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12070017CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10109 MELLO PL CONTRACTOR: STEVEN WINKLEPLECK PERMIT NO: 12070017 OWNER'S NAME: NARAYANAN HARIHANAN S AND SUJATHA V 1299 WHITE DR DATE ISSUED: 10/11/2012 OWNER'S PHONE: 4087812317 SANTA CLARA, CA 95051 PHONE NO: (408) 476-8141 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL U COMMERCIAL License Class Lic. 4 CONSTRUCT A 356 SQ FT ADDITION, REMODEL 260 SQ Contractor ) Date /�� FT �� IN KITCHEN, 150 SQ FT IN BATHROOM, 250 SQ FT OTHER I hereby affirm that 1 am licensed under the provisions of Chapter 9 AREA, RELOCATE FURNACE TO ATTIC, UPGRADE MAIN (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 Sq. Ft Floor Area: Valuation: $77000 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 APN Number: 36905031.00 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 crue against said City in consequence of the Date: granting of this permit. Additi Ily, the applicant understands and will comply Issued by: with all non-point source regula ' ns per the Cupertino Municipal Code, Section 9.18. /`� �� ^ RE-ROOFS: Signature Date / 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 1 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 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. al Code, Chapter 9.12 and will maintain compliance with the Cupertino Muntd 1 have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533,25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: te: 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 Compensation laws of California. If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY 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 1 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION 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 CUPERTINO C7 NEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 7T7-3228 • FAX (408) 777-3333 • building (Dcupertino.org � � F' 00/ 7 r2fADDMON ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERK= # PROTECT ADDRESS /I0/o? 0"ce 0fo! Mt �P1' AME / )� F I 1 W' N/ ``l OWNER NIP PHONE EET STRADDREfSS/ / CLO // F C�-� CITY, SCATT- ZIP / - pLYL rJ Ij U� CSA gTol FAX . CONTACT NAME �^l �vE / 1 I — PHONE %�O I I ^ �I E-WAM Jf 4 L d V r4 "Ld D C, STREET ADDRESS /Jn ! C✓1' 17-e- /�Z I U C CITY, STAT -F -IIP SH�t�%i Flo ` C ^ 9lyo FAX CTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT ❑ OWNER ❑ OWNER-BUrLDER ❑ OWNER AGENT 4L= CONTRACTOR NAMES- e', /��, r `� l 'l LICENSE NUMBER `2� Ll. LICENSE TYPE x BUS. LIC # �j �)Tev (JJ COMPANY NAME E MAEL CI JO . Ce�v� FAX �/ SiiiEE1 ADDRESS/'(2nq ��)�� \,� V (7 1/ CITY, ZiPSA0�� I ZA 6A ��SI ((A PHONE yer)' o(_ l I ARCHITEC IENGINEER-INAME LICENSE NUMBER BUS. LIC # COMPANY NAME 0-C,i f M001i E-MAM FAX STREET ADDRESS 7 2 `1 E. f 1 A,,163-0� Al) CITY, STATE, ZIP 44 P/ -L L C 5'S nc Ff PHO' ��o�� DESCRIPTION OF WORK S-0 EXISTING USE n PROPOSED USE Q L—� CONSTR TYPE i V Y STORIES USE TYPE OCG SQ 7. VALUATION (S) EXIST AREA �� SF NEW Fr R AREA DEMO'J/A AREA -3J TOTAL NET AREA )AW S� - BATHROOM REMODEL AREA KITCHEN OTHER REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: H DETACH ATTACH # OW ELLING UNITS. IS A SECOND UNIT 0 YES SECOND STORY YES �. BEING ADDED? ftJa ADDITION' O PRE -APPLICATION ❑ YES IF YES. PROVIDE COPY OF IS THE BLDG AN ❑ YES 'TIO RECMV: BY: TOT ALUATION ON PL NNING A.°PL a ❑NO PLANNING APPROVAL LETTER EICHLER HOME' r ^ nO !!read By my signalise below, I certify to each of the following I am th property owner or authorized agent to act on the prpperty owner's behalf. I have this application and the information I have provided is correct I have the Description of Work and verify it is accmate. I agree to comply with all applicable local ordinances and state laws relat=toionstruction I antllo entatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: 7--3-1,2 SUPPLEMEN'T'AL INFORMATION REQUIRED PLAN CHECK TYPE ROUTDYG SLIP ❑ GVER-THE-COUN= BUELDING PLAN REVIEW New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure Cl PUBLIC WORES foif any Hazardous Materials are being used as part