11010131 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1187 CRESTLINE DR CONTRACTOR:NEKO ELECTRIC PERMIT NO: 11010131
OWNER'S NAME: CHANDRASEKARAN SRIDHARAN AND VAIDYA 22430 CUPERTINO RD DATE ISSUED:01/25/2011
VNER'S PHONE: 4085171175 CUPERTINO,CA 95014 PHONE NO:(408)4464141
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
License Class Lic.# 3 7 INSTALL 20 RECESSED LED LIGHTING UNITS,4 NEW
SWITCHES
Contractor/ L 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. Sq.Ft Floor Area: Valuation:$1900
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 APN Number:36225005.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION.
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 licant understands and will comply
Issued dq: Date: �
with all non-point source regulation er the upertino Municipal Code,Section
9.18.
fes, RE-ROOFS:
Signature ` 9 Date l 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.
J OWNER-BUILDER DECLARATION Date:
Signature of Applicant:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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)
I,as owner of the roe y g HAZARDOUS MATERIALS DISCLOSURE
property,rty,am exclusive) contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. I will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(x)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
Health&Safe
H
he eaSafety Code,Sections 25505,25533,a53
41.
I have and will maintain Worker's Compensation Insurance,as provided for by t
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authorized agent: ate:
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 CONSTRUCTION LENDING AGENCY
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 I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
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 ARCHITECT'S DECLARATION
;ndemnify and keep harmless the City of Cupertino against liabilities,judgments,
sts,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
LI Building Department
City Of Cupertino
ig
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: 1 P 8 7 L)�e Culerli nO PERMIT# r
OWNER'S NAME:�'I?QH14 AA-" (94NOIRA3 � PHONE# 1 7--1 17
GENERAL CONTRACTOR: BUSINESS LICENSE# 73 7
ADDRESS: CITY/ZIPCODE: f k PeY 0D C SDI
*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 O TAI A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors: `
Signature Date
Please check applicable subcontractors and complete the following information:
V 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
Owner/Contractor Signature Date
CITY OF CUPERTINO
6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 36225005 . 00
DATE ISSUED. . . . . . . : 01/25/2011
RECEIPT # . . . . . . . . . : BS000012562
REFERENCE ID # . . . : 11010131
SITE ADDRESS . . . . . : 1187 CRESTLINE DR
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : CHANDRASEKARAN SRIDHARAN AND V
ADDRESS . . . . . . . . . . : 1187 CRESTLINE DRIVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM NEKO ELECTRIC
CONTRACTOR ALI PAKNAHAL LIC # 31642
COMPANY NEKO ELECTRIC
ADDRESS 22430 CUPERTINO RD
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
TELEPHONE (408) 446-4141
FEE ID UNIT . QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 1, 900 .00 1. 00 0 .00 1 . 00 0. 00
1BREMFIXT NO. FIXTURES 20 .00 63 . 00 0 . 00 63 . 00 0. 00
1BREMRECEP NO. OUTLETS 1. 00 42 . 00 0 .00 42 .00 0 . 00
1BSEISMICR VALUATION 1, 900 .00 0. 50 0 . 00 0 .50 0. 00
1EPERMITFE FLAT RATE 1. 00 42 . 00 0 .00 42 . 00 0 . 00
1TRAVDOC FLAT RATE 4 .00 42 . 00 0 . 00 42 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 190. 50 0 . 00 190 .50 0 .00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 190.50 Visa 044461
---------------
TOTAL RECEIPT 190.50
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ---------------------------
304 ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY
505 FINAL ELECTRICAL 512 FINAL HANDI-CAP
f
RESIDENTIAL PROJECT COVER SHEET-
Assessor's Parcel Number: el
Name of owner. •g }3 1,P ,4 4 I C AA � 4 :f F-&A /i,/
Project address. � i ��.F &'41,J'ti /J Ve r1l U C -19-
Contact person. L/' �� zz� , z.�L Phone.�cZo 3
Fax.
Net square footage of lot.
Existing Proposed
Square footage: First floor: _
Second floor:
Garage:
TOTAL: _ a
Are there at least two 10 foot by 20 foot clear spaces inside the garage? .,
L. _ ivacy protection planting required for the project? Y
Build it Green Total Points
On what floor(s) is work being done? �^
Brief de ription of work. LO- vV 4 2 LE
f1 A
Code editions:2007 CBC N)2007 CFC (Y-N)2007 CMC (Y-N)
2007 CPC (Y-N)2007 NEC N)
Effective 1/1/08
.
�
r
Plan Review Process Work Book Page-8- Revised 06-15-10
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 22840 stoneridge DATE: 01/24/2011 REVIEWED BY: bobs.
APN: BP#: *VALUATION: $200
q*PERMITTYPE: Electrical Permit PLAN CHECK TYPE: Alteration /Addition/ Repair
PRIMARY SFD or Du lex i0111111- APPLICATION
USE: P I-!t)O (t,EA. TYPE:
� a
p0
3 �
APPLIANCE/EQUIP TYPE CAPACITY FEE ID QTY BP FEES
Recep/Switch/Outlets 1BREMRECEP 1 $42
Fixtures, Lighting 1 BREMFixT 5 $63
TOTALS: $105.00
ltcch. }lm!("7rcc:t Elee.Plan Check 0.0 1 hrs $0.00
Pcrmit VC"' Pcr, " l Fce: FElec.Permit Fee: IEPERAIIT
C)urcr lfcch. hup. (4ho'F'hrmb h';"i), Other Elea Insp. 0.0 hrs $42.00
NOTE: Theseees are based on the preliminaryin ormation available and are onlyan estimate. Contact the Det or addn I info.
FEE ITEMS (Fee Resolution 09-051 E f.' 7/1i09) FEE QTY/FEE MISC ITEMS
Plan Checic
Suppl. PC Fee
F-7
PME Plan Check: $0.00
Per wit Fee:
;5uppl. hisp Fee
PME Unit Fee: $105.00
PME Permit Fee: $42.00
('0nstrc1c:1i0n ax
.Iconslical Revicii:Fec:
ff`ork U'itfzow Per-unit?
I'l<ruttirig FCCS:
Travel Documentation Fee: ITRAVDOC $42.00
Stroll", Motion l�e��: Select an Administrative Item
Bldw Stds Commission Fee: 1BCBSC $1.00
SUBTOTALST $190.00 $0.00 TOTAL FEE: $190.00
Revised: 5/27/2010
CITY OF
CITY OF CUPERTINO
11010B)
GENERAL BUILDING
CUPERTINO PERMIT APPLICATION FORM
APN# 3 Ct CQ- Date: r ;L 5 C21 I
Building Address: C RT: TZ- IA� r
Mailing Address (if different from building address):
Are Hazardous Materials being used as part of this project? Yes No
HOA: (Exterior work only) Yes ❑ No JZ If yes, provide letter from HOA
If Residential.is house an Eichler? Yes ❑ No El"If yes, needs planning approval.
Owner's Name: Phone
5RJ0H49AW C. �41X17
Contractor: > Phon : `•f 0 3
,41,1' G� 7`/ Z Fax: .
Contractor License#: C? 3 7 '�1 3 7 �---
V/� / FZ
C� 7/
Cupertino Business License#:
Contact: Phone:C�. p
LFax/e-mail:
Residential Commercial
Job Description: / c�
Building Permit Info:
Bldg ❑ Elect Plumb ❑ Mech ❑
Type of Construction(Usage Class): Occupancy Type:
ILL
1-A, 1-B [III/III/V-A E] II/III B, IV-HT, V-B [�-
Valuation: r Square Footage:
Project Size: Counter ®-�press ❑ Standard ❑ Large ❑ Major ❑
Green Building: Please complete relevant portion of the Green Building/LEED Checklist& attach it
to the application or if applicable, include in plan set & the sheet index.
Points Achieved:
For help, contact Build it Green at www.buildit2reeg.org
Revised 12/06/10