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13090169151 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1535 JAMESTOWN DR CONTRACTOR: IPEK CONSTRUCTION PERMIT NO: 13090169 OWNER'S NAME: AKELA ANAND AND SHRIVASTAVA DIVYA 946 LAKE TAHOE CT. DATE ISSUED: 09/23/2013 OWNER'S PHONE: 4082036698 SAN JOSE, CA 95123 PHONE NO: (408)891 -1996 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL License Class }l� C1Q Q Lic. # 65 REMODEL (3) BATHROOMS, EXTEND M.BATH, PANEL Om UPGRADE UPGRADE 200 AMP, ADD GAS LINE TO COOKTOP, Contractor. Date REMOVE I hereby affirm tha I am licensed under the provisions of Chapter 9 AND REPLACE WATER HEATER (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: $35000 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 36610093.00 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT E RIES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 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 DA OM LAST CALLED INSPECTI N. indemnify and keep harmless the City of Cupertino against liabilities, judgments, may accrue against said City in consequence of the costs, and expenses which Issued by: Date: granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section RE- ROOFS: 9.18. 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. 13 O ER- 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 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. 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 Section 3700 of the Labor Code, for the performance of the work for which this the Health & Safety Code, Sections 25505, 25533, and 25534. Date: 14A 11 permit is issued. Owner or authorized agent: 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 Cal ifomia. 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 upon the above mentioned property for inspection purposes. (We) agree to save ARCHITECT'S DECLARATION 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 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 1 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 ` (408) 777 -3228 • FAX (408) 777 -3333 • building acuoertino.org \� LJ NEW CONSTRUCTION LJ ADDITION LJ ALTERATION / Ti U REVISION / DEFERRED ORIGINAL PERMIY # PROJECT ADDRESS 15,35 5 „ 1 � 'e60 ^ �. ' n - APN 1 I I7 10 � t� —J OWNERNAME /� �0.t'� { � PHONE (408)2-03- • %i. 19 E -MAIL STREET ADDRESS N a CITY, STATE, ZIP �p FAX CONTACT NAME v okrl PHONE E -MAIL STREET ADDRESS I CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER - BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME C aL A ( LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME v v ` E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY. STATE. ZIP PHONE DESCRIPTION OF WORK V - ,�'` J �� _2 OM- �D v�yyN7lvu� ,'.(II 6 �{ ( � �AQ- � padl. w� \ 601 �W � V �+ L Y -Pawv- l &a- C" as J 04-cam EXISTING USE ' PROPOSED USE CONSTR. TYPE # STORIES I USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM REMODELAREA 130 KITCHEN REMODELAREA s OTHER REMODELAREA PORCH AREA DECK A A TOTAL DECK/POWH AREA GARAGE AREA: LJ DETACH ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? ONO ADDITION? ONO I/ A PRE - APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES " ECEI D TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO £ S� By my signature below, I certify to each of the following: I am the property owner or author' a ent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to boil ' co -truction . I authorize representatives of Cupertino to enter the above- identifi property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFqRMATION REQUIRED PI AID CIIECICTXP7 �o izac SLIP.., .. New SFD or Multifamily dwellings: Apply for demolition permit for _ existing building(s). Demolition permit is required prior to issuance of building' ov�R �glr couNTER sUiLDINC PLAN REVIEVI permit for new building. EXPRESS ©'E PLANNING PLAN REVIEW^ _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure iIc woRks . rY