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10060024 CITY OF CUPERTINO 3UILDING PERMIT BUILDING ADDRESS: 10335 FINCH AVE CCNTRACTOR. f PERMIT NO: 10060024 UErFunrrrr r1\/ e WNER'S NAME: SREENATH SREEKANTHAM W245- ea A DATE ISSUED:06/07/2010 OWNER'S PHONE: 4085649194 C � �Z3 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIAL LJ License Class Lic.# ?1W J7 REPLACE 3 SWITCHES 3 LIGHTS 6 RECEPTACLES IN GARAGE ContractorZ 64 Date 1 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:$950 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 AI'N Number:37543010.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION v 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 Is sued by: Date: granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section _ 9.18. / RE-ROOFS: lnatur — Date—6 A I 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 in>pection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: 1 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 I,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 property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE 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 n aintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: H ealth&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's it aterial. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the a r contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. m ill maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: 4=1 Date: 1�_ 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. v ork's for which this permit is issued(Sec.3097,Civ C.) I ender's Name APPLICANT CERTIFICATION bender's Address I certify that I have read this application and state that the above information is ,nrrect.I agree to comply with all city and county ordinances and state laws relating uilding construction,and hereby authorize representatives of this city to enter on the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,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 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C O P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUB(;ONTRACTOR LIST JOB ADDRESS: Q3 ; PERMIT# OWNER'S NAME: �5,�� PHONE# GENERAL CONTRACTOR: �/ ��Z ludS-%L BUSINESS LICENSE # ADDRESS: ZyJ7 CITY/ZIPCODE: � 7�% *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. I am not using any subcontractors: Z=== Signatiire Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS YAME 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 RESIDENTIAL PROJECrr COVER SHEET Assessor's Parcel Number: U.1 Name of owner. i'��il�✓�-Fh �� Project address. Pho Contact person. �Y1CtI'1 l Lam' "'�'� Fax. 10 7 S6 ��,/ 7 Fax. Net square footage of lot. Existin Rroosed Square footage: First floor: Second floor: Garage: TOTAL: Are there at least two 10 foot by 20 foot clear spaces inside tr a garage?— Is privacy p P - protection planting required for the project? Build it Green Total Points On what floor(s) is work being done? Brief description of work. Code editions:2007 CBC N)2007 CFC (Y -1)-Z,007 CMC (Y-N) 2007 CPC (Y -N)2007 NEC N) n lit �lOVE D IN ACCOHDANCI WITH THE CITY OF Effective 1/1/08 CUP[RlINO CO[)ES AND ORDINANCES DATE-__V' - 7- /0 - --- SIG l �r This set of plans and cifications sT be kept on the lob at all times and it isr unlawful to make any changes or alterations on same without written permission from the Building Department, City of Cupertino. I The stamping of this plan and specifications SHAH NOT be held to permit or to be an approval of the violation of any provisions of any City Ordinance or state Law. Plan Review Process Work Book Page-8-Revised 8/05/08 CITY OF CUPE RTINO PERMIT RECEIPT OPERATOR: SylviaM 6 ITEMS OF 6 COPY # 1 Sec : Twp: Rng: Sub: Blk: Lott: APN 375430:_0 . 00 DATE ISSUED. • • • • . . : 06/07/ 2BSOOOOL010 RECEIPT # . . . . . . . . . 100600L4 568 REFERENCE ID # • • • SITE ADDRESS 10335 FINCH AVE SUBDIVISION . . . . . . CITY CUPER'IINO IMPACT AREA . . . . . . OWNER SREENFTH SREEKANTHAM ADDRESS 10335 FINCH AVE CITY/STATE/ZIP CUPERTINO, CA 95014 RECEIVED FROM VOLTZ ELECTRIC CONTRACTOR TBD - TO BE DETERMINED LIC # 00096 COMPANY TBD - TO BE DETERMINED ADDRESS . . . . . . . . . . CITY/STATE/ZIP TELEPHONE . . . . . . . . : FEE ID UNIT QUANTITY AMOJNT PD-TO-DT THIS REC NEW_BAL _ ---------- -------- ---------- 1 . 00 0 . 00 950 . 00 1 . 00 0 . 0 1BCBSC VALUATION 1 . 00 63 . 00 0 . 00 63 . 00 0 . 00 1BREMFIXT NO. FIXTURES 0 . 00 1BREMRECEP NO. OUTLETS 1 . 00 42 . 00 0 .00 42 . 00 0 . 00 950 . 00 0 . 50 0 . 00 0 . 50 1BSEISMICR VALUATION 00 42 . 00 0 . 00 1EPERMITFE FLAT RATE 1 . 00 42 . 00 0 . 42 . 00 0 . 00 42 . 00 0 . 00 1 . 00 1TRAVDOC FLAT RATE ______ ---------- ---------- TOTAL PERMIT 190 . 50 0 . 00 190 . 50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER _ --------------- C 190 . 50 ITISA CREDIT CARD --------------- TOTAL RECEIPT 190 .50 CITY OF CUPERTINO CITY Of CUPEkTINO GENERAL BUILDING PERMIT APPLICATION FORM l 00(0002 APN# _, � r� h, , Date: Building Address: Mailing Address (if different from building address): Are Hazardous Materials being used as part of this project? Yes F1 No HOA: (Exterior work only) Yes ❑ No `FT�:' If yes, provide letter from HOA Owner's Name: / Phone#: rr c Y,c r Contractor: Phone: Z . ,1 Fax: -- Contractor License#: 912 17 4 Cupertino Business License#: Contact: / Phone: Fax: Residenti Commercial Job Description: Building Permit Info: Bldg ❑ Elect C9--� Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, I-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B [}—`` V .. Valuation: Square Footage: d `I _D,oo Project Size: Express 9__§tandard ❑ 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.builditgreen.or y Revised 07/14/09 : r CITY OF CUPERTINO Cin OF GENERAL BUILDING APPLICATION CUPE(�TINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM 1STUCOAP Stucco Applications (up to 400 sf) B additional stucco application 1 WINREP Replacement windows/sliding glass B door (ea 8 wi:idows) 1WINMEWSTR New Window-structural shear B wall/masonry(includes plan ck fee) IEPERMITFEE Electrical Per.nit Fee E 1MPERMITFEE Mechanical Permit Fee M 1PPERMITFEE rPlum=bingmit Fee P 1 ELCPLNCK Stand Alone Electric Pln Ck(hourly) E 1MECPLNCK Stand Alone Mechanical Pln Ck(hrly) M 1PLMBLNCK Stand Alone Plumbing Pln Ck(hrly) P 1 STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B when not over counter) hourly-stand alone 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICR Seismic Residential B 1BSEISMICO Seismic Coinmercial B 1 TRAVDOC Travel &Documentation B 1BUSLIC Business License B C R c �, 5 of 5