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15050134 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11525 SUNSET SPRING CT CONTRACTOR:FIVE STAR WINDOWS PERMIT NO:15050134 OWNER'S NAME: HO YU-LAM AND YEN-PING L 1450 DELL AVE STE C DATE ISSUED:05/21/2015 OWNER'S PHONE: 4082539433 CAMPBELL,CA 95008 PHONE NO:(408)370-3331 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL E] COMMERCIAL ii REMOVE AND REPLACE(18)WINDOWS AND(1)SLIDING License Class 1 c�1 Lie.#��j'Q�2,,[R�� DOOR. Contract oy2rc1R `A�1�1(.ClilfJDate 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:$23400 AxZ--d 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:36652020 00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION c at 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 WITfIIN 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, ''��--��/ �1 �7 costs,and expenses which may accrue against said City in consequence of the Issued by: .e'L�CJL� r!� Date: � granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 918. /� RE-ROOFS: Signatu Date� ( 1 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 255 5,25533,and Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized age Date: t I J 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 1��013 � CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 GURERTINO (408)777-3228• FAX(408)777-3333•building acupertino.org ❑NEW CONSTRUCTION ❑ ADDITION TERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT;# PROJECT ADDRESS APN# 34: OWNER NAME PHONE go � E-MAIL STREET ADDRESS CITY STATE,ZIP FAX CONT CT NAME G. PHONE E-MAIL SIRE ADDRES L' ^ CITE,ST(r� " e�L� � FAX JW ��L qa,4 ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT XCONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGD.TEER ❑ DEVELOPER ❑TENANT CO CTOR NAM-Er LIC ENS ( S T BBA , rJ USS"L.ICC# E-MAIL1 N \ 1 G MAIL \ �l V V -70.' ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE EXISTING 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 DECKIPORCH AREA I GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNrr ❑YES SECOND STORY []YES BEING ADDED? ❑NO ADDITION? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES `REGEVED` TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? []NO 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 haveead this application and the information I have provided is c rrect. I have read the Desc'ption of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relati o ilding const tion. I authorize represe atives of Cupertino to enter the above-' entifi d property for inspection purposes. Signature of Applicant/Agent: Date: ^_ SUPPLEMENTAL INFORMATYON ErzE �ROiriII�GSLIP ze x; N'O New SFD or Multifamily dwellings: Apply for demolition permit for �� VERT existing building(s). Demolition permit is required prior to issuance of buiOUhTER43 € � U¢DINGPLAPTREVIEwlding �` g `l permit for new building. ® � s Pin19I�INGP%AivvlEw 04$ vnpw _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure AINDAT3D - � Cl uBLtc wouuc }; form if any Hazardous Materials are being used as part of this project. � � yYs _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. s- R � STLARY-MERERISTRr x` 4 MRO.NMEPITAT#IEALTHc-�'___�,__ BldgApp_201 1.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 11525 Sunset Spring Ct DATE: 05/21/2015 REVIEWED BY: Sean APN: BP#: "VALUATION: 1$23,400 OPERMITTYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY PENTAMATION 1 GENRES USE: SFD or Duplex PERMIT TYPE: WORK Remove and Replace 18 windows and 1 sliding door. SCOPE F777 x va 5; ri y 6LWA Ah,ch. flan(heck Pharrih.Ilan Check F Iec.Plain Check Mech. Permit Fee: Plumb. I'errnir here: Elec. Permit Fee t)rher Hech Insr. Other Plumb Insp. Oiher-Eiec.Insp. Li ;Irtech hasp.Fee: Plumb. Insp. Fee: L'lec.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 prelimina information available and are onl 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 F 19 # Window/Sliding Glass Door Suppl. PC Fee: (F) Reg. OOT 0.0hrs $0.00 $717.00 1 WINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee-.0 Reg. O OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction fax: Administrative Fee: Work Without Permit? ® Yes O No $0.00 O Advanced Planning Fee: $0.00 Select a Non-Residential O Building or Structure O Travel Documentation Fees: Strong Motion Fee: IBSEISMICR $3.04 Select an Administrative Item Bldy-Stds Commission Fee: 1BCBSC $1.00 .77,;77"'.3"' $4.04 $717.00 �,>f AL FEE:m'' $721.04 Revised: 05/07/2015 Yu- St \C>02x,25' MAY 21 2015 Cir c1p CA x ayR co a ��vi�� ' r,O'�AC�OL o S V-Puvk O Qv �•�. `�0 t'�- ,fit x X "p t n�n� X Q G COMMUNITY DEVELOPMENT DEPARTMENT QP BUILDING D!`,IlSio: j - CUPERTINO �� ti ,&, OL0S :e�. ot2x�lC�'> APPROVED - -- - ��t,�� -,,0 s t of plans ard specifications t,,1UST be kept at the abr si e during ccr, ;ruction. Itis unla.tif l to make any �n�� chM s or alterations on same, or to deviate S3X2�( therefrom,without approval from the Builth = iGj �� c� �� L k� Z _ The Stamping of this plan and specifications SHALL NOT t X13 be held to permit or to be an approval of the violation of any provisions of any City Ordinance r State Law. V BY G PERMI1 115 ri .� 'S rJ �t1AotMl �)0V-t, c. 53 OFFICECOPY i xdCT) FTHASTER _ o sq X 2� Xo st-1 � X'I b x 3SX sq