12040093 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10275 MORETTI DR CONTRACTOR:WONG'S GENERAL PERMIT NO: 12040093
CONSTRUCTION
OWNER'S NAME: GHATTAMANENI PRASHANT B AND CHILU 21150 SARATOGA HILL RD 1 DATE- ISSUED:04/17/2012
OWNER'S PHONE: 4082037612 SARATOGA,CA 95070 PIfONE NO:(408)314-2892
❑ LICENSEDCONTRACTOR'S DECLARATION' BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class_ Lic.q /� O�i67/� MECH r RESIDENTIAL r COMMERCIAL r
Contractor Dates2�C�/ /
1 hereby atTrrm that 1 am liter( under the provisions of Chapter 9 30B DESCRIPTION:KITCHEN REMODEL(3605QFf}NO STRUCTURAL
CHANGES
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
I hereby affirm under penally of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this peril is issued.
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this Sq.FI Floor Area: Valualion:$15000
permit is issued.
APPLICANT CERTIFICATION APN Number:37514002.00 Occupancy Type:
I certify that I have read this application and state that the above infomation is
correct. I agree to comply with all city and county ordinances and slate laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. L/ T Imo-
-�Date d ] (iL Issued by:s �/✓ A G Date: y '/7l
Signature /
r
❑ OWNER-BUILDER DECLARATION Rh:ROOFS:
1 hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed without first obtaining an inspection,1 agree to remove all new materials for
11 as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work.and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signature of Applicant: Dale:
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1 hereby affirm under penally of perjury one of the following three
declarations: HAZARDOUS MATERIALS DISCLOSURE
I have and will maintain a Certificate of Consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materiels requirements under Chapter 6.95 of the
perfamtance of the work for which this permit is issued. California Health&Safely Code,Sections 25505,25533,and 25534. I will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Safety Code,Section 25532(x)should 1 store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this Additionally.should 1 use equipment or devices which emit huardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will
I certify that in the perforance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code.Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Health&Safely Code,Sections 25505,25533,and 25534.
Compensation laws of California. if,after making this certificate of exemption,1
become subject to the Worker's Compensation provisions of the Labor Code,I mull Owner or nulhorind agent: 49
Dale:
forthwith comply with such provisions or This permit shall be deemed revoked. ..i
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I certify that I have read this application and stale that the above information is I hereby affmn that there is a construction lending agency for the performance of work's
correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. 1 understand my plans shall be used as public records.
Signature Date I Licensed Professional
1
CITY OF CUPERTINO
3 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 37514002.00
DATE ISSUED. . . . . . . : 04/17/2012
RECEIPT #. . . . . . . . . : BS000016558
REFERENCE ID # . . . : 12040093
SITE ADDRESS . . . . . : 10275 MORETTI DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : GHATTAMANENI PRASHANT B AND CH
ADDRESS . . . . . . . . . . : 10275 MORETTI DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : GAYWILL C WONG
CONTRACTOR . . . . . . . : GAYWILL WONG LIC # 27583
COMPANY . . . . . . . . . . : WONG' S GENERAL CONSTRUCTION
ADDRESS . . . . . . . . . . : 21150 SARATOGA HILL RD
CITY/STATE/ZI-P . . . : SARATOGA, CA 95070
TELEPHONE . . . . . . . . : (408) 314-2892
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- —-------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 15, 000.00 1. 00 0. 00 1.00 0 . 00
1BSEISMICR VALUATION 15, 000.00 1. 50 0. 00 1 .50 0 .00
1REMRESOTH SQ FEET 380.00 457. 00 0 .00 457 .00 0 .00
---------- ---------- ---------- ----------
TOTAL PERMIT 459.50 0.00 459.50 0. 00
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: DATE: 04/17/2012 REVIEWED BY: larry s
APN: BP#: 'VALUATION: $0
xPERMIT TVPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex PENTAMATION 1R3SFDREM
USE: PERMIT TYPE:
WORK kitchen remodel no structural changes
SCOPE
,Llrr lr. flan Check Plumb. Plun Cheek Eee- Plan Check
Neck Penuil Fee: Plumb. Pomir Fn': !S(rc. Per'mir Fre:
0/ho If('(h. Imp. Oilier Plumb Insp. OilierElcr.buy.
