16010042 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 747 STENDHAL LN PXTERIOR
C OR, PENT NO:16010042
OWNER'S NAME: WOLQAST STEPHEN C AND JEANNE J TRUS -DATE ISSUED:O1/Q6/2016
OWNER'S PHONE: 4082550572 t ENO
( ❑ ) LICENSED CONTRACTOR'S DECLARATION CRIPTION:RESIDENTIAL Q COMMERCIAL F
SIDING REPLACEMENT;LIKE FOR LIKE(1,000
License Class (�! Lie.# �'Cd 3 c z
Contractor_&oDe,p Date
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
r: performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$16000
J 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. APN Number:37542036.00 Occupancy Type:
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORD 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 PAYS FROM LAST CALLED INSP T 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 (fv
granting of this permit. Additionally,the applicant understands and will complyIssued by: Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
cj RE-ROOFS:
Signature Date �0, 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
I 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)
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 5,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this —' f°
permit is issued. Owner or authorized agent:" 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 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
CONSTRUCTION PERMIT APPLICAT16N
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1 i f-k "aZ, 10300 TORRE AVENUE- CUPERTINO, CA 9501A-3255
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COMYiUNI BUILDING DIVISION
CUP-ERTINO: (408)777-32?B- FAX(108)777-3333- bufldlno(c-�cut)e 'LlnC)*0ra
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\TFv-,_OOR DEMO TOTAL
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BATE300M luTic-MN 0-:ER
RMiODELAR:A 0 DEL AREA R7MODZL,4:EA
PORCHARBA D=_CKQ%HA TOTAL DBCKIPORCH4 tiA EIDETIACH
FIATTACH
IDWILLUNG-u-=S: ISA SECOND UXTr L]Y-=S I SECOND STORY
BETING ADDED? No ADDITION?
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By my signature halo;;,I c-,rti-,^y to each of the following: I am the prope.-ty o%krer or aulthor,*Z'A went LOact onth o
e grope, W-ne7's behalf. 1 have read ns
al)Dlication and the information I have provided is r-oi-,ect. lhavt read the Description of-Wo7k arlyle-ri-fy It is accllrate. I ag7ce to-comply:�7_,,'ith all an lica'olt local
Ordinances and stat.lay-es TZ11a.;to building can *ho-;--representatives'of Cupertino to enter the above-identified proptnty or inspection p,--pesos.
S;g_naL-e of_'pol icP nt/A Eent: Date: re��
STJPPILEAfl_ENT AT.TK!T:nR 7vf_kT_;4_N=F OTITRAD
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N-w EFD Or -L. L-or
Mull ifFE-mily gs: AD ly for dtmojitjo,
Derriolitiori per.m. -it is required prior of
permit-for new buil d_illu
Corn.-Inercial B)fts: Prov_;da a connip'lefed Hzzzardc�,us_Miaterlals D"sc,loilure,
for, -Taza:�Ouls Materials 2ze ing used as part o�z
amy 1, Lh:s Drojact.
Copy of Plam,ing Approval,LefteT or vvith PlanDffia prior to
Submittal ofBu;ldLP=,_._,t applicEtio-n. x
B&g:-��,,n_2011.doc revised 0612!111
CITY OF CUPERTINO l I
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS 747 Stendhal Lane DATE: 01/06/2016 REVIEWED BY: PAUL
APN: 375 42 036 BP#: *VALUATION: 1$16,000
PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY SFD or Duplex PENTAMATION 1 GENRES
USE: PERMIT TYPE:
WORK Exterior siding replacement; Like for Like (1,O00 S.f.
SCOPE
77
`vg<.<,;.� # :rl 1 E.<•, ,ta f,.t. ,iYZ: .:i.i U£': is£ � '}'Ir d ''<%„
"
iX�qn
P<,-,h. f�.; .i'r`e.': f ui>ib It -o., ..c.;,. I�S7 .._a•.
NOTE.This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . TheseLees are based on the prelimina information available and are onl an estimate. Contact the De t for addn'l info.
FEE ITEMS (Fee Resolution.1.1-053 li'f. 7''11,13) FEE QTY/FEE MISC ITEMS
Plan Check Fee: Hourly Only? 0 Yes (F)No $0.00 1 hours Plan Check,Hourly
Suppl.PC Fee: (2) Reg. 0 OT 0.0 hrs $0.00 $143.00 ISTPLNCK
PME Plan Check: $0.00
Permit Fee: Hourly Only? 0 Yes Q No $0.00
Suppl.Insp.Fee:Q Reg. Q OT:= hrs $0.00
PME Unit Feer $0.00
PME Permit Fee: $Q,0Q
.rzC.r"# I7Z:3' f"C'FIZ . b`i'z;;': - ..
Work Without Permit? C Yes (j) No $0.00 G
Advanced.Plannin Fee: $0.00 Select a Non-Residential
,.Vavel Building or Structure
Strong Motion Fec: 1BSEISMICR $2.08 F-2.07 hrs Inspections
Bldg Stds Commission Fee: IBCBSC $1.00 $286.00 ISTINSP Inspection,Hourly
SUBTOTAL$ $3.08 $429,00 ...... T(rTAL FEE: $432.08
1!20
Revise 10!0