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15080229CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 23010 CRICKET HILL RD CONTRACTOR: SGK HOME SOLUTIONS, PERMIT NO: 15080229 INC. OWNER'S NAME: MANIKOWSKI CATHERINE TRUSTEE 3801 CHARTER PARK CT STE B DATE ISSUED: 08/31/2015 OWNER'S PHONE: 4082571857 SAN JOSE, CA 95136 PHONE NO: (408) 264-6964 ICENSED -CONTRACTOR'S DECLARATIO JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ INSTALL 1 (1) WINDOW & (13) RETRO WINDOWS AND 1 License Class Lic. 4 6 (1) SLIDER DOOR / Contractor oY/Date I hereby affirm that I am lice sed under the provisions of Chapter 9 (commencing with Section 70 ) 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 Sq. Ft Floor Area: Valuation: $13220 of the work for which this permit is issued. jerformance 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: 34241001.00 Occupancy "I . pe: 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 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 D S FROM LAST CALLEDINSP CT ON. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the 5 /' c �7� Issued by: �"t"� Date: 3 granting of this pe it. Additionally, the applicant understands and will comply with all non- i s rce ations per the Cupertino Municipal ode, S tion 9.18. 5 RE-ROOFS: Signature Da ✓ / 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. 1 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. I have and will maintain Worker's Compensation Insurance, as provided for by will maintain compliance with the C perti Municipal Code, Chapter 9. and the Health & Safety Code, Sect 25 , 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent- Dat permit is issued.7 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 9.18. Signature Date CUPERTINO CONSTRUCTION PERMIT APPLICATION 1W810`J COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building aacugertino.org n N1FW C ONSTRI IC:TION n ADDMON n ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS .� APN OWNER NAME E-MAIL STREET ADDRESS D �e CITY S ATE, 1P . %` FAX CONTACT NAME j� - PHO / %� T �j �j E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT NTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME CENSE NUMBE PAA LICENSE UAE /+ ` /7 BUS. LIC # COMPANY NAMES E-MAIL FAX STREET ADDR. '•v�s'"A'�lL� / PHONE ©� ARCHITECT/ENGFNEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE / DESCRIPTION OF WORKX�7 EXISTING USE PROPOSED USE CONSTR TYPE I # STORIES USE TYPE OCC SQ.F1'. VALUATION ($) 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 0 ATTACH # DWELLING UNITS: ISA SECOND UNIT ❑ YES SECOND STORY []YES BEING ADDED? []NO ADDITION? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YESEIVED B U TION: Vt��z PLANNING APPL # []NO PLANNING APPROVAL LEITER EICHLER HOME? ❑ NOZ W I r I By my signature below, I certify to each of the following: I am the property owner or autho ized agent to act on the property owner's behalf. I have read this application and the information Iihave ovided is co ect. I have read the Description of Work and verify it is accurate. I agre to comp with all applicable local ordinances and state laws retatin u' c uction. I authorize representatives of Cupertino to enter the above-identi d prope for ' purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL FtORMATI N REQUIRED PLAN CHECK TYPE ROUTING SLIP �/ [� OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW New SFD or Multifamily dwellings: Apply for demolition permit for issuance building fisting building(s). Demolition permit is required prior to of rmit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ElSTANDARD El PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE 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 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION 191 ADDRESS: 23010 Cricket Hill Rd. DATE: 08/31/2015 REVIEWED BY: PAUL Meek Perrrtit Fec. APN: 342 41 001 BP#: "`VALUATION: 1$13,220 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex Plumb. Insp. Fee: PENTAMATION 1GENRE USE: PME Plan Check: PERMIT TYPE: WORK Install 1 N window & 13 retro windows and 1 N Slider Door Permit Fee: SCOPE Suppl. Insp. Fee -.0 Reg. Q OT 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 preliminar in ormation available and are onlv an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13) 4ech. Plan Check urrtb. Ptah Check Dec. I'lan Check Meek Perrrtit Fec. I'lrrmh. l'- Elec. Pernfit Fee: �tl�er,9lech. In.�l.>.ET );lux Plumb Lisp.F-I 'their Elec. Insp. A?eh. Insp. Fee: Plumb. Insp. Fee: I'Jec. Insp. Fe(, 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 preliminar in ormation available and are onlv 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 14 # $574.00 Window / Sliding Glass Door I WINREP Replacement Suppl. PC Fee: (F) Reg. OT 0.0 firs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -.0 Reg. Q OT 0.0 firs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction I ax: finirrislrixtire Fec. Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) � ravel Documentation Fees: Strong Motion Fee: IBSEISMICR $1.72 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $2.72 $574.00 TOTAL FEE: $576.72 Revised: 07/02/2015 wk - DE ANZA OAKS HOMEOWNERS ASSOCIATION August 14, 2015 Suzanne Manikowski Lot 161, 23010 Cricket Hill Cupertino, CA 95014 Dear Suzanne, Regarding your recent Architectural Application dated August 10, 2015 (please see attached application and sketch drawing), I am pleased to inform you that the Architectural Committee has reviewed & approved your request. Sincerely yours, Jus Associ ion Manager RECEIVED AUG 31 2015 BY DE ANZA OAKS HOMEOWNERS ASSOCIATION C/O MAVERICKS REALTY MANAGEMENT 268 BUSH STREET, #4200, SAN FRANCISCO, CA 94104 (415) 691-7663 SGK Home Solutions - Permit Guide. 408-264-6964 / www.sgkhomesolutions.com Customer Name: Jurisdiction-. City Q aunty fiAddress: C_k <f (nz Are Permits Require Yes ❑ No Responsible party for obtaining permitGK ❑ Home Own (HO) If SGK, HO esponsible for all city fees. HO Initials SGK Permit Pulling. Fee: HO Initials HOA. Yes G .No If Yes., must be obtained before permits. HO initials HOA approva s ❑ No Floor. Plan is generally always required, there are exceptions. Pictures are required for select cities: Call Office Keep in mind rules and regulations are constantly changing, each city is different. New Title 24 Energy Package. All windows must meet the new standards of .32 LI-Factor and .25 SHGC SCOPE OF WOR # of Window: Retro N/C # of Doors: Retro N/C Material. Are we changing any sizes: ❑ Ye No If yes, please indicate original Size and new size on floor plan If changing sizes you will need Framing Details Office Does have Generic Framing details; which generally work. Are we changing any windows to doors: ❑ Yeo if yes, please indicate it on the floor plan Are we changing any doors to windows: ❑ Ye' No if yes, please indicate it on the floor plan Are we creating/adding any new openings, window or door: Cl Yes ❑ No If yes, please indicate on the floor plan if we are adding openings, depending on where you may need structural calculations and/or elevation drawings. Occassionally a city may require an architectural stampl Some zones within a city have special requi.rementsl Additional Comments: