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B-2016-1190 Permit, App, Fee Est, HOA LetterCITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1190 10737 PAR THREE DR CUPERTINO, CA 95014-4025 (356 07 041) ( S I K GROUP INC ) SANTA CLARA, CA 95050 OWNER'S NAME: VINODKUMAR MAMPATTA V AND ERINGATHODI GEETH (DATE ISSUED: 01/l4/2016 OWNER'S PHONE: PHONE NO: LICENSED CONTRACTOR'S ]DECLARATION License Class Lic. # I o0 t645 Contractor (S J K GROUP INC) Rate 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. hereby affirm under penalty of perjury one of the following two declarations: r. 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. z. 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 'comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Date 'I/ �41 hereby affirm that I am exempt from the Contractor's License Law for one of the snowing two reasons: r. I, as owner o£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) z. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). hereby affirm under penalty of perjury one of the following three declarations: r. 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. z. 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. s. 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, 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. PERMIT INFO: ELECT —PLUMB X RESIDENTIAL _ COMMERCIAL DESCRIPTION: on Remodel (130 SX); Remove (E) slider door at kitchen and enclose; we 2 non load bearing walls (80 S.£) Sq. Ft Floor Area: I Valuation: $18000.00 APN Number: 356 07 041 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. 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. ALL 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. Owner or authorized agent: Date: ' TR CTION LE G F.NCY 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 Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. 2 CUPERTINO I-1 NEW CONSTRUCT ON CONSTRUCTION PERMIT APPLICATION COMMUNI 7 DEVELOPh/TENT DEPART10ENT BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINC, CA 85014-3255 (408) 777-3228 • FAX (408) 777-3333 - buildinc(dcuoerliro.orG I. J ADDI T ION . AL -ER ATION / TI M R'1V1570N / D;757!Z LD ORIGIN e1. PF-iZI✓, tV PROTECT FDDRESS F'PN - 356 ©e 041 a t/1 ONNER NAi� e�frti ,mod I ?HONcC �1Jri - - I:•1✓JJL STREET f.DDRESS b CST Y, STATE, ZTP FAX CONTACT NAME PHONn N..kiL 40b'--")g1 -3 G�ro+ctl c�J' W1o1i I. tar STREcf fDDR_SS >QSS 1 Cr-1Y, STATE, ZiPSA� %<f FAX 01lTcR El. OqT-R-3L3DEB ❑ OtiTZ, RC-*T•r V-COh,�i✓,CTOR ❑coRnz�r, oR AGrrrr Q /.RCF4r CT Q-n`Gn ❑ D1=LOFT ❑ T:NF.h'I CONTRACTOR NAVE'SkA r- I LICENSE NUbtSER I 1,1C=.SETYPR BUS. LiC r: COI,IP/.NY LL-- GwVtA � I FAx �C t' • TLL I S4-yafl.Cdh STREET ADDRESS I C esj Ake '� CLY, STAic, Zit 94n� Chfq, `;4- PHONZ AP.CiETECifrNG,T°PrR MANE I LICENSE A°�TGER I BUS. LIC9 srL COMPANYMWIS I EN.f�L I FAX STREET /DDKESS I C1T, STATE, ZIP I PHOTT -- DESCRIPTION OP' WORT: a?� ain toc(aS- wail_ 0 19CiWL-/ pJC, � -- pen Oq Il W WE . EXISTING USE FROPOSED JIS CONSTR. i1Pc ES70TUEc -- USA IYPB OCC. SQ.FT. I VALUATION(S) G R NEW AREA).REAFLOOR INEE AREA GIY=R 1 TCODE BAi0DELAREA Rm,10E-L A. MODE RA '.ADEL FRE.A /3D S PORCH/AREA DECK A?