08100099 CITY OF CUPERTINO i 14�4>w' "`-
' - BUILDING DIVISION pEjjMjT' C®NTRAOTn0R I1�F TON
BUILDING ADDRESS: PERMITNO.
10452 MERRIMAN RD JON R CRASE CONSTRUCTION INC08100099
NER'S NAME: PERMIT ISSUE DATE
RAJ THIRUMALAINAMBI 164 GILMAN AVE 10/17/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
10452 , 10454 MERRIMAN RD BLDG eO PO O
uOp LICENSED CONTRACTOR'S DECLARATION
u I herby alum Nat 1 un licensed under pmvisimss ---.-Job-Description
of Chapter 9(eemnuxing ----_ _ .. __-._ ......_ .
with Section 70Mly of Divitlon 3 ofdte Ele eta and Professions Cade andmylicenau
in full forte and cRa7W
='q_ License Clea_{L—_Lim.g
Dau Ohl Consumer C'sASE ,0A/.
nr ARCHITECTS DECLARATION
LL 1 undommoul my plans dull he used u Public records
JyU
g GIn Licensed Professional
3 OWNER-BUILDER DECLARATION
a� f I hereby aBrm that 1 am tempt Imm the Conuumer's Lieena law for mc
00 following reason.sand"'
7031.5.Business and Professor.Code:Any lily or only
which requirms a pros,to crostrum.Jur,improve,demnlish,or repair any cmelon,
prior to iu instance.also requires the applicant forsuch permit me Glc a signed statemem
pSC that heulicensed pursuant tothe novidomofthe ComractehllccnaLaw(Chapter 9 Sq.F[. Floor Area Valuation
yds (commencing with Section 7000)of Division 3 of the Business and Professiv.Cello)or
.5 Nu M is meopt therefrom and Ne basis for the alleged eamption.My violation of
Station 70M by airy applicant for a permit subject the applicant to a civil Penalty,of APN Number Occupancy Type
not mom than 0w hundred dollars($Mn
❑Lotho eraf the da,somyormnotimeyw wrthxngesuse'v ec.7W, asatim,
es
and Pr thewons and the smaurt u tots Li are t Law donul set apply 7oa4,Busier of
and Property
bis code The Contractor's ndwho res ares rot appy 1f an owner nr Required Inspections
property who b,pro err improruch impr and who sae ssuchworkMmolrorthrough his
awvemplthe Wilding
sot such improwmcnu art not ear ofo moRernd fe ole If,
however,the building or'unpromovnsIs gftt within one year of mmpledan,We owner-
builder wiB haw s¢buNa of paving Nat k did not build err iminove for pugoa of
sale.). .
0 1.u owner of the I ropcny,am exclusively contracting with licarued mnsuuaa us
construct Ne project(See.7044.Business and PraRstio.Code:)The Coavacmefa U-
ccnse law dean not apply me an owner of property who builds or improves thereon,and
who contracts for Such project{wIN a eonhaclnr(f)licensed pmNanl W the Conhamoh
License law.
0 lamaempturaWSee .B&PCforthiaraason
41t.c. Dau
WORKER'S COMPENSATION DECLARATION
1 be"alum under pully of perjury ons,of do following declaadans:
0 1 have and wal maintain a CatiGate of Conant me alf-i.um for WorkeYSCompn.
atom,as provided for by Section 7700 of the Labor Code.for Ne prfomanee of so
work for which this petit is Innes.
0 1 have and will maintain Wmkch Compensation Insumbea,as required by Section
3700 of de Labor Coo,for the performance of the work fmwhich this petit In indeed
My Worker's CompnsaGm Insurance carrier and Policy numbs K:
carr;er. s7w;'? c%e'e PolicyNn: 7/3-ooa3Ycy9 .
