10070101 CITY OF CUPERTI:vO BUILDING PERMIT
BUILDING ADDRESS: 821 HOOSHANG CT CONTRACTOR:SHRUTI SHETH PERMIT NO: 10070101
OWNER'S NAME: SHRUTI SHETH 821 HOOSHANG CT DATE ISSUED:07/14/2010
NER'S PHONE: 4086555958 CUPERTINO,CA 95014 PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.#
MECH F RESIDENTIAL r- COMMERCIAL
Contractor Date
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:FINAL INSPECTION FOR THE PATIO COVERING
(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:$100
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. APN Number:35902003.00 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 b - '""- 'Date: ( CTr
9.18.
Signature Date
RE-ROOFS:
1114 OWNER-BUILDER 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). �jIL�3
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
[certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534.
not employ any person in any manner so as to become subject to the Worker's Owner or authorized agent:
Compensation laws of California. If,after making this certificate of exemption,I Date:
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 affirm that there is a construction lending agency for the performance of work'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. nify 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
gn—ting 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. , ff Licensed Professional
Signature Date l
CITY OF CUPERTINO
FEE ESTIMATOR-- BUILDING DIVISION
ADDRESS: I DATE: REVIEWED BY:
its APN: I BP#: *VALUATION: $100
*PERMIT TYPE: Building Permit PLE►N CHECK TYPE: Alteration /Addition / Repair
PRIMARY SFD or Duplex OVER TUE APPLICATION 1 R3SFDADD/REM
USE: COUNTER. 0 Yes No TYPE:
MECHANICAL 0 Yes 0 No PLUMBING 0 Yes E) No I ELECTRICAL 0 Yes Q No
x
9 a
cc
3U
TYPE OF FLR AREA
OCCUPANCY TYPE: CONSTR. s .ft. PC FEES PC FEE ID BP FEES BP FEE ID
R-3 (Custom) II-B,111-B,IV,V-B 0 $0.00 $0.00
TOTALS: 0 $0.00 $0.00
FA I I T
NOTE: Theseees are based on the preliminary in ormation available and are only an estimate. Contact the De t or addn'1 info.
FEE ITEMS (Fee Resolution 09-05I EV711/09) FELE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 Select a Misc Bldg/Structure
Suppl. PC Fee: (DReg. 0 OT 0.0 1 hrs $0.00 or Element of a Building
PME Plan Check. $0.00
Permit Fee: 1SUPINSFEE $0.00
Suppl. Insp. Fee:0 Reg. 0 OT 1.0 hrs $126.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
171
Acoustical Fee: 0 Yes Q No $0.00 0
Work Without Permit? 0 Yes G No $0.00 0
Planning, $0.00 Select a Non-Residential 0
Building or Structure 0
Strom Motion Fee: 1BSEISMICR $0.50 0.5 hrs Admin./Clerical Fee
Bldg Stds Commission Fee: 1BCBSC 11.00 $39.00 1ADMIN
SUBTOTALS: $127.50.L- $39.00 TOTAL FEE: $166.50
Revised: 6/30/2010
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 35902003 .00
DATE ISSUED. . . . . . . : 07/14/2010
RECEIPT #. . . . . . . . . BS000010867
REFERENCE ID # • • • 10070101
SITE ADDRESS . . . . . : 821 HOOSHANG CT
SUBDIVISION . . . . . . .
CITY CU PERTINO
IMPACT AREA . . . . . .
OWNER SFRUTI SHETH
ADDRESS 821 HOOSHANG CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : SFRUTI SHETH
CONTRACTOR . . . . . . . : LIC # *OWNER*
COMPANY SFRUTI SHETH
ADDRESS 821 HOOSHANG CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
TELEPHONE . . . . . . . .
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- - --------- ---------- ---------- ----------
-ADMIN HOURS 0 .50 39 . 00 0 .00 39. 00 0 . 00
1BCBSC VALUATION 100. 00 1 .00 0. 00 1 . 00 0 .00
1SUPINSFEE HOURS 1. 00 126 . 00 0 . 00 126 . 00 0 .00
- --------- ---------- ---------- ----------
TOTAL PERMIT 166 . 00 0.00 166 . 00 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 166 .00 VISA
---------------
TOTAL RECEIPT 166 . 00
RESIDEN'T'IAL PROTECT COVER SHEET
Assessor's Parcel Number:
Name of owner. S.H RU-T\
Project address. 8621
Contact person. S Ig RU –T \ Phone. �l O
Fax.
Net square footage of lot.
Existing Proposed
Square footage: First floor: _
Second floor:
Garage:
TOTAL: --, -------
i�
Are there at least two 10 foot by 20 foot clear spaces inside the garage? 1,
Is privacy protection planting required for the project? — —,.
uild it Green Total Points
On what floor(s) is work being done? _
Brief description of work. 1�e-s `� A.Y
Code editions:2007 CBC N)2007 CFC (Y-N)2007 CMC (Y-N) k
2007 CPC (Y -N)2007 NEC (Y-N) .
Effective 1/1/08
V
gp P�
Plan Review Process Work Book Page-8-Revised 8/05/08
McClellan Estates HOA
clo Massingharn &Associates, Inc.
