07050022 CITE'OF CUPERTINO
'BUTLDI?JGDIVISL<Tiv PERMIT ' QR� IMTIf�I
PERMIT NO.
BUILq�rU7 7 NORTHBROOK SQ TBD — TO BE DETERMINED 07050022
OWNER'S(J NAME: PERMIT ISSUE DATE
CHANDRAN, KARTIK & SUNDARESH, 05/03/2007
NeT TM A TvT SANITARY NO. CONTROL NO.
BUILDING PERMIT INFO
ARCHITECT/ENGINEER:
KITCHErT REMODEL BLDG ELECT PLUMB MECH
a p p LICENSED CONTRACTOR'S DECLARATION ry T T Job Description
U
P I hereby affirm that I am licensed under provisions of Chapter 9(commencing
Z w with Section 7000)of Division 3 of the Business and Professions Code.and my license is
a a in full force and effect
j ? License Class Lic.#
E W Date Contractor
ARCHITECT'S DECLARATION
j a< 1 understand my plans shall be used as public records
)aU
U.F- Licensed Professional
y OWNER-BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractors License Law for the
in O following reason.(Section 7031.5,Business and Professions Code:Any city or county
< which requires a permit to construct,alter,improve,demolish,or repair any structure
Z y prior to its issuance,also requires the applicant for such permit to rile a signed statement
>r' ,Ft.Floor Area Valuation
< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 q
rH (commencing with Section 7000)of Division 3 of the Business and Professions Code)or
u R§ that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not more than five hundred dollars(5500).
0 1,as owner of the property,or my employees with wages as their sale compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections
and Professions Code:The Contractor's License Law does not apply w an owner of Q p
property who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improvements are not intended or offered for sale.If,
however,the building or improvement is sold within one year of completion,the owner-
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
afla,owner of the property.am exclusively contracting with licensed contractors to
nstruct the project(Sec.7044,Business and Professions Code:)The Conuacwr's Li-
cense Law does not apply to an owner of property who builds or improves thereon,and.
who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's
License Law. S I
0 I am ex emp under Sec. B&P C for this mason AN TAR
Owner Date
WORKEM COMPENSATION DECLARATION
I hereaffirm under penalty of perjury one of the following declarations:
L]I have and 'll maintain a Certificate of Consent to self-insure for Workees Compen-
sation,as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
0 I have and will maintain Worker's Compensation Insurance,as required by Section
3700 or the Labor Code,for the performance of the work for which this permit is issued.
My Workees Compensation Insurance carrier and Policy number are:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be compacted if the permit is formic hundred dollars($100)
or less.)
1 cenify that in the performance of the work for which this permit is issued.1 shall not
employ any person in any mann%;vr egmc— the Workers'Compensation
Laws of California.Date ll s.L_h�—�
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject to the Worker's Compensation provisions of the Labor Code,you must
Oforthwith comply with such provisions or this permit shall be deemed revoked.
Z" CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a constructinn lending agency for the performance of
a the work for which this permit is issued(Sec.3097,Civ,C.)
QLender's Name
Z L.cndees Address
U 0 1 certify that I have read this application and state that the above information is
w 0-r correct.I agree to comply with all city and county ordinances and state laws relating to
Ubuilding construction,and hereby authorize representatives of this city to enter upon the
a above-mentioned property for inspection purposes.
(We)agree to save,indemnify and keep harmless the City of Cupertino against
rF-r co) liabilities,judgments,costs and expenses which may in any way accrue against said City
U Z in consequence of the granting of this permit. Date
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:
SOURCE REGULATIONS. „� O p 1
U Re-roofs
Signatu orApoicaddContractor Dat
Type of Roof
HAZARDOUS MATERIALS DISCLOSURE
ill the applicant or future building occupant store or handle hazardous material
as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety
Code,Section 25532(a)? All roofs;;hall be inspected prior to any roofing material being installed.
0 Yes 9No
Will the applicant or future building occupant use equipment or devices which
If a roof i:;installed without first obtaining an inspection,I agree to remove
,mit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
District?
0 Yes Jct No
I have read the hazardous materials requirements under Chapter 6.95 of the Califor-
niaHealth&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building 1
docs not currently,have a tenant that it is my responsibility to notify the occupant of the
requirements whi must be met prior to issuance of a Ce 'ficate ofcupan Signature of Applicant Date
S t,3 0
All roof coverings to be Class"B"or better
Owner or autho -red agent Date
CITY OF CUPERTINO
6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: bethe
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 31639062 .00
DATE ISSUED. . . . . . . : 05/03/2007
RECEIPT #. . . . . . . . . BS000001192
REFERENCE ID # . . . : 07050022
SITE ADDRESS 20277 NORTHBROOK SQ
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER CHANDRAN, KARTIK & SUNDARESH,
ADDRESS . . . . . . . . . .
