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15110175CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21860 TERRACE DR CONTRACTOR: HERITAGE DOORS & PERMIT NO: 15110175 WINDOWS OWNER'S NAME: HAGHIGHI FARZAD AND VERONIQUE TRUST 262 HILLSDALE AVE DATE ISSUED: 11/24/2015 OWNER'S PHONE: SAN JOSE, CA 95136 PHONE NO: (408) 266-8306 1 s LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL ❑ REPLACE (9) WINDOWS WITH SAME SIZE ��.ggpp License Class Lic. 0 "LIKE-FOR-LIKE"; REPLACE (2) FIRST FLOOR WINDOWS Contractors \_. Date 14 �� TO SLIDING DOORS. _ 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: $8000 III have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 35625001.00 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which this 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 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 by: Date: \ granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section RE-ROOFS: 9.18. Signature's Date ii a2 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-BUH DER 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 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which thisiz.-91211-1-C Owner or authorized agen Date: 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 9.18. Signature Date CUPERTIND ❑ NEW CONSMUC CONSTRUCTION PERMIT APPLICA T ION COMMiiUNI IY DEVELOPh/iEN T DEPARTh4ENT - BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - blllldlno(aCUDef ino.OrC1 aJDI T ION II LJ RE"'IS!0N / DEFERRED i5IIU7� OZIGINA L PER-1va-1 PRO�f ADDES0 7 -356 _ as - DO I -� OWNER NAIL P O ^ _ !✓ kiZ STRE—El ADDRESS lerC, i Y, STA71 t, ZIP„ L FAX COTTACT N.4 A/.C4�� * N o S T RE:i ADDFz=SS CII Y, STAT -Z, ZIP I FAX El 01A!ReR ❑. ❑ VW `RAC NT COI\' i tikCTOR ❑ CO2TF tCTOR AGENT ❑ ARCT_i-iTECT ❑ --NM\7zBR ❑ D=1= -LOPE ❑ i_NE.NT CONTRACIORNAffq� ' � � I LIC=TSBTYUld? R I LiC-EN 5--- TY'rE BUS. LIC R qa ,2 CO]✓.PATv'Y NAh� F -N LW&I 6 STREET AD S // STATE, i n, Zi ioI ARC -U ECT/`NGL;ErRNA?✓E LICENSEXljbSERBUS. LIC R COIJ,PANYNAhc- I E-M.<IL rPX STREET A.DDRF-SS I CITY, STAT F: ZIP I PriOI DESCRIPTION OF WOPiC n EXIST -NIG USE PROPOSED L'S CONS -1R. TY -?-;z 4 STOR S USE TYPE OCC. SQ.FT. I VALUATION (S) EXL'TG 1,0N FLOOR DEMO TOTAS, AREA APEA ASA I \--7AFL'-A BA IRDOM KiTC-=- N I OT -=R R:1d0DEL A.RPA TPLEMODEL AREA REMODEL AR .k PORCH /LvA DSCK.AaBA TOTAL DB-CI;/?OR C -i A MA I G.=-4AGE ASA: Ll DETACH ❑ ATT.kCH 4 D11 ELLING u -I IIS: I IS A SECOND UNIT ❑ YZS SECOND STORY ❑Y =S BEING ADDED? ❑NO ADDITION? ❑NO PRE-A'PLICATION YES IF YZS, PRO i'IDE COPY OF IS TAE BLDG A -N -' - - ❑ ❑ �=S wC I\ -EDB .= _ _ TOTAL VALUATION: PLAN TNG APPL m ❑ NO PLA XTNG APPROVAL LTR EICHLER HOME? ❑ NO - ~f l rye T� By my signature below, I ter i y to each of the follo;ving: I am the proper] o;; ier or authorized went to act on th perty owner's behalf. I hive read this application and -the information -I -have provided is corect;z I have -read -the -Description of-Work-and:verijr itis actuate --I a-27ee-to-comply with zll applicab?e Ibdt:l- -- ordinances and state !a;us relating -,o bui!din const action. I authorize A reser,tativeS'of Cupertino to enter the above-ionzi t, for Inspection purposes. _Si-IatureofApplicant!Agent:.oC-y- ---_----.._------ _ SUPPLE_ fi_?NjT-AL I-NFOR 4A 1.ON R._,QU1RF-D ' �.= �•�= ..PS.A'� CEEC��'1�E.---�=Y '- _. _-�OL•IZ�G c _ New SFD or Muhifk-nilyd Apply .`or dennolition pe:Dlit or 1JLIl� ng(S). Demolition per-nift S _equ r prior to IsS r�AQ��RT COL�iT YTt BLTILDL�GPL Rt`3i T� eXIStiLg t I a I rA t = =d L1anCe Oi bL 16Ing permit for new building. Erss = @ PL 4C�LGFLa 4 _ z - _ Co.-nmercial Bldgs: Provide a completed Hazardous Materials Disclosure j? PE PLEIC P OnKSs �. �'_ fOITn if any HaZard011s Materials are being used as part of :his project. • � ! I. ,URGE .-� 4.:. ]sx-7'i,EDr�� _ � � . Copy of Planning Approval Leiter or Meeting with Planning pIior t0 Sub Ittal of Building Permit application.T L470R , �ZTz�YS�li; niDItzTFtIG�e _ t � Bldg �a _?OIl,aoc revised 06121/11 CITY OF CUPERTINO WPMa ��M FFF FCTTMATnR — RITILDING DIVISION ADDRESS: 21860 Terrace Dr FEE DATE: 11/24/2015 REVIEWED BY: Phuong APN: 356 25 001 BP#: *VALUATION: 1$8,000 *PERMIT TYPE: Building Permit Window / Sliding Glass Door 1 WINREP Replacement PLAN CHECK TYPE: Alteration / Repair PRIMARY USE: SFD or- Duplex 1 0.0 hrs PENTAMATION PERMIT TYPE: 1 GENRE i WORK Replace 9 windows with same size "like -for -like"; Replace 2 first floor windows to sliding doors. SCOPE :�f£'C'i1. f'1!ar1 i'Y:�C1C Ffec,h;. perrz;f Fee: i 1her Afech. Insp. El Avfec;h. Irish. Fie: 11help1b. Per;731f 1'S0: 11viiib. I?m A 1,Yec. Plan Che",!; ()"her Insp, NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Lire, , anitary Fewer District, School District, etc.). These_fees are based on the prelimina� information available and are only an estimate Contact the Uept_Jor adun'[ tnJo. FEE ITEMS (Fee .Resolution .1.1-053 F,ff. 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 11 # $574.00 Window / Sliding Glass Door 1 WINREP Replacement Suppl. PC Fee: (D Reg. 0 OT 1 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. Q OT0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (".'onsit'tdf..'n'OH JC A": .ri(Iminivrt"Jtive Fee: 0 Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 i I7,ave1 Strong Motion Fee: IBSEISMICR $1.04 Select an Administrative Item Bldg_Stds Commission Fee: IBCBSC $1.00 su$TOTALS $2.04 $574.00 TOTAL FEE. $576.04 Revised: 10/01/2015 UUPERTINO Building Department ME NOV 2 4 2015 PLOT P N ECKED BY REVIEWED FOR CODE COMPLIANCE DATE �[,,— VERONICUE HRZWe /ed By: PLANNING DEPT 21860 TERRACE DR. CUPERTINO, CA 95014 .gyp 9WINDOWS REPLACEMENT LIKE FOR LIKEt54V It SiLL� (� p CUPERTINO 2 LIVING ROOM WINDOW REPLACEMENT WITH DOOR (SAME WIDTH) FIRST F ALL CODES JV �eO13 wCAB�v'� Pi 40 U" op% 17 F ata GARAGE 6'x6'8" (XO) 6'x6'8" (XO) COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION - CUP ERTINO ENTRY APPROVED LAUNDRY V LIVING ROOM This set of plans and specifications MUST be kept at the A x job site during construction. It is unlawful to make any X changes or alterations on same, or to deviate therefrom, without approval from the Building Official. SHALL NOT RECEIVED The Stamping of th;s plan and specifications be held to permit or to be an approval of the violation ' Ordinance or State Law. ^ `s BY, DATE PERMIT # BY SECOND F VERONICUE HAGHIGHI 21860 TERRACE DR. CUPERTINOINO, CA 95014 9 WINDOWS REPLACEMENT LIKE FOR LIKE (SeAM-e 2 LIVING ROOM WINDOW REPLACEMENT WITH DOOR (SAME WID ) ALL 2013 CA BLDG CODES APPLY 6'x6'(CS/CS) 6'x6'(CS/CS) : Building Department P�QU 2 4 2015 DINING ROOM BEDROOM 1 REVIEZI FOR CODE COMPLI NCE wed By; KITCHEN i? x W BEDROOM 2 ° BEDROOM 3 x 0 MASTER x x N A x BATH m MASTER BEDROOM CUPERTINO SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(c.cupertino.org Address 2 I �1 b PURPOSE /s/ /ell ?S PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN fit NEED AND RLEUR TO THE BUILDING DIVISION This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required iii dwellings which do not contain fuel -burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. 1 have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agenft) Name: VErL0N1 q,e bh'6 1' / Si nature..f/.................. .. ......:...... ...................Date: ..:16.... Contractor Name: Sinature........................................................ ... .... ic.#...................................... Date: ................... Smoke and CO form.doc revised 03/18/14 /e f_ CUPERTINO Owner Name WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 Address 21 "0 it No. / ��/ b / -7 s Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. '-No Go to Question 2. 2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its plumbing, installation of water -conserving plumbing fixtures is not technically feasible? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Skip the rest of the forn and sign bottom of form. 4 -No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. iA?-No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ No My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. Please check ONE of the following: ;v1y property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non- compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ My property is a multifamily residential real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water - conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or irnprovernents). ❑ My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). I, as the owner or owner's agent of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 110 1.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and that the water -conserving plumbing fixtures comply with the requirements as indicated in the table on the following nage. I ,-. Owner or Owner Agent's Signature: Date:.I - V Upon completing and signing this Certific� ase return it to'th Bui�, ing Division in order to final your building permit. SB407 2015.doc revised 08/26/15