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15060171 (2)I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 20590 SHADY OAK LN CONTRACTOR: Y/1`1 pc A?/ 114- PERMIT NO: 15060171 I OWNER'S NAME: CHONG FAY JR AND EDIE S la Iji -) L1_ _.. , _ _, t-2!:p I DATE ISSUED: 06/25/2015 1 OWNER'S PHONE: 4083139026 1 , 0034� : Gr I PHONE NO.,,7d ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. # 1--t / _? 7 / Contractor 2Q9 14 M Date `_ -�_ 4 10 tO I3` 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. 1 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. 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 permit is issued. APPLICANT CERTIFICATION 1 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 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 comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date t � tv(r ❑ OWNER- BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 1 hereby affirm under penalty of perjury one of the following three 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. 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 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 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 comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL REMOVE AND REPLACE (4) WINDOWS. Sq. Ft Floor Area: I Valuation: $3000 APN Number: 32344037.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by:. ��9N /ff�G -/ Date: 6 ' C�' /,5 RE- ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: Date:Zi� ✓� C CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional I, Z-4 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPER.TINO, CA 95014 -3255 (408) 777 - 3228• FAX (408) 777 -3333 • building(a-)cupertino.org /JaO/ 71 ❑ NEW CONSTRUCTION ❑ ADDITION tl—ALTER.ATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECf ADDRESS ' ^J APN # ! j—/ 1/ - 3 7 —39 OWNER NAME ` / PHONE „( E -M-AIL STREET ADDRESS CITY SIXIE, � �© G FAX CONTACT NAME PHONE E -MAIL STREET ADDRESS CITY, STATE, ZIP FAX OWNER ❑ OWNER - BUILDER ❑ OWNER AGENT NTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ^ LIC SE NUMB 7 ,I LICENSE TYPE^ BUS. LIC # COMPANY NAME E -MAIL C L H C FAX C ) STREET ADDRESS CITY, S ATE, ZIP _ JI C ME ARCHITECT/ENGINEER NAME LICENSE NUMBER ( BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK ft It 1, w t 4 (,✓ ) r) .f EhTSTING USE PROPOSED USE CONSTR. TYPE # STORIES 1 USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR- DEMO TOTAL AREA AREA AREA NET AREA BATHROOM. KITCHEN. OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH # DW ELLING UNITS: IS A SECOND UNrr ❑ YES SECOND STORY [-]YES BEING ADDED? NO ADDITION? ONO PRE - APPLICATION ❑YES IF YES; PROVIDE COPY OF PLAAIl7NG APPL # ❑ NO PLANT II'G APPROVAL LETTER IS THE BLDG AN ❑YES EICHLER HOME? ❑ 1'0 =RECEIV Y TO VALUATION: VALUATION' ^ By my Signature below, I certify to each of the folloNving: I am the property owner or authorized agent to act on the property owmer's 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 relating to building struction. I author' resentatives of Cupertino to enter the above - identified property for inspection purposes. Signature of Applicant/Agent: Date: ,) -�41 F ✓mil' <O l SUPPLEMENTAL TION RE UI D Q "�� � �_PLA% CHECKIPEtOj��G,,SlIP s MIN f-, ovER°I� e °ilmza sum GPI New SFD or Multifamily d-o ellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building P ermit for new building. QEXPBE's- a Aq� YLAI\ RELIES Commercial Bldss: Provide a completed Hazardous Materials Disclosure a srAnDAxD PuBLicv4oRLS _ form if any Hazardous Materials are being used as part of this project. s L4RGE - IIREDEPT� t r Copy of Planning Approval Letter or Meeting with Planning prior to MaoR submittal of Building Permit application. SANITARY SEGFI R DIST RIOT _- _ _ ;�:1] .EI+'VSROI�'IvIEI�T4L— AEALTH .