12060181CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10677 PAR THREE DR
OWNER'S NAME:
, CA 95014 PHONE NO:
BUILDING PERMIT INFO: BLDG F ELECT F PLUMB r—
MECH r— RESIDENTIAL f— COMMERCIAL r—
JOB DESCRIPTION: REMOVE AND REPLACE (1) WINDOW AND (1) DOOR,
REMOVE
AND REPLACE THE HEADER AT DOOR WTH NEW PSL
Sq. Ft Floor Area: I Valuation: $18000
APN Number: 35607037.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM
LAST
, CALLED INSPECTION.
Issued by: f�Elry f 1f7ZetZ2� Date:
RE -ROOFS:
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.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District 1 will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health
AGENCY
I hereby affirm that there is a construction lending agency for the performance of Hork's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
1 understand my plans shall be used as public records.
Date 24J-4u_Z-aL
Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
10677 Par Three Dr
DATE: 06/29/2012
REVIEWED BY: Sean
M1ADDRESS:
APN:
BP#:
'VALUATION:
1$18,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
PENTAMATION 1GENRES
I PERMIT TYPE:
WORK
Remove and replace 1 window and 1
door, remove and replace the header at door with new PSL
SCOPE
header.
I lcch, i ( "o r;;
Plumb. Plant (-Yieck
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L."(cc. Insp.
NOTE. This estimate does not inehide fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District. eta). These fees are based on the nreliminary information available and are only an estimate Contact the Dent for addn7 info.
FEE ITEMS (Fee Resolution 11-053 E . 711111)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
F-2-1 #
$392.00
Window / Sliding Glass Door
1 WINREP Replacement
Suppl. PC Fee: (E) Reg. 0 OT
0.0
1 hrs
$0.00
PME Plan Check:
$0.00
Permit Fee: Hourly Only? Q Yes (F) No
Suppl. Insp. Fee-0 Reg. Q OT 0.0 1 hrs
$0.00
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
-T-T
Consir action Tax:
Admini.strative lr'ce:
Q
0
Work Without Permit? 0 Yes (E) No
$0.00
Advanced Planning Fee:
$0.00
1 hours
$130.00
Inspections
iSTINSP Inspection, Hourly
0
0
7'?W1 e1 AOcruncnt06011 1"t_WS.
Strong Motion Fee: 1BSEISMICR
$1.80
Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC
$1.00
SUBTOTALS:
$2.80
$522.00
TOTAL FEE:
r
$524.80
Revised: 06/30/2012