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06070072CITY OF CUPERTINO I.'tMA'j.O : BUILDING'Dl-ISION PERMIT As.rz^rsixxf- BUILDING ADDRESS: PARKER PLUMBING PERMIT NO.06070072 8119 PARK GW NER'S NAME: PERMIT ISSUE DATE SANKARA VENKATARAMAN 24 CHELTENHAM E: SANITARY NO. CONTROL NO. (408)374-1832 ARCHITEC irENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job D0SCr1pIlOn 1 hereby affirm Net 1 am licensed under provisions of Chapter 9 (commencing with Secdon 70M) of Division 3 of Ne Basin. and Profession Code, and my license is to fail foreeanlaffect. INSTALL NEW GAS CONNECTION FROM GAS METER TO License Class Data Contractor Lac KITCHEN ARCHARCHITECT'SSDECLARATION ' 1 understand my plans shall W used u public rmords Licensed Professional OWNER-BUILDER DECLARATION 1 hereby aRrm that I am exempt from the Contractor's License taw far the following reason. (Seckm 703 1.5, Business and Pmfessimu Code: Any city or coumy which requires a permit to consumes, slot, improm, demolish, or repair any swmurc prior in its issuance. also befuires Ne applicant for such permit m file a signed slstemem that he is licensed pursuant to the provisions of the, Contractor's littve Law (Chapter 9 Sq. Ft. Floor Area Valuatio$600 (commencing with Section 7000) of Division 3 of Nc Business and Professions Code) or that he Is exempt Nctcfrom and Ne buis for the alleged exemption. Any violation of AEN Number Occupancy Type Section 7031.5 by airy applicvn for a porton sebjcas the applicant he a civil penalty of not mora Nan BK hundred dalton (M). 3 5 610059. 0 0 a� ❑I.Mamrofthepmpmy,nmyemploycawithvngesuuuuwlccompenuuon, I 'iA tI Hf"'af/n a tr�� Rr lquir�ed I�nspec[fyons'9 will dO NC Wart Nd NeaWelWe Ynal lmm�ded OranCRd faf3alC ($r1.. iBd4. BYalllete and Prefe eke. Code: The Comncwr's Lic. Law does ret apply m m an owner of propeny who buildsimproves thereon, and who doessuchwark Wadi through his j�(dI�_TfJ(NyI rd ° awn employees, provided Nat such improvements are not intended or offered farsale, ff. however. the Wilding or improvement is sold within ane year of completion. the owner- he did Wild improve for J(�1 'b L y00La builder will have see Wrden of proving that not or purpose of ole.). u owner of the progeny.. uclus and conuacuns with Deemed ntruacwrs t. �p ( tJ coutroct project (Sec. Business Code:) The Contractor's Li n as mscofand property who iids improve thereon, and, cense Law dose nal apply je ts owner of propmy who d A2C/ o to who canmcs for such projects with a mnuactorts) licensed parwant in W Contruwn's License law. ❑I am'I'mm/ftt 55e. .B&PCfar this mL�son under Owner �}.,(/Q. IlseV Data-7 I Is ' - WOR 5 COMPENSAi10N DECLARATION 1 hereby air,. under penally of perjury ane of see following declwions: I ham and will maintain a CartiOao of Consent in self-insure for Won sCompcm iolion, . Provided far by Section 3700 of the Labor Code, for the performance of the work for which Be, permit is Wood. ❑ 1 have and will maintain Worker's Compensation Insuramc, as toultioud by Section 3700 of the tabor Code, for the performance of the work for which this permit is issued. My Worker's Compensation Insurance artier and Policy number are: Cane. Poli, No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need tel W om plead Base permit is fnon hundred dollars (SIM) nr less.) 1 ccrdfy that in the, performance of Bra work for which this permit is issued. ) shall tel employ any person in any mare crse. m became subject in sec Workers' CompenWian Laws of Califamia. Data Applicant NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should became subject In the Warner's Compensation provisions of the labor Cade, you muse ' forthwith comply with such provisions or this permit shall W deemed revoked. j CONSTRUCTION LENDING AGENCY I mouthywhich chi Nat dere is lending agency far the perfnmance of ' the week for which Nu permit u issued (See 7097, Civ. CJ s ed iSu .3 Lender's Name I<Mcr's Address ' j 1 comfy that I have read this application and sum Nat the aWve information is ' contact. 