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03110091 (3) 'TPERTINO DIVISION PERM x9CONTRACT(�RJNFORMAk N - . . , ,KESS: PERMIT N0.03110091 35 ERNIE CT NAME: PERMIT ISSUE DATE MESH & BEEBA MENON 11/18/2003 NE: SANITARY NO, CONTROL NO. ARCHITECT/ENGINEER: r BUILDING PERMIT INFO BLDG' EL" PLUMB MECH 0 0 +Op LICENSED CONTRACTOR'S DECLARATION Job De n n. �U 1 hereby am ffrrthat I am licensed under provisions of Chapter 9(commencing q a� ¢3 with Section 7m)or Division 3 of the Businessand Professions Code,and my license is .� 2004 jg?< in fall ADD BATHROOM - MAR �• Liccnsc Class Lie.p 3y, Data Contractor Qq ARCHITECTS DECLARATION BUILDING I understood my plans shall W used as public records a e o Licensed Pmio fessnel 1 S OWNER-BUILDER DECLARATION 2<f 1 hereby reaso affirm that 1 1. exempt from the Contractor's License Law for the ❑O (allowing reason. Fruit it 7031.5,Business and Professions Code:Any city or county $ which requires a permit it)ac cnnawc4alter.,nit improve,demolish,or repair any structure 8 0 0 0 that he is e.pursuant ntto theres provisions of the for Commositert rmiuoicensle e and Law(Charter E ¢ (comma(commencing edpurstion7 7") n3oftheBuiness ndPro,law(Code)or Sq. FL Floor Area Valuation d�O (co he is exempt therefrom and of Division of the Businessandmn.Anynvi Cndc)of ��$ Net he is exempt themfmm antl the bmis for Ne alleged exemption.Any violation of o�p Section 7031.5 by any applicant for a permit subjects the applicant10 a Civil penalty of R2QFTi6cr 0 0 Occupancy Type not more than eve hundred depart(6500). P Y YP ❑1,as owner of the property,or my employees with wages in their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractors License Law does not apply to an owner of q p property who builds or improves thereon,and who does such work himself or through his n employees,provided that such improvement¢are maintained oroeered for sale.If, however,the building or improve ant is sold within one year ofcompletion.lieowner- builder will have the burden of proving Out he did not build or improve for purpose of sale.). ❑ I,as owner of the property,am exclusively convecting with licensed contractors t0 construct the project(See.70 ,Business and Professions Cade:)The Contractors Li. cense Law does not apply to an owner of property who Wilda or improves thereon.and. who contracts for such projects with a contricmr(a)licensed pursuantto the Canuactor's License Lew. ❑lam hinder See/// B&PC for this..a. O�ynerane //—/g'dJ 2K WORKER'S COMPENSATION DGCkAtIEATION I hereby affirm under Penally of perjury one of the following declarations: have and will maintain a Ceniecam of Consent no self-insure for Workers Camped. ion,as provided for by Section 37M of the Labor Code.for Ne performance of the work for which this permit is issued. ❑1 have and will maintain workers Compensation Insurance,as required by Section 3700 of the Labor Code,for the Performance or the work for which Nis pens it is issued. My Workers Compensation Insurance carrier and Policy number ere: Cartier. Policy No.: _ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need nal W completed if the permit is forma,hundred dollars(Slip) or leas.) - 1 certify Nat in the performance of the work for which this permit is issued,1 shall not employ any person in any mannar an as to become subject audit Workers'Cmmforeation Laws of California.Dam Applicant NOTICE TO APPLICANT:IL after making this Cerificam of Exemption,you should become suhject to the Worker's Compensation provisions of the Labor Code,you must JO finetwith comply with such provisions or this Farm it shall be decreed rovnked. zCONSTRUCTION LENDING AGENCY I hereby affirm for there is a eonstrvninn lending agency lot the performance of 'YI 7 the work for which this senator is issued(Sea 3097,Civ,C.) W0. t,endcr's Name =z Landes Address V Q 1 cerrify Nat 1 have read this application end stain that the above iafnrmuiun is ----can t agree m