04030258 CITY OF COPER'l'INO �" '�'''
BUILDING DIVISION PER ' CONTRACTnR INk'ORMA- N �g
63m...„ "... 3svm'"'�'k9La s 'u'n
BUILDING ADDRESS: PERMIT NO.
04030258IrTITAT 17T '
OWNER'S NAME: PERMITISSUEDATE
KALLURI EqWAR -/
.NE: SANITARY N N . ONTROL NO.
ARCHITECTMNGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
X00 LICENSED CONTRACTOR'S DECLARATION lob Description
w❑ 1 Mrepy affmm Nm 1 am lienor under sons of Cnap¢r Y(commcneing
dE wiNScI IX10) fDlviziI I'NCBosinc MPromot of
9(mormamis
0,2 c �imunll ndams°cfj -" Lk. o-:J�tu REPLACEING FOUNDATION AS IN PLACE
p
Z-Z au ' - - Comaclm "' CONTRACTOR: BROCKMAN ENGINEERING CONTRACTORS
ARCHITECTSD ATION
? I understand my plans sM1all he used am ureic records
3 u0� Licensed Professional
5 OWNER-BUILDER DECLARATION
1 hereby alRren Nat I am exempt from dre Coon's License Law for the
.�<I
O O following reason.(S"son'7031.5.Business and Pmfessiom Cade:Any city or county
m which aqui..a Permit to construct,aline imprme,demolish.at repair any structure
prior to its issuance,also inquires the applicant for such Permit o rile a signed suumem
?< rhot he is lice nscdpursoanr to the Provisions of the Cmmim's License Law(Chapter 9 Sq.Ft. Floor Area Valuat�g000
BIZ-$ (commencing with Section70Mpof Division 3 of the Business and Professions Code)or
that he is exempt dw.f1 m and the basis foe du alleged cacmp0on.Any violation of
Section 7031.5 by any applicanrfor a Permit subjects the applicant to a civil Penalty of APN Number Occupancy Type
not mom Nan five hundred dollars(5500).
D L,as owner of Ire porputy."my. cmplo ccs with wage u their In mmpenmtian. 3 6213018 . 00
will do the work and the strumase is mol inuMed oroRered for sale(Sec.904,4,Business
and Professions Code:The Convazmfa License Law docs not apply to an ow er of Required Inspections
ompeny who builds or improves Hereon,and whodoessuchworkhimself or through his
;rum employees,provided that such improvements are ne year tc opted n.for ask,Own It.
however,the building or improvement is old within one year of Improv for pu owner-
builder will M1ave the,burden of proving that he did not build or Improve for puryose of
sale.).
D I,as owner of the propeny,am exclusively convening with licensed convectors to
construct La the project(Sec.7(144.Business and property
wh ions Code:)The Contractors ed
come law dors nal apply loan owner of propeny who sad p or impmw thereon,and
who contrecu for such pmKcts with a contrazmr(s)li"nud pursuant to the Convumfs D�
Lion¢law.
❑1 am exempt under See .B&P C for Nis mason
Own" Data
WORKER'S COMPENSATION DECLARATION
1 hereby aRsm under penalty of perjury one of the following decimations:
41
1 hew and will maintain a Ctrolmo a of Cnusent to self-insure for Worker's compere
orba
sn,uprovided for by Section 3100 of the Iabot Code,for the peAornamea of Ne
work for which this permit is issued.
D 1 have and will maintain Workers Compensation Insurance.a inquired by Section
37W of Out Inbar Code,for the performance of the work for which this permit is issued.
1My Workers Compensation Insurance artier and Policy number am:
a bvrier. S ✓kms FU It'�l Policy Na.:- C"tl'v=Li-T lFi
✓y CERTIFICATEOFEXFMPf10N♦REIM WORKERS'
COMPENSATION IN5 EN'CE
Crus section ncad nal be completed Hthe permit is fomite hundred dollars(SIM)
or less.)
1 eenify Nat in the performance of Ne work for which this Permit is issued.l shall not
employ any person in any manner an a to become subject m the Worksss Cempmamon
Laws of California.Da¢
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Eaempllan,you should
become Subject to the Worker's Compensation provisions of the Labor Code,you most
.JOforthwith comply with Such provisions or this Permit shall be deemed mwkcd.
ZCONSTRUCTION LENDING AGENCY
=
[-. I hcnchy affirm Our Nem ism construction lending agency for dePraetor mom of
a> do work for which this Permit is issued(S".30)7,Civ.CJ
W Q Lender's Namc
Ow Lender's Add.
