08040093 CITY OF CUPERTINO
BUILDIN(s.Dlvlsio.i PERMIT C41�1TRAC�'TkQR Z . RMATT9
PERMrf NO.
em1.13115-G�pDgFsMERRITT DR AAA ELECTRIC 08040093
OW NEEWSS NAME: PERMrf ISSUE DATE
RAJ TUPLUR 3249 STEVENS CREEK BLVD - 04/14/2008
NE (408) 557-8899 SANITARY NO. CONTROL NO.
ARCH77ELT/EHGINEER:
BUILDING PERMIT INFO
BLDG EIFCT PLUMB MECH
0 0 0 0
300 LICENSED CONTRACTOR'S DECLARATION
0 1 mmby affirm Nm 1 m li=med under pmvisions of Chapter (commencing Job Description
t1 wiNSecdon7 )ofDivhmn3ofdwBusin P rla ,pfd ndmylkenmb UPGRD METER MN PANL TO 200AMP
o in NII tome an
Lianae ' O Lk.r .
�gt' 'oak Contractor -
�tyypy ARCHrTECI-S DECLARATION
dj S I understand my plana shall he used As public retools
2
u tad Licensed Pru essiaesl
y OWN -BUILDER mDECLARATION
'�0 1 onaven.(Siem that 11. ueaft from the Cssor. o License Law for da:
D O following moon. oomit In
7031.5.L3,Busiess and Re.dem li Cade:Any my m muure
$ which rt9uima•permit m e tion We plot,Improve,demolish,t or repair nay structure
Z S" dust W its censecc,also rtquirte the inions cat for amh permit to U"a signed(cWemenu
zFF< dushculiavca arsuonl 7000:of Division
of We Contrse70h Liccnselaw(CMpter9 Sq.FI. Floor Area 2000 Valuation
(cond8 d.,M is ing amemps Section7000)the
Division 3 of NeBusiness eged=and Pr.My vi Code)of
3 Nst he h uwpl thwfmm and Ne bub for,We Alleged uempdan.My violation of
Sudor 7031.5 by any applicant for a permit,subjecu tate applicut to a civil penalty ofNumber Occupancy Type
m,mom tun five hundred dollars(SM 31629045 B.V64
❑I.uawes of 0k ptoparty,amy wployes with wguu Neksok rnmpew0on,
will do the work,and the another,is not intended m.Mond(mule(See.7044.Burow
And Pmfesslmu Code:The Communes Liana,law des net apply to an owner of Required Inspections
property who builds m improves themim tad who des such work himself M through his
own employes,provided that such improvemetu art not Intended aroReud for We.If.
however,We bolding or Improvement is sold within one year of completion,the owur-
buildu will hew du buden of Proving Nal K dM nm build or improve for purpose of
lake).
❑1.u mrrcr of the property,w exclusively centrsclut with licensed conaadnn b
construct the pmjem(Sec.7011,Business and Pro(usiou Code:)71te Contractors U.
alone law does no,apply 70 An owner of property who builds or impmw dammon,and.
who contracts for such projects with s eonuamm(U lianmd Portland m des Conlrsotes
Licmae law.
❑I m exempt antler See .B At P C far this rtsson
Owner —Dam
WORKER'S COMPENSATION DECLARATION
I hereby Bullion under acuity or perjury one of the fallowing dularWoru
haw and will maintain•canl0com orcownt aro self-insum fm Comp
an.
Comn-
nation,u provided fm by Section 3700 of Am labra Code,fm We pmfomeme of the
work for which this.wit is issued.
❑1 have and will mBlow.Warimea Compensation IUWarue,u required by Section
3700 of the labra Code,per the pcform.o(the work for which this permit is iarcd. '
My Warier,Compensation ltwrame carrier and Policy number Art:
Cartier. Policy No.:
CERTIFICATE OF EKEMP ION FROM WORKERS'
COMPENSATION INSURANCE
Cl7ds aecum reed nota hocmpleted If the amlu Is fume hundrtaideRan(SIM)
ce Int)
1 emory that In the affomance f u f h' A.wit b iarrcd,I"I nm '
employ nary,person in5s m rc uta We Wodteas'Cmperwm - -- .-
taw of Csiifom' .._
Applican,
NOME TO'APP13CANT.If,after residing this Confine,of Exemption,you should
become subjm m the Worker's Com on prevision of the I-mor Code you mw
0 O forthwith comply with such provivau Nu artni,shall be doomed rtvekcd.
ti CONSTRUCI7 NLENDING AGENCY
(—t I hereby affirm that Vert is a coutruminn lendingAgency for the performance of
2Y ti Nc wish for which this areni,is iuood sen.3097,Civ.Q '
Q Lenders Name
z L.Wts.Addmna
U O 1 amufy that 1 have mad this Appliuum And Bute than the Above information is
V.^ corrin 1 agree m empty with all city and emery oruinarcu and auu laws relating m
0 rV^ building construction.And hereby authorise mpmaenutives ofthis city to enter upon the
W .hove-mendorcd Property for inspection Purposes.
ry (Wc).gra m Base,ince !Y and kap hamtkss lite City of Cupertino agues,
rA liabilidu,judgmrn,s.castsud pews whichmayi=yft.yacnuoag.WIzud ty / (—
U Z in consequence of due rani a4 ' L
^� APPLICANT-UNDER DS AND COMPLY WITH ALL N-P 1 Issued by: Date
SOURCE REGUY,A/ z
81}mt�af ApplicaHAZARDO Date Re-roofs2 /0
HAZARDOUS MATERIQSuSURE Type of Roof ✓ `�
WIII the applicant or Mm building aceuputsm.tnom m handle huallous mamriai
AS de0ntd by lir Cuanlm Municipal Code.Chapter 9.12.and can Health And Safely '
Code.Sactm 23532(07All roofs shall be inspected 'or to any roofing material being installed.
