08020040 CITY OF CUPERTINOair- tom,. .::
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BUI1NG DIVISION PERMIT ; CONI'IUMOIt DWO
a
MIT NO.
B "T6`1nESbARDEN GATE DR THD @ HOME SERVICES P�08020040
WSR'S NAME: PERMIT ISSUM DATE
RINIVAS KOMIDI 3200 COBB GALLERIA PKWY STE 02/07/2008
PHONE: 7 n n SANITARY NO. CONTROL NO.
ARCHrl MNCINEER: R&R 3 WINDWS„ 1 ENTRY DR LIK BLDG BUI��GPER�UM80 MECH
3 0 0 0 0
0 LICENSED CONTRACTOR'S DECLARATION - Job Description
rd I hereby affirm Nn 1 me licensed
tondos provisiau of Chapter 9(rnmmorch”' p
Sj`uj with Search 70(11)al'Divivan 3 ofae Buaineu and Professiuu Code,mel my license is
nF is full fares and cRecL
BJZ Dam _ Lk.o
0 F Dem Gntran
e
ARCHITECT DECLA TION
y n 1 understood my plana shall be used u public records
e.
U
u. Licensed Professional
50 OWNER-BUILDER DECLARATION
n
Q j 1 hereby aRmt the 1 1. exempt from the Contractorses,CaLicense Law far de
O O following Tama.permit
t 7(131.5,Business and en.de ons Cole:Any city ar county
$� which mqui s a n permit te c ares do etec improve,demolish,ore a sig any hattersurecuum
Zt prior miriuuncerental Me tie applicant for such permute NeasLneduatemem
g � that he entlnuJpunton700)ofDivisiiu3ofdienuinessanimnselAw(CMpmr9 Sq.Ft. Floor Area Valuation
IIII the he is
Section the
basis for
of Neegedaumton.Any
viCode)ion or
of
$ Nu Section
u exempt Nuefmm and Ne bur for the alleged eumptien.Any violation of
.1 no re Mans by ury applicant for a perms subjccu the applicant te•civil Penalty of APN Number - Occupancy Type
wt moT Nm fiw hundred dollars(gSWk p y yp
❑1,uowner or the diumuces.or is Liammiea conflicted
cx4,Sumon,
will da thawork,and am ore Cha a neU Licenu ora w mo torulapply to an Budwe
and try,wh ou Code:The Gnuanlora nd who law don not apply m an awner is Required Inspections
propertywhob,provirimpmvuthImpro dwho are
himwRor through his
awnemplayec;provided that such Impro id wit toe not intendedmplatimd fm core If,
.
however,the building or improvement is mid within ore year ofImpro a for the comer.
builder will hon the burden of proving Nn he did not ddld or improv far purpose of
wk.).
0 1,as owner of the property.am exclusively contracting with licensed mmmeaces to
construct the Mica(Su.7041,Business and Professions Code)The Communes U.
case law docs not apply to an owner of property who builds or improves Iherson,red,
why contracts for such projects with a conuular(s)licensed pursuant to the Contractors
Lkeve Law.
❑I am exempt under See ,B k PC fm Nis moon
40 nes Dam
WORKER'S COMPENSATION DECLARATION
I hereby affirm under peully,of perjury now of Jen fallowing declua0ons
Olhave prowill for
Se Cerdf3wm of the
Labor Code,
the performance
of due
work,,r provided for mi Section 3700 0(the Inbar Code,for the perfarmana of Jen
work for which this permit is issad.
�I0
ban and will mumuin Warkefs Compensation Insurance,w repaired by Seedan
371 use labor Cade,for the perfarmana of Me work for which this permit is loud.
My Work/e�rs Compeuaa�n�"'rance//``artier and Policy number am:
VLUnp"APoliryNo.aTf-Uz09
CERTIFICATE OF MEM P ION FROM WORKERS'
COMPENSATION INSURANCE
(Thu ection need trot W completed if the permit rfarone hundred dollen SIM)
or lens.)