of this project. _ra! /1-1i C1 ❑ LARGE FD3E DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ submittal of Building Permit application. MAJOR /11 SANITARY SEWER DISTRICT Cl M'rvMOxMxNTA-L HEALTH Bldo 4pp_2011.doc revised 06/21/11 Building Department CITY OF CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 TELEPHONE: (408) 777-3228 • FAX: (408) 777-3333 OUTSIDE AGENCY PLAN CHECKING FEES Date: July 3, 2012 Agency Name: TRB Permit Number: 12070017 Project Address: 10109 Mello PI - Addition/Remodel Plan Check Fees: Hourly plan check fees: Number of hours Plan check based: 1St & 2nd plan checks included in initial plan check fee: $982.80 (Agency Fee -65% already calculated) 3rd plus plan checks: Number of hrs ($260.00 2hr min) Please attach this form with the number of hours spent on the 3rd plus plan checks and send with the plan check comments or if plans are approved, with the plans & approval letter. Please email the plan check comments to: Suew@cupertino.org and Sylviam@cupertino.org. *Please do not give plan check comments directly to the customer. We don't give out the comments until we have all of them back from each department. CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 10109 Mello PI DATE: 07/03/2012 REVIEWED BY: SEAN PC FEE ID APN: BP#: 'VALUATION: 1$77,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: 2nd Unit? ; Yes ' No OTC. 0 Yes 0 No PENTAMATION 1R3SFDADD PERMIT TYPE: WORK I CONSTRUCT A 350 SQ FT ADDITION KITCHEN REMODEL 260 SQ FT BATHROOM REMODEL SCOPE 1150 SQ FT, AND 250 SQ FT OF OTHER REMODEL. OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,111-B,IV,V-B 353 $1,512.00 IADDPLCK $1,230.00 IADDINSP $0.00 PME Plan Check: $0.00 F260 s.f. $600.00 Remodel, Kitchen (<=300 sf) /REMRESKIT Permit Fee: $1,230.00 Suppl. Insp. Fee -.0 Reg. 0 OT T 0.0 hrs $0.00 250 1 s.f. Remodel, Other $400.00 /REMRESOTH PME Unit Fee: $0.00 PME Permit Fee: $45.00 0 # Mechanical $133.00 IMFR=<100 Furnace, Forced -Air TOTALS: 353 $1,512.00 1 $1,230.00 lazuli tr°<aive ):""(,: MECH, HOURLYUMBH(4IRLY Y"es No ELEC, HLX Yes ''No Mech. Plan Check 0.0 hrs $0.00 M(imh P f(w 1:/cc. 1 e w C iai /I Mech. Permit Fee: IMPERMIT P lionhlr,nnrl Fee. C"'Fee Other Mech. Insp.0.0 hrs $45.00 1 �, �; �� ,� dl3 ,�r,-,i�Li ( jlj 'r t) Ll 0.0 hrs $0.00 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreliminary information availahle and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,512.00F—T-570s.f. $600.00 Remodel, Bath (<=300 sf) /REMRESBAT Suppl. PC Fee: (F) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 F260 s.f. $600.00 Remodel, Kitchen (<=300 sf) /REMRESKIT Permit Fee: $1,230.00 Suppl. Insp. Fee -.0 Reg. 0 OT T 0.0 hrs $0.00 250 1 s.f. Remodel, Other $400.00 /REMRESOTH PME Unit Fee: $0.00 PME Permit Fee: $45.00 0 # Mechanical $133.00 IMFR=<100 Furnace, Forced -Air m'w� to noa' 1'ar . _F7__ lazuli tr°<aive ):""(,: 0 0 Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: IPLLONGR $45.89 Select a Non -Residential Building or Structure E) 0 i Travel Documentation Fee: ITPA VDOC $45.00 Strong Motion Fee: IBSEISMICR $7.70 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $4.00 UBTFL�=. $2,889.591$1,733.00 1, TOL $4,622.59 Revised: 07/01/2012 *Our municipal code requires all businesses working in the city to have, a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSP CTION(S) WILL QBE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRAC RS HAVE OB,TAINIJD A;,CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the: following information V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing JOB ADDRESS: /C/ ®q MCL i.0 P e„g- PERMIT #, OWNER'S NAME: 144-1 A(z4YAtJ AII% PHONE:#&v GENERAL CONTRACTOR: BUSINESS LICENSE=# ADDRESS: joZg 0417-1;;- CITY/ZZPCODE < `35 -Os *Our municipal code requires all businesses working in the city to have, a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSP CTION(S) WILL QBE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRAC RS HAVE OB,TAINIJD A;,CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the: following information V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing