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15100048 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10261 PHAR LAI'UR CONTRACTOR:JEMICO LLC DBA PERMIT NO: 15100048 RENEWAL BY ANDERSEN OWNER'S NAME: REINHARDT PHYLLIS L TRUSTEE 30800 SANTANA ST DATE ISSUED: 10/06/2015 OWNER'S PHONE: 4084460346 HAYWARD,CA 94544 PHONE NO:(510)263-3178 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ ��pp IIREPLACE 2(E)WINDOWS ON SIDEYARD,MUST MEET License Class V V� Lic.# �(�� 70 �" PGRESS Contractor � 'Im CA �tC�' C3�te S�N&P 1 hereby affirm that 1 am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions Codc and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: Sq.Ft Floor Area: Valuation:$637 t. 1 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 %PN Number:32639048.00 Occupancy 7ypc performance of the work for which this permit is issued. 1 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. PERMIT EXPIRES IF WORK IS NOT STARTED APPLICANT CERTIFICATION WITHIN 180 DAYS OF PERMIT ISSUANCE OR I certify that 1 have read this application and state that the above information is 180 DS FROM LAST CALLED INSP TION. correct.I agree to comply with all city and county ordinances and state laws relating r to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save Issued by: Date: `O V u 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 RE-ROOFS: all non-point source egulabons er the Cupertino Municipal Code,Section 9.18. All roofs shall be inspected prior to any roofing material being installed.If a roof is Signature Date 101W< installed without first obtaining an inspection,1 agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that 1 am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER the following two reasons: t. 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 HAZARDOUS MATERIALS DISCLOSURE sale(Sec.7044,Business&Professions Code) 1 have read the hazardous materials requirements under Chapter 6.95 of the 2. 1,as owner of the property,am exclusively contracting with licensed contractors to California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain construct the project(Sec.7044,Business&Professions Code). compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Safety Code,Section 25532(a)should 1 store or handle hazardous material. I hereby affirm under penalty of perjury one of the following three declarations: Additionally,should I use equipment or devices which emit hazardous air t. 1 have and will maintain a Certificate of Consent to self-insure for Worker's contaminants as defined by the Bay Area Air Quality Management District I will Compensation,as provided for by Section 3700 of the Labor Code,for the maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the performance of the work for which this permit is issued. Health&Safety Code,Sections 25505,25533,and 25534. 2 1 have and will maintain Worker's Compensation Insurance,as provided for by O or r th rued er 1-1Section 3700 of the Labor Code,for the performance of the work for which this Date: r permit is issued. 3 I certify that in the performance of the work for which this permit is issued,I shall CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of work's become subject to the Worker's Compensation provisions of the Labor Code,I for which this permit is issued(Sec.3097,Civ C.) must forthwith comply with such provisions or this permit shall be deemed Lender's Name revoked. Lender's Address APPLICANT CERTIFICATION ARCHITECT'S DECLARATION I certify that I have read this application and state that the above information is I understand my plans shall be used as public records. 