V C) I ecnify that 1 have read this application and sum that the above OrmmaLon is
W (" mmcL l sigma to comply with dl city and county ominmtts and mule laws.]sungto
pU building construction.and hereby authome represenutivcs of this city to most upon the
W above-mentioned property for impaction purposes
(We)agree to sate,indemnify and keep harmless the City of Cupcnino against
F" N limillues,judgments,costs and expesues which may in any way acct¢against mid City
V z in conscgflcncggqqqq of Nc ting ofthia PcrmiL 3
^ APPLIC NUNO ANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE R/ UL4 N5.
3'3t-C k Re-roofs
'9ngnuL c f pplicmVCcmrmmr Dam
✓✓ V HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupant store or handle hazardous material
so defined by ds Cupenim Municipal Code.Chapter 9.12,and the Health and Safety
Cale.Smuon 25532(a)7 All roofs shall be inspected prior to an roofing material beim installed.
Dyes plNa P P Y g r
Will One applicant or future building t ase equipment of devices which If a roof is installed without first obtaining an inspection,I agree to remove
PP gby then Area
n
mil hanSdnus air conuminanu u defined by the Bay Arca Air Quality Management all new materials for inspection.
Disvin7
❑Yes AN.
1 have mad the hmardous materials requirements under Ctapsr 6.95 of the Califor-
niaHalth&Safcry Cod Sccdona25505.25533md25534.1undcaundlhatifNchuilding
I docs or colly ha u em,Nal it is my responsibility to nouly the w.'cupml of Nc
requlne eta men lxMet four lo immamcenraeeNfiate nraapme' Signature ofApplicant Date
't' n r o uthomed agent Dam All roof coverings to be Class "B" or better
s •
CITY OF CUPERTINO
1 of 1 PERMIT RECEIPT OPERATOR: conniew
COPY # 3
Sec : Twp : Rng: Sub: Blk: Lot :
APN 36213018 . 00
DATE ISSUED. . . . . . . : 03/31/2004
RECEIPT # . . . . . . . . . : 25040
REFERENCE ID # . . . : 04030258
SITE ADDRESS . . . . . : 7902 FESTIVAL CT
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER KALLURI ESWAR
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4115
RECEIVED FROM . . . . : BROCKMAN ENGINEERING
CONTRACTOR . . . . . . . : LIC #
COMPANY . . . . . . . . . . :
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . :
TELEPHONE . . . . . . . . :
•E ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
------ - - - - ------------- ----- ----- ---- ------ --- - -- ---- ---------- -- ------- -
BPERMFEE VALUATION 7, 000 . 00 127 . 00 0 . 00 127 . 00 0 . 00
BENERGY PERMIT FEE 127 . 00 38 . 10 0 . 00 38 . 10 0 . 00
BPLANCHK PERMIT FEE 127 . 00 107 . 95 0 . 00 107 . 95 0 . 00
BUSLIC FLAT RATE 1 . 00 100 . 00 0 . 00 100 . 00 0 . 00
BSEISMICRE VALUATION 7 , 000 . 00 0 . 70 0 . 00 0 . 70 0 . 00
------ ---- ------- - - -
--- ------- --- -
TOTAL PERMIT 373 . 75 0 . 00 373 . 75 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
--- - ------------- ------- - - --- --- ----- -- --
CHECK 373 . 75 16293
TOTAL RECEIPT 373 . 75
•
t S121 WITY OF CUPERTINO*
CITY OF PERMIT APPLICATION FORM o
CUPEkTINO 0(�03 ZSR
IkPN# Date: 1
36`Z 13O1g '3 -31-0�
Building Address: Mailing Address (if different from building address):
"D 0z Fi5n VAt– Cay lzir 6,P"Co,(
Owner's Name: Phone#:
KESwn,(2 q68-2 30 -cc'Z l3
Contractor: License#:
32[xKMHIO L-ICaiNff--W1KJC7 coN! 5GOy01
Contact: Phone: Cupertino Business License#:
M WEST— F .q2S)63w--2
Building Permit Info:
Bld Elect ❑ Plumb ❑ Mech ❑
Job Description: tN rLALC
Residential ❑ pE LAeiN(7 1-ou0DA>jON A-3 Commercial ❑
Sq.Ft. Floor Area: S/Sq.Ft.: \
Cost of Project: Occupancy Group:
Type of Construction: Please check this b`b%.iLLhc4xvofect is a
second-story addition: ❑
Quantity Fee ID Fee Descri tion Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBLDGFEE Bldg Permits . foot BUILDING
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> 1 OOK to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to 1M Btu MECHANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
BBOILER5 Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/Quasi BUILDING
