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08060110 CITY OF CUPERTINO . ra..r^ BUILDING DIVISION PERMIT yCON kWTOR INFORMA BION n�✓;set,1D PERlI MNO. BmLT!T%AD ,R OUNTRY SPRING CT CONDITIONED AIR 08060110 OWNER'S NAME: PERMIT ISSUE DATE NI:SHTALA SATYANARAYANA AND 1701 LITTLE ORCHARD ST 06/16/2008 SANITARY NO. CONTROL NO. (408) 291-2220 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH troll LICENSED CONTRACTOR'S DECLARATION Ib Description 4 U I totally s f me that I am OesCrl focused under provisions of Chapter 9(commencing P with Section 7")of Divivon 3 oftho Business and Profcssiue Code.and an,liceme is ADD F'URNAC'E, & WATER HEATER n in full face and effect. j License Clan Lk.N CFO Data Contractor ' HARCHITECT'S DECLARATION 1 understand my plans ahall W used as public recoNa 3y c o t; Licensed Pmfcssio..I S OWNER-BUILDER DECLARATION i<x I hemhy afrm the'I am exempt front IM Contractors Leon.Law for the C e 0 following mason.(section7031.5.Business and Profcacom Code:Any city or aunty 9 ff which requires a permit toconsumer,elle".improve,demolish,or repair any structure _Z i prior to its issuance.Aw requires the applicant for such Permit o fik a signed ss,mment < that he is licensed pursuant toNcprovisime;ofMeContrmter'ILicemat LawChapter 9 Sq.Ft. FloorArea Valuation sec (commencing wish Section 7f1o0)of Division 3oftheBusiness and ProfusionsCods)or $5881 r3— that he is exempt therefrom and the basis fa the alleged exemption.Any violation of Secdon 7031.5 by any applicant for a permit subjects the applicant m a civil penally of Number Occupancy Type rot mom than fire hundred dollars(53007 3 6 6 510 4 3 .Po P y yP 0 I,as ower of Die property.or my employees wide wage as their role compessalon, will do the work,and the mucume is not intended or offered forsak fire.7004,Business and Prefestie m acode: e Contemner,Licosa law dro oss t apply m son owmor of Required Inspections property who builds or i meow Mermn,and who does such work himsel f or through his awn employees,proNded that Inch improvements,are not intended oroffered for sets.If. howxw,the Wilding or impronmens Is mid within mm year of eempletion,tla owmor- Wilder will hive ted buNen of proving that W did not Wild or improve for purpose of sak.). 1.as owner of the Property...a imively conuano.g;with Iicsmed co recons m cmvuum the project(Sec.7044.Business sed Professions Cade:)The Commutes U. cove law docs not apply It an owner of property,who William improv themors and. whoconmcs,for such projects with a contraaent)licensed pursuant to Me Contractors Lkerus Law. 0 l am eemps under see ,e d PC for this mason Owner Dam WORKER'S COMPENSATION DECLARATION I Wmby affirm under persaty of perjury arm of the fallowing declamations: T ban and will maintain a Certificate of Content to nlf-inmre for Workers Consists. moon,ass provided for by Section 3700 of the Labor Code.for the performanc of Mm wort for which Nis Permit is isucd. 0 1 have and will emiman Workers Compcmnkn Insurance,as reCoined by section 3700 of led labor Code.for the pcolormanu of the work for which Nit Permit is issued My Worker.Compewo.Wed.artier and Policy number ere: Cartier, Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thu nmlm mond her W completed Bthe Permit is(oras,hundred dollars(SIM) or leu) 1 mortify Met he to performance a Me work for which this Permit is issued.I shall nm employ anyperaten in my madder an as to become subject to Urs Wakcri Compensation Laws of California.Dam Applicant NOTICE TO APPLICANT:If.after making Nu Certificate of Exemption,you should become subject m the Worlds,a Compensation previsions of Me Labor Code,you mum .J,z forthwith comply with such provisions or Nu Permit(lull be deemed mrokcd, z O CONSTRUCTION LENDING AGENCY EHerby affirm dust them it a coutmctinn lending agency for the performanc,of > the work for which this permit is issued(Sec.3097,Civ.C.) 0 lenders Name a z Lender,Address V 0 1 citify that 1 bac read this application and sole that the auras information is ErommaL 1 aBm,m comply with all city and comfy ordinances and sum laws elating to Wilding construction,and hereby