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14050078 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 5927 SUTTON PARK PL CONTRACTOR: PERMIT NO: 14050078 D OWNER'S NAME: TANGUTUR SESHADRI S AND PRAMILA �. C DATE ISSUED:05/13/2014 OWNER'S PHONE: 4088282619 1 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑ R 0 REMODEL HALLWAY BATHROOM 50 SQ FT TO INCLUDE, License Class /3) Lic.# a`1 7 ? 7 / M,E,P'S ��¢LfFV2 I? Dv>2 JCS Contractor GI+�t Date l0 3 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. Sq.Ft Floor Area: Valuation:$10000 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:37535037 00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT XPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 1 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 F M LAST CALLED INSPECTION. 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 Issued y: Date-T, with all non-point source regulations per the Cupertino Municipal Code,Section 9 18. 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 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 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, Business&Professions Code) 1,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 the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this 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 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 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 918. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERT[NO (408)777-3228• FAX(408)777-3333• building(1cupertino.org 1� ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS Q u ^') / V APN# !1 5 3-S03--7- 00 S 0 3 /- O0 OWNER�NAME�1 ^ p R w r\ r f ' G LA f(A PHONE 0g — [_ / TIE7 IL STREETAD SS �Iu�LI� ���„ �� , ~ CITY, STATE,ZIP �U pir 0 FAX 1� 17CONTACT NAME tf J—' �I j? ,/� PHONE 1j0i LI_. LACI Gq0—0• AIL STREET ADDRESS r L�C CITY,STATE,ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# ( FON N�F nAP�2oUFM �., 7 7 (3- COMPANY =COMPANY NAME E-MAIL FAX STREET ADDRESS /''j'C/I n,h �/)r 64A CITY,STATE,ZIP 91 r CP- l cl l� P P CIO_ 3 V"( ARCHITECT/ENGINEER NAME/' I/ LICENSE NUMBER J BUS.LI # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP li q V 6 PHONE DESCRIPTION OF WORK LC jyN/ (�'T(f k©efy) Mo &L l IO G 9s F � T /( Fop ill),q, Il `� 1 EXISTING USE PROPOSED USE CONSTR TYPE #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: 0 DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? []NO ADDITION? FIND PRE=APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED 8y w-F qua^�4.'. TOTA ATION: PLANNINGAPPL# ❑NO PLANNING APPROVAL LETTER EICHLERHOME? ❑NO �:� wx 111 i ''. i is ,*p�,. d�'n. By my signature below,I certify to each of the following: I am the property owner or authoriz d agent to act ro owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work en it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building con cti orize representatives of Cupertino to enter the above-identified/p►ropertyy for inspection purposes. Signature ofApplicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED . .. ... New SFD or Multifamily dwellings: Apply for demolition permit for Buu Dmf PIAN it yiEw ` OVE $ECOUNTER �� L existing building(s). Demolition permit is required prior to issuance of building -` R �nnh n4 permit for new building. Exps � � 0 PiaN iNCPLAIVTiE gd 1 xro-�fi _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 5:� annARn �nWN L14PUBLIGwoRKS form if any Hazardous Materials are being used as part of this project. � � � „t £, I `,{I aLLJFIREDEPT' Copy of Planning Approval Letter or Meeting with Planning prior to �� r , �'ul � u� ��� W. © SANITARY SE RDISTRTCT submittal of Building Permit application. ,N. ; ?.paa31X�`„Y ;�y�"t ` `' i•^ ,LArkNVIRONMENTLLAI."HEALTH` BldgApp_201 1.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 5927 sutton park pi DATE: 05/13/2014 REVIEWED BY: Mendez APN: I BP#: *VALUATION: 1$10,000 RPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY PENTAMATION 1 R3SFDREM USE: SFD or Duplex PERMIT TYPE: i WORK remodel hallway bathroom 50 sq ft to include M E P's SCOPE .pbelnb,Marl M,,-mit Fee: PZt"MI). Permit Fee: C?ther'Plumb Ms`n. C}t,'t2t �tet.It st snit. {ze: T lunth Insp. Fee. Elec.Inst l NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These&es are based on the prelimina information available and are only an estimate. Contact the Dept./or addn'l info. FEE ITEMS 6Fee Resolution 11-053 E . 7ff /1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 50 s.f. Remodel,Bath(<=300 sf) Suppl.PC Fee: Reg. ® OT 0.0 hrs $0.00 $626.00 1REWESBAT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Feer Reg. ® OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 on I av: iratttrri. r cri p°c>l et:: 0 Work Without Permit? ® Yes (F) No $0.00 G Advanced Plannin&Fee: $0.00 Select a Non-Residential G Building or Structure 0 %1'itt'z'-1 1. {)C'?;7r,E.'Yf1idP7t?I? Zees: A Strong Motion Fee: IBSEISMICR $1.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 71 X54: $2.00 $626.00 TOTAL FEE: $628.00 Revised: 04/01/2014 Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LTST., JOB ADDRESS: n PERMIT# OWNER'S NAME: VHONE# GENERAL CONTRACTOR: Ytu 4 flpg IPWISINESS LICENSE.,# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A'"CITY OF CUPERTINO BUSINESS LICENSE. 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