04060203 F
OF CUPERTWOILDING DIVISION PER y�-rii,g' ✓ '
aG ADDRESS: _ BHARAT KRISHNA PERMIT N0.04060203
ER'S NAME: FERMITIS UEDATE
NE
BHARAT KRISHN
PHONE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG EIPCf PLUMB MECH
0 0 0 0
uao LICENSED CONTRACTOR'S DECLARATION
d F 1 hereby affirm Ihat 1 am lianscd under provisions of Chapter 9(commencing Job Description
with'cm.'0(offr Division 3 of NC Biuimm asW Professions Code.eni in,license is
� y imfull force and Cff=LREMODEL- -ENCLOSURE FOR HEATER/SUTDY RM IN LIV R
?tg Lima.ClassUs.M
Zc Dam Canuacwr WALL IN LIV. RM FOR KITCHEN/HOOD
ARCHITECTS DECLARATION
M 1 underaund my plans shall W used u public reenfds
to
3 e t; Licensed Profrsai...I
s'ctg OWNER-BUILDER DECLARATION
f 1 hereby affirm'hot I am exempt from the Contractor's License Law for the
no following..an.(Section 703 L.5,Business and Professions Cad.:Any city or county
which¢quires a permit to caramel,alter,improve,demolish,or mpoir any stmctum
zy prior to its hatioee.alw requires Neapplicam for such permit ro flc.Alpidsummem
< Nat he is licensed punuanuothe provisions of the Contractors LianseLaw �
(Chapter Sq.Ft. Floor Area Valuat�1000
C (commencing with Section 7")of Division 3 of the Business and Professions Code)or 4
that he Is exempt therefrom and the basis for Ne alleged exemption.Any violation of
Sc,don 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not more Nan Bw hundred dollars(S500). 3 7.S 13 s; 0 0
❑1,as owner of Ne property,or my employees with wages as their sole compe^saion,
will do the work and the swcmm is not intended or offered for sal.(Sec.7044,Business
uM Professions Code:Th.Contractor's License Law dors not apply'.an owncr of Required Inspections
pmix ny who builds m improves Omrton,and wbo doss s uch work hires s l(or though his
own employees,provided Nm such improvements art not intended of offered for sale.If.
however.Ne Wilding or improvement is mid within one year of completion,the owner-
builder will haw the burden of proving that he did not Wild of improve far purpose of c altltl lr
axle.,). M A' L111i f
Vermont
a owner of the property.em exclusively contracting with licensed mnuactors to
.Lethe project(Sec.7034,Bulinus and property
wh i Wild Code:)The Conuanafs Li- Ir l ®� p v _
law dos no'apply b an owner of Business
who Wilds or improve thereon,and �IIVVI(1 t``Q��
who contracts for such projects with a contractor(a)licensed pursuam m the Conuoctofs
License Law.
❑lam wrailunder Sec -� Bk PC for this¢von
it5t
nc �.,i- r --LL-- Daus/2II(.- 'y/,,t,
�� WORKER'S COMPENSATION DECLA�'ION
1 hereby affirm under petmhy of perjury one of the following declarations:
❑1 haw am will meinuin a Cenifiuu of Consent to self iuum for workefaeompen-
sation,as provided for by Section 3700 of the Labor Code,for Ne performance of the
work for which this permit is issued.
1 have and will maintain Workces Compensation Insurance,m required by Section
3700 of the labor Code,for the perrarmana of the work for which Nis permit is issued. -
My Wmium,Compensetian In...caret.and Policy number art:
Cartier. Policy No.: �
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
mics scaim rcsd not W em^pleted film Permit is foram hundred dolan(s100)
in tela)
1 certify Nat in the performance of Ne work for which this permit is issued.I shell not
employ anypermn in any manner m u to bcame subject on thrWorkeri Compensadon
Laws of califomia.Dau
Applicant
-NOTICE TO APPLICANT:If,after making Nu Certificate of Exemption,you should
become subject 0 the Worker's Compensation provisions of the Labor Codc,you must
.JO forthwith comply with such provisions or this permit shall too deemed revoked.
Z— CONSTRUCTION LENDING AGENCY
h
I hmcb,which this
that Vert iso issued
n lending agency for Ne perfu.....f
FL de work fur which Nis permit u issued(Sec.3097,Civ.C.)
W Q Lender's Nunc
O Z Lender's Address
V O I comfy Nu I haw read this application and note that the above information is
Fcorrect I agree N comply with all city and many ordinances and sum laws relating to
O V Wilding convection.and hereby authorize mprecmtawe of this city to enter upon the
shave-memidgm judgproments,
costs
for i expenses
peNan rimpowhich ms.
