The URL can be used to link to this page

10020070 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21085 RED FIR CT -_ONTRACTOR:SAVITHA AMARNATH PERMIT NO: 10020070 iAJAPURAM OWNER'S NAME: SAVITHA AMARNATH SAJAPURAM !1085 RED FIR CT DATE ISSUED:02/12/2010 r ER'S PHONE: 4089738251 ZUPERTINO CA,CA 950144252 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r— ELECT r— PLUMB License Class Lic.# MECH F_ RESIDENTIAL F COMMERCIAL Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RMDL BATH (commencing with Section 7000)of Division 3 of the Business&Professions V/MECH,ELEC,PLMB,LIGHTNG(98SQ)&COPPER Code and that my license is in full force and effect. 2E-PIPE;NO RE-ROOF&NO STRUCTURAL 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:$1500 permit is issued. APPLICANT CERTIFICATION 4PN Number'l"QS 8.00 Occupancy Type: 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 upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Issued by: ''� � � Date:�'"�� Signature Date OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by 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. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. 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 Owner or authorized ag e'l forthwith comply with such provisions or this permit shall be deemed revoked. _Date: D �D CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save me °ty and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address CC d expenses which may accrue against said City in consequence of the granUlIg of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 n I understand my plans shall be used as public records. Signature "' •"\ Date 1 C) Licensed Professional CITY OF CUPERTINO 7 ITEMS OF 7 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35905028 . 00 DATE ISSUED. . . . . . . : 02/12/2010 RECEIPT #. . . . . . . . . : BS000009741 REFERENCE ID # . . . : 10020070 SITE ADDRESS . . : 21085 RED FIR CT SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER SAl;ITHA AMARNATH SAJAPURAM ADDRESS 21C85 RED FIR CT CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4252 RECEIVED FROM . . . . : SAIVITHA AMARNATH CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY SA'=HA AMARNATH SAJAPURAM ADDRESS . . . . . . . . . . : 21C85 RED FIR CT CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4252 TELEPHONE . . . . . . . . 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 1BPFIXTURE NO OF FIXTURE 1 . 00 8 . 00 0 . 00 8 . 00 0 . 00 1BPWATER UNIT 1. 00 42 . 00 0 .00 42 . 00 0 . 00 1BSEISMICR VALUATION 1, 500 . 00 0 . 50 0 . 00 0 . 50 0. 00 1MPERMITFE FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0. 00 1REMRESBAT SQ FEET 98 .00 570 . 00 0 . 00 570 . 00 0 . 00 1TRAVDOC FLAT RATE 1 .00 42 . 00 0 .00 42 . 00 0 . 00 -- -------- ---------- ---------- ---------- TOTAL PERMIT 705 . 50 0 .00 705 . 50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 705 . 50 #114 --------------- TOTAL RECEIPT 705 .50 OWNER-BUILDEI: VERIFICATION 1. (Check one) I or my immediate family (parent, spouse or child) will perform: A. Y All the work authori2 ed by this permit B. — A portion of the worl: C. None of the work If B or C is checked, complete 2 or 3 below. 2. A state licensed contractor will be hired 0 do: A. _ All of the work B. _ A portion of the wort; (complete section below) Contractor Address/City Phone # State License # Type of work to be performed 3. _ I will utilize unlicensed person(s) ocher than my immediate family to perform all or portions of the authorized work. I understand t:iat I may be an employer (see reverse side). A Certificate of Insurance covering workers' compensation must be on file at the City of Cupertino Building Department office. PersorVFirm Address/City Phone Number Type of work to be erformed .................................................................................................................................................................................. I declare under penalty of perjury that the above is true and correct: I have read and understand the Owner-Builder