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14080210 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10332 SCENIC CIR CONTRACTOR:TBD-TO BE PERMIT NO: 14080210 DETERMINED OWNER'S NAME: MANICKAM OLAGAPPAN AND TRILOCHANA DATE ISSUED:08/20/2014 OWNER'S PHONE: PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL F] �1 l' LOWER LEVEL BATHROOM REMODEL(69 SQ FT); UPPER License Clas1s/ Lic.# Z" 6 4 4 3 LEVEL BATHROOM REMODEL(82 SQ FT). Contractor V(n�',v_va 2lw t.64AJJ Date p�2 0 –6 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:$14500 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:35707006.00 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 accrue against said City in consequence of the c� Date: 4/.oO .1440,granting of this permit. Additionally,the applicant understands and will comply Issued by: �j with all non-point source regulations per the Cupertino Municipal Code,Section 9 18. RE-ROOFS: Signature Date –Zo –14 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 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 the Health&Safety Code,Sections 25!W5,25 33,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: 2"20 41% 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 9 18. Signature Date /yafa�fa CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT.DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228 • FAX(408)777-3333• building ..cuoertino.org CUPERTINO ❑NEW CONST RUCTION ❑ ADDITION '_�ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERI\4IT,? PROJECT ADDRESS 1 ®-�3 S G� \ Q PPN R i��� !/ 7 . �Q 6 OVJNERNPME ` �Gi �� C,�� 1f11 � P'�IOI�'E �� O I E-MAIL STR_=1 ADDRESS CITY, STATE,ZIP FAX ;W'0 3Z tt CONTACT NA✓F PHONE E-MAIL STREET ADDRESS I CITY,STATE, ZIP I FAX ❑ oA=, ❑ OWNER-BuiLDER ❑ OWN'ERAmmrr ❑ CoxrrRACTOR ly CONTRACTOR AGENT ARCHITECT 13 ENGLALR E3 DEVELOPER ❑ TEN.,.NT ON'1'itACTOR NAME �A I LICENSE NL'%-'bER I LICENSE TYPE I BUS.LIC' COMPANY NAME ti n v E-MAIL �) ® '_ t'�2 ^ STREET ADDRESSCITY,STATE,ZIP PHONE 1133 S siI v�, Q- t.. IVJ0d� Ch ©0 -5 21`4 ARCHITECTIEENGIWEER NAME I LICENSE NUMBER BUS.LIC COMPANY NAME E-1,4AIL FAX STREET ADDRESS CITY,STATE,ZIP- I PHONE DESCRIPTION OF WORK c.ckikr42 V Ur.-OM 40w4tl%:NS re.'Gccz� F0iI Vc", , wGa hS � iA 4iv� S�O Ir•P�^ f\r a �c-11�a1Lp3 G\^� e 12 0,s- C C,A VG\h; i +" (2 (00At EN[ISTING L'SE PROPOSED USE I CONSTR TYPEREFS USE TYPE OCC. I SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEN40 TOTAL AREA AREA AREA NET AREA VS BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA I REMODEL AREA PORCHARE.4 DECK AREA TOTALDECKIPORCH AREA GARAGE AREA: DETACH ATTACH DWELLING LIMITS: IS A SECOND L?NIT ❑YFS SECOND STORY EYES BEING ADDED? ❑NO ADDITION? []NO __pR_rFPPL-ICA_7ION-0l'-&S-1z-�,ES,_pROSIDEtOP]'_nF �$$ EBLDG:LN 171 YES E i - - TOTS.L\%ALU.4TION: PLANNING ADPL 9 ❑NO PLAN'NrNTG APPROVAL LETTER I EICHLER HOME? I]NO u By my signature bolo»',I certify to each of the following: I am the property o-%,mer or authorized asent 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 apee to comply,,with all applicable local ordinances and state laNvs relating to b ing c .struction. I authorize representatives of Cupertino to enter the above-identified propenT for inspection purposes. Signature of ApplicantlAgent: Date:44 SUPPLEMENT OR.MATION REQUIRED VW - lA�CH CiZTIPE z. ..x ROUT:I�GSLTP _ New SFD or Multifamily dwellings: Apply for demolition permit for 3 -IM.; 03 ERICOUNTER s �1� EllBTJILDIIGPI iR REkT existing building(s). Demolition permit is required prior to issuance of building J — — permit for new building. �❑E Ta - rwjt � ❑ plNn���L 3 � ` ti; _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure .S' uBLIc moi IpsNE form if any Hazardous Materials are being used as part of this project. T _Co of Planning Approval Letter or Meeting with Planning prior to YZ PY � PP submittal of Building Permit application. Bldogpp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10332 Scenic Circle DATE: 08/20/2014 REVIEWED BY: Sean APN: BP#: "VALUATION: 1$14,500 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1 R3SFDRE WORK Lower level bathroom remodel 69 sq ft); upper level bathroom remodel 82 sq ft). SCOPE 1,kc,.1 i",SFr k 1111wrh. Plan f� l' hcu Fa r<„1.. Pt>t',11iI/ee' Psti Plumb. PE r 1w, ',.. . W e=eY,. I ri;°r. of/w;'Piumb oilg('-r/ <:. /n F-. I"yhind). /(up. Fee: NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn7 info. FEE ITEMS (Fee Resolution 11-053 Eff.' 7/1/13,) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 151 s.f. Remodel,Bath(<=300 sf) Suppl. PC Fee: Q) Reg. 0 OT 0.0 hrs $0.00 $645.00 1REMRESBAT PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? 0 Yes (F) No $0.00 E) Advanced Planning;Fee: $0.00 Select a Non-Residential E) 1 i Building or Structure 0 Strom;Motion Fee: IBSEISMICR $1.89 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 4, � SBOTALS'k;r $2.89 $645.00 TOTAL FEE: $647.89 Revised: 07/10/2014 Building Department City Of Cupertino LM 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 LIST JOBADDRESS: fin; CPERMIT# OWNER'S NAME: utl a iq C Ecu r PHONE# b0 (1.7 4 21 GENERAL CONTRACTOR: JU 6,KJSINESS LICENSE# G 4 3 ADDRESS: 3 i.n - 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 INSPECTIONS) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. O ^ z O + ' I am not using any subcontractors: o Signature Date Please check applicable subcontractors and complete the following information: r/ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date PROPOSED PLAN - BATHROOM 1 DOWNSTAIRS Shower pan Toilet 36" Vanity with 1 sink 10332 scenic cir, Cupertino �N Washer Dryer Utility sink INCA sink Building Dep,, rtment ! AUG 2 0 2014 REVIEWED rOR CODE COMPL ANCE Reviewed By: jam, COMMUNITY G D ' DEPARTMENT Garage BUILDING G /IS!0N'-(GUPERTINO OFFICE C ()�!✓� This eft of plans and s ,pclfications MUST be kept at the c, iri !c iSlr�:cti._-,,�. it's un! ^Jfui to rriai:e any job c; ore! 7� me,or to dcvia;e thNi`Gii"ot5l,wici,out a, -,,.-,val frarn the Building ofdcial. Tl or hl, p ;n c 1r, .. 1Vfi CJc..TSoi^ SHALL NO T RECEIVED . I !ofLff`invfo �liori oti te Law. , an,ypro\I^lotsof nyC - ; la t By AUG 2 0 2014 WJE PEWAI T NO. /�1 G lJ l6 �.•.— �Y Toilet Washer Dryer 73.5" Vanity with 1 sink 138° EXISTING PLAN - BATHROOM 1 DOWNSTAIRS 10332 scenic cir, Cupertino VV C,FC-L- Toilet CjFCi ' Single vanity with 2 sinks S marts° Le D J Closet Tub X Go`` EXISTING AND PROPOSED PLAN - IDENTICAL - 2ND FLOOR BATH 10332 scenic cir, Cupertino