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-0503
RECEIVED FROM . . . . : RECEIPT INTERFACE
CONTRACTOR . . . . . . . : TBE - TO BE DETERMINED LIC # 00096
COMPANY TBL - TO BE DETERMINED
ADDRESS
CITY/STATE/ZIP . . . : ,
TELEPHONE . . . . . . . . :
FEE ID UNIT QUANTITY FMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- -- -------- ---------- ---------- ----------
BENERGY PERMIT FEE 1.00 34 .86 0 .00 34 .86 0. 00
BPERMFEE VALUATION 10, 000.00 169.56 0 .00 169.56 0.00
BPTRAP NO OF TRAPS 1 .00 9. 00 0 .00 9.00 0 .00
BSEISMICRE VALUATION 10, 000 .00 1 . 00 0 .00 1 . 00 0 . 00
EPERMITFEE FLAT RATE 1 .00 38 .37 0 .00 38 . 37 0. 00
PPERMITFEE FLAT RATE 1.00 38 .37 0 .00 38 .37 0.00
-- -------- ---------- ---------- ----------
TOTAL PERMIT 291. 16 0 . 00 291 .16 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 291 .16 VISA
---------------
TOTAL RECEIPT 291.16
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CITY
CUPEkTINfl +
Assessor's Parcel Number: —
.L- KIK- �� i)
Name of owner.
l � EU 11�L i �'I"��`-k' C){� C�� Cil- 1 tom•���� PIJ l..' C-A. [`T�
project address. �
Svm Phone. esn �o� 706
Contact person. Fax.
Net square footage of lot.
Ex:sting ProposedY 2
Square footage: First floor:
Second floor:
Garage:
TOTAL:
N
Are there at least two 10 foot by 20 foot clear spaces inside the g b araae`?�
Is privacy protection planting required for the p:'oj ect? N
On what floor(s) is work being done?
Brief description of work.
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2001 CFC -N)2001 CMC (Z'-N)
Code editions: 2001 CBC 2001 NE(- Y N)
2001 CPC -N)
Effective 11/1/02 r� J-3 t 7
D'EC'EIVED J
3 Igo?
Plan Review Process Work Book Page-B-Revived 4/28/04
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Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
4'UPEkTINO
Building Department
All Cupertino building permits must meet certain conditions related to maintaining
environmental quality and public peace and safety. The two most common
conditions are described below.
STORMWATER POLLUTION CONTROL
State law requires that Cupertino, 12 other Silicon Valley cities, Santa Clara County and
the Santa Clara Valley Water District control stormwater pollution. Educating local
residents and businesses and enforcing siormwater pollution control laws are key parts
of the City's compliance efforts.
Stormwater pollution prevention: It's up to us
In northern Santa Clara Valley, storm drains flow directly to local creeks and San
Francisco Bay, with no treatment. Stormrvater pollution is a serious problem for wildlife
dependent on our waterways, for people living near streams and baylands, and for the
local water supply. Common sources of stormwater pollution include:
• Dripped oil, fuel, and antifreeze from vehicles and heavy equipment;
• Construction debris, including dirt, concrete and paint;
• Landscaping runoff containing pesticides or weed killers; and
• Any material dumped or spilled into streets or storm drains
The property owner and the contractor sl-are ultimate responsibility for activities
occurring at a construction site and will be held responsible for any environmental
damage caused by subcontractors or employees.
For more information on construction-related stormwater requirements, see the
Stormwater quality Regulations section cf the City of Cupertino web site at:
http://www.cupertino.org/city government/departments and offices/
environmental services
COMMUNITY NOISE CONTROL
The basic noise control requirements for construction sites are as follows:
• Typical construction work hours are:
- Weekdays - 7 a.m. to 8 p.m.
- Weekends - 9 a.m. to 6 p.m.
• Construction other than street corstruction is prohibited on holidays.
• Residential daytime noise levels from complaint site - 60 dBA
• Nonresidential daytime noise leve s from complaint site - 65 dBA
For more information on noise cor trot, please see Chapter 10.48 of the Cupertino
Municipal Code, which can be accessed at .http://www.amlegal...com/cupertino ca/
Greg Casteel
Building Official
O
C; BER SIJEET
I�.L Pik �'
oJE
CIT Y Of
CUPEkTINfl
Assessor's Parcel Number: —
Name of owner_ IL -�1K- c�k� j) o � �y� D��S�
�A-
rrojcct allress-
a�2� CU �� TSN o � I0I
S
Sy�/l � Phone.
Contact person. Fax.
Net square footage of lot.
Ex sting / Proposed
Square footage:
First floor. 6 �2 '/
Second floor:
Garage:
TOTAL: -�
araae?
Are there at least two 10 foot by 20 foot clear spaces inside theg b
Isp rivac protection planting required for the project? N
y
On what floor(s) is work being done?
s�w
Brief description of work.
r C
2001 CFC -N)2001 CMC (Y-N)
Code editions: 2001 CBC -E Y N)
2001 CPC -N)2001
Effective 11/1/02
Page-8-Rev.sed 4/28/04
Plan Review Process Work Book