comply with all city and county ordinances and state laws relating m Q V building convection,and hereby aothodre reprcacrumivea of Nis city to enter upon the r 4 anow-mcntiuned property for inspection proPscs. {{....tt (We)agree to save,indemnify and keep harmless the City of Cupertino against Fah liabilities,judgment,costs and expenses which may in any way acerae against said City V 7 in consequence of the granting of this permit. t� APPLICANT UNDERSTANDS NO WILL COMPLY WITH ALL NON-POINT Issued by: Date SOU REGULATIO 1, tevA6 /—Ig'a Re-roofs rotor.of A11OcamVContmcmr Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant Or future building Occupant stare or handle haaarduus material as defined by the Cupertino Municipal,Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑yas to< Will the applicant Or Tamm building oecupam ns,agaipment ter devices which If a roof is installed without first obtaining an inspection,I agree to remove t hazardous air contaminants as defined by the Bay Arca Air Quality Managemcm all new materials for inspection. Ohm? ❑Yes u Ihave mind due haaaNnus materials tequircmams under Chapter 6.95 ofthe Califon tie Health&Safety Code,Sections 25505,25533 and 25534.1 undemea d Ihatif the building does not currently have n Iemda4 that it is my responsibility to madly the Occupant of the hurpments whit mus el prior to issuance I.Cerdecam of Occupancy. SI nature ofApplicant Date e //—lig ��,_3 g r or authofiacd agent All roof coverings to be Class "B" or better WtITY OF CUPERTINO o 3 o v CUP TYOF O PERMIT APPLICATION FORM qWPN # pS Date: ll - ( 9 - 133 S 2Z Building Address: 95-7 V ERN i E CT CU pzRT( N o Owner's Name: RAMesw Be-cNA ME Ne v Phone #: /¢o g 1 25-2 -74-5 6 Contractor: License#: Contact: Cupertino Business License#: Building Permit Info: J J Bldg ❑ Elect Plumb CI Mech ❑ Job Description: O BATH Roo M o Residential � OT Fxifr'lvrl On- Commercial ❑ Sq.Ft. Floor Area: [3 C) r7 Fk $/Sq.Ft.: Cost of Project: Occupancy Group Type of Construction: • Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING 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 BMITIGATC Comm. Housing Mit. Fee BUILDING # 2236D2° lof3L a rr OITY OF CUPERTINO r cITM 0 PERMIT APPLICATION FORM CUPERTINO Quantity Fee 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 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 Pie PLUMBING BPWHEATER Water Heater/Vent 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 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 5 *ITY OF CUPERTINO* CITY OF PERMIT APPLICATION FORM CUPEI,TINO Quantity Fee ID Fee Description Fee Group BREMPOWER Power Device/Apparatus ELECTRICAL 1 BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL BREMSIGNAD Rmdl Sips 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 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 Plumbing Permit Issuance PLUMBING PPLBG Plumbing Fee s foot PLUMBING ZADDCHG Address Chane BUILDING • 3 of 3 Bonus Room Conversion a Beena&Ramesh Menon 957 Vemie Court, Cupertino, CA 95014 (408)253 7456 9' 6" CU 30" Vanity l 5' Walk-in Closet Toil t IF Pocket Door • 3, APPROVED` 14' 9" Window E WR{t THE MY(M Its i �� RDINANC1i,9 18tf�suet d nd specificatio job at all times and it is U* if any changes or, alterations s dMout written permissiot► tom nY�k IWilgtit�@4L City at Cupertino. 1t AMM 61*i:plan and speciRc 90" yyy g to tueld to permit or to bei ao y Td +�p gor%6ta LavL 00 .tt er�A�tLB �' Existing Door i $TALI ' ii, WId SHaHE I"i1hIINEi }zap �r _SII[ - • SEDROori�y � . � O O, " I \y I I ray YYPE X GYP ED- CN) WALLS 11 GEINN(r rl . I 4E4 _ KNL zoo ELG%Va 4 G � I P IFS. gme vtwDpa� 3 I 8 (1105. F1�M ALL. - N DRAWL .PPLE I-" • / NIWGRMG b .4F ..*' nlso•/E . VROVIVG GIAIMBIW.6RA'+-'IN oPF+iwc - :WALL TO ENAP,}.E M$�Tu-V.rioN y II OF FUTURE SOVYL 5Y'Vr&q �\r © >EE RGbI'•I FgNfM XHED4�E I, N - � I - � � ���I�•leco FlKrsplA"-C^ � � i . . I'„r L Pi°f 6AS-W4 uwrr'FBr •q�Eo - .. - L15Y