,blech.Imp. Per- Plumb. bnp. Feelifer. lisp. Fec:
NOTE: This estimate does not includejees due to other Departments(ie Planning,Public Works, Fire,Sanitary Sewer District,School
District,etc). These fees are based on the prefinthra in ormation available and are only an estimate Contact the De t or addn'I info.
FEE ITEMS (Fee Resolulion 11-053 E0' 711111) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 380 s.f. Remodel,Other
Suppl. PC Fee: Q Reg. O OT FO.OThrs $0.00 $457.00 1REMRESOTIl
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Fee.0 Reg. Q OT 0,0 1 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Cunctrurtion Tax
Arbninisn ativ e Fec: O
Work Without Permit? O Yes 0 No $0.00
Advanced Plannine Fee: 0.6 . Select a Non-Residential
%Tara/Docrunrrelrninn Tues: Building or Structure
i
Strong Motion Fee: $0.00, Select an Administrative Item
Blde Stds Commission Fee: $0.00
SUBTOTALS: '_ $0.00 57.00 TOTAL FEE: $457.00
Revised: 0410112012
RESIDENTIAL PROJECT COVER SHEET
Assessor's Parcel Number:
Name of owner. L-4'AS fi!4N7- A7 HAT 7,�g Al q A/ E T
Project address. /a 2 7-S7-- /'90 RT 7 7-1 /> R't v-4-
Contact person. 4�:IL, LL Phone. Zit d X- 3
Fax.
Net square footage of lot.
Existing Proposed
Square footage: First floor:
Second floor:
Garage:
TOTAL: ! ,
Are there at least two 10 foot by 20 foot clear spaces inside the garage? Y—�
Is privacy protection planting required for the project?_ Y
Build it Green Total Points
On what floor(s) is work being done?
Brief description of work. fi>e M O 0 X19b- MUNITY DEVELOPMENT DEPARTMENT
0 .3r Ah C--r k%rW3-L II ION sllPldtT-10
4 (�AROVED
Code editions: 2010 CBC . (Y-N)2010 CFC (Y-N)2010WM–rrof pf�11R-sd specifications MUST be kept at the
(Y- N)2010 NEC (Y-N) lob site during
2010 CPC con tructlon. It Is unlawful to make any
changes or alterations on same,or to deviate
California Green Building Standards Code 2010 therefrom,without approval from the Building Official.
The stamping of this plan and specifications SHALL NOT
Effective 1/01/11 be held to permit or to be a .pproval of the violation
of any p ovisions of Ordinance or State Law.
BY
• f
DATE
CUPERTINO PERMIT NO.
Building Department
APR 16 2012
REVIEWE FOR CO MPLIANCE OFFIC"
COMY
Reviewed By: /
Plan Review Process Work Book Page-8- Revised 12/21/10
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CUPERTINO
Building Department
APR 16 2012
- O N
REVIEWED OR CODE/E MfSLIANCE "
Reviewed By: m � �
TP01 C186424R
W361224 144" 13" Al
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12"
36" 18"
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36" 18 ;
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All dimensions size designations given are M 201 This is an original design and most not be Designed:2012-3-27 ,
subject to verification on job site and .ccxxorocias released or copied unless applicable fee Printed:2012-4-13
adjustment to fit job conditionshas been paid or job order placed.