a form if any Hazardous Materials are being used as part of this project. ❑' ` k LI "RE "EPTa iARG1 FI ; �, Copy of Planning Approval Letter or Meeting with Planning prior to Q,,JOR'`'„ ©sANIrARY sEwER DISTRICT submittal of Building Permit application. = BldgApp 2011.doc revised 06121111 CITY OF CUPERTINO Ti TT 1P CT><M A TnR — RT TTT ,11INf DIVI910N illADDRESS: 1535 JAMESTOWN DR DATE: 09/23/2013 REVIEWED BY: MENDEZ APN: I.BP#: "VALUATION: 1$35,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex p Bath (< =300 sfl PENTAMATION 1 R3SFDREM USE: 0.0 PERMIT TYPE: WORK REMODEL 3 BATHROOMS EXTEND M.BATH PANEL UPGRADE 200 AMP ADD GAS LINE TO SCOPE I COOKTOP, REMOVE AND REPLACE WATER HEATER Mech, Plan Check I i Plumb. Plan Check 10.0 1 hrs $0.00 Elec. Plan Check 10.0 1 hrs $0.00 11, h. Pena it Fee: Plumb. Permit Fee: IPPERALIIT Elec. Permit Fee: IEPERMIT t)iher ;llech. hasp. Other Plumb Insp. 0.0 hrs $47.00 Other Elec..Insp. 0.0 hrs $47.00 11ech. Insp. fire: Plumb. Insp. Fee: Elec. Insp. Fee: 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 preliminary information available and are only an estimate Contact the Dept for addn'[ info. FEE ITEMS (Fee Resolution 11 -053 E . 7if /1/13) FEE QTY/FEE I MISC ITEMS Plan Check Fee: $0.00 135 1 s.f. Remodel, Bath (< =300 sfl Suppl. PC Fee: 0 Reg. ® OT 0.0 hrs $0.00 $626.00 1REMRESBAT PME Plan Check: $0.00 1 # Plumbing Permit Fee: $0.00 $70.00 1 PGA SRES Piping, Gas <=4 Outlets Suppl. Insp. Fee-.0 Reg. Q OT 0.6 T,a'" $0.00 m� Mech, Plan Check I i Plumb. Plan Check 10.0 1 hrs $0.00 Elec. Plan Check 10.0 1 hrs $0.00 11, h. Pena it Fee: Plumb. Permit Fee: IPPERALIIT Elec. Permit Fee: IEPERMIT t)iher ;llech. hasp. Other Plumb Insp. 0.0 hrs $47.00 Other Elec..Insp. 0.0 hrs $47.00 11ech. Insp. fire: Plumb. Insp. Fee: Elec. Insp. Fee: 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 preliminary information available and are only an estimate Contact the Dept for addn'[ info. FEE ITEMS (Fee Resolution 11 -053 E . 7if /1/13) FEE QTY/FEE I MISC ITEMS Plan Check Fee: $0.00 135 1 s.f. Remodel, Bath (< =300 sfl Suppl. PC Fee: 0 Reg. ® OT 0.0 hrs $0.00 $626.00 1REMRESBAT PME Plan Check: $0.00 1 # Plumbing Permit Fee: $0.00 $70.00 1 PGA SRES Piping, Gas <=4 Outlets Suppl. Insp. Fee-.0 Reg. Q OT 0.6 hrs $0.00 200 amps Electrical PME Unit Fee: $0.00 $47.00 IBELEC200 Services PME Permit Fee: $94.00 # Plumbing Construction TUX. $28.00 1PRWHEATR Water Heater Administrative Fee: IADMIN $44.00 Work Without Permit? 0 Yes (E) No $0.00 0 Advanced Planning Fee: $0.00 Select a Non - Residential 0 Travel Documentation Fee: ITRAVDOC $47.00 Building or Structure Strong Motion Fee: IBSEISMICR $3.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 $190.501 $771.00a $961.50 I At�AO AkT A _ 81 4MvM" . Lo � ramiCE COPS r it -. bDU NSTAiKS SAT -AKC70Nk n 1 ' I COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION - CUPERTINO APPROVED This set of plans and specifications MUST be kept at the job site during construction. It is unlawful to make any changes or alterations on same, or to deviate therefrom, without approval from the Building Official. The stamping of this plan and specifications SHALL NOT be held to permit or to be an approval of the violation of any provisions of any City Ordinance or State Law. BY y1 c DATE �,+ j 1� --- PERMIT NO. 1� C� t 0 1 i EIZ, i CUPERTINO Building Departrnent SEP 2 3 2013 REVIEWED FOR CODE COMPLIANCE Reviewed By: �J�' I I 60 V C25 -tp-o i�, E: Q S c`3-A74 R.OW l 72 9� CUPERTINO Building Departnent SEP 2 3 2013 REVIEWED FOR CODE COMPLIANCE Reviewed By: #; 15n � a,n� � � fir. C, .