1 agree to comply With all city and county ordinances and also, laws relating m Wilding construction, and hereby amhon7c represent ms of this city to enter upon the °hove-mcmioned property for inspection purposes. (We) agree w save, indemnify and keep harmless the City of Cepenino against j liabilitics,judgmenm, toss and expenses which may in anyway steno agaiut said City in consequence of the gaming of this permit. ' APPLICANTNDERS ANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: DateSOURC US. Re-roofs Type of Roof Signature of AppliaHDam HAZARDOUS S MATERIALS DISCLOSURE Willy n future Wilding anmammal some nand t e Cuant u deEned by see Cupertino Municipal Code. Clupmr 9.12, and the Health and Safety e. Chapter the Health Cade. OYoonn 25532(a)? t3�N All roofs shall be inspected prior to any roofing material being installed. future If a roof is installed without first obtainingan inspection, I agree to remove P g Will the applicant i Wilding bydieoccupant sew equipment Qu or device which ,:mit nus air conaminans u de0ncd by the Bay Arca Air Quality Management all new materials for inspection. District? District? ❑Yes G11. 1 have mad the buarNws materials requiremens under Chapor6.95 of Ne Califor. ria HalN&SaNlyCode,Such.23505.25577 and 25530.1 undersand Nxtifue Wilding docs ret currently haus a renam. that it is my responsibility to nouly sec o cupanl of IW requiremcnswhiahm, bemetpno�ssumccofaCcrdfcamor (i �.� Signature of Applicant Date ( ' All roof coverings to be Class "B" or better g OwnOho/�/� on dagent Dam - • Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: 11q 1C VI LL -q c k (Lc LE PERMIT # t6o%©o7a OWNER'S NAME: PHONE# k0La57 A GENERAL CONTRACTOR: e a\jxLz t- FAX # Pi&v' Z-0 71t &37-- I 3y I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 1SWner/Contractor Signature n7 /t-5/9 Date 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 Plumbingcr�kln �w++ i` as Roofing Septic Tank Sheet Metal Sheet Rock Tile 1SWner/Contractor Signature n7 /t-5/9 Date im 1 of CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35610059.00 DATE ISSUED.......: 07/13/2006 RECEIPT #.........: 35233 REFERENCE ID # ...: 06070072 SITE ADDRESS ..... SUBDIVISION ...... CITY .............: IMPACT AREA ...... OWNER ............: ADDRESS ..........: CITY/STATE/ZIP ... 8119 PARK VILLA CL CUPERTINO SANKARA VENKATARAMAN 0 OPERATOR: amyw COPY # : 2 RECEIVED FROM ....: SANKARA VENKATARAMAN CONTRACTOR .......: STEVE PARKER LIC # 25024 COMPANY ..........: PARKER PLUMBING ADDRESS ..........: 24 CHELTENHAM WAY CITY/STATE/ZIP ...: SAN JOSE, CA 95139 TELEPHONE ........: (408)374-1832 *EE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC BENERGY PERMIT FEE 1.00 34.86 0.00 34.86 BPGAS OULETS 1.00 5.40 0.00 5.40 PPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 TOTAL PERMIT : 78.63 0.00 78.63 VOICE ID DESCRIPTION 202 UNDERFLOOR PLUMBING 502 FINAL PLUMBING ENERGY 507 FINAL PLUMBING • NEW BAL 0.00 0.00 0.00 ---------- 0.00 VOICE ID DESCRIPTION 301 ROUGH PLUMBING 506 GAS TEST r • 40 ARCHITECTURAL APPLfICATION Name of Association: Name of Owner(s): OTT L e? —41 Address of Unit:_ (1 (--ytr-Liel Work Phone: CC10 5t5t Home Phone: _� �rj� f 2— Applicant agrees and understands that the application does not fulfill all of the conditions and requirements for an approval. In addition to this completed "Architectural Application" form, the applicant must submit to the Architectural Review Committee (and/or Board of Directors) a set of plans and specifications showing the nature, kind, shape height, materials and locations of the proposed architectural alteration. It is also understood by the applicant that the submission must be in writing. There may be additional information required as deemed necessary to make a decision. Until all information is submitted to the committee, the application will be deemed to be incomplete and the application will stand unapproved. GENERAL DESCRIPTION OF PROPOSED WORK (Include drawings, if appropriate) Applicant agrees and understands that, in the event the modifications is approved by the Committee or Board, that they may impose "Special Conditions" of construction and maintenance on the approved work. Any special conditions shall be attached and be a part of the approval. Any deviation from the approved plans, specifications, or special conditions