11070232CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1448 S STELLING RD I AND ADA TI
MUKHERJEE SHOUVIK I PERMIT NO: 11070232
0"'NER'S NAME:
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lic. #
Contractor Date
I hereby affirm that 1 am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
1 hereby affirm under penalty 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 permit 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
permit is issued.
APPLICANT CERTIFICATION
I certify that 1 have read this application and state that the above information is
correct. 1 agree to comply with all city and county ordinances and state 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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature Date,
0" OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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 or offered for sale (Sec. 7044,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
1 hereby affirm under penalty of perjury one of the following three
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 permit 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
permit is issued.
I certify that in the performance of die work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If, after making this certificate of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state 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
mr' -nify and keep harmless the City of Cupertino against liabilities, judgments,
C, nd expenses which may accrue against said City in consequence of the
granung of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
� .. Date 7 ?:1 L I
1448 S STELLING RD
CUPERTINO, CA 95014
BUILDING PERMIT INFO
MECH F
DATE ISSUED: 07/29/2011
PHONE NO:
BLDG r— ELECT r PLUMB r
RESIDENTIAL COMMERCIAL
JOB DESCRIPTION: MOVE FRONT DOOR, REVERSE INTERIOR GARAGE
DOOR,
MOVE WATER HEATER & WASHER/DRYER, CHANGE CLOSET
DOOR IN BEDROOM, REMOVE EXISTING FIREPLACE &
Sq. Ft Floor Area: I Valuation: $12000
APN Number: 36617092.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by:
Date:
RE -ROOFS:
All roofs shall be inspected prior to any rooting material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Add
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professio
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1448 S STELLING RD I AND TRACTOR: MUKHERJEE SHOUVIK I PERMIT NO: 11070232
OWNER'S NAME:
1 CUPERTINO, CA 95014 1 PHONE NO: I
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lic. #
Contractor
Date
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
hereby affirm under penalty of perjury one of the following two declarations:
i. 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 permit is issued.
2. 1 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
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state 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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply with
all non -point source regulations per the Cupertino Municipal Code, Section 9.18.
Signature Date
OWNER -BUILDER DECLARATION
hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
1. 1, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec.7044, Business & Professions Code)
2. 1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
t. 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 permit is issued.
2. 1 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
permit is issued.
3. 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 Worker's
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
must forthwith comply with such provisions or this permit shall be deemed
revoked.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. 1 agree to comply with all city and county ordinances and state 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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply with
all non -point source regulations per the Cupertino Municipal Code, Section 9.18.
Date A I I I' i
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
MOVE FRONT DOOR, REVERSE INTERIOR GARAGE DOOR,
MOVE WATER HEATER & WASHER/DRYER, CHANGE CLOSET
DOOR IN BEDROOM, REMOVE EXISTING FIREPLACE &
vCS/G� �2U
blk' &1112-5-
Sq.
1`125
Sq. Ft Floor Area: I Valuation: $12000
APN Number: 36617092.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued b . Date: V-- L (—G
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.I2 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
�AAAISDater I
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
� CITY OF CUPERTINO
r1 FEE ESTIMATOR - BUILDING DIVISION
imlADDRESS:
1448 S Stelling Rd
DATE: 07/29/2011
REVIEWED BY: LarryS
PC FEE ID
APN:
BP#:
"VALUATION: 1$12,000
%PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Du lex
USE: p
2nd Unit? , Yes " No
OTC? 0 Yes (F) No
PENTAMATION 1 R3SFDREM
PERMIT TYPE:
WORK
move front door, reverse interior garage door, move water heater and washer/dryer, chane closet door
SCOPE
in bedroom, remove existing fireplace and chimney, move furnace to attic and place over an interior
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
R-3 (Custom)
II-B,111-B,N,v-B
100
$994.0
ADDPLC
$963.00
IADDINSP
1•:i.^.: I•i•+: i�,'r=
$0.00
PME Plan Check:
$0.00
T
Permit Fee:
$963.00
Suppl. Insp. Fee -0 Reg.
0 OT
1 0.0
1 hrs
$0.00
PME Unit Fee:
$0.00
TOTALS:
100
$0.00
$0.00
$963.00
MECH, HOURLY 0 Yes O No
PLUMB, HOURLY Q Yes Q No
ELEC, HOURLY Q Yes Q No
MISC ITEMS
Plan Check Fee: Hourly
Only? Q Yes
C) No
_ ii:.r,^.
t f!la•, Piet: rt,`: h..g .
r 3; ! r-; .' J it9,9,
�4�`r.•t/2. ItLi't1. t'[?E:•�
f�lTtrtn'!. [r}.�/3.l'c=�•:
1•:i.^.: I•i•+: i�,'r=
NOTE: These fees are based on the Dreliminary information available and are only an estimate. Contact the Dent for addn 7 info.
FEE ITEMS (Fee Resolution 11-053 E . 711111)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee: Hourly
Only? Q Yes
C) No
$0.00
hours Plan Check, Hourly
$130.00 ISTPLNCK
Suppl. PC Fee: 0 Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
T
Permit Fee:
$963.00
Suppl. Insp. Fee -0 Reg.
0 OT
1 0.0
1 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Couvir7alv'm I(1'v
Acoustical Fee:
0 Yes 0 No
$0.00
Q
E)
Work Without Permit? 0 Yes 0 No
$0.00
Planning Fee:
PLLONGRNGR
$13.00
Select a Non -Residential
Building or Structure
E)
0
Strone Motion Fee:
IBSEISMICR
$1.20
Select an Administrative Item
Bldp, Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$978.20
$130.00
TOTAL FEE:
I $1,108.20
Revised: 07/04/2011
CITY OF CUPERTINO
FEW FEE ESTIMATOR - BUILDING DIVISION
NOTE: These fees are hated on the nreliminary information available and are only an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution I1-053 E . 7/1/11)
ADDRESS: 1448 s. stelling rd.
DATE: 08/09/2011
REVIEWED BY: bobs.
MISC ITEMS
APN:
BP#:
"VALUATION: 1$8,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
10.01hrs
PENTAMATION 1 GENRES
PERMIT TYPE:
WORK
revise structural braced walls at existing baths.
SCOPE
NOTE: These fees are hated on the nreliminary information available and are only an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution I1-053 E . 7/1/11)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee: Hourly Only? 0 Yes 0 No
$0.00
hours Plan Check, Hourly
$260.00 ISTPLNCK
Suppl. PC Fee: E) Reg. 0 OT
10.01hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee0 Reg. 0 OT
0.0
1 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
�, lril`�Ytft'liflk> 1 i.i
Acoustical Fee: 0 Yes 0 No
$0.00
0
0
Work Without Permit? 0 Yes E) No
$0.00
Planning Fee
$0.00
Select a Non -Residential
Building or Structure
0
i
1r.�rr I3nr:rnnenrr rii!>;r �'�:
Strong- Motion Fee: IBSEISMICR
$0.80
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
1 $1.801
$260.00
TOTAL FEE:
$261.80
Revised: 07/04/2011