B-2016-2094 I
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2094
20232 JOSEPH CIR CUPERTINO,CA 95014-2235(316 24 048) THD AT-HOME
SERVICES INC
ATLANTA,GA 30339
OWNER'S NAME: KLEIN MARIA V TRUSTEE DATE ISSUED:06/09/2016
OWNER'S PHONE:650-575-8650 PHONE NO:(770)779-1423
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class GLAZING Lic.#83602_1
Contractor THD AT-HOME SERVICES INC Date 04/30/2018 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 2 PATIO DOORS-LIKE FOR LIKE
I hereby affirm under penalty of perjury one of the following two declarations:
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:$3347.00
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 316 24 048
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,Secti . 8. 180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 6/9/2016 Issued by:ABBY AYENDE rAJl1'l}U1 a�1/�'�
Date:06/09/2016 1 MJ Vy1
O)YNER-BUH,DER
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS:
following two reasons: All roofs shall be inspected prior to any roofmg material being installed.If a roof is
1. 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:6/9/2016
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. I HAZARDOUS MATERIALS DISCLOSURE
2. I 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
3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous
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,Sections 25505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agent:
APPLICANT CERTIFICATION Date:6/9/2016
I certify that I have read this application and state that the above information is CON TR J TI L
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construe or d ng 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.
I
Licensed
Signature Date 6/9/2016 Professional
i
CONSTRUCTION PER, APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
10300 TORRE AVENUE-CUPERTINO, CA 95014-3255
CUPERTINO (408).777-3228-FAX..(40,8)777-3333-.building(-cuperting-or -a�G�-('
❑NEW CONSTRUCTION ❑ ADDITION LIALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECTADDRESS Pi
a ` 1 , APN# : JJ _ Ali`OWNERNAME A q /� i�I I PfjON� / O E•MAIL
STREETADDRESSf 1 1� T1 1 CITY,STATE,ZIP 4= FAX
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CONTACT NAME JEFF RAINEY PHONE 510-427-4260 E-MAILJEFFREY.RAINEY@ATT.NET
STREET ADDRESS 1069 EDGEMERE LANE CITY STATE,ZIP HAYWARD, CA 9454-5 FAX 510-783-1041
❑OwNER ❑ OwNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR Z3 CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME LICENSE NUMBER 836021 LICENSE
S BUS.LIC#
9 C 13,C 17
COMPANY NAME E-MAIL FAX "�Q
THD AT HOME SERVICES i 510-357-3750
STREET ADDRESS CITY,STATE,ZIP PHONE
2456 VERNA COURT SAN LEANDRO,CA 94577 510-877-4550
ARCHPPECT/ENGINEERNAME LICENSE,NUMBER BUS.LIC#
COMPANYNAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK Iv 2C)PI—L-5-
2,L I A
EXISTINGUSE PROPOSED USE CONSTRTYPE #I!STORIES
'Z USE TYPE OCC. SQ.FT. VALUATION($)
EXISTG NEW FLOOR DEMO TOTAL
AREA AREA AREA NET AREA
BATHROOM KITCHEN OTHER
REMODELAREA REMODELAREA REMODELAREA
PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH
❑ATTACH
#DWELLING UNITS: ISA SECOND UNIT ❑YES SECOND STORYi D YES
BEING ADDED? ❑NO ADDITION? iD NO
PRE-APPLICATION D YES IF YES,PROVIDE COPY OF IS THE BLDG Ali D YES RE IVED BY` s. x TOTAL,VALUATION:
PLANNINGAPPL# DNO PLANNING APPROVAL LETTER EICHLERHOME? 0N
By my signature below,I certify to each of the following: I am the property owner or authorized agent act o the 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 lawns relating to building constructi nze representatives- aper iTi=Chter the above-identified property for inspection purposes.
Signature of ApplicanUAgent_: Date: /
SUPPL NTALINFORMATI 0nD
PLAN CHECK TYPE>F § ROUTIIVG SLIP a
New SFD or Multifamily dwell s: or demolition e rmit for
y g p <OVER THE COUNTED ❑s Bi1H DINGPLAN REVIEW
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. EXPRESS ��i�i �r�� PI APNINGPI AN�REVIEW `
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure C�'sT NDARDm S Cj PUBLIC ORKS
f
form if any Hazardous Materials are being used as part of this project.
_Copy of Planning Approval Letter or Meeting with Planning prior to
� ❑�MAJORt � � .+❑ SANTI'ARYSEWERDISTRICTt:
submittal of Building Permit application. I a s
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BldgApp_201 1.doc revised 06121111
LEGEND: SCOPE OF WORK:INSTALL(2)RETROFITVINYL,DUAL ^
® = RETROFIT WINDOW/PATIO DOOR/ENTRY DOOR LOCATION GLAZED,LOW E,PATIO DOORS.NO(N)CONSTRUCTION,
FRAMES WILL NOT BE DISTURBED. O ti
DINING ROOM LIVING ROOMLO
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PATIO DOOR PATIO DOOR NOTE;WINDOWS/PATIO/ENTRY DOORS; C/) rn
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COMMUNITY DEVELOPMENT DEPARTMENT U
BUILDING DIVISION-CUPERTINO
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FIRST STORY (FRONT YARD) This set of plans and specifications MUST be kept at I it N
job site
FLOOR PLAN JOSEPH CIRCLE e during construction. It is unlawful to make a� / � �
changes or alterations on same,or to deviate o
NOTE: therefrom,without approval from the Building Officio 1 v
1).SMOKE DETECTORS;WHEN A BUILDING PERMIT IS REQUIRED,SMOKE DETECTORS SHALL BE INSTALLED;(a)IN EACH SLEEPING ROOM,(b)OUTSIDE Effzb&P�j E§ -Tdfi(�1f�E�lLyT �I I of E,,+�LL N 06.06.16
BEDROOMS,(c)ON EACH ADDITIONAL STORY OF THE DWELLING,INCLUDING BASEMENTS AND HABITABLE ATTICS BUT NOT INCLUDING CRAWL SPACES AN�D�U�I �A kC�pIC�C �4�n approval of the violatio i NTS
2).CARBON MONOXIDE ALARMS:WHERE A PE TIS EQU 'FOR E ONS,REPAIRS OR ADDITIONS IXCEEDING$1,000.00,EXISTING DWELLINGS S�LL�PG}G�INFTIAVE XTTEP�S�ft'(f � "EtSf� IV osawwev D
A P= C HAL LL�L
D€DTRI}{A C BON'M; YE
LOCATIONS;(a)OUTSIDE OF EACH SEPARATE DWELLING UNIj�S`�EEPI pN TH I A CINITY OF THE BEDROOM(S),(b)ON
Y wE FT NCLUD _ EN C 0,4, R.R315). 6Tu�+1 9314201
(W
Vo TOPROVIDE BEFORE FINAL INSPECTION). DATE srr
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