08040056 CITY OF CUPERTINO H �
BUILDINGDIVISfON PERMIT 196 TRAC" ORYIN .yORMATION
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BUagI�G VE%RRITT DR BEST KITCHEN & BATH P618� �b56
OWNER'S NAME: PERMRISSIIBDATE
AKILA KANNAN 1850 HOURET CT 04/08/2008
ONE: SANITARY NO. CONTROL NO.
(408) 942-5520`. —
RCHITECDENGINEER: BUILDING PERMITINFO
BLDG ERCT PLUMB MECH
0 0 0 0
3
'z LICENSED CONTRACTOR'S DECLARATION lob Description
rd li p 1 Manby.farm Nn 1 un licensed under pmvisons of Chapter 9(commencing II
nz1 t5, wiNSecdon7")of DiviAon3ofdm Buunmud fummu Code,sal-Pyke�is INSTL KTCHN SINK
in full forte and affect. �f/
Lkem.ClAas Lk.t
f Dao: Contractor
` ARCHI'TECT'S DECLAWATION
1 Understated my plus shit h Used As public records
;yU
ya Licensed professional
OWNER-BUILDER DECLARATION
iN I hcmhy a1Rres that I am mcmpt from dee Canmactars License Law for the
O O following mason.(Salon 7(131.5,Business and Pmforsiam Cade:My city or county
g which requires a Permit to connotes.alter.Impmw,demollah,ar repair any mueluro
prior A,its issuance.aim requites Me applicant for such Permit to file a signed statement -
@?5 <
[hat Ise is licensed puaunt to Ne pmviskee,of Ne ConvectorsSq.FLFloor Area $325 license Low 9 Valuation
i g (commencing with Section 70001 of Division 3 of Me Business and Profmbons"a)or
l� IML he is exempt thmfmm and Ne buts for Ne Alleged exemption.Any Waladon of
Section 7031.5 by my Applicant for A permit subjects the applicant to•civil Rnally ofNumber Occupancy Type
not morn dun ftw hundred dollars ISM 3 16 2 9 04 5 !V V'
❑1,As.,of the property,Or my employees with warm u thee,uta campemadon.
will do the work,and Ne structure Is not intended ar mfcred fmisle(Sec.7044.Business
And ProfesUam Code:Th.Commerce,Lt..law does m1 Appy Man owner of Required Inspections
property who builds or improv Nam.,and who does smh work himrelf m 1Nough his
ownemployem,puWded Nn such improvemems Am ret intended aolremd Tarsale.If.
however.Ne building or Impmwmenl Issold within oto your of completion.the owner.
builder will low the burden of proving that h did rot build or improve for purpose of
ulc.y
car Me Project
the property,A..l mcass ad colexabsg olid:)licensed Contractor's
comreomm
consumer La Ne project(Sec.7044.Bminof and property
who m Cade:)The Contra n.Li-
cenu law las nal Apply m An owns of promny we,Wilds or improve thorn.and, ,
whe mMacle far such pmFcu wiN.conuecmt(sl licensed punmm to Ne Cmnmx7oe,
License law.
❑lam.umptunl1mlSee ,B&PCfor tide
Owner A(!/ Data .
RKERS COMPENSATION DECLARATION
1 hereby alum under penalty of perjury am of M following Occlusions:
1 ham end will monW n A CaNOmu of Consent to¢I&infero for Workers Cents,
Iran,a provided for by Section 37M of rhe labor Code,for the performance of the
rk for which this permit is issued.
