15050144CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21067 RED FIR CT
CONTRACTOR: H & J CONSTRUCTION
PERMIT NO: 15050144
OWNER'S NAME: MANISH & ASHWINI MAHAJAN
14938 CAMDEN AVE #111
DATE ISSUED: 05/22/2015
OWNER'S PHONE: 4088071195
SAN JOSE, CA 95124
PHONE NO: (408) 561-5156
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL 0
z
BATHROOM REMODEL (56 SQ FT); REMOVE AND
License Cl Lic. N -
RELOCATE
FURNACE/A/C/TANKLESS WATER HEATER; REMOVE
Contractor
AND
i hereby of trm that I am licensed under the provisi ns of C apter 9
REPLACE (2) SLIDING DOORS; INSTALL CIRCUIT FOR
(commencing with Section 7000) of Division 3 of the Business & Professions
EV.
Code and that my license is in fall force and effect.
1 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
nsation, as provided for by Section 3700 of the Labor Code, for the
Sq. Ft Floor Area:
Valuation: $60000
ce of the work for which this permit is issued.
yrninv"e-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
pert it i issued.
APN Number: 35905020 00
Occupancy Type:
APPLICANT CERTIFICATION
��K,y
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
%y
granting of this permit. Addifonally, the applicant understands and will comply
Issued by:,� Tl Date: / )
with all non -point source re tattoos per the Cupertino Municipal Code, Section
9 18.
f
RE -ROOFS:
Signature Date I
All roofs shall be inspected prior to any roofing material being installed. If a roof is
ll ,
installed without first obtaining an inspection, i agree to remove all new materials for
inspection.
ElOW ER-BUiLDE ECLARATION
Signature of Applicant: Date:
1 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
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. 1 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 ofthe 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 74550 25533, and 5534.
is issued.
Owner or authorized agent: Date:permit
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
CONSTRUCTIO 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
Leader'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
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
1 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
CI'T'Y OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
,k +
ADDRESS: 21067 RED FIR CT
DATE: 05/22/2015
REVIEWED BY: SEAN
0P;�ERMIT
APN:
BP#: �Q ��
-VALUATION: $60,000
TY PE:: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY Multi -Family Dwelling
USE:
Buildina is
1 >3 Stories Q Yes Q No
PENTAMATION 1 R2REM
PERMIT TYPE: A
WORK
BATHROOM REMODEL 56 SQ FT • REMOVE AND RELOCATE FURNACE/A/C/TANKLESS WATER
SCOPE
HEATER; REMOVE AND REPLACE (2) SLIDING DOORS; INSTALL CIRCUIT FOR EV.
,k +
Mech. Plan Check0.0 hrs $0.00
! hI .oih ! !fm (7w" r
Elec. Plan Check 0.0 hrs $0.00
Mech. Permit Fee: IMPERILIIT
1 iu+ir; . !',.v,-arr% I ,rc.
Elec. Permit Fee: IEPERMIT
Other Mech. Insp. 0.0 hrs 1 $48.00
r1r!r : ;'r'++, ,:, /Ifs 'v
Other Elea Insp. 0.0 hrs $48.00
6ir•/.Ir i.V'. i'. ,..
l'lunrh. 1;�,�%. 1•?-,
laec. !r, s�>. I•'<<::
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 prelimina information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Efl' 711.!13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
F756 . s. f.
$645.00
Remodel, Bath (<=300 sf)
IREMRESBAT
Suppl. PC Fee: 0 Reg. Q OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
2 #
$431.00
Window / Sliding Glass Door
1 ii.viNREP 7 Replacement
Permit Fee:
$0.00
Suppl. Insp. Fee:Q Reg.
Q OT
0.p
hrs
$0.00
0 # Mechanical
$143.00 1MFR=<100 Furnace, Forced -Air
PME Unit Fee:
$0.00
PME Permit Fee:
$96.00
0 #
$72.00
Mechanical
IBREMAIR A/C Units (<=I OK cfm)
ur:,r rac !i[nr 1:r.:
Administrative Fee:
(ADMIN
$45.00
1 #
$143.00
Electrical
IBREMNIISC I Special Circuits
Q
G
Work Without Permit? Yes (E) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
G)
A
Travel Documentation Fee: ITRAVDOC
$48.00
Strong Motion Fee:
IBSEISMICR
$7.80
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$3.00
SI7BTOTALS "",
$199.80
$1,434.00
TOTAL FEE
$1,633.80
Revised: 05/07/2015
7�,3 . `,0
COMMUNITY MANAGEMENT SERVICES
May 5, 2015
Manish Mahajan
21067 Red Fir Court
Cupertino, CA 95014
Re: Cupertino Roundtree HOA
Dear Manish:
This letter is confirmation that the association has received your application for the following
modifications to your home as stated in your application and subsequently clarified throughout
exchanges of ernails between you and 1: interior remodel to include an additional bathroom,
installation of a mini -split heating/cooling system, microwave oven installation, tankless water -
heating system installation, replacement of two sliding doors, sun -tunnel installation, and
installation of exterior electrical outlet for vehicle charging.
Please note the conditions placed on the approval given for these items are described in the
emails we exchanged between March 23, 2015 and April 23, 2015 and hereby made part of this
approval letter.
Thank you for the detailed supporting material accompanying your application.
Sincerely,
ROGER WERT
Association Manager
cc: Board
File
1935 Dry Creek Road, Suite 203 Campbell, CA 95008-3631 voice (408) 559-1977 fax (408) 559-1970