10090235 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10327 WESTACRES DR CONTRACTOR: PERMIT NO: 10090235
"9
OWNER'S NAME: JAYASUDHAMUTHUSAMY / p^( A-c: . DATE ISSUED:09/24/2010
NER'S PHONE: 4085977884 � ` / C° PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F ELECT F PLUMB
License Class Lic.# 9 /lJ 53 r r MECH r RESIDENTIAL I— COMMERCIAL
Contractor ^,)G COL SY (-,Date —2 q— I
JOB DESCRIPTION:REMODEL KITCHEN(220SQ),2 BATHROOMS(110SQ)&
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business&Professions COPPER
REPIPE;NO RE-ROOF&NO STRUCTURAL
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
Sq.Ft Floor Area: Valuation:$42000
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:35914022.00 Occupancy Type:
correct.I agree to comply with all city and county ordinances and state laws relating
to building constriction,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, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this pen-nit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations p r the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature Date 'q_ ZY_09 Issued by:����� Dato, 6
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date:
construct the project(Sec.7044,Business&Professions Code).
ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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 HAZARDOUS MATERIALS DISCLOSURE
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 read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of Califonua. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I muss Owner 0 agent: _
forthwith comply with such provisions or this permit shall be deemed revoked. Date:_
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
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 relatinl. I hereby affirm that there is a construction lending agency for the performance of work's
to building construction;and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
unify and keep harmless the City of Cupertino against liabilities,judgments,
,and expenses which may accrue against said City in consequence of the Lender's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR--BUILDING DIVISION
ADDRESS: 10327 Westacres DATE: 09/24/2010 REVIEWED BY: jsg
APN: I BP#: *VALUATION: 1$42,000
*PERMIT TYPE: Building Permit PLA N CHECK TYPE: Alteration/ Repair
PRIMARY ftll;il; PENTAMATION 1GENRES
USE: SFD or Duplex r:!_U()R 4/ PERMIT TYPE:
WORK
SCOPE
tr, lj, /'!crri Uh,(k Plumb.Plan Check 0.0 hrs $0.00
Fluinb.Permit Fee: IPPERMIT I:tac. P.rrrii; t��
T_ Other Plumb Insp. 0.0 hrs $42.00 Olhcr
Li
NOTE: These fees are based on the preliminaty in ormation available and are only an estimate. Contact the De t or addh7 info,
FEE ITEMS (Fee Resolution 09-051 Ef.. 7//10' FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00_= s.f. Remodel,Kitchen(<=300 sf)
Suppl.PC Fee: 0 Reg. 0 OT0.0 hrs $0.00 $570.00 IREMRESKIT
PME Plan Check: $0.00 = s.f. Remodel,Bath(<=300 sf)
Permit Fee: $0.00 $570.00 IREMRESBAT
Suppl. Insp. FeeO Reg. 0 OT Fo.0 hrs $0.00 = # Plumbing
PME Unit Fee: $0.00 $0.00 IPRREPIPE I Re-Pipe Interior
PME Permit Fee: $42.00 L__Lj # Plumbing
CunIlwczion 1 cn $0.00 1BPWSVCS Water Service
Acoustical Fee: 0 Yes 0 No 50.00 0
Work Without Permit? 0 Yes 0 No 10.00 0
Planning Fee: $0.00 Select a Non-Residential 0
Building or Structure 0
Travel Documentation Fee: ITRAVDOC $x-2.00 i
Strong_Motion Fee: IBSEISMICR 94.20 Select an Administrative Item
Bldv Stds Commission Fee: IBCBSC 52.00
SUBTOTALS: $W.20 $1,140.001TOTAL FEE: T $1,230.20
Revised: 9/22/2010
RESIDEN'T'IAL PROJECT COVER SHEET
Assessor's Parcel Number:
Name of owner. fY\tXT L�a 5 4kt>v�-y
Project address.
Contact person. OX PO Zo V I L1 K('A Plione. Q�) 3�� — 0
Fax.
Net square footage of lot.
Existing Proposed
Square footage: First floor: ,—
Second floor: _
Garage:
TOTAL:
Are there at least two 10 foot by 20 foot clear spaces inside the garage? �-j
�._
Is privacy protection planting required for the project? N ,�.
Build it Green Total Points
On what floor(s) is work being done? one L���e� P44,��,e
Brief description of work.
Code editions: 2007 CBC N)2007 CFC -N)2007 CMC N)
2007 CPC -N)2007 NEC -N)
Effective 1/1/08 PPPfaOJELt
IN ACCORDANE L vViTF! tNE CITY G
CUPENTINO CODES��ORDINANCE
DATE___
SIGNED mations MU i?
This set of plans and
he kept on the loh at all times and it i'
mlawful to ake ary -hanges or alterati
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on same without,ntten permissiM
on f c m
the Building De artn}ent.City of Cupen nc.
The stamping orth ;>lan and specrfK at ons
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approval 01,the
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Plan Review Process Work Book Page-8-Revised 8/05/)8
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CITY OF CUPERTINO
ADDITION/REMODEL
CUPERTINO FEE SCHEDULE
APN# _ - Date:
Is a 2,dunit beingadded? Yes ❑ No ® If es. lease fill out the permit application for 2" unit.
Building Address: ►i-
Mailing Address (if different from building address):
Owner's Name: ,ky Phone# :
Contractor: P C-, }��, �� d. Phone#:
E� ,. . 8- Fax#:
Cupertino Business License: t-'- ' `' State Contractor License#: 9 951\-V
Contact: Phone#:
Fax#:
Landscape Ordinance Compliance:
Landscape area in sq. ft. (includes all irrigated areas):
If 2,500 sq. ft. or less, compliance with the Lands,-,ape Water-Efficiency Checklist is required.
If more than 2,500 sq. ft., a complete Landscape Project Submittal is required.
Compliance Method: ❑ Plant Type ❑ Water Budget
Building Permit Info:
Bldg. 9 Elect. ❑ Plumb. [] Mech. ❑ Hillside ❑
Job Description:
Addition-What is being added?(Be Specific):
What is being remodeled (not including addition)?
Remodel Includes Re-Roof: Yes ❑ No P9 If yes list number of squares
Remodel Includes Structural: Yes ❑ No �,Q
Do you have the pre-application planning approval? Yes ❑ No ❑
If yes, please provide a copy of your plannin ; approval letter. Planners name:
Square Footage:
Addition: Porch: Deck: Garage: Detached Attached
Remodel: Kitchen `�-2 0 Bath \\0 QNA Other
Type of Construction (Usage Class): Occupancy Type: 6>, A
1-A, 1-B ❑ HADN-A ❑ II/III B, IV-HT, V-B ® Valuation: vr'1 12�lnl
Please check this box if the project is a
Project Size: Express ❑ Standard ❑ Large ❑ :vla'or ❑ second-story addition ❑
Please complete relevant portion of the Green Building
Checklist & attach it to the application or if applicable, Green Building Points Achieved:
include in plan set& the sheet index.
Revised 05/18/10