10020043 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 18671 MEDICUS CT CONTRACTOR:MAI'S CONSTRUCTION PERMIT NO: 10020043
OWNER'S NAME: KULKARNI RADHA 359 N PARK VICTORIA DR DATE ISSUED:02/08/2010
VER'S PHONE: 4089730321 MILPITAS,CA 95035 PHONE NO:(408)202-4875
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r- ELECT r PLUMB
License Class Lic.# -7 s 7 so g
i
MECH RESIDENTIAL COMMERCIAL
Contractor MAT S 6),Sr b-A C L-i a^Date
JOB DESCRIPTION:REMODEL KITCHEN,NEW CABINETS,COUNTERTOP,
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business&Professions ADD NEW
Code and that my license is in full force and effect. W6 NEAR ENTRY;NO RE-ROOF&NO STRUCTURAL
( Q)
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:$7000
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:37526007.00 Occupancy Type:
correct.I agree to comply with all city and county ordinances and state laws relatinl,
to building construction,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 permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS R M LAST CALLED INSPECTION.
9.18.
Signature Date t'O Issued by: Date:
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one cf 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 compensatioi, 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).
I hereby affirm under penalty of perjury one of the following three
ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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 California. 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 mu;t Owner or orize-&a ent, /
forthwith comply with such provisions or this permit shall be deemed revoked. ^ - Date: g!to
y �
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is
I hereby a
correct.I agree to comply with all city and county ordinances and state laws relatir g 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
in,+Pmnify 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
,ling 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 I understand my plans shall be used as public records.
Signaturel/7Date_q 19 110
Licensed Professional
CITY OF C:UPERTINO
PERMIT RECEIPT OPERATOR: patg
3 ITEMS OF 3 COPY # : 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 37526007 . 00
DATE ISSUED. . . . . . . : 02/08/2010
2000009709
RECEIPT # . . . . . . • • . : 10020043
REFERENCE ID # • • •
SITE ADDRESS 1BE71 MEDICUS CT
SUBDIVISION CUFERTINO
CITY . . . . . . . . . . . .
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : KULKARNI RADHA
ADDRESS . . . . . . . . . . : 18671 MEDICUS CT
CITY/STATE/ZIP CU"ERTINO, CA 95014
RECEIVED FROM RADHA KULKARNI
CONTRACTOR DAJID T. MAI LIC # 23479
COMPANY . . . . . . . MAPS CONSTRUCTION
ADDRESS 359 N PARK VICTORIA DR
CITY/STATE/ZIP MILPITAS, CA 95035
TELEPHONE (408) 202-4875
UNIT QUANTITY AMOUNT PD-TO-DT THIS REC --NEW-BAL-
FEEID ---------- ----------
___ ---------- 2 . 00 0 . 0
------------- 7, 000 .00 2 .00 0 . 00
1BCBSC VALUATION 0 .00 1 .40 0 .00
7, 000 . 00 1.40 0 . 00
1BSEISMICR VALUATION 160 .00 1140 . 00 0 .00 1140 . 00
1REMRESKIT SQ FEET - --------- ______ --
-
1143 .40
0 .00 1143 .40 0 . 00
TOTAL PERMIT
REFERENCE NUMBER
AMOUNT
METHOD OF PAYMENT --------------------
------------
---------------
CREDIT CARD 1, 143 .40 MC
---- ----------
TOTAL RECEIPT 1, 143 .40
w 44C Com
CITY OF CUPERTINO
ADDITION/REMODEL
CUPCITYEi�TINO PERMIT APPIACATION FORM
APN # Date:
2-0 10
Is a 2°d unit being added? Yes ❑ No If yes, please fill out the permit application for 2'0 unit.
Building Address:
di( � �O�n2r� arm r0 if A 0 O 1
Mailing Address (if different from building address':
Owner's Name- Phone#
fi< o% _ q?. 32�
Contractor: Phone#: 40'9- 20 - 7 2 3
Fax #:
Contractor License#: -3 L+1 C)
Cupertino Business License#:
Contact: r, Phone#: 40q-- q-1'3-03 )
1< Fax#:
Building Permit Info:
Bldg. L Elect. Plumb. j Mech. ❑ Hillside El
Job Description:
Addition-What is being added?(Be Specific):
What is being remodeled (not including addition)? j<;(Z:0,e n _ n e,J e q lei yQ rS"
Add he" L-0-All nea-b c t_wj.