Information (reverse side). .a Property Owner's Signature: Date: 0 )-J I _Z(0 Job Address: J Permit# 0 Any changes to the information provided on this form shall be submitted to the City of Cupertino Build Department. CITY OF CUPERTINO ADDITION/REMODEL CUPEkTINO PERMIT APPLICATION FORM APN # D L- Z ' �. Date: 0-2- Is Is a 2 nd unit being added? Yes ❑ No If yes, please fill out the permit application for 2" unit. Building Address: a 1 0 ?, S 12 i��l-J l-t a C j Co P C,to T(M 0 c.A- VSO l q Mailing Address (if different from building address) Owner's Name: hone 9 33 Contractor: d Phone#: Fax#: Contractor License#: Cupertino Business License#: Contact: Phone#: Fax#: Building Permit Info: Bldg. EZ Elect. [� Plumb. Mech. �' Hillside ❑ Job Description: Addition-What is being added?(Be Specific): ^�,t� w '� eat'u¢�� u \ What is being remodeled (not including ad ition)? Remodel IZuM Re-Roof. Yes ❑ o aIf yes list number of squares Remodel Includes Structural: Yes ❑ No Do you have the pre-application planning ap,:)roval? Yes ❑ No ❑ If yes, please provide a copy of your plannin ;approval letter. Planners name: Square Footage: Addition: Porch: Deck: Garage: Detached Attached Remodel: Kitchen Bath kz Ipther Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT,V-B ECJ" j2.--? Valuation: oo Please check this box if the project is a second-story addition ❑ Projectlize: Express ❑ Standard Large E] :Major EJ 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 C.UPERTINO ADDITOPUREMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft DECKS 1R3SFDADD OR 1R3SFDREM 1 DECKWOOD Deck (Wood)-3ach B (Each) 1 DECKRAIL Deck Railing-Each B (Each) GARAGES 1R3SFDADD OR DETACHED 1R3SFDREM 1GARDTW<=1K Wood Frame Lp to B 1,000 SF (eacY) 1 GARDTM<=1 K Masonry up to 1,000 SF B (each) 1 BCONSTAXR 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 Wocd up to 300 B SF 1PATIOENCLM Enclosed Meted up to 300 B SF 1PATIOENCLO 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 1REMRESBAT Bath Remode.up to 300 B " SF 1REMREOTH Other Remod,A up to 300 B 66 SF CITY OF CUPERTINO ADDITOP REMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft IMECPLNCK Stand Alone N_echanical M Pln Ck (hourly 1 PLMPLNCK Stand Alone F umbing P Pln Ck (hourly) 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee i IBSEISMICRE Seismic Resid(;ntial B I TRAVDOC Travel &Documentation B IBUSLIC Business License B r3 n1=i 1� RESIDENTIAL PRI3JECT COVER SHEET Assessor's Parcel Number: Name of owner. SAY ITtA A IkMAP,9,kTK S X -Y APU1Z4+ -?) Project address. 21 TQHS RM �-ttR (-'- CU1�LPRT t\Ab CA-RScpliT Contact person. A\Y'1A%--),r4NT H ( /A-JAVU('An l hone. (A-L)&) 9--�3- F'ax. Net square footage of lot. k C) 3 lr`� Existin_g Proposed Square footage: First floor: Second floor: Garage: TOTAL: Are there at least two 10 foot by 20 foot clear spaces :nside the garaZz. N Is privacy protection planting required for the project" Y 4 Build it Green Total Points j ' On what floor(s) is work being done? Brief description of work. T Code editions:2007 CBC (Y N)2007 CFC N)2007 CMC a)N ) N 2007 CPC �-N)2007 �NEC N) IN A(.CORI, '1PF'It()VFD CUP[RTINO CODt IATH ND ORDINANCES Effective 1/1/08 DATE SIGNED This set of plans and c4--frcations MUST be kept on the iot,at ,ll hr nes and it,s unlawful to make any hange',or alterations C� on same without w rtten perrnrssron from the Building DAartn,ent_ Crty,_)f.Cupertino. The stamping o thrs 0xi an(l specifications SHALL NOT be hel<7 r,,perrnrt or to be an approval of the vrolat� •n ,t any provionsis of any CityOrdinan .•ur .tate Law v Plan Review Process Work Book Page-8-Revised 8/0508 I � � C W m 0� r C- - — O u. u1 CDLIV �, 7 � o 1- o CO (!1 qz LV tj _ t r ,1J E G � 4 _ ZjOS1�S IY1N��d h � � jo O -!- o L� Z g p a; 3 3 a h � n � .. V ci CO C9 cn v E rA CIA ul CD ci as-5 to cg ,�} t n w �m 4 X � 3 3 N1� QN O 3 i uj aL p. 1 co 493 •• z CP. coi CIO 2 •• t�A 4 � C9 w iiZz I i�Cx ( p2E. � 3 Ct b v z Q cl a 00 cr ® S Q — m 40 �N w 1 ,- 9qs � j i O or zo .� II 9 t c zZ q w 5 f/) G �► n � ►IZ�t. L � 4 1 cn WO c 1l1 O � a 13Y. x f Q L Q a z ► o O �