11060195 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10405 MANN DR CONTRACTOR:ALPS CONSTRUCTION& PERMIT NO: 11060195
REMODELING
OWNER'S NAME: SHRIDAR SUBRAMANIAN 681 E BROKAW RD DATE ISSUED:06/22/2011
S'R'S PHONE: 4089307054 SAN JOSE,CA 95112 PHONE NO:(408)898-6474
❑ LICENSED CONTRACTOR'S DECLARATIONF_
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.# yO( MECH RESIDENTIAL COMMERCIAL
Contractor `� C oin r l/� DateTAAA 2 Z I
I hereby affirm that I am licensed under the provisio�fcter9 JOB DESCRIPTION:REMODEL HALL BATH(40SQFT);NON-STRUCTURAL
(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 declarat(oris:
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. Sq.Ft Floor Area: Valuation:$7000
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. APN Number:32645021.00 Occupancy Type:
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 PERMIT EXPIRES IF WORK IS NOT STARTED
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR
indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION.
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 Issued by l Date �'ZZ—L�
9.18. /
Signature i �y Date ULVI Z Z/I(
RE-ROOFS:
L OWN R- ILDER DECLARATION 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
I hereby affirm that I am exempt from the Contractor's License Law for one of inspection.
the following two reasons:
I,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: Date:
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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE
declarations: I have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material.
I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air
Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued,I shall Health&Safety r Code,Sections 25505,25533,and 25534.
not employ any person in any manner so as to become subject to the Worker's Owner or t rized agent:
Compensation laws of California. If,after making this certificate of exemption,I Date:
_+A,,b A�/7
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. CONSTRUCTION LENDING AGENCY
I hereby ffi that there is a construction lending agency for the performance of wrk's
APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.)
I certify that I have read this application and state that the above information is Lender's Name
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 Lender's Address
upon the above mentioned property for inspection purposes.(We)agree to save
i-`unify and keep harmless the City of Cupertino against liabilities,judgments,
and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION
g,—.Ling of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. Licensed Professional
Signature Date
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32645021. 00
DATE ISSUED. . . . . . . : 06/22/2011
RECEIPT #. . . . . . . . . BS000013859
REFERENCE ID # . . . : 11060195
SITE ADDRESS . . . . . : 10405 MANN DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . . CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : SHRIDAR SUBRAMANIAN
ADDRESS 10405 MANN DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : MEHRDAD ZAMANI
CONTRACTOR ALI ZAMANI LIC # 28677
COMPANY ALI'S CONSTRUCTION & REMODELIN
ADDRESS 681 E BROKAW RD
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE . . . . . . . . : (408) 898-6474
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 7, 000 . 00 1. 00 0. 00 1 .00 0. 00
1BSEISMICR VALUATION 7, 000 .00 0 .70 0 . 00 0 .70 0. 00
1REMRESBAT SQ FEET 40 . 00 570. 00 0. 00 570. 00 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 571. 70 0 . 00 571.70 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 571.70 VISA
---------------
TOTAL RECEIPT 571.70
PROJECT DATA - RESIDENTIAL
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO, CA 95014-3255CUPERTINO
(408)777-3228• FAX(408)777-3333•building a4cuper ino.org
PROJECT ADDRESS)� /� M n APN T_#
OWNER NAME �1 ✓r A`_ �� a, 1, PHO Q _ E-MAII.
STREET ADDRESS V\f� CITY, STATE,ZIP FAX
APPLICANT
NAMEA I i Z(W CA'A P NE
STREET ADDRESS qq
CITY,STATE, ZIP IS_/ F 2-01 -1O IS) 4v\ — Q
❑ OWNER ❑ OwNER-Bun DER ❑ OWNER AGENT kcoyTRA=R ❑coNTRAcrOR AGENT ❑ AR=cr ❑ENGINEER ❑ DEVELoPER ❑TENANT
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lag=
IN, ffiEf 'ONII _qro
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EXISTING USE(S): PROPOSED USE(S):
OCCUPANCY(S): _�� TYPE OF PARCEL
CONSTRUCTION: AREA:
FIRE Y N WUI AREA: Y N FLOOD AREA: Y N
FSIEsNuc AEe� C N p 6
SPRINKLERS:
r
wY; v < a> yy6
Existing Proposed Q z
LU
Floor Area: First Floor: s.f. w° o m ° ° v
Second Floor:
S.
z!—
Garage S.f a�Q c m C) �"
TOTAL: s.f. J f.�" ° C o' m CJ
m o L
CLU d C fi�
Q. v� 2 6 Q o
cv a
Are there at least two 10 feet by 20 feet clear spaces inside the garage? Y N 9 o ° o
m � �(n +.-� p � O
Is privacy protection planting required for the project? Y N 2 a tim a
•sc13 0)E •Qca o 0
Ci
Governing Codes: 2010 California Building Code(based on the 2009 International Building C*d� x �z
2010 California Residential Code (based on the 2009 International Residentbi m � W
2010 California Plumbing Code(based on the 2009 Uniform Plumbing Cod%)
14 e
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
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Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: Q Q UI {� r� PERMIT#
OWNER'S NAME: 5 PHONE#
GENERAL CONTRACTOR: Al BUSINESS LICENSE# _
ADDRESS: 6� t, (6 C CITY/ZIPCODE: J 2-
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
2-
1
I am not using any subcontractors:
4
I
ature Date
Please check applicable subcontractors and co lete the following information:
6/ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring / Carpeting
Linoleum /Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting /Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
n /Contractor Signature Date
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10405 mann dr. DATE: 06/22/2011 REVIEWED BY:
APN: BP#: "VALUATION: $7,000
°PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY PENTAMATION 1 R3SFDREM
USE: SFD or Duplex PERMIT TYPE:
WORK remodel hall bath non structural
SCOPE
77
Li
NOTE: These fees are based on the preliminary information available and are only an estimate. Contact the De t or addn'1 info,
FEE ITEMS (Fee Resolution 09-051 Ist'. 7"1,10) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 = S.f. Remodel,Bath(<=300 sf)
Suppl.PC Fee: 0 Reg. 0 OT hrs $0.00 $570.00 1REMRESBAT
0.0
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl.Insp. Fee4@ Reg. 0 OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Acoustical Fee: 0 Yes 0 No $0.00 0
Work Without Permit? 0 Yes 0 No $0.00 0
Planning Fee: $0.00 Select a Non-Residential 0
Building or Structure 0
A
Strong Motion Fee: IBSEISMICR $0.70 Select an Administrative Item
Bid 7 S'tds Commission Fee: IBCBSC $1.00
SUBTOTALS: $1.70 $570.00 TOTAL FEE: $571.70
Revised: 04/29/2011
/ / (1)6 01915-7)
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX(408) 777-3333• building
:UPERTINa c@-cupertino.org
I—
u NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS �� O l APN t 2 J
OWNER NAME : -kc�, 1r1 - PH O n3o 7 E-MAIL
STREET ADDRESS T-)
�" CITY, STATE,ZIP cI k j FAX
CONTACT NAME fi {{ ? I f PHONE t E-MAIL
tagL
.`
i `" •�.LC�►'l v�'
STREET ADDRESS r t CITY,STATE ZIP �C M_
❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT l CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME Z LICENSE NUMBER�� LICENSE TYPE BUS.LIC#
�/ E-MACOMPANY NAME` ( ) r1 l�(G" - V1 1
STREET ADDRESS `?� CITY,STATE,ZIP n �a _ , PHONE
ARCHrIECT/ENGINEERNAME LICENSE NUMBER I l rj BUS.LIC# ( [
COMPANY NAME E-MAIL, FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
CCRIPTION OF WORK
EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES 1
WR
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 AREAGARAGE AREA: ❑ DETACH "
❑ ATTACH $
#DWELLING UMTS: IS A SECOND UNrr ❑YES SECOND STORY
YES
BEING
_
BEING ADDED' ❑NO ADDMON' ❑NO
PRE-APPLICATION ❑ YES IF YES PROVIDE COPY OF PLANNER'S NAME:
PLANNING ADPL# ❑ NO PLANNING APPROVAL LETTER s ;,,,..:.. •,?a. °s x<, ..;. gp: ,.:; - '•
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 provi a is correct. 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 buil g nstruction. I authorize representatives of Cupertino to enter the above-idea Ified.prop for inspection purposes.
Signature of Applicant/Agent: Date: 7.
SUPPLEMENTAL INFO ON REQUIRED �:Z,,
New SFD or Multifamily dwellings ply for demolition permit for °
existing building(s). Demolition permit iS`required prior to issuance of building ."
permit for new building.
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
n if any Hazardous Materials are being used as part of this project.
_
Copy of Planning Approval Letter or Meeting with Planning Prior to a °
submittal of Building Permit application
BldgApp 2011.doc revised 03/16/11