� �A '�5OA M MR i�, r,b1E f- 0 P, �-- - 102- 4P-I-Ep., CUPERTINO Ruilding Department SEP 2 3 2013 REVIEWED FOR GODS COMPLIANCE Reviewed By. >� y , �z S1 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1535 JAMESTOWN DR CONTRACTOR: IPEK CONSTRUCTION PERMIT NO: 13090169 OWNER'S NAME: AKELA ANAND AND SHRIVASTAVA DWYA 946 LAKE TAHOE CT. DATE ISSUED: 09/23/2013 OWNER'S PHONE: 4082036698 SAN JOSE, CA 95123 PHONE NO: (408)891 -1996 JOB DESCRIPTION: RESIDENTIAL COMMERCIAL 13 ❑ LICENSED CONTRACTOR'S DECLARATION License Class_ Lic. # A 544,6 9 REMODEL (3) BATHROOMS, EXTEND M.BATH, PANEL i (� UPGRADE 200 AMP, ADD GAS LINE TO COOKTOP, Contractor I_ f re Ia A,, CxCJt`Uate 0 0 3 REMOVE I hereby affirm that I am licensed under the provisions of Chapter 9 AND REPLACE WATER HEATER (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. REVISION #1- REVISE (2) BATHROOMS -ISSD OTC 10/18/2013 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 Valuation: $35000 performance of the work for which this permit is issued. i " Sq. Ft F or AN I have and will maintain Worker's Compensation Insurance, as provided for by APN her: 36 093.00 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which is % permit is issued. t APPLICANT CERTIFICATION I certify that I have read this application and state that the ab ve i is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances to laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter 180 DAYS FROM LAST CALLED INSPECTION. upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against. liabilities, judgments, p G •� 8' �7• costs, and expenses which may accrue against said City in consequence of the Issued by: Date: 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. RE- ROOFS: Signature Date D 1 3 All roofs shall be inspected prior to any roofing material being installed. If a roof is --4#---J 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 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) property, rty, am exclusively contracting with licensed contractors to 1, as owner.of the roe y g 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 compliance with the Cupertino Municipal Code, Chapter 9.12 and 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 will maintain the Health &Safety Code, Sections 5505 25533, and 25534. Owner or authorized agent: Date: 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 I hereby affirm that there is a construction lending agency for the performance of become subject to the Worker's Compensation provisions of the Labor Code, I must work's for which this permit is issued (Sec. 3097, Civ C.) forthwith comply with such provisions or this permit shall be deemed revoked. 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 upon the above mentioned property for inspection purposes. (We) agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City inconsequence 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION VA 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 1� 1 GUPERT(NC1 (408) 777 -3228 •FAX (408) 777 -3333 • buildin cu ertino.or 11 61 ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/ T REVISION/DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 5(35 - /'+ <Tn Lakff l (j•N�� L � (', r OWNER NAME✓ PHONE Q _ - MAIL�� A 11��n41t STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAME ° PHONE E -MAIL � r s.s0. n m r� - . STREET ADDRESS '15110-A I CITY, STATE, ZIP r 0 FAX ❑ OWNER ❑ OWNER -- BUILDER ❑ OWNERAGENT 1A CONTRACTOR 11 CONTRACTOR AGE ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGrNEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR TYPE I # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH []ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY []YES BEING ADDED? []NO ADDITION? ONO PRE- APPLICATION []YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES 'tRE@ET � Y ^�'',. TOTAL VAL TION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO NIXON By my signature below, I certify to each of the following: I am the property owner or authorized ag to act on the property owner's behalf . 