I anify that in the performance of the work for which this permit Is issued.I shall not
employ any person in my manner m as in become subject to the Workers'Comperuation
Laws of California.Date
Applicant
NOTICE TO APPUCAND If.after making this Cenifiam of Exemption.you Mould
become subject ce the Worker's Computation previsions of use labor Code you mut
.J O forthwith comply with such provision or this permit shall be dcemed meted.
.zee h CONSTRUCTION LENDING AGENCY
[—i Imuch,-Mon the Nem era construNnn leading agency far the performmce of
(Yi the work for which dds pemtit is issued(Sec.3097,Civ.C.)
W�Q Undoes Name
z I<nders Address
U 0 1 anlfy that I have read this appliudan and state Nu Nc above Inrurmauun u
V.^^ cotrtxt I agree to comply with all city and county ordinances and state lawn Taming to
C)Ell: building construction,and hereby someone Tpmmauuws of Nis city to enter upon the '
IA
above-mentroned property for expenses purpowhich may
LL (We)agree te save,indemnify and keep humin the City of Cupertino against
w.rZ incomentuatoofth,coN and expenses which may in my way acerae ag4utsaid Cly
C)z inconsegnenee UNDERSTANDS
AND WILL
�7
.. APP NT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOU REGULATIONS.
"" am ¢a3IALSD E Data Re-roofs .
allotment of Appliran�UC ror T ' Data '
H Boo= MATERIALS DISCLOSURE Type of Raof,
Willy he plicant orCummm,Mum spat Co e.Chantsmre or handle Health adrloux Safety OeOSc by the Cuperdno Munieipel Cade.Gapter 9.13,and Jte HnIN and Safety
woe,Moy.25532(1)? All roofs shall be inspected prior to any roofing material being installed.
❑Yu pa
will thea Bart ro rotors building Occupant am If a roof is installed without first obtainingan inspection,I agree to remove
PP g P equipment ar devices which P
emil hea rmuc air cmumiunu he dcfincd by Ne Bay Area Air Quality Management all new materials for inspection.
Gimlet? P
0Yu /tea
I have Tad the hason4 mucriar mquiromcnu under Chapmr6.95afOmGlifm-
nuHcaiNdkSafcryCoda,Scabu25505,35533 um25534.lundcruned theifdm building _ —7�
dm umendy haw a mnanL Nu it u my responsibility m nadry Ne recap.,of Ne
m nu which the tpdortexamoscafa Cenlumdoof Occupuwy. Signature of Applicant Date
owner m suNarlea a Dam All roof coverings to be Class"B"or better
aw CITY OF CUPERTINO
CUPERTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN# n / O �� 1P D 0 Date: F
Building Address:
.�2 r7 c, Je -D .
Mailing Address (if different from building address):
Owner's Name: Phone#:
Sr ; W ; vqs vo
Contractor: Phone:s/o_ 73
—7-1-1 - ie //0 M e Sem✓ yes
Fax: `S/J '7d?U FS-10
Contractor License#: g3( C F J C �-s S
• Cupertino Business License#: C/ C
Contact: Edward g �o Q Phone: .5-/0.- yy�- /idZ/
North Bay 'Gregervyc,
Fax: 5-/0 ' 3VOP9- P60 9
Residential ' Commercial
Job Description: rn! ✓t C�JW s
Building Permit Info:
Bldg X Elect ❑ Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
1 FR, 11FR ❑ 11, 111, V-1HR ❑ 11, 111, 1V V-N ID S //�
Valuation:� i73 Square Footage:
'
® Project Size: Standard Large ❑ Major ❑
ao CITY OF CUPERTINO •
CUPERTINO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1BTEMPPER Temporary Building Permit (good for B
30 days)
1BBOILERI For the installation or relocation of ea M
boiler/compressor to &including 3
horsepower, or ea absorption sys to &
incl 100,000 Btu/h 29.3kw)
1BBOILER2 Installation/relocation of ea M
boiler/compressor over 3 horsepower
to &incl 15 horsepower, or ea
absorption ss over 100,000 Btu/h
1BBOILER3 Installation/relocation of ea M
boiler/compressor over 15 horsepower
to & incl 30 horsepower, or ea
absorption sys over 500,000 Btu/h to
& incl 1,000,000 Btu/h
1BBOILER4 Installation/relocation of ca M
boiler/compressor over 30 hosepower
to &incl 50 horsepower, or for ea
absorption sys over 1,000,000 Btu/h to
& incl 1,750,000 Btu/h
1BBOILERS
Installation/relocation of ea boiler or M
refrigeration compressor over 50
horsepower, or ea absorption sys over
1,750,000 Btu/h
1BAPPL6TH For ea appliance or piece of equip M
regulated by this Code but not classed
in other appliance categories, or for
which no other fee is listed in this
code.
