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14110079 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10228 PALO VISTA RD CONTRACTOR:ANDERSON PERMIT NO: 141 10079 INSTALLATION OWNER'S NAME: CHARLES&TERRI YAGER 696 AUZERAIS AVE DATE ISSUED: 11/13/2014 OWNER'S PHONE: 4089217440 SAN JOSE,CA 95126 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑ REMOVE AND REPLACE (24 WINDOWS)TO MEET License Class Lie.# S6"O 6C)/ EGRESS IN Date K7--Contractor �Q J f' / BEDROOMS,AND(2)DOORS �J�� .�[� / �� -- 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. 1 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:521000 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 .APN Number:35702060.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 certify that I have read this application and state that the above information is PERMIT E IRES ORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN Igo YS OF P RMIT 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 T 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 granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signatu Date�� All roofs shall be inspected prior to any rooting 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 [hereby affirm that 1 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(x)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 this �_ Owner or authorized agent: �� 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 Compensation Taws of California, If,after making this certificate of exemption,1 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, l 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 APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION em 103DD TORRE AVENUE•CUPERTINO, CA 95014-3255 I CUPERTINO (408) 777-3228• FAX(408)777-3333• buildingQcupet no.orq ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS /O APN# 3S_1 02 D /O OWNERNAME r V (� PHONE C�Q{l, L! (�( �J E-MAIL STREET ADDRESS ' V P4 k (S�� ^h CITY, STAT �I�V c l,ro FAX CONTACT NAMEJdLJ �/ /l PHONEE-MAIL C STREET ADDRESSCITY ,STATE,ZIP (-) Z� FAX G C �� 5,v- El OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ® CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Id / (mac / LICENSE NUMBER LICENSE TYPE BUS LIC P COMPANY NAME r' E-MAILFAX STREET ADDRESS Ih CITY,STATE,ZIP, L PHONE J -ZT-5 2a,, _V0 J ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA A"DECKA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH []ATTACH #DWELLING UMTS: IS A SECOND UNIT ❑YES SECOND STORY El YES BEING ADDED? ❑NO ADDITION? []NO y PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY: TOTAL VALUATION: NN PLAING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO / By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the roperty o er'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 accu gree to comply with all applicable local ordinances and state laws relating to bui ' g construction. I auth r' representatives of Cupertino to ente the above-identified property for inspection purposes. Signature ofApplicant/Agent: ate: SUP ENTAL INFORMATION REQUIRED PLAN CITE CKTYPE'" ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for VolER-TxE-CouNTER ❑ BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑'EXPRESS ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to .❑.MAJOR - ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BIdgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR— BUILDING DIVISION WPERMIT DDRESS: 10228 palo vista rd DATE: 11/13/2014 REVIEWED BY: Mendez PN: BP#: �V 'VALUATION: $21,000 PE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY PENTAMATION USE: SFD or Duplex __TPERMIT TYPE: 1GENRE WORK �removaand replace 24 windows to meet egress in bedrooms and 2 doors SCOPE Ll Lj NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District, etc. . Theseees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 Ej1' 7%1!131 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 26 # Window/Sliding Glass Door Suppl. PC Fee: Q) Reg. 0 OT 0.0 hrs $0.00 $860.00 1WINREP 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 0 Work Without Permit? 0 Yes ) No $0.00 0 Advanced Planning Fee: $0.00 Select a Non-Residential (F) Building or Structure 0 i Strong Motion Fee: IBSEISMICR $2.73 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $3.73 $860.00 TOTAL FEE: 1 $863.73 Revised: 10/01/2014 TOTAL UNIT QTY:26 e ReS LINE MARK UNIT ITEM QTY LAUNDRY All Ultrex Rectangles-Direct Glaze 1 RO 47 X 47 3/4 r2)/FOYER All Ultrex Rectangles-Direct Glaze 2 V RO 591/2"X 60" aP4410 IST 3� MNG ROOM All Ultrex Rectangles-Direct Glaze RO 591/2"X 60" (9--LIVING ROOM All Ultrex P4 Direct Glaze 1- RO 48"X 102 7/64" �5 LIVING ROOM All Ultrex P4 Direct Glaze 1 0 ® vs yl�3 RO 48"X84 39/64" 6 LIVING ROOM All Ultrex Single Hung 3 CN 2050 RO 24"X 60" �7 �TCHEN All Ultrex Glider 1 JAI i� ad a- ()coo r plAce r,Ic RO 70 3/4"X 431/4" &FAMILY ROOM / All Ultrex Glider 2 RO 71"X 60" rAvider4eq o STS 11#4 O/AMILYROOM l Clad Sliding Patio Door 1 CN 80R66R RO 96"X 80" i ��.sop �® ZOOO 10 BATHROOM TOILET All Ultrex Double Hung 1 RO 36"X 47" 11 BATHROOM All Ultrex Single Hung 1 RO 24"X 46" 12 96EST BEDROOM All Ultrex Glider Triple Sash 1 RO 951/2"X 47 3/4" 1 MUSIC ROOM All Ultrex Glider Triple Sash 1 RO 951/2"X 47 3/4" gr�ql`FICE All Ultrex Single Hung 4 RO 48!'X 45 3/4 15 UPSTAIRS BATH-TOILET All Ultrex Double Hung 1 RO 48"X 471/4" 16 UPSTAIRS BATH-TUB All Ultrex Double Hung 1 RO 48"X 471/4" '> 17 HALL All Ultrex Single Hung 1 0 r 01 � 8 RO 30 3/4"X 36" f P /S 107 C'EFAftTME-111-47 02- 0-2— UIQ i i7P� -CUPEKT INN 44 . '7 APPROVED t" rf i rIC' 1' T r.:,. _. 4 F .,.:4 a sY� ,,,�a.lens9US! be kept at the It iS ilaiWful to make any '3 cr 6! Ail I °=imv, 0r to dev;,-;42 tI,;refrom, 1-'hG t i' T:.::� ",--a I�i�. Off, Sec J FI(jo r i- I L L Sr 0,6 r P Sr h � 5 LOQ' PLANS `� � Lv t.7 40 c✓ S CHECKED Ily DATA d�1'9J dow, S PL#t41NG DEPT.'-- I beck r�� e5 ress DATE H1.OG. DFprr. C