sundries repretms,tiw of this city to enter upon the Ga Wve-mentioncd propertyset for inspection purposes (We)agmes te saw,Indemnify and kap IermleY the City of Cupertino against ry Z inconseque consequence of th,casuand exp,nwmit. may in any wyaccm,against said City . ()z 1) A APPLICANT of Mm granting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. srenaum of ApplianUContrmmr Dam Re-roofs HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the ePConso a(Muni Wilding eaupmtsm.1 or handle Me hrmdoa material C de.Sec by the Cupertino Municipal Code.Chapter 9.13.and the Heath and Safely Case.Sentient 255324)7 Oyes ON. All roofs shall be inspected prior to any roofing material being installed. Will Nes applicant or fuwre Wilding occupant um equipment or rkvim which If a roof is installed without first obtaining an inspection,I agree to remove t havaNnus air cmumimnv as dcfned by the Bay Area Air Quality Management all new materials for inspection. s,tri„7 OY,] ON. I have mal Ne heaarduus maeriais requimmcros under Chapter 6.95 of the Califor. nu Health k safety Code.Sections,25505.25533 and 25534.1 understood Met if the Wilding doe not currently bas.u:nana Met it is my responsibility to notify ted occupan,of the requinmentswhich most Wmet inner mbills cof.cerdreateafOccupacy. Signature of Applicant Date Owner or authorined agent Dam All roof coverings to be Class'%¢,'or better CITY GF CUPERTINO 0_1 4��- - BUILDIMG DIVISIQN PERNIITCONTRACTbQRNFORNr7ATIO BUILDING ADDRESS: PERMIT NO. 1.1.522 COUNTRY SPRING CT CONDITIONED AIR 08060110 OWNER'S NAME: PERMIT ISSUE DATE N1:SH`j'ALA SATYANARAYANA AND 1701 LITTLE ORCHARD ST 06/16/2008 SANITARY NO. CONTROL N0. (408) 291-2220 ARCHITECT9ENGINEEIL: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 I� .Op LICENSED CONTRACTOR'S DECLARATION Job Description 4 1 hereby Kinn that 1 son liamcd under pmvlsions of Chapter 9(commencing with Section 70!10)of Division 3 of the Business and Professions Code.and my license is ADI A/C N in full forte and attract. 'r— Dn— ucenr^�••�IA(,/ Lie.g( aF¢°�a Daum ) V aJ Contractor.ARCHMECTs ATION i W< 1 understand my plans dull be used as public rteoNs . 5yU 5 G Licensed Pwfewional Sys OWNER-BUILDER DECLARATION sZ O f 1,ruby alarm Nat 1 exempt from the Canuannae Law for the ' L eO following meson.(Section 9(131.1.5.Business and profession Code:Cade::A Any city or county whit,lequiles a prsmit w canswcL alar,improve,dcmnlW,m¢pair anY stmcwrt Sx> prioreis issuance,aiw rcquirex the applicant far such permittofileadpned sutemem S< mat he is licensed pu mullto the provisions of Lite Contractors Limnse Law(Charter 9 Sq.Ft. Floor Area Valuation yFg (commencing with Section 7(X0)of Division 3 of the Business Md Professions Code)or $5881 — that W is exempt therefrom and the basic for the alleged exemption.My Holatfan of Section 7031.5 by any applicant far a permit subjects due applicant to s civil penalty ofNumbet O nor more dun five hundred dollars(5300). 3 6 6 510 4 3 q81GGLL ant p y T'pe I,u owner of The ProPmtY,m rase wPloyw wW wages a the"v sok campwuadon, will do lie worl4 and thestructure is notinuMed or offered forale(Sm.7OµBusiness ns Required Inspections art Professions Code:The Conuutar's License Law does nal apply to an water of q p pmpmY who buildsmimpmvea Wtract.aM who does suchwut l irmelror through his own employes,provided that such improvements tee m almuc tied oroffertd forsale IL however,the building or impmvemcnt is Mid within arts year of completion,the owner. budder will have the Widen of proving that he did rat Wild as improve fm pontoon or ale.). ❑I.as owner of the property am exclusively contracting wins licensed contractors to constmn the Minn.(Sec.7044.Busts.and Professional Code:)M Contractor.U. . cents law dos not apply to an owner of property who Wilds or improves thereon,and who contracts for sucin projects with a contractor(s)licensed pursuant to the C°nursom s Licanm Law. Iamea."Ptandnr Bee ,B&PCforthill.. 