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10070165 CITY OF CUPERTIN O BUILDING PERMIT BUILDING ADDRESS: 6683 JOHN DR CONTRACTOR:MANA GENERAL PERMIT NO: 10070165 CONTRACTOR TIER'S NAME: SREENIVASU SUDIREDDI 1839 TAMPA WAY DATE ISSUED:07/26/2010 OWNER'S PHONE: 4083911553 SAN JOSE,CA 95122 PHONE NO:(408)3754288 V( LICENSED CONTRACTOR'S DECLARAAT�ION BUILDING PERMIT INFO: BLDG� ELECT� PLUMB r License Class Lic.# �y/�� bF MECH RESIDENTIAL r COMMERCIAL Contractor MAID A- Cr 6'NF 9 A L CA IN JOB DESCRIPTION:TEMP POWER FOR ADDITION&REMODEL 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:$1500 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 APN Number:36927055.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that 1 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 WORT{IS NOT STARTED to building construction,and hereby authorize representatives of this city to enter WITHIN 180 DAYS OF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 DAY ROM 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 regul ions per the Cupertino Municipal Code,Section Issued by: Date: 9.18. ature 1 Date RE-ROOFS: ❑ 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: 1,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. 1 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 maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the permit is issued. Health&Safety Cod ,Sections 25505,25533,and 25534. 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 Own' or thoriz ent: 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 huilding construction,and hereby authorize representatives of this city to enter Lender's Address the above mentioned property for inspection purposes.(We)agree to save ..__.;mnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additio ally,the applicant understands and will comply I understand my plans shall be used as public records. with all non-point source regul ions per the Cupertino Municipal Code,Section 9.18. Licensed Professional Date Signature w ' CITY OF CUPERTINO 4 ITEMS OF 4 PERMIT' RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36927055 . 00 DATE ISSUED. . . . . . . : 07,/26/2010 RECEIPT #. . . . . . . . . BS )00010953 REFERENCE ID # . . . : 10 )70165 SITE ADDRESS . . . . . : 6633 JOHN DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER SREENIVASU SUDIREDDI ADDRESS 6633 JOHN DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM SREENIVASU SUDIREDD CONTRACTOR CARLOS ORELLANA LIC # 27468 COMPANY MAYA GENERAL CONTRACTOR ADDRESS 1839 TAMPA WAY CITY/STATE/ZIP . . . : SALE JOSE, CA 95122 TELEPHONE (408) 375-4288 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- -- 1BCBSC VALUATION 1, 500 . 00 1 .00 0 . 00 1 . 00 0 .00 1EPERMITFE FLAT RATE 1. 00 42 . 00 0 .00 42 . 00 0 . 00 1ERT<200 UNITS 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00 1TRAVDOC FLAT RATE 1. 00 42 . 00 0 . 00 42 . 00 0 .00 ---------- ---------- ---------- ---------- TOTAL PERMIT 127 . 00 0 . 00 127 . 00 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 127 .00 MC --------------- TOTAL RECEIPT 127 .00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ------------------------- 402 TEMPORARY POWER CITY OF CUPERTINO FEE ESTIMATOR-- BUILDING DIVISION Eli ADDRESS: DATE: 07/26/2010 REVIEWED BY: APN: BP#: 'VALUATION: $1,500 "PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Temporary Power SFD or Duplex APPLICATION 1 REAP14 P TYPE: a4 W as 00 3U APPLIANCE/EQUIP TYPE AMPS FEE ID VOLTS BP FEES Service(incl. Temp.'Power) 100 1ERr<200 <=600 $42 Elec.Permit Fee: 1EPERMIT T7 $42.00 NOTE: These fees are based on the preliminary in ormation available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 09-051 Of 74 09) FEF, QTY/FEE MISC ITEMS PME Unit Fee: $42.00 PME Permit Fee: $42.00 Work Without Permit? Q Yes (D No $10.00 Travel Documentation Fee: ITRA VDOC $42.00 Select an Administrative Item I3ld�c Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $127-oo $0.00 TOTAL FEE: $127.00 Revised: 6/30/2010 CITY OF 1,'-- UPERTINO TEMP POWER CUPEk INO PERMIT APPLICATION FORM APN # 3b", 9 65 � Date: p _ 6 10 Building Address: G Imo° CUP -T-JA)O , C I — `� `�01 Owner's Name: Phone #: Contractor: Phone #: C A Fax #: Contact: Phone #: Contractor License #: M Aw A e Nr R Cupertino Business License#: Job Description: T�b►U n Residential Commercial Valuation (cost of project): ' C� Type of Construction: N/A Quantity Fee ID Fee Description Fee Group Permit Type IERT>1K Res. Temp Power>1K E 1REAP14 Amps I ERT<200 Res. Temp Power<200 E l Amps 1 ERT2001 K Res. Temp Power 200-1 K E Amps IEPERMITFE Electric Permit Issuance E IELCPLNCK Electric Plan (:heck E 1BCBSC Cal