NY t Co 1 f-b(`� 0( 2s� c M� l� @ FA"Cb)U• v ' - 7" STREET ADDRESS - Y,S7ATH,ZIP �~ PHONE -..na A q ARCHiTECUENGINEER NAME LICENSE NUM13U BUS.LIC N COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK (A�� �t./)h -9 -4 / EXISTING USE PROPOSED USE CONST&TYPE I AMRIES U56 TYPE OCC. SQFT. VALUATION($) F.XMTG NEW FLOOR DWO TOTAL AREA AREA AREA NETAREA BATHROOM IGTCHEN OTHER REMODELAREA REMODEL AREA REMODEL AREA PORCH AREA I DECK AREA TOTAL DECKRORCH AREA OARAOE AREA: InDEFAcH ❑ATTACH #DWELLINGUNM ISASECGNDUNrr ❑YES SECONDSTOAY ❑YES BEING ADDED? ❑NO ADDITION? [:]No PRE•AiPLiCATION ❑YEs IF YEs,PROVIDE COPY OF IS THE BIAG AN ❑YES TOTAL.VA U TIO 0 0 PLANNING APPL A ❑NO PLANNING APPROVAL LECIER EICHLERHOME? ❑NO By my signature below,I certify to each of the following: I am the prope owner or anthonzed ag on the property owner's behalf, I hhe 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 taws relatin bulTding construction. i authorize representatives of Cupertino to enter the above a '$ed r erty for inspection purposes. Signature of ApplicantlAgent:_ i/ Date; SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECRTYM R0VnNGSLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ ova THE-COWi TER ❑ EUILDINGPLAN REV1[ w 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 11 STANDARD ❑ PtreLWwORrss Form if any Hazardous Materials are being used as part of this project, ❑ LARGE ©-FIR DM _Copy of Planning Approval Letter or Meeting with Planning prior to MAdGR ❑ SAWARY SEWERDISTRICT submittal of Building Permit application. ❑ ENVTROP(MENTALHEALTH BldgApp 2011.doc revised 46/21111 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 887 ALDERBROOK LN DATE: 04/21/2015 REVIEWED BY: MELISSA APN: 369 20 007 BP#: "VALUATION: 1$10,444 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex PENTAMATION 1GENRES USE: I I PERMIT TYPE: WORK REPLACE 2 E WINDOWS & 1 E SLIDING GLASS DOOR LIKE FOR LIKE SCOPE ___ E _ w Mech. Plan Check Plumb.Plan Check Alec.flan Check Meeh. Permit Fee' Plumb. Permit Fee: Elea. Permit Fee: L tlecki. lnsp. [IF-t- Other Plumb InsP. (aiher lSlec.Insp, . Insp,Fee: Plumb.hasp. Fee: Insp. Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Theseees are based on the prelhiniina information available and are only an estimate. Contact the De t or addn7 info. FEE ITEMS (Fee Resolution 11-053 E . 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Window/Sliding Glass Door Suppl. PC Fee: (j) Reg. ® OT 0.0 hrs $0.00 $431.00 I WINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee-.0 Reg. ® OT 0,0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administrative Fee: Work Without Permit? ®Yes (E) No $0.00 0 Advanced Planning Fce: $0.00 Select a Non-Residential 0 Travel Doculnenlation Fees: Building or Structure i Strong Motion Fee: IBSEISMICR $1.36 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 r $2.36 $431.00 a E TOIL FEE $433.36 Revised: 04/01/2015 Project name: Wilson,Eva Renewal 887 Alderbrook byAndersen. Cupertino Backyard/Rear Setback WINDOW NE LAGEYEMT OFFICE 80X68 P/D_ 35X21 m ster I XO living bath bath 35X21 XO entry CUPERTINC Building n apartment APR 2 12015 a REVIEWED FOR CODE COMPLIANCE Reviewed By Street/Front Setback Setback Setback LOPNI-"HT DE FARTMi APPROVED jKED �`° �� � ,.T � � F. � „T �� ,, PLAT PLA This t of p!a„s a5d s e f colions us b0 I, ;tat t1,2 — job Siti L'ii l � cor'stru,^;-i �l. It is L myf, I � C� qy DATC ?i I. PLANNING m pir ol t,6, CUPERTINO �.. �. R&C �p1S Scope of work: e �r c.L r mod � ��