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11040019
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7559 BARNHART PL OWNER'S NAME: SHARAD KUKRETI O' -R'S PHONE: 4088650632 ❑ LICENSED CONTRACTOR'S DECLARATION License Class Contractor Lic. # 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. I 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 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 CONTRACTOR: TBD -TO BE DETERMINED PERMIT NO: 11040019 DATE ISSUED: 04/04/2011 PHONE NO: BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH RESIDENTIAL F COMMERCIAL JOB DESCRIPTION: REMODEL 220 SQ FT TO KITCHEN, REMOVE AND REPLACE KITCHEN CABINETS, GRANITE COUNTERTOPS, NEW APPLIANCES, ADD GFCI OUTLETS, RECESS LIGHTING I 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) 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: 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 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, 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. y APPLICANT CERTIFICATION Sq. Ft Floor Area: I Valuation: $26400 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, and expenses which may accrue against said City in consequence of the .ng of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Zf // Date 4 APN Number: 36616076.00 I Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPEEJCTION. Issued Date: i� 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: Date: 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 9.12 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. OwnC or orized agent: Date: 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 Professional r) 1 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: `I en' DATE: REVIEWED BY: APN: BP#: *VALUATION: 1$26,400 ,PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1 R3SFDREM USE: p PERMIT TYPE: WORK SCOPE AIl1TO. TLRn .,d ,,.. #1. r 1J* .is.or„ nirnilnhlo "Ptd nro nNIU a" octimato_ Ca"tart the Dent fnr addn'1 info. FEE ITEMS (Fee Resolution 09-051 Eff 7/1/11 t1" T. P1, Ch, QTY/FEE MISC ITEMS Plan Check Fee: r $0.00 =s.f. $570.00 }ir1C t .:r1, �ie'l, 1 7 Li 0.0 1 hrs t�iC AIl1TO. TLRn .,d ,,.. #1. r 1J* .is.or„ nirnilnhlo "Ptd nro nNIU a" octimato_ Ca"tart the Dent fnr addn'1 info. FEE ITEMS (Fee Resolution 09-051 Eff 7/1/11 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 =s.f. $570.00 Remodel, Kitchen (<=300 so IREMRESKIT Suppl. PC Fee: (F) Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:O Reg. 0 OT 0. 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Lc�rrstr-aa�€=r�t ct Acoustical Fee: ® Yes (F) No $0.00 0 O Work Without Permit? 0 Yes (D No $0.00 Planning_Fee. $0.00 Select a Non -Residential Building or Structure t 1 Z �,Z'iFi`t't 1 �tiC"tttttft?i,ti�ift f"ci'L'J- '.trong_Motion Fee: 1BSEISMICR $2.64 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: 1 $4.641 $570.00 TOTAL FEE: $574.64 Revised: 03/01/2011 CUPERTINO PROJECT DATA - RESIDENTIAL COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinpCcDcugertino.org PROJECT�DRESS / APN # /r , .S G2 N ct OWNER NANrIE -P ONE E-MAIL, r CITY, STATE, ZIP G-h� `�s 0/4 7FAX STREET ADDREV APPLICANT NAME, J Gin PHONE �/v ._ 4-Y& E 6 - E-MAIL STREET ADDRESS n �%_f� CITY CITY, STATE, ZIP �/J �/ �� FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT Existing Floor Area: First Floor: s.f. Second Floor: �J s Garage s. f. TOTAL: s.f. Are there at least two 10 feet by 20 feet clear spaces inside the garage? Y N Is privacy protection planting required for the project? Y N Governing Codes: 2010 California Building Code (based on the 2009 International Building Code) 2010 California Residential Code (based on the 2009 International Residential Code) 2010 California Plumbing Code (based on the 2009 Uniform Plumbing