The URL can be used to link to this page

13120090 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10586 MERRIMAN RD CONTRACTOR:AMERICAN VISION PERMIT NO: 13120090 WINDOWS INC OWNER'S NAME: WRAY LAWRENCE F AND JINI C 400 MATHEW ST DATE ISSUED: 12/11/2013 OWNER'S PHONE: 4084464610 SANTA CLARA,CA 95050 PHONE NO:(408)617-0901 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL License Class Lic.# —rtw Lto REMOVE AND REPLACE 7 WINDOWS LIKE FOR LIKE ' AND 2 Contractor Date PATIO DOORS,CREATE OPENING FOR NEW WINDOW 1 hereby affirm tl frpe 1 censed under the provisions of Chapter 9 (commencing win 7000)of Division 3 of the Business&Professions Code and that my s in full force and effect. I hereby affirm analty of perjury one of the following two declarations: I have and will maiertificate of consent to self-insure for Worker's Compensation,as pfor by Section 3700 of the Labor Code,for the performance of the or which this permit is issued. Sq.Ft Floor Area: Valuation:$17000 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 APN Number:34216123.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that 1 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, d hereby authorize representatives of this city to enter upon theAv "'on' pr petty for inspection purposes. (We)agree to save 180 D M LAST CALLED INSPECTION. indemnies the City of Cupertino against liabilities,judgments, costs,anhi yaccrue against said City in consequence of thegrantingit. Ad tionally,the applicant understands and will comply Issued by: Date:with all r a re latioVs per the Cupertino Municipal Code,Section 9.18. _ RE-ROOFS: SignatuDate 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. ❑ UILDER DECLARATION Signature of Applicant: Date: I hereby affirm Vandstructure xempt from the Contractor's License Law for one of the following twALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,as owner of thr my employees with wages as their sole compensation, will do the work, is not intended or offered for sale(Sec.7044, Business&Professions Code) 1,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,S4hea (a)s o Id I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,sequ' ent or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as definay r a Air Quality Management District I performance of the work for which this permit is issued. will maintain complianceup rt' o Municipal Code,Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Cod25 0 25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Owner or authorized ageDate:12'11-M I certify that in the performance of the work for which this permit is issued,I shallnot 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 CON ENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a con c on ending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is iss (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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION 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. CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION V 0 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 �61 CU P E R'C[N O (40B)777-3228• FAX(408)777-3333•building(�cupertino.org 0� 25NEW CONSTRUCTION ❑ ADDITION TERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROSECT ADDRESS �0 J�`-J� WI�nl� PO. R APN j J/f� I �3 OWNERNAME ! ,� ^^y 1 ;,G,W�W"y PHONtclt)44(.Zai o E-M IL STREETADDRESS (ps�S ��Iw1.yN ,(� CITY, STATE,ZIP C.)DcitrrIa01 op, gSo%y FAX CONTACT NAME ;1r T _ -1 W PHO`Q olio -1-09ol E-MAIL �./cNcl �YF�W STREET ADDRESS(' � ` CITY,STATE, ZIP S C�m•�l Glrr-�a FAjotp )(A1T_090r ❑ OWNER ❑ OWNER-BUILDER ❑ OW NTER AGENT ErCONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT ONTRACTOR NAME 1 IIRw+ LICENSE NTUMBERm Z(,�, LICENSE TYPE BUS.LIC R COMPANY NAME E-MAIL WM FAX A�IZXtCA+� Y lslo•-+ L�11 J�Ob � C:G rv\O�tici►�JJ\ on)wla ��r�Z�) STREET ADDRESS CITY,STATE,ZIP PH B 'L.ZZS-A W rnAoc�4 2p. 5t-M q CA �30(aS o� STdZ-1 33 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK _ W 1i.1 D o.,� . I�LJp�N�. NLw }11. � �✓Crry ns � 8 w�.+,po""S �4..►d � �'[1a A�i.IfLS T,i�+L. EXISTING USE PROPOSED USE CONSTR TYPE 'STORIES 61sA(w�r f,"10 I USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REN40DELAREA REMODEL AREA REMODELAREA PORCH AREA DECK ARP.�A TOTAL DECK,TORCH AREA GARAGE.AREA: DETACH ❑ATTACH DWELLING UNITS: ECOND UNIT ❑]'ES SECONDSTORY ]'ES G ADDED? ZNO ADDITION? f5VO PRE-APPLICATION [1 YES IF YES,PROVIDE COPY OF IS THE BLDGAN �� RECEIVED OTAL VALUATION: NN'IN PL.AG APPL r E]NO PLANNING APPROVAL LETTER EICHLER HONIE? � By Iny signature below,I certify to each of the foli4oct. : I am the property owner or authorized act on th roperty owner's behalf. I have read this application and the information I have provided is Ihave read the Description of Work and verify it is ac rate. I agreeto comply with all applicable local ordinances and state laws relating to build ;co n. I authorize representatives Of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL 0 A ON REQUIRED cHEcrzT CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10586 merriman rd DATE: 12/11/2013 REVIEWED BY: MENDEZ APN: BP#: 'VALUATION: 1$17,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Duplex PENTAMATION 1GENRES USE: PERMIT TYPE: WORK remove and replace 7 windows like for like and 2 patio doors create opening for new window SCOPE Ll JICClk /i`.all. FCC," NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works, Fire,Sanitary Sewer District,School District,eta). Theseees are based on the prelinddna information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution II-053 EQ' 71'L/Q FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F-9-1 # Window/Sliding Glass Door Supp/. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $557.00 IWINREP Replacement PME Plan Check: $0.00 1 # Window/Sliding Glass Door Permit Fee: $0.00 $834.00 I WINMEWSTR New(Shearwall/Masonry) Suppl. Insp. Fee-0 Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (.d lY1(l7l.�t)`Clid i'i'f`i�i'. Work Without Permit? 0 Yes (F) No $0.00 0 Advanced Planning Fee: $0.00 Select a Non-Residential Q Building or Structure Strong Motion Fee: IBSEISMICR $1.70 Select an Administrative Item Bldp,Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $2.70 $1,391.00 TOTAL FEE: $1,393.70 Revised: 10/01/2013