Loading...
03060024 CITY OF CUPERTINO BUILDING DIVISION PERMIT CU,N,T12CTUIi TNF,OItMA +IO BUILDINGADDRESS: TI PERMITNOD3O6OO24 20996 PEPPER TREE IN NER'S NAME: FERMTT 19CPEP0 3/2 0 O 3 .ASAD KANNEGANTI HONE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH p �10 Zp LICENSED CONTRACTOR'S DECLARATION Job Description rel 1 hereby aff on that I am licensed under pmWsiona of Chapter 9(commencing z�� wide Section 70I10)of Division 3Of me Business and Pruleadmia Code,and my license is ADD NEW WALLS w ��nni�� in fa¢o ettett FIN A L80 nZ inicanm Class IJc.I r ,vfa�, Ltt- Dek Con DEC oilS ARCHITECTS DECLARATION SEP 1 6 2003 I understand my plans shall be used u public recaN 3 Licensed Professional ^ OatNEm camaDER DECLARATION R a I I hmmhy,afnm(Sco that 1 I.S.eacmpl from the Contns Co License law for the BUILDING 0 0 which mreason.(Salim IIO LB.alnrss and Prafuelum Cate:My oily or county • •• �7 which requsma a permit also re enres the alar.Improve,demolish.or repair any swment prior m lB laNadp pursuant to ma lhovisio s,of forthe ch Contractor's emdl m ane,e a Law IDNaem 3*aQtion _ that he(coma is lk&wit punuanl7 the provisions,DisW.of the Beat is laanicad. Chapter9 Sq.FI.Floor Area $ (commencing with Salon 70W)af Dividon 3.f ft Busl•...and Prokasinm CMe)ar r3 Wt lo LL exempt titerefrom and the basis for the alle{W assumption.My violation of Section 7031.5 by,ay applicant fora permit subjects me applicant to a civil penally of er Occupancy Type not more than five hundred dollars(S500k I,as owner of the pmpmy,or my mnployees with"gas as doer sok compensation, will do the work.and me Mo..iswttamarind a offered forsale(Sm.70/1,Bodness Re Ulred Inspections and Professions Cade:The Commodes License law does at apply k an Owner of 102 — P I ERS 9 p property who bulldaar lmprnvca deereon,and whodoesatso arkhimself orthrough his 103 — UFER awn employees,provided that such improwmenisrt na aot Intended offeaed fmaalf.IL however.the building or improvement is mid within one year of completion.the Owner. 104 — REBAR builder will love the burden of proving that he did Out build or improv fa purpose of sale.). 105 - ANCHOR BOLTS ❑1,an Owner of da,propcny.am exclusively contracting with licensed contncron m 106 - SEWER & WATER convect Use project(Sec.7044.Business and Profession Cade:)The Comractors Li cense law does not appy k an owner of property who builds or important,thereon.and. 202 — UNDERFLOOR PLUMBING who contracts for such pmjccu with a conlramor(s)licensed pursuant to the Contractor's Lie lo 2O3 — UNDERFLOOR MECHANICAL . ❑lamxm da See. ,BaPCfath4reason 204 - UNDERFLOOR FRAME nor D. Foo 205 - UNDERFLOOR INSULATION ORKER'S COMPENSATION DECLARATION 301 - ROUGH PLUMBING I herebyafnrm under pewtyaf perjury ane of dee following declantiau: 302 — TUB & OR SHOWER ❑I havemd will maintain.Cenifiateaf Consent ksel6Wure for WonersCompea. 303 — ROUGH MECHANICAL anion,as provided for by Section 37W of the labor Code,far the For--ma Of We work for which thispermhiaissued. 304 - ROUGH ELECTRICAL ❑1 ban and will maintain Workers Compensation Insurance,as"plead by Section 305 - FRAME 3700.(dw JaberCode.for the performance of the work for which this permit is Issued. 306 — HOEDOWNS My Worker's Compeasam tiImu once caller and Policy number am; Canter. PolicyNo.: 307 - INSULATION CERTIFICATE OF EXEMPTION FROM WORKERS' 308 — SHEETROCK COMPENSATION INSURANCE (This scoon need notbccampleted isle petmit is foram hundreddollan($IBM 309 — EXTERIOR LATH orkas.) 310 - INTERIOR LATH I certify deal In dee performance of the work for which this permit is issued.I shall not 311 - SCRATCH COAT employ any permn in my manner sec as to become subject to me Worked Compensation 313 — ROOF NAIL Law.of Calif ono.Deck Applicant 501 - FINAL ELECTRICAL ENERGY NOTICE TO APPLICANT:IL after making this Cer ineste of Exemption,you should became subject an the Workers Compensation provisions of the Lein Cnde you must 502 - FINAL PLUMBING ENERGY .JO forthwilb comply widomchpmvisiansorthis KnoeilshaBxdamcdrewired. 