1ELEC1NSP Other Electrical Inspections (per hour) E
1MECHINSP Other Mechanical Inspections (per M
hour)
1PLMBINSP Other Plumbing & Gas Inspections P
(per hour)
IMEETINGIHR Application Meeting B
r� CITY OF CUPERTINO
• CUPRTINO GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
ACOUSTICAL
REVIEW
1ACOUSFDW SFDWL/DuplexNew B
1ACOUSRESAD SFDWL/Duplex-Addition/Alteration B
IACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
1CHIMNEY Chimney B
1CHIMNEYR Chimney Repair B
FENCES
IFENCE>6FT Non-masonry, over 6 ft in height B
1FENCEMAS>6 Masonry, over 6 ft in height B
FIREPLACES
1FIREPLMAS Fireplace Masonry B
1FIREPLFAB Fireplace Pre-Fabricated/Metal B
1FLAGPOL>20 Flag pole (over 20 ft in height) B
1MODUSTRU Modular Structures B
FOUNDATIONS
1FOUNDREP Foundation Repair B
1PILECAST Pile Foundation Cast in place concrete B
1PILEDRIV Pile Foundation Driven (steel, pre- B
stressed concrete)
3 of 5
CITY OF CUPERTINO
CUPEf�TINO GENERAL BUILDING APPLICATION •
FEESCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
IGENCOM
RETAINING
WALL(CONCRETE
OR MASONRY
1RETSTN Standard (up to 50 ft) B
1RETSP310 Special Design, 3-10' high (up to 50 `) B
1RETSP10 Special Design, over 10' high (up to B
50'
1RETCRB< Gravity/Crib Wall, 0-1O'high (up to B
50 ft
1RETCRB> Gravity/Crib Wall over 10' high (up to B
50 ft
SIDING
1 SIDEST/BK Siding, Stone &Brick Veneer B
interior/exterior)
1SIDEOTHER Siding all.other B
SKYLIGHTS
1SKYL<10 SF Skylight less than 10 sf B
1 SKYL>10SF Skylight greater than 10 sf or B
structural
1STAIRS Stairs-first flight/ea addt'l B
STORAGE RACKS
1 SRACKS<=8 Storage Racks 0-8' high (up to 100 sf) B
1SRACKS>8 Storage Racks over 8' high (up to 100 B
st
1STUCOAP Stucco Applications (up to 400 sD B
additional stucco application
4 of 5
CITY OF CUPERTINO
c GENERAL BUILDING APPLICATION
• CUPEI�TINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
I 1 WINREP Replacement windows/sliding glass B
door (ea 8 windows)
1WINMEWSTR New Window-structural shear B
wall/masonry includes plan ck fee)
IEPERMITFEE Electrical Permit Fee E
IMPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit Fee P
1ELCPLNCK Stand Alone Electric Pln Ck(hourly) E
1MECPLNCK Stand Alone Mechanical Pln Ck(hrly) M
1PLMPLNCK Stand Alone Plumbing Pln Ck (hrly) P
1 STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B
when not over counter) hourly-stand alone
/ 1BSEISMICR Seismic Residential B
IBSEISMICO Seismic Commercial B
1TRAVD0C Travel &Documentation B
1BUSLIC Business License B
5 of 5
CITY OF CUPERTINO
2 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32630086.00
DATE ISSUED. . . . . . . : 02/07/2008
RECEIPT #. . . . . . . . . : BS000003877
REFERENCE ID # . . . : 08020040
SITE ADDRESS . . . . . : 20961 GARDEN GATE DR
SUBDIVISION . . . . . . .