shall cause the permit to terminate and become null and void. Applicant agrees and understands that failure to conform to these requirements will be automatic authorization by the applicant to have the work brought into conformance with the approved plans, specification, and special conditions. Applicant further agrees and understands that all costs incurred by the Association as a result of bringing said work into compliance shall be a charge against owner's lot. Such costs shall include costs of construction, reconstruction, administration, fees, attorney fees and reasonable court costs, if incurred. It is also agreed that no work will be initiated which would be a violation of any of the provisions of the Association's Declaration of Covenants, Conditions, and Restrictions or any applicable building code; be an annoyance to the residents, or increase the cost of insurance. Applicant agrees to indemnify the Association against any and all acts or claims arising in connection with the improvement, including but not limited to any and all acts, omissions, or claims arising in connection with the approval, construction, operation, maintenance, repair, use or removal of the improvement, including attorney fees and costs of litigation in connection therewith. Applicant agrees that, in the event the application is approved, all maintenance, repair or replacement of the approved item will be the sole responsibility of the unit owner and further that any expense incurred by the Association that is the direct or indirect result of the approved change shall also be the sole responsibility of the unit owner. All work should be initiated with consideration of the grounds, esthetics, time and noise factors. Applicant understands that all necessary permits and approvals from municipalities or other jurisdictions are the sole responsibility of applicant and that Committee/Board approval of this application is subject to the applicant receiving all such necessary permits and approvals. Applicant agrees to the foregoing conditions and accepts those conditions as evidence by the owner's Sig)((moi nature: � .(A�1�- / Date: STAFF USE ONLY: Approved: %/ Denied: Signed: Date: I— /02 —U b M cm or CUPEkTINO CITY OF CUPERTINO PERMIT APPLICATION FORM OM O(]2 N #IDrV Date: V 7 h A C - Building Address: Mailing Address (if different from building address): 5kkq VkvILAAL" C -W i-VNrJ,5) Owner's Name: 1 Phone #: /t 0 1 406,— CG�O- 5F\n1&:LAKA \f.L(Qkq-T-Lj-Rgt^Ar� Contractor: -5i- "e— +; er - License #: Contact: Phone: Cupertino Business License#: SO) M E Fax: MECHANICAL Building Permit Info: Boiler> 500K to 1M Btu Bldg ❑ Elect ❑ Plumb I]/ Mech ❑ Job Description: Irsltiq ne r �c5 caw cerin. �ro.^ TRS "Lte� ho Kcl'� Residential (� Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: • G of Occupancy Group: BCONSTAX Construction Tax Type of Construction: Please check this box if the project is a Ind/Off/Comm/Quasi second -story addition: Project Size: Standard ❑ Large ❑ Major ❑ Con. Tax for BQ Zone Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K 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 <= 1000A ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3 (I ao bTY'OF CUPEkTINO CITY OF CUPERTINO PERMIT APPLICATION FORM QuantityFee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical - MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pb1g Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING 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 rinkler/Backflo PLUMBING BPSTORM Stonn/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water HeaterNent 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 Furnace > l OK btu MECHANICAL BREM14EAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC 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 BREEMRESAPP Remodel Res Appliance ELECTRICAL 2of3 (+ CITY OF CUPERTINO CIiV OF PERMIT APPLICATION FORM CUPERTINO Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL 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 Ternp 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 PLLONGRNGC Planning LR Comme/ Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Change BUILDING 3of3