❑1 have And will maintain Workcfs Compemallot Imuruce,as mgairod by Section
37M of Ne Inbar Code.for Ne performance of dee work for which this permit is iuued. '
My Workers Compensation Inwnma curier and Policy number am:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(ITIS xNm reed not becorn pheted if de permit is far ane hundred dollars(S 100)
Us UAL)
1 cenifv Net In the perfomenm Of ark fm which this pmmit is bound.)shall at
cmployanypersoninuymArjsoAhdO re object m Me Worker' eno
compJon
Laws of Ctlifomia Date Iii l®K
NOTICE
ant
NOTICE TO APPLICANT:If,aper mnsati oAsio, of LaborlC d you should
become subject to tiro Workers Compensation provbsbom of Ne manna Cada,you mut
OZ forthwith comply with such provrdom Or Nu mail Mall be dcemcd mekcd. '
Z N CONSTRUCTION LENDING AGENCY
[r 1womyafar that Nam baa comumcthm kUfir,.gency far le,Nuforanmuf
0o woe,for which titin peril b iouW(Sec.3097,Civ.C.)
ttJ Q Luders Name
z Landers Address
U Q I certify that 1 haw read this application and sum that the abuse lot oraMm u
[7. F corm.l Agrm to comply with At city and county ordinances cab mrc laws mating to
V building construction,and hmby Authorise mpaaaotalM of this city to uta UP"ft
W W---.doped property far inspeNon Purposes
0.t (We)Agree to caw,indemnify and keep harleas 0e City of Cupertino Against
Qn IlabiOGm.judgments.sou and expmum which may in any way aeave rgainsl sold City
C.1 z AmLICANT UND Rtu taflhbmrll.
^� APPLICANT UNDER NDS AND WILL COMPLY WITH ALL NOryWPOINT' Issued by: Date /
SOURCE REGULATION 015
Signuuro of AppliandCon r Oak Re-roofs
HAZARD US MATERIALS DISCLOSURE Type of Roof
Will Oe applicant ar future Wilding ucupantnom or handle hamdom msrcrial
U deRtxd by de Cupertino Municipal Cade.Chapter 9.12,and de HesN and Safmy,
Case.Section u532(.)7
❑YG nU c/,[ All roofs shall be inspected prior to any roofing material being installed.
Writ Ne Applicant or future budding occupant use equipmenl or devices which If a roof is installed without first obtaining an inspection,I agree to remove
it hummus air couumbmnu As de0md by Ne Bay AMA Air Gently Mumgcmcmt all new materials for inspection.
U1,17 --//
❑Yee LgNu
I hawmad cite hundmumsteris.25533 mmu34.1u aPterd.95i[&Cdbfon
riaHmlNhSefety Cade,Seetiau27505,25577 and 23534.1 uMastand Nati(Ne Wilding
dam tot nt,why haw A taus Net It i issuance
Of,ocni c notify Ie,Ucupant of Ne
mymmmenD whine he met priarmb.mt.nmaracwnnarnaraecp.ary. 09 Signature of Applicant Date
Owner or surcadend get mrc I All roof coverings to be Class'W'or better
CITY OF CUPERTINO
• 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Seo: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31629045 . 00
DATE ISSUED. . . . . . . : 04/08/2008
RECEIPT # . . . . . . . . . : BS000004412
REFERENCE ID # . . . : 08040056
SITE ADDRESS . . . . . : 19730 MERRITT DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : AKILA KANNAN
ADDRESS . . . . . . . . . . : 19730 MERRITT DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2440
RECEIVED FROM . . . . : RAJ K TUPLUR
CONTRACTOR . . . . . . . : DAT LE LIC # 25716
COMPANY . . . . . . . . . . : BEST KITCHEN & BATH
ADDRESS . . . . . . . . . . : 1850 HOURET CT
CITY/STATE/ZIP . . . : MILPITAS, CA 95045
TELEPHONE . . . . . . . . : (408) 942-5520
• FEE ID UNIT----- QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 325 . 00 0 .50 0. 00 0. 50 0. 00
1PPERMITFE FLAT RATE 1 . 00 40 .79 0. 00 40.79 0. 00
1TRAVDOC FLAT RATE 1. 00 40 .79 0 . 00 40.79 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 82 .08 0. 00 82 . 08 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 82 . 08 #1293
---------------
TOTAL RECEIPT 82 . 08
CITY OF CUPERTINO
CUPEkTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN# v , / Date:
Building Address:rn �J-,F-1 la
I°1?3o I/N-� +� T al:Wtel Cup6RT11,,rO , Cwt .
Mailing Address (if different from building address):
Owner's Name: Phone#:
RflT 7L) pr,L) - AKL-A keffI AI-AN
Contractor: Phone:
PC-S7 Kr rcr-r Cr/ Mvfl 9A7H CORP.
Fax:
Contractor License#: '2-304
Cupertino Business License#: 'Z5 (�
Contact:
kC L-6- Phone: W-9'y 2 SSv�
Mi
Fax:
Residential 14Commercial ❑
Job Description: INS7f1 LL K17C � SAN k
Building Permit Info:
Bldg ❑ Elect ❑ Plumb [D.- Mech ❑
Type of Construction (Usage Class): Occupancy Type:
1 FR, 11FR E] 11, 111, V-lHR El 11, 111, lV V-N a'
Valuation: { _p 3u. Square Footage:
Project Size: Standard ❑ Large ❑ Major ❑
r
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
IBBOILER2 Installation/relocation of ea M
boiler/compressor over 3 horsepower
to &incl 15 horsepower, or ea
absorption ss over 100,000 Btu/h
1BBOILER3 Instal lation/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
IBBOILER4 Installation/relocation of ea 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
1BBOILER5 Installation/relocation of ea boiler or M
refrigeration compressor over 50
horsepower, or ea absorption sys over
1,750,000 Btu/h
1BAPPLOTH 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.
IELECINSP Other Electrical Inspections (per hour) E
1MECHINSP Other Mechanical Inspections (per M
hour)
1PLMBINSP Other Plumbing& Gas Inspections P
(per hour
1MEETINGIHR Application Meeting B
�- CITY OF CUPERTINO
CUPEf�TINO GENERAL BUILDING APPLICATION
FEESCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1 GENCOM
ACOUSTICAL
REVIEW
lACOUSFDW SFDWL/Duplex New B
lACOUSRESAD SFDWL/Duplex-Addition/Alteration B
IACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
1 CHIMNEY Chimney B
1 CHIMNEYR Chimney Repair B
FENCES
1 FENCE>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
1PMECAST Pile Foundation Cast in place concrete B
1PILEDRIV Pile Foundation Driven (steel, pre- B
stressed concrete
•
3of5
CITY OF CUPERTINO
CUPEf�TINO GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group IGENRES or
1GENCOM
RETAINING
WALL(CONCRETE
OR MASON=
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, 0-10'high (up to B
50 ft
1RETCRB> Gravity/Crib Wall over 10' high (up to B
50 ft
SIDING
1 SIDESTBK Siding, Stone &Brick Veneer B
interior/exterior
1 SMEOTHER 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
]STAIRS Stairs-first flight/ea addt'l B
STORAGE RACKS
1 SRACKS<=8 Storage Racks 0-8' high (up to 100 so B
1 SRACKS>8 Storage Racks over 8' high (up to 100 B
st
1STUCOAP Stucco Applications (up to 400 so B
additional stucco application
4of5
��- CITY OF CUPERTINO
CUPERTINO GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1 GENCOM
1 WINREP Replacement windows/sliding glass B
door ea 8 windows
1 WINMEWSTR New Window-structural shear B
wall/masonry includes plan ck fee
1 EPERMITFEE Electrical Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit Fee P
IELCPLNCK 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
1BSEISMIC0 Seismic Commercial B
1TRAVDOC Travel &Documentation B
1BUSLIC Business License B
5of5
at Community Development
s 10300 Torte Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
0 - Building
Buildin De artment
JOB ADDRESS: PERMIT #
-rt �3v
PHONE # LOWNER'S NAME: fO
GENERAL CONTRACTOR:Q FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information
60 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
u
/ er/Contractor Signature Date