Bldg Standards B ALL PERMIT _ Commission Fee TYPES 1BSEISMICR Seismic Residential B 1 TRAVDOC Travel & Doc umentation B Fee Revised 01/07/09 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: 40B JOHtJ D e U —f TERM IT# O D Q D 16 OWNER'S NAME: E7 j Q _ PHONE# 0 GENERAL CONTRACTOR: M A n3 G RL BUSINESS LICENSE# ADDRESS: j qjC( TAM ITY/ZIPCODE: *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 SUBCONTP ACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 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 BUILDING PERMIT BUILDING ADDRESS: 6683 JOHN DR CONTRACTOR:SREENIVASUESUDIREDDI PERMIT NO: 10040136 OWNER'S NAME: SREENIVASU SUDIREDDI f 683 JOHN DR DATE ISSUED:07/14/2010 OWNER'S PHONE: 4083911553 t:UPERTINO,CA 95014 PHONE NO: JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ LICENSED CONTRACTOR'S DECLARATION -ONVERTING EXISTING SPACE INTO A 571 SQ FT 2ND JNIT.INCLUDES 2 BEDROOMS,2 BATHROOMS&A KITCHEN. License Class Lic.# Contractor 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. Sq.Ft Floor Area: Valuation:$50000 1 hereby affirm under penalty of perjury one of the following two declarations: 1. 1 have and will maintain a certificate of consent to self-insure for Worker's occupancy Type: Compensation,as provided for by Section 3700 of the Labor Code,for the APN Number:36927055.00 p y yp performance of the work for which this permit is issued. 2. 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 EXPIRES IF WORK IS NOT STARTED permit is issued. WITHIN 180 DAYS OF PERMIT ISSUANCE OR APPLICANT CERTIFICATION 180 DA S FROM L T CALLED INSPECTION. 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 `J to building construction,and hereby authorize representatives of this city to enter Issued b l' Date: upon the above mentioned property for inspection purposes. (We)agree to save Y 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 RE-ROOFS: all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 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 Signature Date inspection. Signature of Applicant: Date: OWNER-BUILDER DECLARATION ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER eby affirm that I am exempt from the Contractor's License Law for one of .ollowing two reasons: t. 1,as owner of the property,or my employees with wages as their sole HAZARDOUS MATERIALS DISCLOSURE compensation,will do the work,and the structure is not intended or offered for (Sec.7044,Business&Professions Code) 1 have read the hazardous materials requirements under Chapter 6.95 of the sale 2. 1, owner 4 the property,Pr exclusively contracting with licensed contractors R California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& construct the project(Sec.7044,Business&Professions Code). Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use;equipment or devices which emit hazardous air 1 hereby affirm under penalty of perjury one of the following three declarations contaminants as defined by the Bay Area Air Quality Management District I will t. I have and will maintain a Certificate of Consent to self-insure for Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Compensation,as provided for by Section 3700 of the Labor Code,for the Health&Safety Code,Se ions 25505,25533,and 25534. performance of the work for which this permit is issued. G 2. 1 have and will maintain Worker's Compensation Insurance,as provided for by Owner a t sized ag rtt. /I( Date:--- Section 3700 of the Labor Code,for the performance of the work for which this � D permit is issued. CONSTRUCTION LENDING AGENCY 3. 1 certify that in the performance of the work for which this permit is issued,l shall not employ any person in any manner so as to become subject to the Worker's 1 hereby affirm that there is a construction lending agency for the performance of work's Compensation laws of California. If,after making this certificate of exemption,I for which this permit is issued(Sec.3097,Civ C.) become subject to the Worker's Compensation provisions of the Labor Code,I Lender's Name must forthwith comply with such provisions or this permit shall be deemed Lender's Address revoked. APPLICANT CERTIFICATION ARCHITECT'S DECLARATION I certify that I have read this application and state that the above information is 1 understand my plans shall be used as public records. correct.1 agree to comply with all city and county ordinances and state laws relatin; to building construction,and hereby authorize representatives of this city to enter Licensed Professional_ 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 non-point source regulations per the Cupertino Municipal Code,Section 9.18. Signature Datejl v C