�A TOT.1 D'CK ORCi: 11E A ' - GJ RACE /v'`E.S: DIT C•i S ❑Ai T.4C'.i �— ,".DV�1Li1JG GATT S: IBA CECON➢UNiC ❑YES SECOND STORY ❑1_S BEING ADDED? ENO I ADDITION? ❑NO pRZ-eon,cCf±ON ❑YES 7 YEE, PROvmE COPY OF IS THE BLDG AN ❑) TOTALV¢DU.g110N: PLA.M0 VPLm ❑NO I EICHLER-nma? El By my signature below, I certify to each of the folb'e•ing: I am the property ot;ner or authoriz_ agent to act I e e; y owner's behalf, I have read this aoDlication and the information I have provided is core I have read the Description of Work End verify curate. I agree to comply with ell applicable local ordinances and state laws rel Etins Yo bb Ildin,, cc Strucoon. I authorize represen-tives of CL'ye.rtino to enter the above-ident!5ed pro/party for inspection purposes. Sivature ofApplicEWAgent: f/./�i-.///S�- Date: I l l I b SLYPLEMENTALiNFOR-M, a QUIRED -- -- - `- - New SFD or Mulilf«+iiy dwell,�gs. ADp!y for Laroht,o-r, pt,;t for Demol+tion is ._ _- DY rtSCOLkrrq -. ---- _ z= `� '• h'5L'rJ�`'DL\GPr nA zZR1.> a.=_ existing bnilci:rg(s). pe,-±rt :eau red prior to ±ssu s'?ce Di 6Lflu± P e-*rt for DeW buiiding. r x � Pk.AEaS � ;�>`�� -z --- - PLS'CN-rl)rYLz vrF1E�l3 �. _ Corm- er ial Bides ei- zao,uN Provide a comolAd ds atenzi, Discos Kr _ .l if F_-±y, Hazardous Materials c:a LSed as part of this Ur Oj--ct Copy of Plann ing Approval Letter or NQeeun,,,iS Pl= =ng prior to ,:ubnrilal ofBwlding Pe.nita plication ICTRrCT __E» ii S_z 'gs_ `G`•11s ±i'1 F�`�'i.�-y �tiG1l .................... i1_T Wig, B1do4PP_2011. doc revised 06121111 CITY OF CUPERTINO 5-;06- uqo FEE ESTIMATOR - BUILDING DIVISION 10737 Par Three Drive DATE: 01114/2016 REVIEWED BY: jaiADDRESS: APN: 356 07 041 BP#: 1$18,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD OY Duplex p PENTAMATION 1 R3SFDRE USE: PERMIT TYPE: WORK Kitchen Remodel 130 S.f. ; Remove E slider door at kitchen and enclose Remove 2 non load SCOPE bearing walls (80 S.f.) .Aleclr. P/an Check Plunih. 111cm Check piec. N w Check &lach. Perffal I er: l'iunrh, Porria F'ee: Eir:c_ 1'erirrdt i'�•e: OlttcrPifinbCarp. 0thar1 e, hisp, Ejiiiheritkuh.ln.,p. :Ifech. Inq). lea: Pli?nib. Lisp, r ee; 1vta,- lrtp_ I o"', NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School n;"i ;,f ei, 1 Th.,, lone n -, hac,d an )hn nrntiavinnry infnrsnniinn availahle and are onlv an estimate. Contact the Dent for addn'l into. FEE ITEMS Fee Resolution I1-053 Eff 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 180 s.f. $645.00 Remodel, Kitchen (<=300 sf) IREMRESKIT Suppl. PC Fee: (D Reg. C) OT 0.0 hrs $0.00 PME Plan Check: $0.00 80 s.f, $431.00 Remodel, Other IREMRESOTH Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. O OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Adininistraliv Fee: 0 G Work Without Permit? ® Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 Dade/ Docu r7entwion Fees:� Strong Motion Fee: IBSEISMICR $2.34 Select an Administrative Item —� B(d Stds Commission Fee: IBCBSC $1.00 SUBTOTALS:[ $3.34 $1,076.00 TOTALFEE- $1,079.34 Revised 01/ 16 JAN 14 2016 Fairway VII Homeowner's Association REF: Vinodkumar Residence 10737 Par Three Drive You have Fairway VII Board approval to proceed with the remodel as planned. Please note that this is primarily to check for visible/aesthetic effects on neighbors, etc. and does not cover building codes, safety, workmanship, etc. You will need permits from the City of Cupertino to cover this. Matt Schwiebert Fairway VII President January 13, 2016