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
rlhuaccnon need not becmnplcwd lithe permit Is for one hundred dollars($100)
or leas)
1 certify Nat in the performancc of the work for which this permit u Wood.I"I nm
employ any person in my member an as to baone subject me the Warkors'Compnsaum
Laws of California.Duc
Applicant
NOTICE TO APPLICANT.If,after making NIs Ccrtircam of Exemption,you should
become subject to the Wodces Compnsktion provisions of the laW,Case you mus
., O foMWlth comply with such provisions of this petit shall be deemed rewkcd.
z Vy CONSTRUCTION LENDING AGENCY
1 hereby M.tW there is a construction lending aper y for ore performance of
a> dte walk for which Nit pmol is issued(Sec.3097,Cm.C.)
C lander'.Name .
z Lender:Address
V Q I eerily Nat I have reW this application and state Nat Ne above information is
I34 F comet.1 agree to comply with all city and county ordinances and sum laws totaling to
OV building comauction.and hereby atronar representatives of Nu city to enter upon the
U
shave-mention cal properly for inspection purposes.
(We)agree to save.Mentally and kap hustles use City of Cupertino against
rFr Vj Iiabiliimjudgmenu,comardapaux whichmaymanywayaarnxagainstaid Cy
()z in consequence of also granting of this prmh. /{
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-P01 Issued by: Date /f/—/
SOURCEREqu 3. _
7 Re-roofs /
Signuum of ppli onuacmer D
OUS MATERIALS DISCLOSURE Type of Roof
the torfuture building occupant vete or handle hauadon,material
as defined by the Cupertino Municipal Code.Chapter 9.12.and the Health and Safety
Section M324)?P)? � � All roofs shall be inspected prior to any roofing material being installed.
.tae.
❑Yes
Will the appheaeror future bussing occupant este equipment or aexiees which If a roof is installed without first obtaining an inspection,I agree to remove
emit haardnm air contaminants as dcrined by the Bay Area Air Quality Management all new materials for inspection.
D.WmL?
Ya
I have rend Ne Wallo s maoriaurequirtmcnu under Chapter 6.95 of the,Cairo.
mal Health B Safely Code Sections 2585.25533 real 25534.1 understand Na if lie building / 117dos row^.^
t comenuy have a l nrt
nut it u my mmunc niby u roder dry =owl or de
mquiemc u which mus Wmet Our to issuance of a CeWate of Occupancy. a[UCeO .Kppllcant at
Owner or auNanrcd agent Dau'
All roof coverings to be Class'W'or better
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 34229061 . 00
DATE ISSUED. . . . . . . : 10/17/2008
RECEIPT # . . . . . . . . . : BS000006378
REFERENCE ID # . . . : 08100099
SITE ADDRESS . . . . . : 10452 MERRIMAN RD
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACTAREA . . . . . . .
OWNER . . . . . . . . . . . . : RAJ THIRUMALAINAMBI
ADDRESS . . . . . . . . . . : 10452 MERRIMAN AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : CRASE CONSTRUCTION
CONTRACTOR . . . . . . . : JON R CRASE LIC # 22250
COMPANY . . . . . . . . . . : JON R CRASE CONSTRUCTION INC
ADDRESS . . . . . . . . . . : 164 GILMAN AVE
CITY/STATE/ZIP . . . : CAMPBELL, CA 95008
TELEPHONE . . . . . . . . : (408) 370-1485
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ------- ---- ---------- ------ ----
1BSEISMICR VALUATION 12 , 900 . 00 1 . 30 0 . 00 1 . 30 0 . 00
1CLOSOPNIN EACH 1 . 00 428 . 00 0 . 00 428 . 00 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 510 . 88 0 . 00 510 . 88 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- ----------- --------------
CHECK 510 . 88 51365
---------------
TOTAL RECEIPT 510 . 88
., Community Development
4 10300 Torre Avenue
;. Cupertino CA 95014
Telephone(408)777-3228
* CITY OF Fax(408)777-3333
M TINO
Building Department
JOB ADDRESS: PERMIT #
/oySa icYS-S' �iC�tr✓ Det (� fK0 ,10
OWNER'S NAME:
PHONE # ynB 96g oS 7
GENERAL CONTRACTOR: C t 45E Ca.✓1�x ricn on/ FAX # -Yee• 37a ,;z 3 s
I am not using any subcontractors: o
Si ature Date
Please check applicable subcontractors and com ete the following information:
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
MR0!20- UF 91
M;
V14
is
Assessor's Parcel Number:
Name of owner. IC4,7- 7?IIX Xlt-lf C /*A/
Projectaddress. /,0Y52 5' IV L/5-
Contact person. Phone. y0P 968 ps v7
Fax. 0.238
Net square footage of lot.