11have read this application and the information I have pr vided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buil ing c struction. I authorize representatives of Cupertino to enter the above- identii) property for inspection purposes. Signature of Applicant/Agent: 1 Date: SUPPLEMENTAL O TION REQUIRED `. F'tovTBVCSL Iili`¢O R BUILD1IYG AN7LEVIEW _ New SFD of Multifamily dwellin s: Apply for demolition permit for issuance building existing building(s). Demolition permit is required prior to of permit for new building. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure _ form if any Hazardous Materials are being used as part of this project. b w, Copy of Planning Approval Letter or Meeting with Planning prior to ) a _ submittal of Building Permit application. k B1dgApp_AI Ldoc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION M7 ADDRESS: 1535 JAMESTOWN DR DATE: 10/18/2013 REVIEWED BY: mendez APN: BP #: EVALUATION: $0 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY Civil / Religious activities PE USE: Commercial Building in BQ zone? ® Yes (D No PERRMIT MIT TYPE: YPEE: : WORK I REVISION #1 REVISE 2 BATHROOMS SCOPE Xlec:h. flan Check �1ec;tt. Perinit Fee: Other Mech. Insp. Hech. Insp. Fee: Plumb. Plan Check Plumb. Permit t -ee: Other Plumb Insp. Plumb. Insp. Fee: Elec. Plan Check EI<:c. Permit lee: L--d Other Elec. lisp. Elec. Insp— Fee: iee: n..cr.,. crz .a.. P. *— C..,;t.- OVowor INWriet. School NOTE: This estimate does not inetuaejees aue to oine «epussc...o District, etc . These fees are based on the relimina information available and are only an estimate. Contact the Dept or addn'1 in o. FEE ITEMS Lee Resolution 11 -053 Eff. 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. ® OT 10.0 1 hrs PME Plan Check: $0.00 $0.00 Permit Fee: Suppl. Insp. Fee :Q Reg. .0 OT 0,0 hrs $0.00 $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAW Administrative .Fee: $0.00 Work Without Permit? ® Yes Q No $0.00 U, Revised: 10/01/2013 F 1555 jwujn TbWN fir' Cu -4fticl C!6 9561+ r- 81 LAO "�!]F- �'-oKz bbWt�STAUI�S T AT�AKcoNk 56 X Li 1 lS�I 1i 1uLC�cswA l9` � -P� �- CUPERTINO ... Building Department COMMUNITY DEVELOPMENT DEPARTMENT BUILDING Dl ",ASION - CUPERTINO APPROWED This set of plans a6d specifications MUST be kept at the Job s ;te during construction. it is unlawful to make any cnang8s or alterations on same, or to deviate therefrom, without approval from the Building Official. The tc:mpino of this plan and specifications SHALL NOT be held t3 pert :it or to be an approval of the vitiation o= WTI! lon$ of any City Ordinance or State Law. B Dv �' T _ pERMIT NO. AlpTm OCT 18 2013 REVIEWED FOR CODE COMPLIANCE CUPERTINO Rt,ildinc Department EP 2 3 2013 ;;EV EV.'E;; I=u %R :C.'ODE COMPLIANCE Reviewed By: ',� Amt 1535 Q wm ,-� t\ cbr. L r,bIE F0 P.E MAMF - -DAT-�I P om !q iER CUPERTINO Building Department SEP 2 3 2013 REVIEWED FOR CODE COMPLIANCE Reviewed By: //—; s.1 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1535 JAMESTOWN DR CONTRACTOR: IPEK CONSTRUCTION OWNER'S NAME: AKELA ANAND AND SHRIVASTAVA DIVYA OWNER'S PHONE: 4082036698 ❑ LICENSED CONTRACTOR'S DECLARATION License Class!! Lic. # Contractor CNJ >�1 ?ate 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. 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 permit is issued. APPLICANT CERTIFICATION 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will compl with all non -point source regulations per the Cupertino Municipal Code, S ion 9.18. QQ Signature Date O 2U 3 ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the 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. Signature 946 LAKE TAHOE CT. SAN JOSE, CA 95123 JOB DESCRIPTION: RESIDENTIAL PERMIT NO: 13090169 DATE ISSUED: 09 /23/2013 PHONE NO: (408)891 -1996 COMMERCIAL ❑ REMODEL (3) BATHROOMS, EXTEND M.BATH, PANEL UPGRADE 200 AMP, ADD GAS LINE TO COOKTOP, REMOVE AND REPLACE WATER HEATER REVISION # 2 - ADD (N) 220V /50AMP OUTLET RECEPTACLE IN GARAGE FOR EV USE - ISSUED 10/28/2013 I Sq. Ft Floor Area: APN Number: 3661 Valuation: $35000 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DA ST CALLED INSPECTION. Date: A) 22l; RE- ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. 