BCONSTAXBQ Con. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax —Resi/Mobile BUILDING
BELEC1000 Elec 600V <= IOOOA ELECTRICAL
BELEC1001 Elec 600V > IOOOA ELECTRICAL
BELEC200 Elec Svcs 600V <= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
BMITIGATC I Comm. Housing Mit. Fee BUILDING
4 Z S-zs(� D
lof3 37
3 , ZJ'
Step- , SrITY OF CUPERTINO
CITY OF PERMIT APPLICATION FORM
CUPERTINO
Quantity Fee ID Fee Description Fee Group
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BOVERTIME Inspection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE Pblg Fixture PLUMBING
BPGAS Gas Piping System Fee PLUMBING
BPINTERCEP Ind Waste Interceptor PLUMBING
I BPLANCHK Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plan Check Repeat Fee BUILDING
BPREPIPE Re i e Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn S rinklerBackflo PLUMBING
BPSTORM Storm/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain & Vent PLUMBING
BPWATER Install/Alter Water Pie PLUMBING
BPWHEATER Water Heater/Vent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit > 10,000 cfm MECHANICAL
BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Fumace> I OK btu MECHANICAL
BREWMAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
13REN MISC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power Device/Apparatus ELECTRICAL
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Mar uee ELECTRICAL
2 of 3
SCC' *CITY OF CUPERTINO
CUP YOF PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group
BREMTHEATR Theatrical Lighting Fix ELECTRICAL
BREMVENFAN Vent Fan Single Duct MECHANICAL
BREMVENSYS Ventilation Systems MECHANICAL
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Inspection BUILDING
BSWIM Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM
Temporary Bldg Permit BUILDING
BTEMPSVCS Temp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicals . foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issue PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
ZADDCHG Address Chane BUILDING
•
3 of 3
( 1
SEC JOB: 04-0006
ADDRESS: 7902 FESTIVAL COURT
R O C K M A N CITY: CUPERTINO
'ENGINEERING CLIENT: MR. KALLURI AND MRS. LAKSHMI VENKATARAMAN
' ' DATE: 1/27/04
DRAWN BY: RJB
LIC.NO. 560401 -
FOUNDATION/GRADEBEAM REPLACEMENT
AS-IN-PLACE
AREA OF REPLACEMENT (*��N FRONT ENTRY
oFflft
Copy
(E)BLOCKING
� (N S SIDI SNG OR TOP
SIDI
WOOD I (E)FLOOR JOIST/GIRDERS
I
n}�FLASHING AS NEC.
MAR v ZC�4 5/8"0x12"ANCHOR BOLTS
ALTERNATE OUTSIDE FACE rA I; 1 w/2'x2"X3/16"WASHERS
TO ACCOMMODATE OF NEW CONCRETE V���r..Ey�1Tp.L��y ® I; I @4'O.C./1'MAX. FROM
oe° ARTME� :I EACH END OF PLATE
P'�S[ !Vr I•• I
(E)GRADE I I #4 REBAR"L"S @ 18"
ALTERNATING DIRECTIONS
4-#4 REBAR HORIZONTAL i I OR VERTICALS @18"DOWELED
E INTO EXISTING PIERS
APPROVE® I I F NECESSARY
1
................:.
IN ACCORDA CE WITH E CITY OR —
I
CUP ERT 0 DES AND ORDIN _ _ _ _ _I oy SPREAD FOOTING
I I
GATE -- ......................_.....I......i...........................i
I I
SIGNED
This set v. 1`131's and specific tions MUST
Do kept on the job at all time and it is un
lawful to make any Changes or, alterations (E)PIER
on same without ,+vm
ritten permission from
the building Dept., City of Cupertino.
The stamping of this plan and specifications
,'HALL NOnnnfffT be held to permit or toovisiong b or.
\fialationany
CONCRE7Lpf�b tI P( 12 C( o to Law.
-DOWEL E0B`ffb 6" @ JUNCTION w/EXISTING FOUNDATION
•5/8"0x12"ANCHOR BOLTS w/2"x2"X3/16" WASHERS @4' O.C./1' MAX. FROM EACH END OF PLATE
SCALE:NONE
P.O. BOX 1223 9 BRENTWOOD, CA 94513 (925) 834-2899 • Fax (925) 834-7831
CITY OF CUPERTINO
BUILDING DIVISION PERMIT .CONTRAC°"TQR INFORMATION•
BUILDING ADDRESS: PERMIT NO.04030258
OWNER'S NAME: PERMIT ISSUE DATE
KALLUR
NE:
SANITARY 0 TROLNO.
ARCHITECDENGINEER' BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
Loa LICENSED CONTRACTOR'S DECLARATION - — - -
IHere .rrirm mal I am Rama aaaer v Sia-arcnaP. 9 aammmamg lob Description
soil Sec )af Division3of0eBusi^�p°�Pfafenius Cade.andmylicenscu
n in full r or t. ✓ -...