❑res
Will the applicant per future building occupant use equipment or devices which If a roof is installe �tvi bfirst obtaining an inspection,I agree to remove
.t humdnto air contaminants As defined by the Bay AMA Air Quality Management all new materials s !(tlOn.
adricl7 /// i.' ���
Oyu aAu
Ih.ve mad the mmA Abmquimmcnu underCMpterh.95 Ne CO'ory i
cab Health&SarcyyCotle, `au2550.25533uti 25531.1utaictawai th Ifdte ding i�
does mit arrtryry h Wail many mNllity m n fitY aaav r
rtgmrtmcn h m IPri of.Certificate Signature ofApplicant Date
29rerr/ubc;Mocd aeam Dam All roof coverings to be Class'W'or better
CITY OF CUPERTINO
• 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31629045.00..
DATE ISSUED. . . . . . . : 04/14/2008
RECEIPT #. . . . . . . . . : BS000004469
REFERENCE ID # . . . : 08040093
SITE ADDRESS . . . . . : 19730 MERRITT DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : RAJ TUPLUR
ADDRESS . . . . . . . . . . : 19730 MERRITT DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2440
RECEIVED FROM . . . . : AAA ELECTRIC
CONTRACTOR . . . . . . . : WILLIS TANG LIC # 27828
COMPANY . . . . . . . . . . : AAA ELECTRIC
ADDRESS . . . . . . . . . . : 3249 STEVENS CREEK BLVD
CITY/STATE/ZIP . . . : SAN JOSE, CA 95117
TELEPHONE . . . . . . . . : (408) 557-8899
• FEE ID UNIT QUANTITY AMOUNT. PD-TO-DT THIS REC NEW BAL
-------- ------------- ------ ---------- ---------- ----------
1BSEISMICR VALUATION 2, 000. 00 0. 50 0. 00 0.50 0. 00
1EPERMITFE 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 #1230
---------------
TOTAL RECEIPT 82 . 08
CITY OF CUPERTINO
® CUPEkTiNO GENERAL BUILDING
PERMIT APPLICATION FORM
Date:
Building Address: I ,p
1
?
Mailing Address (if different from building address):
Owner's Name: Phone
Contractor: � Phonq \
Fax
Contractor License #:
Cupertino Business License #:
c?, -7 �a
Contact: q� Phone:
wFax:
Residential Commercial
Job Description:
Building Permit Info:
Bldg ❑ Elect� Plumb ❑ Mech ❑
Type of Construction(Usage Class): Occupancy Type:
1 FR, 11FR ❑ 11, 111, V-IHR ❑ 11, 111, 1V V-N ❑
Valuation: 20 O Square Footage:
Project Size: Standard ❑ Large❑ Major ❑
•
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 Install ation/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 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
CUPEfr,TINO GENERAL BUILDING APPLICATION
• FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
ACOUSTICAL
REVIEW
IACOUSFDW SFDWL/Duplex New B
1ACOUSRESAD SFDWL/Duplex-Addition/Alteration B
IACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
1CHIMNEY Chimney B
1CHININEYR Chimney Repair B
FENCES
1FENCE>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
I
3 of 5
ac CITY OF CUPERTINO
CUPEI�TINO GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1 GENCOM
RETAINING
WALL(CONCRETE
OR MASONRY
1RETSTN Standard (up to 50 ft) B
IRETSP310 Special Design, 3-10' high (up to 50 `) B
IRETSPIO Special Design, over 10' high (up to B
50'
IRETCRB< Gravity/Crib Wall, 0-10'high (up to B
50 ft
1RETCRB> Gravity/Crib Wall over 10' high (up to B
50 ft
SIDING
1SIDESTBK Siding, Stone &Brick Veneer B
(interior/exterior
1SIDEOTHER Siding all other B
SKYLIGHTS
1SKYL<l0 SF Skylight less than 10 sf B
1SKYL>IOSF Skylight greater than 10sfor B
structural
1STAIRS Stairs-first flight/ca addt'l B
STORAGE RACKS
1SRACKS<=8 Storage Racks 0-8' high (up to 100 sf) B
1 SRACKS>8 Storage Racks over 8' high (up to 100 B
st
1 STUCOAP Stucco Applications (up to 400 so B
additional stucco application
4of5
ac, CITY OF CUPERTINO
CUt �TINO GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group IGENRES or
1 GENCOM
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
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit Fee P
1 ELCPLNCK 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
` 1TRAVDOC Travel & Documentation B
1BUSLIC Business License B
5of5
Community Development
10300 Torre Avenue
s / Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
�UPEkTINO
Building De artment
JOB ADDRESS: PERMIT _0 k ot,) ��
OWNER'S NAME: cgPHONE
GENERAL CONTRACTOR: IFAX #
I am not using any subcontractors:
Signa a 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
•
Owner/Contractor Signature Date