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10040177 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 810 SEPTEMBER DR CONTRACTOR:A PLUS CONTRACTING PERMIT NO: 10040177 IWNER'S NAME: VIJAY&VINITA GANPULE 383 HANS WAY DATE ISSUED:04/30/2010 OWNER'S PHONE: 4088779437 SAN JOSE,CA 95133 PHONE NO:(877)929-5524 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class G azLic.# Zc��J o 77 REMODEL 110 SQ FT TO KITCHEN p,. ���/f� *SEE NOTES* Contractor /14 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:$11000 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:36214023.00 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 I — r` "�- -2 Issued b Date: �U granting of this permit. Additionally,the applicant understands and will comply k%'" with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. ��� any roofing lignature�'-�,���,�j�-------���� 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. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: 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 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 maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&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 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 I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534.J/_ Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: 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 on the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION .emnify 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 CITY OF CUPERTINO ADDITION/REMODEL CITY OF CUPEl�T1NO PERMIT APPLICATION FORM APN# 0 0 Date: t_5(p 2 1 Z4 0 113> -Is a 2" unit being added? Yes ❑ No If yes, please fill out the permit application for 2" unit. Building Address: M4a"'ngAddress (if di erent from building address): Oe: Phone # CPhone#: `P 9'1q-6 s a y Fax #: 37 9?35- Conkractor License#: 'a7S Cupertino Business License#: S igs-1-71 Contact: E-d /9, a / Phone#: �,7�-y W 1 /7 p - � Building Permit Info: Fax #: 7. y v Bldg. Elect. Plumb. C -- Mech. ��Y Hillside ❑ Job Description: Addition-What is being added?(Be Specific): What is being remodeled (not including addition)? Remodel Includes Re-Roof. Yes ❑ No� If yes list number of squares Remodel Includes Structural: Yes ❑ No Do you have the pre-application planning approval? Yes ❑ No 0--' If yes, please provide a copy of your plann!R&approval letter. Planners name: Square Footage: Addition: Porch: Deck: Garage: Detached Attached Remodel: Kitchen �Cath Other Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B II/III/V-A ❑ II/III B, IV-HT, V-B 11_,�) Valuation: //000 Please check this box if the project is a Project Size: Express tandard ❑ Large F] Major addition El Ma'or❑ 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. ***For Office Use Only*** Over-the-Counter ❑ Revised 07/06/09 CITY OF CUPERTINO ADDITION/REMODEL CUPEkTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft ADDITIONS 1R3SFDADD 1PLLONGRNGR Long Range PL Planning/Residential 1R3INSP Dwellings Inspections B 1 R3PLNCK Dwellings plan check B 1 R3REPINSP Dwellings Repeat B Inspection 1R3REPPLNC Dwellings Repeat Plan B Check 1 R3HINSP Dwellings Hillside B inspection 1 R3HPLNCK Dwellings Hillside plan B check 1 R3HREINSP Dwellings Hillside B Repeat Inspection 1R3HREPLNC Dwellings Hillside B Repeat Plan Check 1 R3ALTINSP Dwellings Alternate B Materials Inspection 1 R3ALTPLNC Dwellings Alternate B Materials Plan Check 1 PCESS Cesspool P 1PPRSEWG Ea. Private Sewage P Disposal System 1 PRSEWER Sewers P 1BPSPRINK Lawn Sprinkler/Backflow P 1 BPWSVCS Main Water Service P 1 BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE SeismicResidential B 1RER00FRES Residential Re-roof Each B 100 SF CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft DECKS 1R3SFDADD OR 1R3SFDREM 1 DECKWOOD Deck (Wood)-Each B (Each) 1 DECKRAIL Deck Railing-Each B (Each) GARAGES 1R3SFDADD OR DETACHED 1R3SFDREM 1 GARDTW<=1 K Wood Frame up to B 1,000 SF (each) 1GARDTM<=1K Masonry up to 1,000 SF B (each) 1 BCONSTAXR Construction Tax Res (new detachedgarage) PATIO'S OPEN 1R3SFDADD OR 1R3SFDREM 1 PATIOWOOD Wood Frame up to 300 B SF 1 PATIOMETAL Metal Frame up to 300 B SF 1 