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07050239 CITY OF CUPERTINO BUILDING DIVISION PERMIT � C?R IMTI�N . PERMIT NO. BUILDI16t!) J.ESS�ORTHBROOK SQ BAY AREA ENTERPRISE 07050239 G 11 G / / lV PERMIT ISSUE DATE OWNER'S NAME: CHANDRAN, KARTIK & SUNDARESH, 2110 MA14GIN WAY 05/23/2007 SANITARY NO. CONTROL NO. (408) 23:3-5043 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH Ig p p LICENSED CONTRACTOR'S DECLARATION Job Description }tit r 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing REVISION—DIVIDING WALL BETWEEN FAMILY RM/GAME RM. Z with Section 7000)of Division 3 of the Business and Professions Code,and my license is >>N in full force and effect. ORIG PE:ZMIT #07050022—NO NEW PERMIT. j ? License Class Lic.# p Date Contractor F ARCHITECTS DECLARATION j aa < I understand my plans shall be used as public records )yU e w y Licensed Professional a OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for the 00 following reason.(Section 7031.5,Business and Professions Code:Any city or county g which requires a permit to construct,alter,improve,demolish,or repair any structure o w prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation ?< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 >q.Ft.Floor Area $1000 r.t=- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or Q�$ 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 316390622 . bT Number Occupancy Type not more than five hundred dollars(5500). ❑I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended oroffered for sale(Sec.70",Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of 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.). 20,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business and Professions Code:)The Contractor'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 contractors)licensed pursuant to the Contractor's License Caw. ❑1 am exemptun r Sea B&P C for this reason Owner DM 0 S KERS COMPENSATION DECLARATION I hereby affi under penalty of perjury one of the following declarations: ❑I have and will maintain a Certificate of Consent to self-insure for Worker's compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Workers Compensation Insurance carrier and Policy number are: Carrier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manitW"W101014"b' to the Workers'Compensation Laws of C-1-- V 1l 1 Applicant NOTICE TO APPLI AW.If,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must ,J Q forthwith comply with such provisions or this permit shall be deemed revoked. Z " CONSTRUCTION LENDING AGENCY Fr I hereby affirm that there is a construction lending agency for the performance of - fY the work for which this permit is issued(Sec.3097,Civ.C.) W A Lender's Name Lender's Address U C I certify that I have read this application and state that the above information is w correct.I agree to comply with all city and county ordinances and state laws relating to O U building 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 „Ey CA liabilitim judgments,toss 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 REG TIONS. dDmAf trS�03(o r Re-roofs Signature of Aicant/Contractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will 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 shall be inspected prior to any roofing material being installed. ❑Ya a Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection, agree to remove emit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new Materials for inspection. District? ❑Yes [ " I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Codc,Sections 25505,25533 and 25534.1 understand that if the building does not currently have a tenant,that it is my responsibility to notify the occupant of the require ms which must be met prior to issuance of a certificate of Occu an Signature of Applicant Date 05 All roof coverings to be Class"B"or better Owne or authorized agent Datc CITY OF CUPERTINO ITEM 1 OF 1 PERMIT RECEIPT OPERATOR: suew COPY # 1 Sec: Twp: Rng: Sub: Blk : Lot : APN 31639062 . 00 DATE ISSUED. . . . . . . : 05/23/2007 RECEIPT # . . . . . . . . . : BSC00001445 REFERENCE ID # . . . : 07C50239 SITE ADDRESS 20277 NORTHBROOK SQ SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER CHINDRAN, KARTIK & SUNDARESH, ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-0503 RECEIVED FROM . . . . : SUYDARESH/SUMAN CONTRACTOR GREG FEIST LIC # 28273 COMPANY BAS' AREA ENTERPRISE ADDRESS . . . . . . . . . . : 211.0 MANGIN WAY CITY/STATE/ZIP . . . : SAN JOSE, CA 95148 TELEPHONE (4(,8) 238-5043 FEE ID UNIT QUANTITY ],MOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- -- -------- ---------- ---------- ---------- BPLANCKREP HOURS 1 .00 87. 14 0 .00 87 . 14 0 . 00 -- ------ ---------- ---------- ---------- TOTAL PERMIT 87. 14 0 . 00 87 . 14 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 87.14 VISA --------------- TOTAL RECEIPT 87.14 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 101 FOUNDATION 102 PIERS 103 UFER 104 REBAR 105 ANCHOR BOLTS 106 SEWER & WATER 202 UNDERFLOOR PLUMBING 203 UNDERFLOOR MECHANICAL 204 UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION 301 ROUGH PLUMBING 302 TUB & OR SHOWER 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 305 FRAME 306 HOLDOWNS 307 INSULATION 308 SHEETROCK All? k2 CPA-�JJ-a 0�1 ro— YV\. iN ACCORDINCE WITH THE CITY tit CUPERTINO CODES AND ORDINANCES )ATE,. -S -17 0 N E 0— N-118 of W pans &110 ''pacltications must t�1 Dept cin thy; i,01)a' I'l times and it is Un I.. 't"kfLll to nIJke 2,,V "ho,'190S or alteration '1'1 SM wit"IM 'k vv;'ilten, permission from tie bul4ng 1) t., City (If Cupertino. rhe starnpin?at airs s plan and sPecificationg'% V1.1. NOT be herd to Permit cr to be a `00roval of the violation of any provislo 1*1v 0tv Orli f ante of State Law, It -vz -7o S x 4L k Jvy oo Qlf 4er .: +/. . ``, `fes I ` h> *-- 4J - Ing.✓ I ?bre . Wall eellftr Gy N �rd►!1 H (� D 2-Y, m cn key k 13r,ao14 s CF\ CITY OF CUPERTINO 70-5-&;z3� *C10F PERMIT APPL]_CATION FORM 1 CUPERTINO So 0 APN# Date: Building Address: Mailing Address (if different from building address): ae 'l� nioLTHP� GL r�4zl►Jv CA, sbf Owner's Name: Su V W SJ NP k �C SH Phone #: Contractor: License CA,, 311 &. 