Code) 2010 California Mechanical Code (based on the 2009 Uniform Mechanical Code) 2010 California Electrical Code (based on the 2009 International Electrical Code) 2010 California Energy Code 2010 California Green Building Standards Code Cupertino Municipal Code ProjectData-Residential.doc revised 03/09/11 1 v Y r N N U) m W m M N E z c 0 cc U N C (O H C Q1 O L U W �� 4 ITEMS OF 4 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36616076.00 DATE ISSUED.......: 04/04/2011 RECEIPT #......... BS000013087 REFERENCE ID # ...: 11040019 SITE ADDRESS 7559 BARNHART PL SUBDIVISION ...... CITY CUPERTINO IMPACT AREA ...... OWNER SHARAD KUKRETI ADDRESS 7559 BARNHART PL CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: patg COPY # : 1 RECEIVED FROM QUALITY CONSTRUCTIO CONTRACTOR TBD - TO BE DETERMINED LIC # 00096 COMPANY ..........: TBD - TO BE DETERMINED ADDRESS .......... CITY/STATE/ZIP ...: TELEPHONE ........: FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ----------------------- 1BCBSC VALUATION ---------- 26,400.00 ---------- ------ 2.00 0.00 2.00 0.00 1BSEISMICR VALUATION 26,400.00 2.64 0.00 2.64 0.00 1BUSLIC FLAT RATE 1.00 115.00 0.00 115.00 0.00 1REMRESKIT SQ FEET 220.00 570.00 ---------- 0.00 570.00 ---------- 0.00 ---------- TOTAL PERMIT ---------- 689.64 0.00 689.64 0.00 METHOD OF PAYMENT AMOUNT REFERENCE -------------------- NUMBER ----------------- --------------- CHECK 689.64 #917 --------------- TOTAL RECEIPT 689.64 Gt,JPEFtT'1NO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(@gugertino.orp ❑ NEW CONSTRUCTION ❑ ADDITION ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # '` �j PROJECT ADDRESS —2S- 7G APN # 2 / A (VI (c O% / / • / / I IV OWNER NAME S �� PHO70 i- _ /- ` L E-MAIL gra �' y� r 2 �1 ✓ STREET ADDRESS 7s /s� CITY TATE, ZIP � GI S�/ C / FAX N ,. /V CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX E3 OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACrOR ❑ CONTRACIOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME T� LICENSE h E �T LICENSE TYPE BUS. LIC # l COMPANY NA ' i ! l' " E-MAIL // FAX '7QLtJ STREET ADDRESSN CI STATE. Z n '� 9 �7� Z PHj�IE L� . �� 41 Cho�� bQL ARCHTPECT/ENGINEERNDME_To 4 N J ( LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX 5� STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK Ae,Vt04-,31 N �� _ ALL U2 m V,v >' 7'6 4 �-iciW,j CFL EXISTf4GUSE PROPOSED USE CONSTR TYPE # STORIES FFI SE'• I+TL1F EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA . PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑DETACH -u , a ❑ ATTACH K F. N DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES a^ BEING ADDED? ❑ NO ADDITION? ❑ NO 'a PRE -APPLICATION ❑ YES IFYES. PROVIDE COPY OF PLANNER'S NAME: I�CE[yBj� 'rQ'I',ES,ALtJ,eO'TJQN PLANNING APPL N ❑ NO PLANNING APPROVAL LEITER-� -�� b� F x ` r By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provides corr t. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to ilding,con ction. I authorize representatives of Cupertino to enter the above- identified property for inspection purposes. / Signature of Applicant/Agent: Date: SUPPLEMENTRMATION REQUIRED riarrcrri k RR©r�Tm�sLH New SFD or Multifarn y dwe lings: Apply for demolition permit for ❑ fJEYiTHE©TJIIkTElfDYk�i"e�RF,IO�".1i? existing building(s). Demolition permit is required prior to issuance of building permit for new building. Ek >ESSP1RE Bldgs: Provide a completed Hazardous Materials Disclosure ❑ s'FANJ)ARDn ,..� ❑ P t1[ WaRxs _Commercial form if any Hazardous Materials are being used as part of this project. ❑ LeYRGE)D$EE s _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ M4JQR3AI!##t ' $LwER DTSTRICG submittal of Building Permit application. LPrIYIR©NIWIENtA REALTIt BldgApp_201 1. doc revised 03/16/11