503 — FINAL. MECHANICAL ENERGY Z ti CONSTRUCTION iso IONLENDINGAGENCY 504 - FINAL BUILDING ENERGY -f" ichor which doss there is con(Sce.3nrendin C.) far de nerfuomencc of x� thcwuokforwhichlhlapermitleiasued(Sa.309],Civ.C.I 505 - FINAL ELECTRICAL W Lender's Nurse (L Q Lenders Add. 506 - GAS TEST U O I certify that 1 haws read this appliatlon and sate Net the above information is 507 - FINAL PLUMBING O F' correct,I agree w comply with all city and county mulnwes and more lawn relating to 5 - FINAL MECHANICAL ulh . U Wilding construction,and hoebyaodm representves atiofdo.city wvtuatpon me W shove-mentioned propeny far Inspeedan Purposes 0 9 FIN GRADE 0. (We)agree to save,indemnify and lump homeless,the City of Cupertino against O F I N li.bllillm,judgments.costs and expense.which may in any way seem against Old City U in cons an a of me gmatus of this permit r y APPLICA NDERSTANDS ANO WILL COMPLY WITH AL NON-POINT Issued by'.�'1 A� WORKS Date URGE RE LA NS. �36�924yD'a Re-roofs Signature of licant/Contrmmr Dare HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will me app seas,or future building Occupant skk or handle hasardaus material as defined by the Cupenino Municipal Code,Chapter 9.12,and me Health and Safety 'a.Section 25532(.)+ All roofs shall be inspected prior to any roofing material being installed. ❑secs R No Will the applicant or future building Occupant um equipment or dcvio o which If a roof is installed without first obtaining an inspection,I agree to remove emit wardens air contaminants as do fined by me Bay Area Air Quality Management all new materials for inspection. District] ❑Ya qV. I have read me hvardnuam.terialsreyuirtntents under Chapkrd.Y3af the Cali(ory ni.HcahhaSofelyCade,S=U..Z505,25533un125534.1�ui(de building d urrentI low a tenant,data r my mt,paviNlity re no acupmt error F. emu bemapdorkissuanceor.courfl ne acupmcy. Signature of Applicant Date o6/e{hoG 8 Owner or audeorimd agent Out. All roof coverings to be Class"B"or better CITY OF CUPERTINO. �' "" "' € T '''•` �' �' f ``" BUILDING DIVISION PERMITaONTRa�CyTQR,IN 'OAT,I, , , BUILDING ADDRESS: E AN'T'I PERMITNOO 3 0 6 0 0 24 20996 PEPPER TREE LN WNER'S NAME: PERMIT 2003 RASAD KANNEGANTI PHONE: SANITARY NO. CONTROL NO. ABUILDING PERMIT INFO RCHITECT/ENGINEER: BLDG ELECT PLUMB MECH 0 0 0 0 LOP LICENSED CONTRACTOR'S DECLARATION Job Descri tion LupLs 1 he.by M Nat 1 am m licensed under provision of Chapter 9(amencing p .a�4s with Section 70f10)ofDNW..3ofthe Business and Pronasions CadC,aM my lice.¢is ADD NEW 'WALLS <G in full(.rte and effect. FINN CO zLicense Class Contractor ,Y `G n Dam GOOlDECL - Iq- ARCHITECTS DECLARATION I understand my plan. hail he used as public meortls SEP 16 2003 �a 5 Licensed Professional OWNER-BUILDER DECLARATION ON �y I hereby.(Bete on 1 1. exempt from d r Conveners License Law for the BUILDING .O fallowing first.. etch 1 ]1131.5,Business and Pro.disc.ll Codc:Any s y or county hand a�9 which its W,uat•r,also recnmvucLalw,ntforsudeermitt are Psigneday awnum v�.m Fiy Prionniuissuamgalsurequires the epplieam(or��chpermittofileaxigncdsmlemcnt 3VIBT dtion < that he I,licensed pursuant to the provisions of the Conlmctor+Ucansc Law(Chapter 9 Sq.Ft. Floor Area (commencing with SCaiod70)0)of Divuian Sofdsc Bueimtsnm Profaasions Cadc)m e3$ Nat he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit ubjccu the applicant to a civil Family of 3C Occupancy Type not mem than five hundred dollars(ML 1,u owner of the property.Or my employ.with waW u their role carepensatlon, bill do thewah,a.d the swanre,is not intended or offered forsale(See.7W.Business Required Inspections and Professions Codc:The Conmctors License Law does not apply to an owner of 102 - PIERS q p property who Wilda or improves the.on,and who dassush work himsedforthrough his 103 — UFER own employees,Provided that such improvements tie not Intended or offered for sale.IL however.the building or improvement is sold within one year of completion,the owner. 