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15060171 (3)
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20590 SHADY OAK LN CONTRACTOR:Y/1`?pcA?/114- PERMIT NO: 15060171 Geri%: rimae—r-,i oISI OWNER'S NAME: CHONG FAY JR AND EDIE S t5l% 9 DATE ISSUED:06/25/2015 OWNER'S PHONE: 4083139026 TDAEr, C0,9PHONE NO-, .�p37 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL E] COMMERCIAL L, REMOVE AND REPLACE(4)WINDOWS. License Class Lic.# � / �-7/ Contractor .Q9 �4 A Date `_-�_4 K1 tO IJ- 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. Sq.Ft Floor Area: Valuation:$3000 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:32344037.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 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 DAYS FROM LAST 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 Issued b ��N F/G/� Date granting of this permit. Additionally,the applicant understands and will comply y:. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date v`Z 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 1 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) 1,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 1 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 Zi�✓ Owner or authorized agent: permit is issued. Date: 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPER.TINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•building(LD-cupertino.org /JaO/ 71 ❑NEW CONSTRUCTION EJ ADDITION TERATION/TI El REVISION/DEFERRED ORIGINAL!PERMIT# PROJECf ADDRESSC I ` `,1/\ ' ^J APN' -39 -3 j-/,/ - o 3 7 OWNERNAME ` / PHI. ( E-1.4-AIL STREET anDREss oa � � CITY, SIX? , � �© G FAx CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX 13 OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT NTRACTOR ❑CONTRACTORAGEN/T ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LIC SE NUMB 7,I LICENSE TYPE^ BUS.LIC# C� COMPANY NAME r j C ) E-MAIL C L H C FAX STREET ADDRESS �y- CITY,S ATE,ZIP _ C ME I J ARCHITECT/ENGINEER NAME LICENSE NUMBER ( BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK EhTSTING USE 'PROPOSED USE CONSTR TYPE #STORIES 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: ODETACH ❑ATTACH #DWELLINGUNTrS: IS A SECOND UNrr ❑YES SECOND STORY [-]YES BEING ADDED? NO ADDITION? ONO PRF-APPLICATION ❑YES IF YES;PROVIDE COPY OF IS THE BLDG AN ❑YES =RECEIV Y TOT?�> VALUATION' PLANNQING APPL# ❑NO PLAN1 I''G APPROVAL LETTER EICHLER HONIE? ❑NO � ^� � By my Signature below,I certify to each of the folloNving: 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 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: Z,) J4 ell', 11 m�z <O l SUPPLEMENTAL TION RE UI D Q f-, _PLAi�CHECKIPEtOjG,SlIP ' New SFD or Multifamily d-oellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building ovER�I�e°laza suty cI permit for new building. l? QEXPBE�- a Aq� YLAI\ItE�IES `ate`-'-�'"'- „v ,- - �. `� _•,__ . _ MES Commercial Bldsg: Provide a completed Hazardous Materials Disclosure s srAnDAxD PUBLicv4oRLs` yap_ form if any Hazardous Materials are being used as part of this project. L4RGE I!IREi") t r Copy of Planning Approval Letter or Meeting with Planning prior to MaaoR s x Y - SANTTARY SEGFI R DIST RIOT submittal of Building Permit application. BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 20590 SHADY OAK LN DATE: 06/25/2015 REVIEWED BY: SEAN APN: BP#: S- 6 `VALUATION: $3,000 xPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1 GENRES USE: PERMIT TYPE: WORK REMOVE AND REPLACE 4 WINDOWS. SCOPE ,l tech. Plan('heck 1'lruwh. 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: Phtnrh. hesp. Fe" Oee. Insp. Hee: NOTE: This estimate does not include fees due to other Departments(i.e. Planning,Public Works, Fire,Sanitary Sewer District,School District,etc. . Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS(Fee Resolution 11-053 E .� 711,'13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00F$431.001 # Window/Sliding Glass Door Suppl. PC Fee: 0 Reg. © OT 0.0 hrs $0.00 1 WIN]?-FP Replacement 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 Work Without Permit? O Yes (j) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential Tt'aa °t 1?nt't-t:rrc�ttlitlit�ri T` r� _ Building or Structure I Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldp-Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $431.00 TOTAL FEE: $432.50 Revised: 05/07/2015 BLit 0 tp6 0oor w�►�Dov✓ 3 3 RECEIVE JUN 2 4 2015 1c) Y: Yr J �T 0 D-1 ti z d JM � COMMUNITY DEVELOPMENT DE BUILDING DIVISION - CUPE TINO APPROVED Lvi N G This set of plans and specifications MUST a kept at the If f job site during construction. It is unlawful o make any changes or alterations on same, or to deviate PLOT PLAN therefrom, without approval from the Builing Official. 7B/The Stamping of this plan and specifications HALL NOT be held to permit or to be an approve! of t e lation DATEof any pro�isions of any Citv Orn' PLANNING DE BY-,.-���/✓__ -' State w. .DATE L' _ CUPERTINO PERMIT # I � � OFFICEY 17 ov1Z FLOO R- I 1 - Ci.�SE 4� 0 M�5 Eft �o ,�\ w d-, w G G � J � � ZG / l\ASTP,-z l3 ED R va x U �NPow C� JADY oAK c-1 00 70 ►1 VAAN pOVJ ZOE� 0 S HA DY oA 1�- 6 OED zoo N.S 70/1 CW6L LOYD, B (� Z �r W��.Nt7�w 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