05090165 CITY OF CUPERTINOBUILDING DIVISION PERMIT �CONTRACTOR'INFORMATION`1
BUILDING ADDRESS: PERMIT NOU 5 0 9 016 5
1325 ASTER LN
OWNER'S NAME: PERMIT ISSUE DATE
Alk SANJAY & SHRILEKHA CHIKAIMNE 09Z23/200S
ONE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 (�
uo, LICENSED CONTRACTOR'S DECLARATION
uC I hereby affirm that I am Bernard under provisions of Chapter 9(commencing Job Description
4xW with Section 7")of Division 3 arrive Business and professinm Code,and my license is
<ta in full farm and effect. DEMO POOL
��� License
Class Contractor
rove Dom Comrazmr
ARCHITECTS DECLARATION to
y59-L.t I understand my plans shall he used a public records
or
�pN Licensed PrefcssionaI fa�� 105
3 OW NERBUILOER DECLARATION 0J et
I hcrthy vtTrm that I am exempt from the Contractor's License Law for the �rlr�Jp)fp1 IN'ryy n fes,
pO follwhich
(section ito)ostr Business asap Pe,demolish.
city county 1(l\ry fl'/p (I �It N� p . —$6000
qm which trims a omit re convm0.pIter,improve,demolish.arm air signed awment U t1llJJ 1'1 II 11 f t' H N, ,Y
Z i j prior m i¢i en s d e.purs ant to res shovisio s o for Contractor's
ontrauch rmi0o fle a ence, ave(Chapter
Fi (co menccmrscJ pursuant to the of Division
of thee,Business
uatmr and Praclaw(C Code)
Sq. F[.Floor Area —"" U� VaIU`IIGO
'10 (cat he is(commencing Section7")and the
Division r of the aged essand on.Any
Code)ser
y�� Net he u exempt sMrtfmm and Ne bazu for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
not more Nan five hundred dollar(5500). er Occupancy Type
0 1,az owner of the pmpeny,or my employees with wages as their sole compensation,
will do the work,and the swcmm is not intended or offered for sale(Sec.7014,Business
and Professions Coda:The Contractor's License Law does nos apply to an owner of Required Inspections
property who Wilds crimproves rhemon,and who doessuch work himselfor through his
own employees,provided that such improvements arc not intended or offered for sale.If,
however,the building or improvement is sold within one year of completion,the owner-
builder will have the burden of proving that he did not build or improve for purpom of
f, sale.).
"c ❑I,as owner or the property,am exclusively contracting with licensed contractors m
constmcs the pm/cc,(Sec.7044,Business and Professions Cade:)The Commerce.Li
Cents,Law does not apply to an owner of propcny who Wilds or improves thereon.and
who trousers for such pmjecrs with a eor aetor(a)licensed pursuant to lW Connaes 's
LieenseIsco.
❑1 mexemps sal Se./ B&P Nis n
Owner / W/I Dam 2 O
WORKER'S COMPENSATION DECLARATION
1 n r by aRrm under penalty of perjury one of the following dcclarmuro:
I hs'tfand will mainuin aCert rL=m of Cnrrscntto toll-insum fa Work e%Compcn-
mtion.$pmvidcd for by Section 37W of the Labor Code,for Ne pcAormm.of the
Wolk fo which this permit is issued.
C]I hast and will maintain Worker's Com,.don Insurance,as squired by Section
J700 of the labor Code,for the performance of the work for which this permit is issued.
My Worker's Compensation Insurance camicr and Policy number art:
Cartier: Policy No.: _
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
msuucsion need not becompleled if de permit is Boom hundsAdollms($1007
or less.)
1 certify Nm in N panomance rf thc work for whit Nis r is u issued,l shall not
cmployanype mypi azmhaomcG j c om(enm0on
laws of Ca ifrry . , ,
APPIi<anl I 1q 4
NOTICE BO A A .1.a ro m�ikng�I( Ccmfc of xcmption,you should
.am!
suhj I m the Workefl Comptwtion provisions of the labor Code,you muss
.J O forthwith comply with such provisions or this permit shall he deemed revoked.