H 6. (We)agree to sew.indemnify and kap harmless the City of Common against
Z in CO=q=ngments,coolindOf this emay in any way same againseaid City
V z A APPLICANT
of Negranting of this permit.
t—' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOO EGULATION
.-k T_� �� `I?Z X04 Re-roofs
igne'urt afAppli UContw
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Na applicant or fun uilding Occupant store or handle hazardous material
as dcfand by the Cupenino Mu cipal Code,Chapter 9.12,and Irk.Health and Safety
Code.s.etion2s532(.n - All roofs shall be inspected prior to an roofing material beim
❑vee ON. P P Y g g installed.
Will the applicant of future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection.
District?
❑Yu CaNu
I have mad the handnes materials requirements under Chapter 6.95 of the ctfror-
'a Health di SafstyCode,Sections 255(15.25533 and 25534.1 untemand thatifthe Wilding
mosTol currently how a tenant,that it is my milamibiliry,In nWty the occupant of N.
req �spm�/{s hichmum metpAortaissuanccofaccnificamoPOc.npmcy. Signature of Applicant Date
lnA..._?5— --4__a.._ 6(�zz%ate
Owner or authofixed agent bore All roof coverings to be Class"13"or better
10-4- 10" 10'-0"
0
�-9'-0 1116"
I
o Existing Wall O
Heater to be C
Removed o
f.
n
e JU5RTI'NO
CITY ®
APPROVED UICDING DRAPTMEMT
n1M
WACCOR
C PERTI
D Oa°
ED Q
Is set �lY
k ton Qnamcwpa
to m Ike any c?wgp C7=E�No a C=
ut written p (,gym L`oi lt8
C 0 o rtment, City of Cupo dn"'Le
Tn 3 tamping of this gm OW
41 L NOT be held to psmtl at to ga 0
Ir<val of the violation of any poWatona pg
I, liy Ordinance or State Lacy. 4
b
Existing Layout: Wall Structures
r CA aS-01�
11r-4• to• 10'-4•
•
4
0
ih
zv
9'4 1116"—
New Window II 11�
0
Combustion Air R 00
grill door iv
�F
to 4 O�
r T-(Y'
R
in
7-0" I f z 11 . . WED
Jew Enclosure '4 z
V
or Neater Unit New Wall
m CDS ER
11'-1 7/16"
CP
New Wall
20
0
ti
•
r
Proposed New Layout: Wall Structures
10'-4• to• 1a4'
•
4
0
io
N
i 9'-41/16"
O
� 4 0� �
'7
m
New Enclosure
for Heater Unit
A NEW
k IcR 3 2004
RUI ISIEPAPTM NT
Fn
tP-t 7/,G'
Proposed Electrical and Telecom
!-VHF kve . c Pyr f f'90,, CA -
• EXISTING ROOF
CEXISTING Mainl
Beam /
NEW R19
mclosure will match Insulation
the fireplace
enclosure tq
r1 ^n
b
NEW Ceiing
New JUN 23 2004Heateb
p{yQ�
shed r - CRY'�/� OF CUPERT
I �
adjacent F
eXito BUIL ING DEPART T
fireplace m
10,-4„ 1 a, 1 n-41
Side Elevation and
• Ceiling Plan
CITY OF CUPERTINO
BUILDING DIVISION PERMIT CON TRACTORANFORMATION
BUILDING ADDRESS: _ BHARAT KRISHNA PERMIT No.04060203
OW NER's NAME: PERMIT I SUE DATE
BHARAT KRIS /20
E: ONTRSANITARY N0. COL NO.
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
u0Z' LICENSED CONTRACIOWSDECLARATION Job Description
ZC I hemby affirm that 1 am licensed under provisions of Chapter 9(commencing
<ou with Section 7")of Division 3 of NC Business and Prefessiom Code.and my license is �p
�„ in oeeaedeffec'' REMODEL- -ENCLOSURE FOR H�Ior` A IN LIV R
S b,? License Class Lic.p I
nFI Data Comrsemr WALL IN LIV. RM FOR KI TC E
W ARCHITECTS DECLARATION
7 1 undersunJ my Plana shall he used as public mounds
_a. DEC ?/ 1004
o G Licensed Professional
S OWNER-BORDER DECLARATION
0 C I hereby a(Bw Nal 1 1. exempt from sew Convns;Co License Law Boom
p0 followingmason. comi,t ]1131.5,8 0tesand Profession Codd:Any city or County%�4, which rtyUs u a e,ralio m CMrweL pplic Ion pore',dersh Permit i of.,an ed iwelYm
L thiormiuissuance,alsuroquims prevision of for eacContractor's
ccomfile a Law
smemem
F2CthetWisliccnsedpursuenlmthepmvisionsofNCConlsacmr'sLiccnulaw.(Chapmr9 Sq.Ft.Floor Area a OO
ur-S (commencing with Section 7000)of Division 3 afire Business and Prafessioru Code)or
Nn he is eumpt Ihemfum and Ne basis for Be alleged gumption.Any violation of
Section 7031.5 by any applicant far a permit subjects the applicant m.civil penalty,of APN Number Occupancy Type
not mom thu fisc hundred dollars($5001
0 1,as owner of the property,or my employ=with wages as their silo compensation. 37533017 . 00
.