Existin
Square.footage: First floor: Propose
Second floor:
Garage:
TOTAL:
e there at least two 10 foot by 20 foot clear spaces inside the garage?
Is privacy protection planting required for the project?
On what floor(s) is work being done? DN�
Brief desc ripI ion of work. fe 77e,4 P4,qr,z eE v E a:e,r e i/tlE 7162,vAeF Aflwx 3 oec Y C ryo-y Ue,-le;c z/,r C
bU,IW /C72E
At,-: A-17C
Code editions: 2008 CBC N)2008 CFC 6CiN)2008CMC (Y-N)
2008 CPC (Y--AFN
LE
.)2008q, �C,
0 —
im AIXORDAWCE MH THE MY 01
GWMNO CODES AM OMPAM
Effective 1/1/08
)AX.—L4)---0�`o11
SIGN —
Thiis set , -7
be kept on ."d K 10 on
whi to M aiteletion, M7 1720
onseffle VV J1 • : M ssion Iron
the building
The stamping 01 ,h,a P It n. .Pecdicafionl
• SHALL NOT be he'd t pe mit or to be Or
app(Ml Of the violation of any provision
If Soy City Ordinance or )tete I-Rw
Plan Review Process Work Book Page-8-Revised 1/1/08
aCOCITY OF CUPERTINO
UERTFINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN #
2 29 Qel Date: �p i7 ,zoa�
Building Address:
/091V 110'IS-51
Mailing Ad ess (if different from building address):
Owner's Name: Phone#:
T �n-72-- y A/ - 0M'l ai�aM�i /�8 30� 8�G 6
Contractor: Phone: yp9, 96 F. ory-7
GJ/LASE CO1/S77P.u617eA1 Fax: YpP 3 70 pa 3 8
Contractor License#: 6115117
Cupertino Business License#: a a d S
Contact: Phone: c/p8, 968• PTY7
• �YA�v 7v/iiv�✓ Fax: yvf• 37 a38
Residential Commercial
Job Description:
,Qlycsl<F DR�yff6E9 F�LAxjin/6 �i.cr Fcvc cic�,
Qeq�cE ®faMl96lr) c�ecrxie cc.c<ur(c,,rr.,v:�_ rirE� .
IPFPGAc€ Act iNsuc-i+noN fin/ .4-r/i< R-,v� tT�rcrz-s� .
6✓Au- Ax.E
Building Permit Info:
Bldg 9-- Elect p Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B Eg--- 2. —
Valuation: Square Footage:
4, 9ea �
Project Size: Express [7/9—tandard ❑ Large ❑ Major ❑
Green Building: Please complete relevant portion of the Green Building/LEED Checklist& attach it
to the application or if applicable, include in plan set& the sheet index.
Points Achieved:
For help, contact Build it Green at www.buflditgreen.org -
Revised 7/01/08
CITY OF CUPERTINO
ITY O
CUPEkTiNO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1 BBOILERI 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
FBBOIL=ER3
Installation /relocation of ea M
boiler/compressor over 3 horsepower
to & incl 15 horsepower, or ea
abso tion sys over 100,000 Btu/h .
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 •
1BBOILER4 Instal lation/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
1 BBOILER5 Install ation/relocation of ea boiler or M
refrigeration compressor over 50
horsepower, or ea absorption sys over
1,750,000 Btu/h
1 BAPPLOTH 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.
1 ELECINSP 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