Z Di CONSTRUCTION LENDING AGENCY
1 hereby affirm Nat there is a construction lending agency I'or the performan r of
!Yi the work for which this permit is issued(Sec.3097,Civ.C.)
GQ Lender's Name
D z Lendeh Address
V O 1 certify that 1 have read this application and more that the above infom d u t is
k P correct.I agree to comply with all city and county ordinances and stem laws relating to
OU Wilding construction,and hereby amhmire MpmxnmtiM of this city to enter upon the
r W
mon-mentioned property for iuspecuon purposes.
F�C. (We)agree to nave,indemnify and keep harmless the City of Cupertino against
fn liabilities,judgments,costs an parties which may in any way accrue against mid City
U z in consequence of the grand f this permit.
'-' APPLICANT UNDERST Dx WILLCCCOMPLY WITH ALL NO -POI Issued by: Date �23—G p
SOURCE REGULATION S.
/� -� Re-roofs
✓'
Signature rf ApplicanUCon mor T
BFARDOUS MATERIALS DISCLOSURE Type of Roof
Will the appli tser Tums building mcupam rem¢or handle hamNous material
u dcfncd by the Cu( Wino Municipal Code,Chapter 9.12.and the Health and Safety
ale.Odrn zss3z a)? ��1 ,,,ass All roofs shall be inspected prior to any roofing material being installed.
Ya WNu
^\ If a roof is installed without firs[obtaining an inspection,I agree to remove
Will the applimm or future building occupant sex equipment or devices which g
it haaardous air conmmirroM az defined by the Bay Area Air Quality Management all new materials for inspection.
Istria?
C]Yea u
I have mad the lxmca usm mriaRrequirements under Chapter 6.95arrive Califor-
niaHcal g:SefcsyCode,SCNurs 25505,25533 and 25534.1 undersand thatBthe Wilding
dos not to ndyh .reser at it my responsibility to nrfl Y the upanlnrthe
requite' n n 'tru bop pdortoiammvm.f.CmdfC1 rr u <. . Signature of Applicant Date
owder nr ammoriana agent Da All roof coverings to be Class "B"or better
e� Community Development
i f 10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
� CITY OF Fax(408) 777-3333
UPE(�TINO
Building Department
JOB ADDRESS: l 25 T�p, �,J PERMIT #
c c Tr ND 19'"d '?0/Z ,j
OWNER'S NAME: (��}��-P/j7J F� PHONE #
GENERAL CONTRACTOR: SIR SEASvNS L,1JZSC FAX #
d_ uu
I am not using any subcontractors: Llb
Signature Date
Please check applicable subcontracto s and complete the following information
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
® Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
v�Le-ec.� 23 0,5�
Owner/ ntractor Signature Date
,awl•► CITY OF CUPERTINO
CITY OF DEMO S �o /
CUPE(�TINO PERMIT APPLICATION FORM
APN # -3�K6/ /I/ // o Date:
09 z 3 X05
Building Address:
1'325 As4eY Lone co.gsoly
Owner's Name: Phone #:
SCnja y &L SkrI IekhG Chikormarle (4o$) - 257 - lolq
Contractor: License#:
I:aar seoso»sCo),dscoL i), $obcal-Senvice & liouI;r- 687145
Contact: Phone#:
SCo�-} Tbhnson dg _3s$ - 8003
Applicant/Contractor:
Building Permit Info:
Bldg Elect Plumb Mech
Job Description:
Residential• DO 1I ° I �LWVO O�) Commercial:
Sq.Ft. Floor Area: $/Sq.Ft.:
Architect/Engineer: Valuation:
Type of Construction: Occupancy Group:
Qty. if
A licable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILIDNG
BSEISMICOM Seismic Commercial BUILIDNG
BSEISMICRE Seismic Residential BUILIDNG
BPLANCHK Plan Check Fee BUILIDNG
BUSLIC Business License BUILIDNG
1 V