CITYCUPERTINO.
. . . . . . . . . . . . . .•
IMPACT AREA . . . . . . . . '
OWNER . . . . . . . . . . . . : SRINIVAS KOMIDI
ADDRESS . . . . . . . . . . : 20961 GARDEN GATE DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : EDWARD A GREGORY
CONTRACTOR . . . . . . . : FRANCES BLAKE LIC # 29818
COMPANY . . . . . . . . . . : THD @ HOME SERVICES
ADDRESS . . . . . . . . . . : 3200 COBB GALLERIA PKWY STE 20
CITY/STATE/ZIP . . . : ATLANTA, GA 30339
• TELEPHONE . . . . . . . . : (510) 731-1004
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 2, 173 . 00 0.50 0. 00 0. 50 0. 00
1WINREP EACH 8 1 . 00 367 .00 0. 00 367 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 367 . 50 0. 00 367 .50 0. 00
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Community Development
'1 10300 Torre Avenue
rCupertino CA 95014
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Telephone(408)777-3228
CITY OF Fax(408)777-3333
CUPEkTiNO
Building Department
All Cupertino building permits must meet certain conditions related to maintaining
environmental quality and public peace and safety. The two most common
conditions are described below.
STORMWATER POLLUTION CONTROL
State law requires that Cupertino, 12 other Silicon Valley cities, Santa Clara County and
the Santa Clara Valley Water District control stormwater pollution. Educating local
residents and businesses and enforcing stormwater pollution control laws are key parts
of the City's compliance efforts.
Stormwater pollution prevention: It's up to us
In northern Santa Clara Valley, storm drains flow directly to local creeks and San
Francisco Bay, with no treatment. Stormwater pollution is a serious problem for wildlife
dependent on our waterways, for people living near streams and baylands, and for the
local water supply. Common sources of stormwater pollution include:
• Dripped oil, fuel, and antifreeze from vehicles and heavy equipment;
t • Construction debris, including dirt, concrete and paint;
• Landscaping runoff containing pesticides or weed killers; and
• Any material dumped or spilled into streets or storm drains
The property owner and the contractor share ultimate responsibility for activities
occurring at a construction site and will be held responsible for any environmental
damage caused by subcontractors or employees.
For more information on construction-related stormwater requirements, see the
Stormwater Quality Regulations section of the City of Cupertino web site at:
http://www.cui)ertino.ora/city government/departments and offices/
environmental services
COMMUNITY NOISE CONTROL
The basic noise control requirements for.construction sites are as follows:
• Typical construction work hours are:
- Weekdays - 7 a.m. to 8 p.m.
- Weekends - 9 a.m. to 6 p.m.
• Construction other than street construction is prohibited on holidays.
• Residential daytime noise levels from complaint site - 60 dBA
Nonresidential daytime noise levels from complaint site - 65 dBA
For more information on noise control, please see Chapter 10.48 of the Cupertino
Municipal Code, which can be accessed at htto://www.amlegal.com/cuoertino ca/
•
Greg Casteel
Building Official
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Community Development /
10300 Torre Avenue
Cupertino CA 95014
Telephoue(408)777-3228
C EIkTIN0
Fax(408)777-3333
, _ _
Building Department
JOB HOOK2SC990/ c9al-d",, �4 -le 3),. PERMIIT# 0
961
C01YO
OWNER'S NAME: . ti's Vs ,/ s PHONE # y0 d°- 973 -el V'z
GENERAL CONTRACTORf/ p/ E r/SCS FAX# Sio- 7d O- J J I p
I am not using any subcontractors: &104L ova? . 7- 7-L�
Signature Date
Please check a Plicable subcontractors and complete the following information
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring- Carpeting
Linoleum/ Wood
X Glass/ Glazing -0-110flame. Se,-vs-,:es
Heating
Insulation
Landscaping
Lathing /
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
�C Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contrct i ature Date