104 - REBAR builder will have dm burden of proving Nal he rot Wild ild or improve for purpose of e 105 - ANCHOR BOLTS ❑1,as owner of the property.am mclmively contracting with licensed contractors to 106 - SEWER & WATER consumer the prejen(Sec.7044.Business and predations Code:)The Contractor's Li- 202 — UNDERFLOOR PLUMBING "me Taw does not apply to an owner of property who builds or improves Nemo.,and who contracts for such projccu with a contradart)licensed pursuant o the Contractor's - UNDERFLOOR MECHANICAL License V . ❑lam xmp der Sec ,B&PCforthbmasa 204 - UNDERFLOOR FRAME wrcr D. o Poe 205 - UNDERFLOOR INSULATION OR *S COMPENSATION DECLARA 301 - ROUGH PLUMBING l hereby s(Bmm under penalty of perjury am of tk following declarations: 302 - TUB & OR SHOWER - ❑l Invaded will mdnuin+Ceri0esm Of Comemtoself-Insure for WorkeM1Compen- 303 - ROUGH MECHANICAL Minn.a provided for by Section 3700 of the labor Code,for dm performance of the work for which this Permit is housed. 304 - ROUGH ELECTRICAL ❑1 ban and will maintain Workers Compensation Insurance,as required by Section _ 305 - FRAME 3700 of the Labor Code,for the performance of the work for which this permitis issued. 306 - HOEDOWNS My Workers Compensation Insavma carrier and Polity number am: Canner: Pa0cyN..: 307 - INSULATION CERTIFICATE OF EXEMPTION FROM WORKERS' 308 - .SHFi,ETROCK COMPENSATION INSURANCE (Thus section need not be completed if the permit H intone hundreddollares(S10() 309 - EXTERIOR LATH orbs) 310 - INTERIOR LATH I,eertify that In the performance of the work for which this permit is issad,I shall not 311 - SCRATCH COAT employ any Person in any menncrxnu N become subject u the Workers'Camlabounan 313 - ROOF NAIL Laws of C+lifomia.Data Applicant 501 - FINAL ELECTRICAL ENERGY NOTICE TO APPLICANT.If,after making this Corifcam of Exemption,you shtuld become subject to the Worker's Compensation previsions of the Labor Code,you must 502 - FINAL PLUMBING ENERGY ,JO !anhwiNamptywiNsuchpmvisinn+orNiaPermit manmemmcdo:vwkee. 503 — FINAL. MECHANICAL ENERGY .z. CONSTRUCTION LENDING AGENCY 504 - FINAL BUILDING ENERGY j-r4 1 hereby elEtm that tMrt is.construction lending agency for f Performance of ly'> the work for which this Permit isissued(Sec.3097.Civ.C.) 505 - FINAL ELECTRICAL 5 wag LmiLeadce.Adde 506 - GAS TEST z lenders Aderess _ . U O 1 ecnify that I have read this application and ante dual the above information is 507 - FINAL PLUMBING IU F correct.I agree to comply with all city and county ordinances and sum laws relating m 5 - FINAL MECHANICAL 0 U building construction,and hereby authorise mP.senthdrtal Of this city to enter upon the yw ahavameatinmd property for inspection putpacas. 09 FIN GRADE `. (We)agree to save,indemnify add keep heartless the City of Cupertino ag+iml 0 FIN +I r^y liabilities,judgments.costa and expenses which may In any way accrvc against Said City U intonugmneofthcgrmlingo(IhisPcrmil. S1 A WORKS APPLICA NDERSTANDS AND WILL COMPLY WITH AL NON-POINT Issued by. Date URCE RE LAT NS. 912 ,u 3 Re-roofs Signature of plica.✓Camnnor I Dale HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or rum.building occupant nom or handle hvudous materiel as dcBned by the Cupenino Municipal Code,Charter 9.12,and the Health and Safety code,Section 15532(.)7 ❑Ya PN. All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building oceupanl use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit m"'ohms air contaminants u defined by the Bay Area Air Quality Management all new materials for inspection. District ❑Yes �Nu 1 have mad Ne humorous materials re,inemem under Chapter 6.95 Of the Cslibb- nia Health a Safety Code,Scetiom 25505,25533 and 25334.1u un ui(de Wilding d rte tly have a tennnt.Nat it is my resrondhihly m n^ ce.peat of the Ft c c mu Wmetpriortoissuanceofaccmrlcam Occupancy. Signature of Applicant Date I w 06/O3 2tr.3 / All roof coverings to be Class "B"or better Owner or aumoriud.gem Dam OWNER-BUILDER