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 Licensed Professional 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 CONSTRUCTION PERMIT APPLICATION 15JV� • ,C COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION \ 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 CUPERTMO (408)777-3228• FAX(408)777-3333•buildino aDcupertino.oro ❑1,7EW CONSTRUCTION ❑ ADDITION It ALTERATION/TI ❑ REVISION/DEFE///R��RFD ORIGINAL PERI.4IT PROJECT ADDRESS n 26 I RW I�r APN 439(0`i'`(,1 C"'. OWNER NAME 111{ `C �/ � PHONE q o�,1 ;1 iw- 03q J IE-NAIL STREET ADDRESS �/��1{ I `^!, `I�r CITY, s ZI�I t`�1� J�� q✓ J FAX CONTACT NAME I V A OwS I PHONE��L �/ E-MAIL STREET ADDRESS O _ 'n f,a M S� C STATE �0 q I/(-I I FAX 13 OWNER ❑ 01VNER-BUD-AER ❑ MhWEERAGENTCONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DE\'ELOPER ❑ 7EN.41.T CONTRACTOR NAME i ��. LICENSE NUMBER Q-7-a 76), LICENSE TYPE f7// I-I BUS.LIC k COMPANY NAME r^ ) f/l dl �pytq�// GI I �� E-MAIL C7 l l FAX STREET ADDRESS ! ("u' l�(J `•�� CITY.STATE,ZIP SZ(l PHONE ARCHTTECT/ENGINEER NAME LICENSE NUMBER BUS.LIC d COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK ( 1 E)CISTING USE PROPOSED USE CONSTR TYPE 1 4 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 I DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH []ATTACH T D41'ELLING UNITS; IS A SECOND UNPr ❑YES SECOND STORY ❑YES BEING ADDED' []NO ADDPTION' []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES IJ Pt �-"' rt- TOyAL VcJJpT10N: I�Sf/ I PLANR.TNG.4PPLK ❑NO PLANNII.'G APPROVAL LETTER EICHLER HOME' ❑NO - � ��lBy my signature below,I certify to each of the following: I am the properly owner or authoriz d agentthe 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 t+ buildi construc' n. authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: l� Date: `0I� `� rX' .tom tea fi - a SUPPLEMENTAL! ORMATION REQUIRED s • } is PLA�.CHECKTI�E _ -� .RO_IJTII�GSLIP;� New SFD or Multifamily d%vellings: Apply for demolition permit for O�ERTH7tCOU!\iER BTTrTPPWL4NR existing building(s). Demolition permit is required prior to issuance of building r "f , r as � a '" s permit for new building. �� E REss z i' = r sr,TL`c�PA.REQ tE« 0, s _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure A .A-� sT 'DARD UB wo" t form if any Hazardous Materials are being used as part of this project. _ x 1L F 3 _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. L7�sni.TrbARYsERDISTRI a h .�F1' BIdgApp_2011.doc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10261 Phar Lap Dr. DATE: 10/06/2015 REVIEWED BY: PAUL APN: 326 39 048 BP#: 'VALUATION: 1$6,357 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1 GENRES USE: TPERMIT TYPE. WORK Re lace 2 E Windows on Side and Must Meet Egress SCOPE 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 preliminarl information available and are only an estimate. Contact the De t or adds 7 info. FEE ITEMS(Fee Resolution 11-053 1j/ _ I l3) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 2 # Window/Sliding Glass Door Suppl. PC Fee: Q Reg. 0 OT0.0 lirs $0.00 $431.00 IWINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. 0 OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 ('onshruclion Tus: Iclministrative Fee: 0 Work Without Permit? 0 Yes 0 No $0.00 0 Advanced Planning Fee: $0.00 Select a Non-Residential 0 /rave/ Building or Structure 0 Strong Motion Fee: IBSEISMICR $0.83 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.83 $431.00 TOTAL FEE: $432.83 Revised: 10/01/2015 RECEIVED Project name: 44_15_8134- REINHARDT, Phyllis Renewal 10261 Phar Lap Dr 0 6 2015 byNndersen. Cupertino,CA 95014 Mm Backyard/Rear Setback 22 .. .......,.. 102 Bedroom 2 C,J%IMUNITY DEVELOPMENT DEPAR N Setback BUILDING DIVISION - CUFERTIr Setback? 101 Bedroom 1 APPROVED This set of plans and specifications P,1UST to 1, the i-b site during c^n,truction. It is unla'.tiful to " any Garage changes or alte��Yns on same, or to ate herefrom, Bu: cial, ng of tn,s plan and specifications NOT LAT C, KED F'Y he held to permit or to be an approval of the violation ,f any prov , - any City qrdoinc or State Law. TE /G �/ BY � N - �" DATE PLANNING DEPT PERMIT #____ CUPERTINO Street/Front Setback 22 Floor I-Overfit,I-Ltrim, Current Current Exact Order Exact Order Room Description Pian Style NF=FFrame,or Handing Opening Opening 1E)# Stock Door Width Height Width Height Bedroom 101 GL-AP NF 703/4 40 703/8 395/8 Bedroom 102 GL-AP NF 703/4 40 703/8 395/8 1 — -i mom Scope of work: Replacing two windows lowering sill to be UBC compliant for egress OFFICE COPY Phyllis Reinhardt 10261 Phar Lap Dr. Cupertino,CA 95014 RE: Architectural Application The Oakdell Ranch Homeowners Association has deemed your application complete and approved your application as submitted. To replace 2 windows to remain the same style and size. RECEIVED OCT 06 2015 BY