� -. B1dgApp_2011.doc revised 06/21/11 FM_7 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION La.' ADDRESS: 20590 SHADY OAK LN DATE: 06/25/2015 REVIEWED BY: SEAN F, Permit Fc� APN: BP #: SV &v `VALUATION: $3,000 xPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: Plttnrh. hesp. Fe" PENTAMATION 1 GENRES I PERMIT TYPE: WORK REMOVE AND REPLACE 4 WINDOWS. SCOPE NOTE: This estimate does not include fees due to other Departments (i.e. 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'1 info. FEE ITEMS (Fee Resolution 11 -053 E .� 7/1,'13) ,lfech. Plan ('heck Phuwh. Plan Check Elec..Plan Check F, Permit Fc� Plumb. Per-mil 1�1"" i ;, Other A/ech. Insp. Other Plumb Insp. Other Elec. Insp. Li ;Vlech. Insp. Fee: Plttnrh. hesp. Fe" Oee. Insp. 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 fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 11 -053 E .� 7/1,'13) FEE QTY /FEE MISC ITEMS Plan Check Fee: $0.00 = # $431.00 Window / Sliding Glass Door 1 WINREP Replacement Suppl. PC Fee: 0 Reg. © OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-.E) Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administrative Fee: Q E) Work Without Permit? O Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure 0 O I Tt Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldp- Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $431.00 TOTAL FEE: 1 $432.50 Revised: 05/07/2015 .&W - RECEI V E JUN 2 4 2015 ZC) S� Y: SNAKY oA►-. JsT F�� o rc, I�6 000",-, �U D-1 t) I P 6 I3 toiN K C COMMUNITY DEVELOPMENT DE BUILDING DIVISION - CUPE TINO APPROVED This set of plans and specifications MUST a kept at the job site during construction. It is unlawful changes or aft o make any z d Lev erations on same, or o deviate PLOT PLAN therefrom, without approval from the Buif ing Official. SHE The Stamping of this plan and specifications HALL NOT be held to permit or to be an approve! of t e lation DATE of any pro isions of any City On' -� ? - -, PLANNING DEI BY r State w. DATE PERMIT # '-�_ `OFFICE COPY Uf��iDov✓ G S-L L��6 Door,- 33 Sr ��f zo S SHAaV ofail Z fJ o FLoo(- 4, G� 9 J 1? G Al\ A STP,-z 13 E172aa M UAN POW zos- C� 0 SADY oA K `' 00 AN ZoSSo SNA DY oAl�- OLD zoo N. VJ � Do w,� CW6L LoW01 `t BIZ, W- �.Noow 9,7 C- i I IAN G�- UD \Pi Qf-L q // 13R / �-vtN pad June 24, 2015 Fay Chong 10019 Oakleaf Place Cupertino, CA 95014 Re: Cupertino Countrywood Homeowners Association 20590 Shady Oak Lane, Cupertino, CA 95014 Dear Mr. Chong: The Cupertino Countrywood Homeowners Association has approved your architectural request to install dual pane windows and sliding doors with white vinyl trim at 20590 Shady Oak Lane, subject to: 1. The installation being performed by a licensed contractor. 2. Any necessary City of Cupertino permits being obtained. 3. Any damage or maintenance resulting from the window installation being your responsibility to repair. 4. The white vinyl window trim not exceeding a half -inch more than the existing aluminum trim. 5. No grids being installed on the windows. 6. The glass being clear and untinted. (No reflective coating is permitted. Low E is allowed as long as it is not reflective.) 7. The windows being recessed like the existing windows and the wood trim re- installed to maintain the exterior building appearance. 8. Any touch up painting being completed to match the existing colors. 9. It is our understanding that the upstairs bedroom windowsills must be lowered approximately 3 inches to meet fire code egress requirements, thus requiring construction grade windows to be installed in the upstairs bedroom windows. You should check with your contractor and the City of Cupertino to verify. Thank you for submitting your architectural request to the Association. It is suggested that you keep this letter with your other important real estate documents. Sincerely, Community Management Services, Inc. Bob Soares, Senior Association Manager Cupertino Countrywood Homeowners Association cc: Board of Directors