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09100099 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7610 KIRWIN LN CONTRACTOR:TBD-TO BE DETERMINED PERMIT NO:09100099 OWNER'S NAME: VENKATESWARA&SAILAJA SIDHABATHUNI DATE ISSUED: 10/15/2009 'ER'S PHONE: 4087771299 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARRATIONr� BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class 23 Lic.# U 6 .401— 6 t� G MECH RES DE COMMERCIAL Contractor — % Date I hereby affirm that am licensed under t rovisions f Chapter 9 JOB DESCRIPTION:REPLACE, I OWS,REMODELING KITCHEN, (commencing with Section 7000)of Division of the Business&Professions TWO(2)BATHROOMS;WONG'S GENERAL CONSTRUCTION PD Code and that my license is in full force and effect. 10/14/09 FOR BUS LIC 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 Sq.Ft Floor Area: Valuation:$18500 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:35922019.00 Occupancy Type: APPLICANT CERTIFICATION 1 certify that I have read this application and state that the above information is correct. 1 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. 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. -..... ___.._......_._ Issued r` a Signature � Date L OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that 1 am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. 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, Signature of Applicant: Date: Business&Professions Code) 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 HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should 1 use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I Owner or authorized agent: ` become subject to the Worker's Compensation provisions of the Labor Code,I must "L-- Date:/O forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address ir' -inify and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the gh—ung 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 I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date CITY OF CUPERTINO 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35922019.00 DATE ISSUED. . . . . . . : 10/15/2009 RECEIPT #. . . . . . . . . : BS000008940 REFERENCE ID # . . . : 09100099 SITE ADDRESS . . . . . : 7610 KIRWIN LN SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : VENKATESWARA & SAILAJA SIDHABA ADDRESS 7610 KIRWIN LN CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4357 RECEIVED FROM . . . . : SAILAJA SIDHABATHUN CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096 COMPANY TBD - TO BE DETERMINED ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 18, 500. 00 1 .00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 18, 500 . 00 1 . 90 0 . 00 1 . 90 0 .00 1REMRESBAT SQ FEET 120 . 00 570 . 00 0 . 00 570 . 00 0 .00 1REMRESKIT SQ FEET 200. 00 570 . 00 0 . 00 570 . 00 0 .00 1WINREP EACH 8 1. 00 380 . 00 0 . 00 380 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 1522 . 90 0 . 00 1522 . 90 0 . 00 METHOD OF PAYMENTAMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 1, 522 . 90 AMEX --------------- TOTAL RECEIPT 1, 522 . 90 CITY OF CUPERTINO O� 1:SVC--I ADDITION/REMODEL CUPER�TINO PERMIT APPLICATION FORM APN # r�� o�� l � • � � Date: `O �L�- �1 - Is a 2"unit being added? Yes ❑ No N If yes, please fill out the permit applic tion for 2" unit. Building Address: -7 6 ( 0 k ( P t..% I(\) t rJ ) C 12 i rJ o CtA 9 Mailing Address (if different from building address): Owner's Name: V ri w AkA 9�S -A— A Phone# : n e> -T ti Contractor: Phone#:4,� Klo nc l S G ti cJ�?�"S Fax #: Contractor License#: 8 r- y- G 6 � Cupertino Business License#: Contact: Phone#: 4, 0 211> ) vt i L a Fax#: Building Permit Info. Bldg. Elect. Plumb. Mech. ❑ Hillside ❑ Job Description: Addition-What is being added?