Remodel Includes Re-Roof. Yes ❑ No IS If yes list number of squares
Remodel Includes Structural: Yes ❑ No 15
Do you have the pre-application planning approval? Yes ❑ No ]
If yes, please provide a copy of ourlannin a royal letter. Planners name:
Square Footage:
Addition: Porch: Deck: _ Garage: Detached Attached
Remodel: Kitchen' O S -4 -Bath Other
Type of Construction (Usage Class): Occupancy Type:
I-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, 'V-B
Valuation: �7 C 0 C Please check this box if the project is a
second-story addition ❑
Project Size: Express Standard ❑ Large ❑ Major❑
Please complete relevant portion of the Green F uilding
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
ADDITON/REMODEL
FEE SC_,HEDULE
Quantity Fee ID Fee Description Fee Group Permit Type
Sq Ft
DECKS 1R3SFDADD OR
1R3SFDREM
1DECKWOOD Deck (Wood).Each B
(Each)
1DECKRAIL 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)
1BCONSTAXR Construction Tax Res
(new detached garage)
PATIO'S OPEN 1R3SFDADD OR
1R3SFDREM
1PATIOWOOD Wood Frame up to 300 B
SF
1PATIOMETAL Metal Frame up to 300 B
SF
1PATIOOTHER Other Frame up to 300 SF B
PATIO'S CLOSED 1R3SFDADD OR
& SUN ROOMS 1R3SFDREM
1PATIOENCLW Enclosed Wcod up to 300 B
SF
1PATIOENCLM Enclosed Metal up to 300 B
SF
1PATIOENCLO Other Enclosed Patio up B
to 300 SF
1COVPORCH Porch Coverod-Each B
(Each)
REMODELS 1R3SFDREM
1REMRESKIT Kitchen Ren-odel up to B (Deduct "$"for ea plan
�dQ s 300 SF check
1 REMRESBAT Bath Remod-11 up to 300 B 66
SF
1REMREOTH 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
1MECPLNCK Stand Alone l Iechanical M
Pln Ck(hourl,i
1 PLMPLNCK Stand Alone F lumbing P
Pln Ck (hourly)
IBCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission lee
I BSEISMICRE Seismic Resic ential B
ITRAVDOC Travel &Documentation B
IBUSLIC Business License B
IN A. ,()Fit)AI J± 14VI T tf THE CITY OF
T'1 c
UI F Ii I INCA ANI,,OHDINANCES
"?. LATE
SIGNED 1)w
This set of plans ands ifications MUST
be kept on the lob at all time;and it is
unlawful to make any changes or alterations
on same without wntten Permission from
the Building Department. City of Cupertino.
The stamping o n this PI,, and specifications
SHALL NOT be held ti)permit or to be an
approval of the v;olat)on of any prcwisions
of any City Chdinanc e�x .�,r.rtt taw,
_r z
r^..
t�
�}
-)
-70 ry
RESIDENTIAL KITCHEN REMODEL
THESE REQUIREMENTS ARE FOR PERIAITS ISSUED ON OR AFTER JANUARY 1, 2010
BUILDING DIVISION REQUIREMENTS
A permit is required for kitchen remodels that i iclude the replacement kitchen cabinets. A permit is
not required for kitchen countertop replacement or re-facing of existing cabinets. If a permit is
required, it shall be obtained prior to the start o*the remodel.
Following is a listing of the general requiremer is based on the 2007 California Building Code, 2007
California Electrical Code, 2008 California Energy Efficiency Standards. For additional information,
including requirements for new/altered plumbi ig (water, sewer, or gas lines), contact the Building
• All counter receptacles shall be GFCI protected and located so that no point is more than 24-
inches from a receptacle outlet. Counter top areas with a minimum dimension of 12" in width
shall be provided with a receptacle. Receptzcles shall be located no more than 20" above counter
top. Islands/peninsulas shall have at least on a receptacle. (CEC 210.52)
• Countertop receptacles shall be on two 20-ainp branch circuits. Separate circuits shall be provided
for the garbage disposal and the dishwasher. (CEC 210.11)
• Smoke detectors shall be provided in all sleeping rooms and adjacent hallways, multi-levels, and
basements. (CBC 907.2.10.2)
• A minimum of 50% of the total rated lighting wattage (based on the maximum allowed for each
fixture) shall be high efficiency fixtures (e g. fluorescent). The Kitchen Lighting Section of the
"Residential Lighting" form (located on the Lack of this page) shall be completed and provided to
the building inspector at the rough electrical inspection. The following table defines the
requirements for high efficiency lighting (20(18 California Energy Efficiency Standards Section 150):
HIGH EFFICIENCY LIGHTING REQUIREMENTS
Lamp Power Rating Minimum Lamp Efficiency
15 watts or less 40 lumens per watt
over 15 watts to 40 watts 50 lumens per watt
over 40 watts 60 lumens per watt
Location of C ounter Top Receptacles
Small Appliance-Of Application
Does not count for counter top
24 in ! 24 in �
' The smal appliance circuit can
24 in I
Max Max i 12" Max as in ! supply outlets for the kitchen
Refrigerator Range
® ! ^ Max ; counter tops,refrigerator,dining-11
room,and similar areas,but..
in
A countertop 12 inches or larger M x
requires a receptacle(s).
24 in ® a
Max
Island
Peninsular ! ! Q
Islands and peninsular counter tops p I
...the small appliance circuit cannot supply disposals,
each required one receptacle. I dishwashers,other appliances,or outdoor receptacles.
NOTE:Counter top sections A through D. I Ig 24 in
Max
are treated as individual counter tops for ,
the purpose of determining the location of _
receptacles. = ..._. .. . ,.
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
-UPEkTINO
Building Department
JOB ADDRESS: I S 6 ^7) M P i�u S �'� ..ate PERMIT#
Q ; A I sL9i a zov 3
OWNER'S NAME: R&MAA K v Lk 4 rRv► PHONE #
GENERAL CONTRACTOR: `
,.� -- -,'on FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and co m lete 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
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
21g 10,
Owner/Contractor Signature Date