PATIOOTHER Other Frame up to 300 SF B PATIO'S CLOSED 1R3SFDADD OR & SUN ROOMS 1R3SFDREM 1PATIOENCLW Enclosed Wood up to 300 B SF 1PATIOENCLM Enclosed Metal up to 300 B SF 1 PATIOENCLO Other Enclosed Patio up B to 300 SF 1 COVPORCH Porch Covered-Each B (Each) REMODELS 1R3SFDREM 1 REMRESKIT Kitchen Remodel up to B (Deduct "$"for ea plan 300 SF check 1 REMRESBAT Bath Remodel up to 300 B " SF 1 REMREOTH Other Remodel up to 300 B " � SF CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft 1 REMRES2 Remodel Residential B Greater than 1000 sq ft 1 REMRES3 Remodel Residential B Greater than 2500 sq ft. 1REROOFRES Residential Re-roof Each B 100 SF REMODEL PLNCK 1STPLNCK(1-3 for Standard Plan Check B NOT FOR OVER THE remodel) COUNTER PLAN CKS. WINDOW/SLIDING 1R3SFDREM GLASS DOOR 1 WINREP Replacement windows B (ea 8 windows) 1 WINNEWNSTR New Window (non- B structural) 1WINMEWSTR New Window (Structural B Shear Wall/Masonry) 1 WINBAYSTR Bay Window (Structural) B SKYLIGHTS 1R3SFDREM 1 SKYL<10 SF Skylight less than 10 sf B 1 SKYL>10SF Skylight greater than 10 B sf or structural 1STAIRS Stairs-first flight/ea addt'l B IEPERMITFEE Electrical Permit Fee E 1MPERMITFEE Mechanical Permit Fee M 1PPERMITFEE Plumbing Permit Fee P 1 ELCPLNCK Stand Alone Electric Pln E Ck (hourly) / "0P I M.Indoor Air Quality and Finishes 1.Use Lm No-VOC Paint 1 IAQ/Healthis es 2.Use Low VOC,Water-Based Wood Finishes P y 0 21AQ/Health pts y=yes 0 3.Use Low/No VOC Adhesives 3 IAQ/Health ises 4.Use Salvaged Materials for Interior Finishes yy 0 3 Resource pts y=yes p 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Healthis — es 6.Use Exterior Grade Plywood for Interior Uses P Y-y 0 1 IAQ/Health pts y=yes p 7.Seal all EgDsed Parddeboard or MDF 4 IAQ/Healthis es B.Use FSC Certified Materials for Interior Finish P yy p 4 Resource pts y=yes p 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes p 10.Install Whole House Vacuum System 3 IAQ/Healthis P Y=Yes p N.Flooring 1 1 1 1.Select FSC Certified Wood Flooring B Resource pts y=yes p 2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 3.Use Recycled Content Ceramic Tiles 0 4 Resource pts y=yes p 4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 5.Use Exposed Concrete as Finished Floor 4 0 Resource pts y=yes p 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes p 1 1 1 Total Points Available: 140 130 57 Total Points Project Received: 0 0 0 .r Vz G:data/progs/greenbuildingguidelines/remodelers/greenpointsfinal2.12.D4protectedxls CITY OF CUPERTINO 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN 36214023 . 00 DATE ISSUED. . . . . . . : 04/30/2010 RECEIPT #. . . . . . . . . BS000010292 REFERENCE ID # . . . : 10040177 SITE ADDRESS 810 SEPTEMBER DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER VIJAY & VINITA GANPULE ADDRESS 810 SEPTMEBER DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4127 RECEIVED FROM . . . . : EDWARD MULLINS CONTRACTOR EDWARD L MULLINS LIC # 25457 COMPANY A PLUS CONTRACTING ADDRESS 383 HANS WAY CITY/STATE/ZIP . . . : SAN JOSE, CA 95133 TELEPHONE (877) 929-5524 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 11, 000 .00 1 . 00 0 . 00 1 . 00 0 . 00 1BPGAS OULETS 1 . 00 63 . 00 0 . 00 63 . 00 0 . 00 1BSEISMICR VALUATION 11, 000 .00 1 . 10 0 . 00 1 .10 0 . 00 1PPERMITFE FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00 1REMRESKIT SQ FEET 110 .00 570 . 00 0 . 00 570 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 677.10 0 . 00 677 . 10 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 677 . 10 VISA --------------- TOTAL RECEIPT 677 . 10 f i !J I i i n ozo A �� .� 7j- t can d � i �- 1 {� r L GJ i i 7.-4 o -y �,, L4 6 iV,q S n in V us I 1 ►� :� � D a m 3iii Ca p � D � I oz—-30 F o 2 ozD _ rr,rn R.P m ynN a O 13 \' C C f � D3m `ova rnncn �+ i 1 � I I pe X000 I ),qno j14Orl 14 IM i G 1 F S NLN 5 yC P 1 r I ( i I i !I i i Li 5T Rim I hew • Rini c/' 3. Run dam/ {i"hG%r641i7' ©rfhw1 _to�epdrer�� 7"rb �-� Leave > la1" $` t t ; �z t ;; p/sp���q/ ��3o� eQch 1 SIP G®h vcr7'" re /8 7 j2> 1 e'o ve-" Po U/C". ve'n't Cl reldi�`brw7ch 4 333 Hans Way San Jose, CA 915133 .: tic. #727527 1477-WP-5524 c;�~ n e,r fior Gr r6o t o alwP Frr d(g e P 1n/ / r7� 3 0- f ! 7-op C�lr' 6o P a 1 1: r 1 I