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B-2016-1909 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1909 22910 STONEBRIDGE ST CUPERTINO,CA 95014-5642(342 13 028) BROTHERS HOME IMPROVEMENT INC ROCKLIN,CA 95765 OWNER'S NAME: MILLER GERTRUDE J DATE ISSUED:05/09/2016 OWNER'S PHONE:408-396-8198 PHONE NO:(916)791-9170 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B.C-17 Lie.#699009 Contractor BROTHERS HOME IMPROVEMENT INC Date 11/30/2016 X BLDG —ELECT —PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH X RESIDENTIAL_COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect: JOB DESCRIPTION: REPLACE 4(E)WINDOWS RETROFIT(LIKE FOR LIKE),AND I hereby affirm under penalty of perjury one of the following two declarations: REPLACE 5(E)PATIO DOORS t. 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. 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 permit is issued. Sq.Ft Floor Area: Valuation:$18115.00 APPLICANT CERTIFICATION 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 342 13 028 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,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED SPECTION. Ir Date 5/9/2016 Issued by:Alex Vallelungra Date:05/09/2016 OWINE DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RF-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is t. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:5/9/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER t. 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. HAZARDOUS MATERIALS DISCLOSURE 2. 1 have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&Safety Code,Section 25532(x)should I store or handle hazardous s. 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 material. Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code Sectio 5,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. O .e+e7"matd v. ized.,a APPLICANT CERTIFICATION Da e:5 9 2b I` I certify that I have read this application and state that the above information is CONS TION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 5/9/2016 Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE®CUPERTINO, CA 95014-3255 CUPERTIh10 (408)777-3228• FAX(408)777-3333 • building(c)-cupertino.org —.Z O(f _ l q o q ly "l ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT PROJECT ADDRESS �M APN S'4 2I 1 OWNER NAME f I '�f�f l �� I PHONE 08 3A/ Q E-MAIL STREET ADDRESS Z �)h: I CITY, STATE,ZIP I FAX CONTACT NAME PHONE`� „� / E-MAIL STREET ADDRESS p CITY,STATE,ZIP FAX ❑ OWNER ❑ OW NER-BUILDER ❑ OWNER AGENT 1-1CONTRACTORbeo-N RACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ,,4 LICENSENUMBER P9 LICENSE TYPE q /j, BUS.LIC k COMPANY NAME E-MAIL 7 ( FAX /✓ l �/ *Oaft Am,( STREET ADDRESS rCITY,STATE,ZIPa� 95 �`/ PHONE / �� �A ARCHITECT/ENGINEER NAME /Y LIC ENSE NUMBER (Q� BUS.LIC 9 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF`,l'OP,K EXISTING USE PROPOSED USE CONSTR TYPE 4 STORIES USE TYPE OCC. SQ.FT. VALUATION(5) 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 4 DWELLING UNITS: IS A SECOND UNIT [I YES SECOND STORY E]YES I — A BEING ADDED? ❑NO ADDITION? ❑NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES ==RECEIVED Y TO AL VALUATION: PLANNING ❑NO PLANNING APPROVAL LEITER EICHLERH0N E? ❑NO ® P 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 c ruction. I authorize representatives of Cupertino to enter the above-Iden/pfiiedBprropperty for inspection purposes. Signature of Applicant/Agent: Date: �C SUPPLEME TA ORMATION REQUIRED New SFD or Multifamily dwellings: Apply for demolition permit for �� Y aQ OVER THl<COU TER Q ,BUILDII�GP1 A 'IEF[ � c existing building(s). Demolition permit is required prior to issuance of building �, "� 'u ,a- s+a.-tom-, �^07 a-era permit for new building. ;- -EaPREss a PLAN INGPLANREVIES ,� �����. .`�.��,�'� �-�� •gig �"'"�.. � _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure i❑ T DAxD © =>'UBIAGWORxs form if any Hazardous Materials are being used as part of this project. IN ,, gg r AIZG) �_ kIRE DEPT 9 f _Copy of Planning Approval Letter or Meeting with Planning prior to x � a xI rx OR fl!- 1R'ITARY�EiYERDISTRCT*� submittal of Building Permit application. -� ��� � t -•:�,� a 'M1 .. Wit, m e�. El\VIROAIIIENT�L fIEAM-TPI 3„ . BldgApp_2011.doc revised 06121/11 1 R � Y COMMUNITY MANAGEMENT SERVICES, INCORPORATED May 6,2016 Trudy Miller 22910 Stonebridge Street Cupertino, CA 95014 Re: CUPERTINO STONEBRIDGE ASSOCIATION Architectural Approval Dear Trudy, Thank you for submitting your request for window and door replacement to the Association for architectural review. Your request is approved as presented.Please advise when the installation is complete. If you have any questions,contact me at 408 559-1977 or by email at djohnson@communitymanagement.com. Sincerely, Diana Johnson, Community Management Services, Inc. Association Manager CUPERTINO STONEBRIDGE ASSOCIATION cc: Board of Directors Unit File 1935 Dry Creek Road, Suite 203•Campbell CA•95008-3631 ®voice(408) 559-1977 •fax(408)559-1970 p0 NS CTHCKED 6hl�y 0 Z2-,qlo q7ba&44?' .9T D A. ler qS z)/ ' M 7-1/71Z PLANING DEPT CUPERTINO 0,,GEIVF,D s� r�0 ICE 'ko mF' 0pt,v1ENT.-DEART,. NT PR-VINO co, CUP DNP DIVISION ED PRO I 4) APbe kep. and spe6fical"Q h-s -rna�e any, 00y, ns is unja'Nful to This set of PI 3 . It construction. to (je'\j.t 15� job site.don)9 c alterations on or .".0. thp.,Building changes (jr ao ut appfo\lcll Q trieretrlom, plan and pec, c60�'s Stamping e YJ or to bGib al of the V,t,o lation nc'e of State be held to Pl�. eany el PERMIT