11 Contact: r S,� O p66 Phone: Cupertino Business License#: � to Building Permit Info: �) ��`d UJQu bQ- I im.'v, mew Bldg ❑ Elect L Plumb ❑ Mech ❑ Job Description: Residential ❑ Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: 6 ��d Occupancy Group: Please check this box if the project is a Type of Construction: P El � ` w second-storyaddition. Project Size: Standard ❑ Large ❑ Ma or ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER ether Appliances MECHANICAL 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 E oiler> 1.75M Btu MECHANICAL BCONSTAX -onstruction Tax BUILDING BCONSTAX In 3/Off/Comm/Quasi BUILDING BCONSTAXBQ Ccn. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax-Resi/Mobile BUILDING BELEC 1000 El ec 600V <= 1000A ELECTRICAL BELEC1001 Flec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V <=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD anergy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING of 3 N7 x CITY OF CUPERTINO CUPE�TIN o PERMIT APPLICATION FORM Quantity Fee ID lee Description Fee Grou BMISCELL 1V: CITY OF C UPERTINO aTYOF PERMIT APPLI=CATION FORM CUPERTINO )uanti Fee ID Fee Description Fee Group BREMSIGNAD Rmc.l Signs Add Branch ELECTRICAL BREMSIGNS Rem Adel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Veit Fan Single Duct MECHANICAL BREMVENSYS Ventilation S stems 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 Tem orar Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC electrical sq foot ELECTRICAL EPERMITFEE Elco Permit Issuance ELECTRICAL MPERMFEE 1N[echanical sq. foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Pl zmbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING PLLONGRNGR PlanniRS Long Range Residential PLANNING 3 of 3 CITY OF CUPERTINO �t � n BUILDING DIVISION PERMIT IYUtITIf�Y PERMIT NO. BUILt r��tesNORTHGLEN SQ AFFORDA13LE WATER HEATERS & 07050249 �J L [� PERMIT ISSUE DATE OWNER'S NAME: HARVEY DAVID M AND JACQUELINE 24707 S"�N FERNANDO RD 05/24/2007 SANITARY NO. CONTROL NO. NE: (661) 259-7131 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH i p O LICENSED CONTRACT'OR'S DECLARATION Job Description (: I hereby affirm that I am licensed under provisions of Chapter 9(commencing ZU with Section 70(X))of Division 3 of the Business and Professions Code,and my license is REPLACE 40 GAS GAS WATER HEATER/GARAGE r a a in full force and effe U j ? License Clazs Co # 413 r Dare S'EP .B Contractor � ARCHITECTS DECLARATI 7 C a I understand my plans shall be used as public records )yU U.t Licensed Professional O< OWNER-BUILDER DECLARATION } 1 hereby affirm that I am exempt from the Contractor's License Law for the pO following reason.(Section 7031.5,Business and Professions Code:Any city or county <m which requires a permit to construct,alter,improve,demolish,or repair any structure z y priorto its issuance,also requires the applicant for such permit to file a signed statement Ft.Floor Area Valuation _ that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 >q $1400 e.h (commencing with Section 7000)of Division 3 of the Business and Professions Code)or Li L 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 31641050 . bl Number Occupancy Type not more than five hundred dollars(5500). ❑I,as owner of the property,or my employees with wages az their sole compensation, will do the work,and the structure is not intended or offered for We(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of 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.). ❑I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor'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. ❑I am exempt under Sec B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑I have and will maintain a Certificate of Consent to self-insure for Workers Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Nr have and will maintain Workers Compensation Insurance,as required by Section �37ft of the Labor Code,for the performance of the work for which this permit is issued. My WorkeespensatLQU Ie '"L Policy No.:nsu_rancc;carrier and Policy number are: fi ,Q Cartier. �b r O�U CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become subject to the Workcrs'Compensation Laws of California.Date 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 construction lending agency for the performance of a> the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name 2 Lender's Address U 0 1 certify that I have read this application and state that the above information is V.r"' correct.1 agree to comply with all city and county ordinances and state laws relating to 0 U building construction,and hereby authorize representatives of this city to enter upon the U above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against 0.,Hy to liabilities,judgments,costs and expenses which may in any way accrue against said City U 2 in consequence of the granting of this permit. Date ►� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOURCE REGULATIONS. Re-roofs Signature of Applieanl/ -tractor Date NAZARDOUS MATERIALS DISCLOSURE Type of F.00f Will 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)? �-y� All roofs shall be inspected prior to any roofing material being installed. ❑Yes Y-u If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes t..,`. yA- I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code.Sections 25505,25533 and 25534.1 understand that if the building does not currently have a tenant,that it is my responsibility to notify the occupant of the requirements which ust be me`prior to issuance of a Ccrtif�`ofoeeupancy. Signature ppl ieant Date •]v All roof coverings to be Class"B or better Owncr or auIVzcrd agent Date Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 °'UPEKTINO Buildi:n De artment JOB ADDRESS: PERMIT # . a 0 3-5 Po rlr, `Q,�, Slaalr< OWNER'S NAME: Q PHONE # of- (,-a 3--S GENERAL CONTRACTOR FAX # I am not using any subcontractors: tL-T 4- 2� " Signature Date Please check applicable subcontractors and complete 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 — S-4 Y- 0 Cu /Contractor Signature Date