406-314-2892+6 All Drawing N: 1
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING OMSION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228• FAX(4108)T77-3333; buildlna(a�cuoertino.orD
❑NEW CONSTMUCnON [IADDIMON IK ALTERATION/TI ❑ REVLSION/DEFERR0 ORIGINAL Fu-wr 6
PROJECT ADDRESS j 0 2 7 5 M 0 /PF i T I D R I vF AFN e 3—7 5 , — (�
D�tNAEE PRASHANT 6HAi%ilmolvENI �iOq 2o37d/ : ' 54iAe' Py/tA/�AMAI rt[n, �J9„•Iq;(. m
STREET ADDRESS to a'7-5 Mokf; it Z)RtvE Orr, 'ATEzrP CUP£te:.Ne CA 95cAq FAx
cONTALTNANIE PRAS/-I!iW% '6;HAirRlv2!lNEMI PHONE4 b82c376z E-MAB
P,AAFFq n75�eA,� ,AYrgr�- oM
�TADDR /075 Mo'LPEfir DQ �'�A'F �CufEki„era C/� 9Sai/� FAX
❑OWNER ❑ OWNER-RuaDPx ❑ OWNEXAGENT WNtRACT R ❑CONrnncTORAGENr ❑ ARcErrEcT ❑ENmNEmm ❑ DEVELOPER ❑muxt
WNTRACTDRNAME •. / v, A/ LICENSE NU6fl3E8 =NSETYPE BUB.LIC!
COMPANY NAME E-MAR �I FAX .
AAl. W9N E/ I ep
91EFET ADDRESS r<.6RY,SrATE IIP PHONE
p f'I/LL �Qc, y'3'o 7 v
ARCHTTECT/FNGWEERNAME LICZ40 NUMBER BUS.LIC a
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE ZIP PHONE
DESCRIPTION OF WORK
1 0'
EXISTING USE PROPOSED USE CONMTYPS ro
�Sa45 USE TYPE OCC SQFI'. VALUATION(S)
AREA KU
NEW FLOOR - DEMO TOTAL
AREA
AREA AREA TARFa
BATHROOM XITCKEN O EIR
REMODELAREA MMODELAREA REMODELAREA O
PORIXAREA OEIX AREA TOTAL DEC&PORCH AAFA GARAGE AREA: DETACH
ATTACH
O DWELLING WITS: ISASECONDUNIT YES SRCONDSTORY QYES
RIDING ADDED? ❑NO ADDRTONT ❑NO
PRE-APPLICATION []YES IF YEA PROVIDE COPY OF ISTHRBLOGAN E3 YES RECEIVED BY: TOTAL VALUATION:
PIAM(INOAPPLO ❑NO PLANNING APPROVAL LETTER KICHIMHOMET r3 NO bf9a _
By my siguatme below,I mafy to each of the faUawmg: I am the Ftoovty awuec or Rathoriwd ascot to act On the pnrperty.ovme{s h.half-I bavc rwd this
application and the mfImnatiau I have provided is cotrecL I have read the Description of Wait and verify it is accarate. I agree to comply With all applicable local
atdID®cis cad stain laws telatiag to hmldmgtous9actloa I ambo ' tepteunmtive of Cupertino to enter the above-i ed prop tar,htspecdoo purposes.
Signagecm
of Applit/Agcm: Date: Z
SUPPLEMENT -INFORMATION REQUIRF3J PLANT=tx TYn ROPIIl•IG SLD•
New SFD or MUltifaraily dwellings: Apply for demolition permit t'ar' - 'l
;biting building(s). Demolition permit is re�gtrired prior io issuance-of building OVER-Ti eoaxrEx -- ❑ BOB.DiNG PLAN BEVICW
permit for new bmldmg• ❑ PL.unsatcPLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ srArmARn ❑ POactcwoms
form if my Hazardous Materials are being"used as part of this project Lj ❑ F@E bm-r
Copy of Plc iag Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ sArsrARY szwER OrsTElcr
submitW ofBuildmg Permit appUcatiou.
❑ ENVIROKMETTAL HEALTH.
BldgApp 2011.doc revised 06/21171