137M e Data WORKER'S COMPENSATION DECLARATION 1 Washy affirm under penalty of perjury anent the following declaradans: haw end wBl mainuin a Certificate ofCamcmw self-inns fwwmterscomprn n,u provided fm by Section 37M of the Labra Code,fm the peAo Trance of the for which this permit is Onaed. have and will maiman Workefs Compensation Insurance,as retrained by Section of the labor Code,far me pedmmane.1 the work far which this permit u issued.Workeh Cmmpe 'o wranca meandalicy nupub'a�art�:,,'�'�ico - IilrylNa.:f�a'=s�I-I 1111 RTIFICA OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE - (I,It aecdon send not Wcmnphand if the Permit is Fortune hunthnd dollars($10(l) or leu.) 1 certify the,in the Mr....of thn work for which$is permit u issued,1 shall out employ layperson in any manncrw as to become subject to the Workeri Compcsuadon Laws of California.Data Applicant NOTICE TO APPLICANT.IL after making this Certificate of Exemption.you should WcOme subject to the Worker's Compensation provisions of the LSWr Code,you must .J z raMwith comply with such provisions or this permit shall he dcemeb revaknd. Z O CONSTRUCTION LENDING AGENCY I hemby afire that there is a construction lending agency for the performamc of 0.S .fir the writ for which this permit is issued(Sec.3097,Civ.C.) Q (amber's Name z L<ndcls Md. . U Q I certify that 1 have lead this application ad mute Wt the allow information u Igo E correct.1 agree to comply with all City and county Ordinances and state laws relating to 1 .� Wilding corsuuction,aM hereby wmod,e rtpnewnutiwa of this city to cnterupan the f1d aWve-mentioned property fm inspection ImPONOs (we)agree to save,indomniry and keep harmlw the City of Cupertino against V liabilities, consequence of -.-. en ,calls Md exp. which may in any way.cense against said City Z l / ^ APP ICANfUNDERSTANDrthulermIL COMP Y WITH ALL NON-PONT Issued by: Date SO C E e , r_ sip sir ppbeartrcan car /( Re-roofs HAZARDOUS MATERIALS DISCLOS RE Da Type of Roof / WiB tie applicant m forum Wilding acvpantswre or lundlc ha,mdeut material ao defunbd by the Cupmino MuPi :Iy. cipal Cade.Chapwr 9.13,and the Health and Safety Code,S23572(x)9 '10W All roofs shall be inspected prior to any roofing material being installed. ❑Yu Will the applicant or(love building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove sL ha,ardous air comaminamu as defined by the Bay Arta Air Quality Management all new materials for inspection. OYc] �No .. 1 have need Us hvuE<Lus mawerni requiremcess underehaper6.95°1rthe Califon all Hcalmd:SalnYCade Sccdmu 25505,25533 am 25534.1 macrsund muff me Wilding t cunendY have a tenant It u m rtspamibiliry u ratify pan of `qto Signature of Applicant Date ow emanthe me,eent D, All roof coverings to be Class'/¢ or better f CITY OF CUPERTINO 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN I . . . . . . . : 36651043 . 00 DATE ISSUED. . . . . . . : 06/16/2008 RECEIPT # . . . . . . . . . : BS000005120 REFERENCE ID # . . . : 08060110 SITE ADDRESS . . . . . : 11522 COUNTRY SPRING CT SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : NISHTALA SATYANARAYANA AND SEE ADDRESS . . . . . . . . . . : 11522 COUNTRY SPRING CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5116 RECEIVED FROM . . . . : CONDITIONED AIR CONTRACTOR . . . . . . . : RICHARD READ LIC # 22334 COMPANY . . . . . . . . . . : CONDITIONED AIR ADDRESS 1701 LITTLE ORCHARD ST . CITY/STATE/ZIP . . . : SAN JOSE, CA 95125 TELEPHONE . . . . . . . . : (408) 291-2220 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL . ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 5, 881 . 00 0 . 60 0 . 00 0 . 60 0 . 00 1EPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00 1MPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00 1MRRAA UNITS 1 . 00 61 . 19 0 . 00 61 . 19 0 . 00 1PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00 ITRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 .79 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 224 . 95 0 . 00 224 . 95 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 224 . 95 .VISA --------------- TOTAL RECEIPT 224 . 