5'q? Liceateceas t Lie# r:0�101 REPLACEING FOUNDATION AS IN P CE
^o am cam CONTRACTOR: BROCKMAN ENGINEE A' S
y ARCHITECTED ATION
Y w I understand my plans mall W mod=rteards
3 H Licensed Professional APR 20 2004
vt OWNER-BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contactor&Liccnse Law for the
00 following mason.(Section 7031.5.Business and Profossions Cmc:Any city or county
which requires a Permit to construct.eller,improve,dam d W.Or repair any structure RIM DING
rZy prior to its issuance.also memos the applicant for such Permit to rile a signed namment
iso
not he is licensed pursuant to the provisions of the Cmumchas Let.Law(Come,9 Sq. Ft.Floor Area Vauat4�o9000
p�3 (commenting with Section 70g)of Division 3 of the Business and Professions Code)or
mat he is esompt therefrom and the noir for me alleged exemption.Any violation of
Section 7031.5 by airy applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not mom tion five hundred dollars D5001.
❑L asowner of me property,army employees with wager as their rete Compensation. 36213018 . 00
will do the work and the sumum is notimendea araBereaformic(Sm.7064,Business Required Inspections
and Professions Coda:The Cmanseme,License Law does tot apply On an ower of q P
property who builds or impmm demon,and whoclam such work himself or through his
covam ployces,paviaed thatsah improvements she not intended oroRered formle.If.
however,the building ne improvement is sold within ane year of completion.the owner.
builder win have the harem of proving that he aid not Wild or improve for purpose of
sale.).
1,as owner of the propenY•am oeloively Connoting with licensed cuntnmos m
eo..I an,pmje¢(Sec.7066,Business and Professions Code:)The Convectors U.
clean law does not apply an an owner of property who builds at harrows theman,and
who mntracs for such projects with acommcmr(s)licensed possuant to the Comnemrs
License La-
0 1 stn exempt under Sec. .B&P(7for Nis moon
Owner Dm,
WORKER'S COMPENSATION DECLARATION
1 hereby&Rum under penalty of perjury one of the following decimations:
❑Ihave and will maintain a Certificate of Consent to self-insmefwWakeraCompen-
sation,as Provided fm by Section 37M of the labor Cade,for the performance or dm
work for which this permit is issued.
l]I have and will maintain Workers Compensation Insunn¢,m mquired by Section
3700 of the Labor Code,for the performance of the work for which this permit is issued.
t(dy Workers Compenation Insuanee arrim and Paliry number am:
a t7slrier. STATE Fume) Polict'No.:'jl6-L'LV'D`frL.(i
✓Y CERTIFICATE OF EXEMPTION M WORKERS'
COMPENSATION IN ANCE
(11is union need not he completed if tic permit Is form=hundreddollem($100)
or kgs)
I certify that in the performance of to work for which this Permit is issued,I shall not
employ any person in any manner an as to become mbjecuo the Workert Compensation
Laws of Califomia.Dam
APPIUMIL
NOTICE TO APPLICANT:If,after making this Ccrincae of Exemption,you muula
become Subject to the Worker's Compensation provisions of the Labor Code,you must
.JO forthwith amply with men provisions or this permit shall he damed revalued.
z '--' CONSTRUCTION LENDING AGENCY
F. .N-. Ihereby of an that dere is a cowmnian lendingapney fm f per(urmaueof
CLQ the wark for which this permit is issued(Sec.309],Co.G
G Lender's Name
_Z Lonjor',Addreart
s
U Q 1 certify that I have mad this application and sum that the Olson iarom sh un is
ly F caner.I agree to comply with all city and county ordinances and sum laws mlating to
pU building convection,and hereby authorial mpresematins of this city to enter upon the
r above-mentioned papeny for inspection purposes+
(We)agree in awe,indemnify and keep harmless the City of Cupertino against
Hliabilities,judgments,costs and expenses which may in any way accrue against mid City
[Jz in cc OC ofine ting of this permit.
APPLICM END ANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:S4"Ca Date
SOUR R UL Q NS.
at - x'31-d Re-roofs
gnJ f pPltc VAZARDOUS_tor Dam
MATERIALS DISCLOSURE
HType of Roof
Will de applicant or future building Occupant score or handle hazardous material
o defined by de Cupertino Municipal Code.Chapter 9.12,and the Heald and Safety
Cmc,Soup.255320)9 All roofs shall be inspected prior to any roofing material being installed.
0Yes C1Na
Will the mplicmt or future bu iding 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 Area Air Quality Management all new materials for inspection.
District? ���///
❑Ye 1tNu
I have mal the haafdous materials requi¢menu under Chapter 6.95 of the Califon
nice Health&SafetyC Seeucas 25505.25533 and 25536.1 understand that if d➢building
does not rtC Y na @Hent th➢111 Ice my ne3ppn{Ibi111Y b nallly the YapNt of the
mquire Mm bcmmpdarmitsaatt«araceaifea. Cagan 1� Signature ofApplicant Dale
a amariaeaaseat DateAll roof coverings to be Class"B"or better