2542 S. Bascom Avenue, Suite 170
Campbell, CA 95008
408-540-5050 Fax 408-371-5130
July 13, 2010
City of Cupertino
Code Enforcement
10300 Torre Avenue
Cupertino, CA 95014-3255
RE: Exterior Patio Cover @ 821 Hooshang Curt
To Whom It May Concern:
The owners of 821 Hooshang Court communicated to the Board of Directors that the
Code Enforcement Department of the City of Cupertino that a permit was required for
the patio cover and that prior to issuing a Kermit, the McClellan Estates HOA must
provide evidence of approval for the patio cover at said location.
The current Board has reviewed the coven and we have determined that the patio cover
does not violation any provisions of the 0"0311's or architectural guidelines for the
Association. Therefore, unless there is some code issue involved, the Board hereby
approves the existence of the patio cover.
If you have a question or concern, please contact the Association Manager for
McClellan Estates, Richard Overhouse, via telephone at 408-540-5048 or email at:
roverhouse@massingham.com.
Sincerely,
Richard Overhouse
Association Manager
On behalf of the Board of Directors
cc: file
4
(27
CITY OF (�UPERTINO
CUPEkTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN# .�`� CA C)3
Date:
-- U
Building Address: ,�
c� "0 a S 1-t A N G_ C 1 C.01PC_(Z-yk Qk a CA !3soiLr
Mailing Address (if different from building address):
Are Hazardous Materials being used as part of thi;; project? Yes No
HOA: (Exterior work onW Yes No ❑ If yes, provWe letter from HOA
Owner's Name: Phone#: _
Contractor: Phone:
Fax:
Contractor License#:
Cupertino Business License#: _---
Contact: Phone:
Fax: �.—
Residential Commercial
Job Description:F� 11 `
v1� �� C-4 O.�- O'Z� oh-44 o CSS v Q,,-J
Building Permit Info:
' Bldg Elect ❑ Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
1-All-B El II/III/V-A El II/III B IV-HT V-13 _
Valuation: 24 Square Footage:
Project Size: Express ❑ Standard 2"Large Major ❑
Green Building: Please complete relevant portion A the Green Bu' ding/LEED Checklist& attach it
to the application or if applicable, include in plan set& the sheet index.
'joints Achieved:
i For help, contact Build it Green at www.builditgrf!en.or
Revised 07/14/09
OWNER-BUILDER DISCLOSURE FORM
COMMUNITY DEVELOPMENT DEPAR"-MENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333•; �i -iii i = �"
CUPERTINO
Dear Property Owner(s):
An application for a building permit has been submitted in ,our name listing yourself as the builder of the property
improvements specified at:
SITE ADDRESS g VA b OS H{rN.6t C"r• APN BP#
OWNER NAMES"R�-z\{-���C-.A. OWE R ADDRESS ; AO son
)4
DESCRIPTION OF WORK: \` ZU-'n^ `�` "r-- r'`W— ��✓����
We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of
your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We
will not issue a building permit until you have read, initialed your understanding of each provision, signed,and
returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless
you,the property owner, obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
(DIRECTIONS:Please read and initial each statement bel Dw to signify you understand or verify this information.)
�61. 1 understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-
Builder'building permit that erroneously implies that the property owner is providing his or her own labor and material
personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by
an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not
provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my
insurance coverage for injuries to workers on my property.
42. 1 understand building permits are not required to be signed by property owners unless they are responsible for
the construction and are not hiring a licensed Contractor to assume this responsibility.
<:Z11-%,3. I understand as an"Owner-Builder" I am the responsible party of record on the permit. I understand that I may
protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her
name instead of my own.
_A&4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license
numbers on permits and contracts.
�5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the
total value of my construction is at least five hundred Sollars($500), including labor and materials, I may be
considered an "employer" under state and federal law.
S#36. I understand if I am considered an "employer" under state and federal law, I must register with the state and
federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to
unemployment compensation for each "employee." I :also understand my failure to abide by these laws may subject
me to serious financial risk.
understand under California Contractors' StE to License Law, an Owner-Builder who builds single-family
residential structures cannot legally build them with tt,e intent to offer them for sale, unless all work is performed by
licensed subcontractors and the number of structureE does not exceed four within any calendar year, or all of the work
is performed under contract with a licensed general building Contractor.
. I understand as an Owner-Builder if I sell the )roperty for which this permit is issued, I may be held liable for
any financial or personal injuries sustained by any suosequent owner(s)that result from any latent construction
defects in the workmanship or materials.
a vnerBuilderForn? 2010.doc revised 04/14/10