0 Owner or authorized agent: Date: 3 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION O'A 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 CUPERTINO (408) 777 -3228 • FAX (408) 777 -3333 • building ZD-cupertino.org MISC sq-1 ❑ PLUMBING ❑ MECHANICAL ❑ ELECTRICAL ❑ O MISCELLANN �� PROJECT ADDRESS I C, t `A ^ n n (�� �'. J nt T7 V # o _ 0 G r%l � `Glwu"v, OWNERNAME A HOtNE (400 )Z37 6j 18 E MAPL STREET ADDRESS C' v CITY, STATE, ZIP FAX CONTACT NAME PHONE E -MAH. STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER - BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME n I 1 ` LICENSE NUMBER 2 7EN713 BUS. LIC # COMPANY NAME E -MAIL \ FAX STREET ADDRESS 70_A • CITY, STATE, ZIP Ate. © PHON Q ARCHITECT/ENGINEERNAME LICENSE NUMBER COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD .,DUPLEX ❑ MULTI - FAMILY BUILDING: ❑ COMMERCIAL PROJECT IN WILDLAND ❑ YES URBAN INTERFACE AREA ❑ NO PROJECT IN ❑ YES FLOOD ZONE ❑ NO IS THE BLDG AN ❑ YES EICHLER HOME? ❑ NO DESCRIPTION OF WORK AAA t TOTAL VALUATION: RECEIVE' By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the prope er's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurateoKgree to comply with all applicable local ordinances and state laws relating to building cbnstructi . I authorize representatives of Cupertino to enter the above -id ntified roperty for inspection purposes. Signature of Applicant/Agent: Date: O SUPPLENE TAL ORMATION REQUIRED 3 L =�-§M'„ tw MEPMiscApp 2011.doc revised 06121111 rM CITY OF CUPERTINO IOU T. cr"1%4 A T1112 — UTTTT .1 lT*JC "IVICInN imADDRESS: 1535 JAMESTOWN DR DATE: 10/28/2013 REVIEWED BY: MELISSA APN: 366 10 093 BP #: *VALUATION: MISC ITEMS *PERMIT TYPE: Building Permit Plan Check Fee: PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex 1 # E ctrical $47.00 IBR CEP Recep /Switch/Outlets PENTAMATION 1 REAP 10 I PERMIT TYPE: USE: 0:0 hrs $0. WORK REVISION # 2 - ADD N '220V /50AMP OUTLET RECEPTACLE IN GARAGE FOR EV USE - ISSUED SCOPE 10/28/2013 Mech. Plan Check Plumb, Plan Check Elee. Plan Check 10.0 1 hrs $0.00 Mech. Pe>rinit Fee: Plumb. Permit Pee: Elec. Permit Fee: IEPERMIT Other ;i9ech. Imp. Other Plumb Insp. Other Elec. Insp. 0.0 hrs $47.00 A,kech. Insp. Fee: Plumb. hap. Fee, • Elec. Insp. Fee: NOTE: This estimate does not includejeer due to older Departments (Le. running, ruunc .•u,na, . 91., �...�.�...y -• -� District, etc.). 1 nese fees are Dasea un [ne reuiiuioui as vsasscv. .�... -•.�. -. « -» »• -- _____._____ _ _ FEE ITEMS (Fee Resolution 11 -053 E . 711113) FEE QT MISC ITEMS Plan Check Fee: $0.00 1 # E ctrical $47.00 IBR CEP Recep /Switch/Outlets Suppl. PC Fee: Q Reg. ® OT 0:0 hrs $0. PME Plan Check: $0.30 Permit Fee: $0.00 HIN pa Q Q y,p Mech. Plan Check Plumb, Plan Check Elee. Plan Check 10.0 1 hrs $0.00 Mech. Pe>rinit Fee: Plumb. Permit Pee: Elec. Permit Fee: IEPERMIT Other ;i9ech. Imp. Other Plumb Insp. Other Elec. Insp. 0.0 hrs $47.00 A,kech. Insp. Fee: Plumb. hap. Fee, • Elec. Insp. Fee: NOTE: This estimate does not includejeer due to older Departments (Le. running, ruunc .•u,na, . 91., �...�.�...y -• -� District, etc.). 1 nese fees are Dasea un [ne reuiiuioui as vsasscv. .�... -•.�. -. « -» »• -- _____._____ _ _ FEE ITEMS (Fee Resolution 11 -053 E . 711113) FEE QT MISC ITEMS Plan Check Fee: $0.00 1 # E ctrical $47.00 IBR CEP Recep /Switch/Outlets Suppl. PC Fee: Q Reg. ® OT 0:0 hrs $0. PME Plan Check: $0.30 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. .® OT Q Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee- $47.00 Cnnswuction .Tax: _F_T Administrative Fee: IADMIN $44.00 Work Without Permit? ® Yes No $0.00 Advanced Planning Fee. $0.00 Select a Non - Residential Building or Structure 0� Travel Documentation Fee: 1TRAVDOC $47.00 Strong Motion Fee: $0.00 Select an Administrativ It m 1 w Bldg- Stds Commission Fee: $0.00 $138.00 $47.00 ` pAL FEE y 0 Kevwea: ,utu,i/wio 1 Z29 Y5o AM? fir- c"v �1 L� oz. i �911- ��Ill OFFICE COPy