will do the work.and Restructure is nal intended or offered Beside(S .7W,Business Required Inspections
and Professions Code:The Conuactor't Licenm e ns Law docs not apply to an owner of q P
property who Wilds in improves thereon,and whodorssuchworkhimulforthmugh his
man employee,provided Nat such impmvemcnu art not intended oroRcred Buick.If,
however,the building or improement is sold within one year of completion,the owner- -
builder will have the burden of proving that be did rot Wild or improve for purpose of -
sal(,).
V1,u owner of the propmy,am aclmively contrming with liar comranors m
amwcl the pmjm(Sec.7044,Business and Rafusions Code:)The Cons es U-
came law dons not apply man owner of property who Wilds or improve forces,and
whoeonuaeu for such M*u with a comosemr(s)licensed purarm in the Consistencies
License law,
l am x mppi under See. -y�— B A P Cfor this..an
O nc _[s7 kn..� F w= D (
am�71 nisO I
WORKER'S COMPENSATION DECLA A�pN
1 herby affirm under penalty of perjury on,of the following declaration:
have and will maintain a CutiOeam of Consent to self-insert for WarkeesCompen-
siums,as provided for by section 3700 of the labor Code,for on performenm of tie '
work for which this pawn is issued.
1 have and will maintain Worker's Compensation mtsuraa,as acquired by Section
37W of Ne Labor Coda for one performance of the work for which this permit is issued.
My Wortees Compensation Imuran carrier and Policy number are:
Cartier: Policy Ne.: I
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thissecdon need non W comploeG Bthe pewit is feature hundred dollars(SIM)
or but.)
1 amf,that in one pgrfow+eu of due work far which this pewit is issued,l sha11 mol
employ any person in any manner u as in become subject to the Wmicesi Compensation '
Law,of California.Date
Applicant
NOTICE TO APPLICANT:IL after making this Cendicam of Exemption,you should
become Subject m the Worker's Component..provisions of IW L Wr Code,you most
.J 0 forthwith comply with such Provisions or this Pewit shall be deemed newtukod.
'Z CONSTRUCTION LENDING AGENCY
Fw Iheubyaffiw that Nomiso communion lending agenry for the pcif...of
!Yi the work for which this pewit is issued(Sec.3N7,Co.C.)
6W. A Undoes Name
z Loader's Address
U 0 I certify,Nat I how read this application and sum that the aW n information is
U.P comem,I agree in comply with all city and county ordinaries and sum laws relating in
0 U building consuaction,and hereby authorim representatives of this city to enter upon the
[27 iflisnebabili monuonod propertycosts
for inificuums,a,.a puryh,es.
" gy (We)agree m ave,indemnify and keep hawleu the City of Cupertino against
in consequence
o nu,granting exp is proa which may in any way accrue againseaid City
U in APPLICANT
ofIWgaming of this permit.
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOU EGUL2RTION�g-
GUL l,_ 16Re-roofs
w
ignarc of A' HAZA DOUS MATERIALS DISCLOSURE D�— Type of Roof
Will theappOeart orfm inkling occupant stem or handle hatsrdous material
az defined by sex Cupertino Mu cipal Coca.Chapter 9.12.and the Health and Safety
code.Saiiz632(+)]
0y. [ Na All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtaining an inspection,I
Will the applicant or future building occupant tau equipment or dcvias which g agree to removeisP
t hazardous air contaminants as defined by Be Bay Area Air Quality Management all new materials for inspection.
vic0
Utes pt4u
I have mail the h vemicusmaedals requirements under Chap rrb.95 of IW Califor-
nia Health&S+fetyCede,Sections 25X15.25533 and25534.l undcumnd thatiflW Wilding
ofcn.htlyhast a=nem,thm it is my rmpadinfity m aoYty IM occupal of the
wrier error mm pdarmiapan¢aracertiha!nyPoecapan,y. Signature of Applicant Date
-� —� (��-6" All roof coverings to be Class"B" or better
Owner or amnomcd agent n