(Be Specific): What is being remodeled(not including addition)? o lk 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 If yes, please provide a copy of your planning approval letter. Planners name: Square Footage: Addition: Porch: Deck: Garage: Detached Attached Remodel: Kitchen a 0 v S' Bath o� 0 Other Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B II/IIIN-A ❑ II/III B, IV-HT, V-B (P 3 Valuation: ero Please check this box if the project is a second-story addition ❑ Project Size: Express ❑ Standard _ ar e ❑ 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*** F-1Revised 07/06/09 Over-the-Counter 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 1R3PLNCK Dwellings plan check B 1R3REPINSP Dwellings Repeat B Inspection 1R3REPPLNC Dwellings Repeat Plan B Check 1R3HINSP Dwellings Hillside B inspection 1R3HPLNCK Dwellings Hillside plan B check 1R3HREINSP Dwellings Hillside B Repeat Inspection 1 R3HREPLNC Dwellings Hillside B Repeat Plan Check 1 R3ALTINSP Dwellings Alternate B Materials Inspection 1R3ALTPLNC 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 1BPWSVCS Main Water Service P 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE SeismicResidential B 1REROOFRES 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) 1 GARDTM<=1 K Masonry up to 1,000 SF B (each) 1 BCONSTAXR Construction Tax Res (new detachedgarage) PATIO'S OPEN 1R3SFDADD OR IR3SFDREM 1 PATIOWOOD Wood Frame up to 300 B SF I PATIOMETAL Metal Frame up to 300 B SF 1PATIOOTHER Other Frame up to 300 SF B PATIO'S CLOSED 1R3SFDADD OR & SUN ROOMS 1R3SFDREM 1 PATIOENCLW Enclosed Wood up to 300 B SF 1PATIOENCLM Enclosed Metal up to 300 B SF 1PATIOENCLO Other Enclosed Patio up B to 300 SF 1 COVPORCH Porch Covered-Each B (Each) REMODELS 1R3SFDREM I REMRESKIT Kitchen Remodel up to B (Deduct "$"for ea plan 20-0 300 SF check 1REMRESBAT Bath Remodel up to 300 B 64�2 0 SF 1 REMREOTH Other Remodel up to 300 B " SF M.Indoor Air Quality and Firiishes- 1.Use L affilo-VOC Paird 1 IAQ/Health pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes. 0 3.Use Lowft VOG Adhesives 3 IAQ/Health pts y=yes D 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Health pts y=yes D 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 7•Seal all Paebcar cit MIFF 4 IAQ/Health. pts y=yes 0 8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes D 10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0 1 1 1 N.Flooring 1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yesl D 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 1 i i Total Points Available: 1 1401 130E----571 Total Points Project Received: 1 01 01 0 G:data/progs/greenbuildingguidelines/remodelers/greenpointsfina12.12.Mprotected.xls RESIDENTIAL PROJECT COVER SHEET Assessor's Parcel Number: Nameofowner. VPAJKAjrswAUe SA 1L A s(7)HAAAr►Hvf0 Project address. `7C. (0 i Q W It Al 4,n! D E2-1 /-/V 0 a! eO Contactperson. A L Phone. 69 Fax. Fw"Net square footage of lot. _ 4 IN - Existing Proposed Square footage: First floor: Second floor: Garage: TOTAL: re there at least two 10 foot by 20 foot clear spaces inside the garage? Y�4 Is privacy protection planting required for the project? N On what floor(s) is work being done? Brief descri tion of oll !� G W �7 CnhM a ati-r L ` tiJ rn o 1 .� v In c �� f Code editions: 2008 CBC -N)2008 C C N)2008 CMC 0-N) 2008 CPC -N)2008 NEC N) Effective 1/1/08 IN ACCORDANP FFTW TH THE CIN OF CUP[RTINO CODE�, AND ORDINANCES DATE_ SIGNED - Thbe kept on the is set of plans and specifications MUST unlawful to make anb at all times and it is on same without written Permission or alterations the tutlding Department, Permission from The stamping o this plan and s f Cupertino. SHALI NOT be held to Pecs ications aPProval of the violation�ut��oro si an Of any City O,dinance or state Plan Review Process Work Book Page-8-Revised 1/1/08 _ 206" 522"- -- -30" - ; - ___.._... 552" 30" -252" 852„ 282" 482"I -18 .z 21,E 36 36" 3 2 y 15" .39fly IN, 10M.AVAUMMM ., i -- _- 1 � W304012 L W3040 1 j I!!I' W382224 j ' DB21 B36-,1 R0 B36_ \\ SB311 x;124 D15H IQ_ B15R i rn i J N - , co' il0 G tza �2Po S RA G 7 3n— � W2440 �W36251 N BESO DB18 'fl 2L WM2740 ' N K: :...18" ; ..12' 3p,, 30" I' 45" 45" . ._ 24" - -36" -27" All dimensions-size designations This is an original design and must Designed: 2009-10-6 given are subject to verification on 3 not be released or copied unless Printed: 2009-10-11 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. GAYWILL WONG 1006# All Drawing#: 1 o 0 Win � C(A 7Q6 47- 10 jl �l tA Community Development 10300 Torre Avenue -;I fz Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 :UPEkTINO Building Department JOB ADDRESS: -76(D k t ,2wi N L-tJ, e uprizzi,-7oPERMIT# OWNER'S NAME: PHONE #40a>— 31q -- 2 GENERAL CONTRACTOR: 10 vjoy) FAX # I am not using any subcontractors: _ *'u" l0//4 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 Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date