95 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL CITY OF CUPERTINO F FURNACE/AC CUPER-TINO . PERMIT APPLICATION FORM APN # (O / O() Date: Building Address: l 5272- Ct4 d Owner's Name: Phone#: g�� a �1S112 40t6 a9 Contractor: Phone#: C P VY J 8 L Fax #: Contractor License#: Cupertino Business License#: tl(A 2 Contact: Phone#: Fax #: #: Building Permit Info: El Plumb Plumb ❑ Mech Job Description: rr ��-- F""" �. tQc�el— Residential Commercial For Residential Installations: Attic I" floor ❑ 2nd floor ❑ Adhere to minimum setback requirement ❑ For Commercial Installations: Replacement same weight ❑ Additional weight (structural calcs) ❑ Structural Calculations required for new installation [� New installation Planning Approval Required ❑ Cost of Project: Type of Construction (usage Class): Sgt . oC) t >7 C Strapped On Platform L1 Bonded Li New Locatio Replacement Valuation: Green Building: Must attach Green Building Check list to this application CITY OF CUPERTINO. I�� FURNACE/AC CITY OF FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group FURNACE FURN/AC 1 PGASRES Residential for ea gas piping system of P 1-4 Outlets IBPGAS For each gas piping system of 5 or P more per outlet. 1BSEISMICR Residential Seismic B 1MECPLNCK Mechanical Plan Check M 1 MFR=<100 Furnace Syst<=100k BTU install or M relocate ea forced-air/gravity type famace/burner, incl ducts/vents attached to such appliance up to and include 100,000 Btu/h 1MFRN>100 Furnace Syst> 100k BTU install or M relocate ea forced-air/gravity type fumace/bumer, incl ducts/vents attached to such appliance over 100,000 Btu/h 1 EPERMITFEE Electric Permit Fee E l 1MPERMITFEE Mechanical Permit Fee M 1PPERMITFEE Plumbing Permit P / 1TRAVD0C Travel Documentation B 1BUSLIC Business License B CITY OF CUPERTINO FURNACE/AC CITY OF CUPERTINO FEE SCHEDULE , Quantity Fee ID Fee Description Fee Permit Type Group AIR FURN/AC CONDITIONING 1BCAIRHAN Commercial A/C Units <= lOk CFM B 1MCRAA Commercial Mech Repair/alt/add M 1BSEISMICO Seismic Commercial B 1PGASCOM Commerical for ea gas piping System P 1-4 outlets 1PGASRES Residential for ea gas piping system P of 1-4 Outlets 1BPGAS For each gas piping system of 5 or P more per outlet. Comm/Resid 1BREMAIRHAN Residential A/C units<= l Ok CFM B 1MRRAA Residential Mech Repair/alt/add M 1BSEISMICR Seismic Residential B IEPERMITFEE Electric Permit E 1MPERMITFEE Mechanical Permit M IPPERMITFEE Plumbing Permit P ITRAVDOC Travel Documentation B 1BUSLIC Business License B s zu Community Development 10300 Torre Avenue It Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 �UPEkTINO Building De artment JOB ADDRESS: PERMIT# OWNER'S NAME: S PHONE # " Y2qj-7-Z2 GENERAL CONTRACTOR! CM7h L- 6S < FAX # ( G — Z7 L-4, I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing H ( N& Z Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile I, 10 ky V Owner/Contractor SL ature Date CITY OF CUPERTINO M ITEM 1 OF 1 PERMIT RECEIPT OPERATOR: pdtg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36651043 . 00 DATE ISSUED. . . . . . . : 06/23/2008 RECEIPT # . . . . . . . . . : BS000005186 ' REFERENCE ID # . . . : 08060110 SITE ADDRESS . . . . . : 11522 COUNTRY SPRING CT SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : NISHTALA SATYANARAYANA AND SEE ADDRESS 11522 COUNTRY SPRING CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5116 RECEIVED FROM . . . . : CONDITIONED AIR CONTRACTOR . . . . . . . : RICHARD READ LIC # 22334 COMPANY . . . . . . . . . . : CONDITIONED AIR ADDRESS . . . . . . . . . . : 1701 LITTLE ORCHARD ST CITY/STATE/ZIP . . . : SAN JOSE, CA 95125 TELEPHONE . . . . . . . . : (408) 291-2220 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 5 , 881 . 00 0 . 60 0 . 60 0 . 00 0 . 00 1EPERMITFE FLAT RATE 1. 00 _ . 40_79 40 . 79 0 . 00 0 . 00 1MPERMITFE FLAT RATE 1 . 00 40 . 79 40 . 79 0 . 00 0 . 00 1MRRAA UNITS 1 . 00 61 . 19 61 . 19 0 . 00 0 . 00 1PPERMITFE FLAT RATE 1 . 00 40 . 79 40 . 79 0 . 00 0 . 00 IPRWHEATR UNITS 1 . 00 24 . 48 0 . 00 24 . 48 0 . 00 1TRAVDOC FLAT RATE 1 . 00 40 . 79 40 .79 0 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 249 . 43 224 . 95 24 . 48 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 24. 48 VISA --------------- TOTAL RECEIPT 24 .48 VOICE IO DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL •