BLD-2023-2388_SignedPermit.pdf ITY OF
BUILDING PERMIT
CITY HALL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
PHONE 408-777-3228
CUPERTINO WWW.CUPERTINO.ORG
BUILDING ADDRESS: 8195 PRESIDIO DR APN: 356 11 092
PERMIT NO: BLD-2023-2388
OWNER'S NAME: IM MOONHWAN AND EUNHO
OWNER'S PHONE:707-696-0800
CONTRACTOR: SRC ROOFING
CONTRACTOR PHONE:
DATE ISSUED: Oct 30. 2023 ISSUED BY:Abby Ayende VALUATION: 13000
JOB DESCRIPTION: REROOF; TEAR -OFF; INSTALL OSB; COMP SHINGLES - (18 SO)
LICENSED CONTRACTOR'S DECLARATION:
NO: 872394 EXP DATE: 02/29/2024
7000) of Division 3 of the Business & Professions
CONTRACTOR: SRC ROOFING LICENSED CLASS:C39 LICENSED
ROOFING
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section
Code and that my license is in full force and effect.
as provided for by Section 3700 of the
I hereby affirm under penalty of perjury one of the following three declarations:
❑ I have and will maintain a certificate of consent to self -insure for Worker's Compensation,
Labor Code, for the performance of the work for which this permit is issued.
Section 3700 of the Labor Code, for the
not employ any person in any manner so as to
this certificate of exemption, I become subject to
with such provisions or this permit shall be
I. I have and will maintain Worker's Compensation Insurance, as provided for by
performance of the work for which this permit is issued.
❑ I certify that in the performance of the work for which this permit is issued, I shall
become subject to the Worker's Compensation laws of California. If, after making
the Worker's Compensation provisions of the Labor Code, I must forthwith comply
deemed revoked.
HAZARDOUS MATERIALS DISCLOSURE
& Safety Code, Sections 25505, 25533, and 25534. I
M I have read the hazardous materials requirements under Chapter 6.95 of the California Health
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or
air contaminants as defined by the Bay Area
Chapter 9.12 and the Health & Safety Code,
handle hazardous material. Additionally, should I use equipment or devices which emit hazardous
Air Quality Management District I will maintain compliance with the Cupertino Municipal Code,
Sections 25505, 25533, and 25534.
EPA LEAD -SAFE DISCLOSURE
No:
❑ An EPA Lead -Safe Certified Renovator will be responsible for this project.
Certified Firm Name: Firm Certification
✓ No EPA Lead -Safe Certified Firm is required for this project.
CONSTRUCTION LENDING AGENCY
of the work which this permit is issued
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance
(Section AV7, Civil Code).
Yes El No
Lender's Name:
Lender's Address:
APPLICATION CERTIFICATION
with all city and county ordinances and state
the above mentioned property for inspection
judgements, costs, and expenses which may
understands and will comply with all non -point
I certify that I have read this application and state that the above information is correct. I agree to comply
laws relating to building construction, and hereby authorize representatives of this city to enter upon
purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities,
accrue against said City in consequence of the granting of this permit. Additionally, the applicant
source regulations per the Cupertino Municipal Code, Section 9.18.
� Date
Signature , Oct 30, 2023
EVERY PERMIT ISSUED SHALL BECOME INVALID UNLESS THE WORK ON THE SITE AUTHORIZED BY SUCH PERMIT IS COMMENCED WITHIN 365 DAYS AFTER ITS ISSUANCE,
OR IF THE WORK AUTHORIZED ON THE SITE BY SUCH PERMIT IS SUSPENDED OR ABANDONED FOR A PERIOD OF 365 DAYS AFTER THE TIME THE WORK IS COMMENCED.
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • permitcenter@cupertino.org PERMIT #B -
CUPERTINO I REV# DEF#
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION ❑ T.I. ❑X MEP ❑ RE -ROOF ❑ SWIMMING POOL/SPA
PROJECT ADDRESS 10212 Denison Ave
APN# 316-28-016
OWNERNAME Balaji Guruajan PHONE
425-786-5182
E-MAIL bajaji.gururajan@email.com
STREET ADDRESS
CITY, STATE, ZIP
10212 Denison Ave
Cupertino, CA 95014
❑x CONTRACTOR NAME ❑ OWNER -BUILDER COMPANY
NAME
LICENSE NUMBER
LICENSE TYPE
Kong Nguyen
Mike Counsil Plumbing
679261
C36
STREET ADDRESS 1915 Otoole Way
CITY, STATE, ZIP San Jose, CA 95131
E-MAIL PHONE
BUS. LIC #
Permits@mcplumbing.com 408-272-4900
403430
❑ ARCHITECT ❑ OWNER ❑ OWNER AGENT ❑ CONTRACTOR AGENT ❑ ENGINEER ❑ DEVELOPER ❑ TEN.A\T
CONTACT NAME
E-MAIL
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTON Underfloor drain/waste line replacement for 2 bathrooms (6 fixtures).
TOTAL VALUATION:
$16,665
■❑SINGLE-FAMILY/DUPLEX ❑MULTI -FAMILY ❑ INDUSTRIAL ❑ COMMERCIAL
USE
TYPE
OCC
SQ.FT.
VALUATION ($)
EXISTING USE
EXISTING SF
NEW FLOOR SF
PORCH
SF DECK SF
DEMO SF
STORIES #
TOTAL NET SF
REMODEL
REMODEL KITCHEN
REMODEL OTHR
GARAGE ❑ ATTACHED
BATHROOM SF
SF
SF
SF ❑ DETACHED
EXISING S
EICHLER
❑❑ S
SECOND STORY ADDIT❑ION YES
FIRE SPRINKLERS [I N
N
❑ NO
DWELLING
SECOND DWELLING ❑ YES ❑ ATTACHED❑ DETACHED OTHER
UNITS #
UNIT ADDITON: ❑ NO S F
POOLS
❑ FIBERGLASS ❑ VINYL -LINED ❑ GUNITE ❑ PREFABRICATED
POOL - SF SPA - SF SPA ATTACHED ❑ YES ❑ NO TOTAL - SF
RECEIVED BY:
Commercial or Multi -Family Buildings with Public Swimming Pools requires Department of Environmental Heath approval
RE -ROOF
EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑
WOOD SHINGLES ❑ TILE OTHER (SPECIFY)
REMOVE /REPLACE ❑ NO
IF NO
PLYWOOD ❑'�z" ❑ 3/8- PLYWOOD
TYPE:
PITCH:
ROOF CLASS
❑ YES
# OF LAYERS
I
THICKNESS ❑ 5/8- OTHER
❑ OSB ❑ CDX OTHER
.12
A
PROPOSED ROOF TYPE: []BUILT-UP ROOF ❑ASPHALT SHINGLES ❑ WOOD SHAKES []WOOD SHINGLES ❑ OTHER
*Provide a signed copy of the Cupertino's Tear -Off Policy SF #of SQUARES
By my signature below I certify to each of the following: I am the property owner or authorized agent to act on 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 laws relating to building construction. I authorize representatives of Cupertino to
enter the above -identified property for inspection purposes. I acknowledge and authorize all information contained on this application form
to be made available for public record.
Signature of Applicant/Agent: Date: 10/25/23
SUPPLEMENTAL INFORMATION REQU RED
*New SFD/Second Dwelling Units/Multifamily Dwellings: A Demolition permit is required prior to issuance of a building permit for all new construction.
*Commercial Buildings: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project.
*Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application.
*HOA-Provide a letter of approval from the Home Owner's Association
BldgApp_2017.doc revised 01101121
INSPECTION RECORD
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 10212 DENISON AVE Cupertino APN: 316 28 016 PERMIT NO: BLD-2023-2373
OWNER'S NAME: GURURAJAN BALAJI AND VENUGOPAL SRIVIDHYA TR OWNER'S PHONE: 425-786-5182
CONTRACTOR: MIKE COUNSIL PLUMBING INC, 1915 O'TOOLE WAY SAN JOSE CONTRACTOR PHONE: 408-272-4900
DATE ISSUED 11/22/2023 11:19:46 AM ISSUED BY:VALUATION: $16665
JOB DESCRIPTION
REPLACE UNDERFLOOR DRAIN/WASTE LINES FOR 2 BATHROOMS (6 FIXTURES)
INSPECTION TYPE DATE STATUS INSPECTOR
UNDERFLOOR PLUMBING 2023-11-09 Failed Rodney Weathers
FINAL PLUMBING 2023-11-09 Failed Rodney Weathers
UNDERFLOOR PLUMBING 2023-11-17 Cancelled
FINAL PLUMBING 2023-11-17 Cancelled
UNDERFLOOR PLUMBING 2023-11-22 Passed Paul O'Sullivan
FINAL PLUMBING 2023-11-22 Passed Paul O'Sullivan
FINAL BUILDING 2023-11-22 Passed Paul O'Sullivan
EVERY PERMIT ISSUED SHALL BECOME INVALID UNLESS THE WORK ON THE SITE AUTHORIZED BY SUCH PERMIT IS COMMENCED WITHIN 12 MONTHS AFTER ITS ISSUANCE, OR IF THE WORK
AUTHORIZED ON THE SITE BY SUCH PERMIT IS SUSPENDED OR ABANDONED FOR A PERIOD OF 12 MONTHS AFTER THE TIME THE WORK IS COMMENCED.