VERIFICATION • 1. (Check one) I or my immediate family (parent,spouse or child) will perform: A. All the work authorized by this permit B. _ A portion of the work C. _ None of the work If B or C is checked, complete 2 or 3 belo R EC �D n s 2003 2. A state licensed contractor will be hired to do: A. _ All of the work B. _ A portion of the work (complete section below) Contractor Address/City Phone # State License # Type of work to be performed • 3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or portions of the authorized work. I understand that I may be an employer (see reverse side). A Certificate of Insurance covering workers' compensation must be on file at the City of Cupertino Building Department office. Person/Firm Address/City Phone Number Type of work to be performed ..................................................................................................................................................................................... I declare under penalty of perjury that the above is true and correct. I have read and understand the Owner-Builder Information(/rev a side). Property Owner's SignatuDate: AC,�o a j1 On 3 2� JobAddres . It pr, 00FA,1Rge L& QE CUA6RTtw6 Permit# Any changes to the information provided on this form shall be submitted to the City of Cupertino Build • Department. 0 - C*Y OF CUPERTINO CUP TYOF O PERMIT APPLICATION FORM U� °6 Ll APN# 77 Date: 061D,312-0 0 3 Building Address: , /;20996 P6PA'RrAGE LANC "cr CC)pCRTINo, CA -95014 Owner's Name: Phone#: PRASAD KANAj42 A" r1 (4oz) -7 S-7- 8060 Contractor: a J�lkk n License #: Contact: 'I v '' )l�J� - Cupertino Business License#: 7B1dgl)C ' ding Pi it Info: Ele t Plumb ❑ Mech ❑ ob es 'ption: )�/ Q Residential E] T CLQ mercial ❑ Sq.Ft. Floor Area: $/Sq.Ft.: Cost of Project: / ej"`�j"D Occupancy Group: Type of Construction: Quantity Fee ID Fee Description Fee Group BAPPLOTHER OtheTAppliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> IOOK 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 > IOOOA ELECTRICAL BELEC200 Elec Svcs 600V <=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC I Comm. HousingMit, Fee BUILDING 2- 1 of 3 lof3 �^ Cry OF CUPERTINO • CUPEI�TINO PERMIT APPLICATION FORM QuantityFee ID Fee Description Fee Group BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi-Family Res MECHANICAL BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL BNEWMULTI Multifamily Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BNUMULTI New Multifamily Res PLUMBING BNUSFD New Single Family Res BUILDING 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 BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING Alk BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain &Vent PLUMBING BPWATER Install/Alter Water Pipe PLUMBING BPWHEATER Water HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BRENLkMiAN A/C Units<= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREM 3USWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Fumace MECHANICAL BREMFURNOV Relo Fumace> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL 2 of 3 • CITY OF CUPERTA of PERMIT APPLICATION FORM CUPEkl iNO . Quantity Fee ID Fee Description Fee Group 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 Sips,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 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 I Plumbing Permit Issuance PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING • 3 of 3 UBMITTA #1 Jr1 ° APPROVED CUFERT►NO D ORDINANCES r /ttsq G DATE P L,—� c�aJl UUo A .L.\-Val SICNED� / o,f- . C I LJI gilt Z�.R cam chis set of dans and ..uications Mus, be kept 0 the jc' all times and it is un lawful to ME, any changes or alterations on sam , without vi iiton permission fram a e p w _ the building Dept., City of Cupertino. The stamping of this plan and specifications Q�d K C(z V'. D SHALL NOT be held to permit Or to be oh dt a`� JUN approval of the violation of any prcvisibfl< 0 3 1003 ,f anv City Ordinance or Statb Lew. By