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B-2016-1468 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT O:B-2016-1468 7480 ROLLINGDELL DR CUPERTINO,CA 95014-5813(359 31 061) GRAND-NEST CONSTRUCTION SARATOGA,CA 95070 OWNER'S NAME: CHATTANATHAN GURUVAYURAPPAN AND GURUVAYURAP DATE ISSUED:05/05/2016 OWNER'S PHONE:408-506-6658 PHONE N (408)891-8059 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic.#965419 Contractor GRAND-NEST CONSTRUCTION Date 09/30/2017 X BLDG —ELECT —PLUMB I hereby.affirm that I am licensed under the provisions of Chapter 9(commencing MECH X RESIDENTIAL_ OMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: CONSTRUCT(N)SIDE YARD ADDITION(245 S.F.) I hereby affirm under penalty of perjury one of the following two declarations: 1.. 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 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. Sq.Ft Floor Area:490 Valuation:$40000.00 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 APN Number: Occupanc Type: and state laws relating to building construction,and hereby authorize 359 31 061 R-3(Custo ) 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 PERMIT EXPIRES I WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS F PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature IQ d�1Pr�J //l Date /55 /2016 Issued by:Abby Ayende Date:05/05/2016 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: - following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. I,as owner of the property,or my employees with wages as their sole installed withoutfirst obtaining an ins-,ection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for spection. sale(Sec.7044,Business&Professions Code) z. I,as owner of the property,am exclusively contracting with licensed Signature ofApplicant: contractors to construct the project(See.7044,Business&Professions Code). Date:5/5/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. 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. HAZARDOUS MATERIALS DISCLOSURE z. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cup rtino Municipal Code,Chapter 9.12 and the Health&Safety Code,Section 2 532(x)should I store or handle hazardous 3. 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 material. Additionally,should I equipment or devices which emit hazardous air contaminants�as defined by the ay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the upertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health-&Safety Code,Sections 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall / be deemed revoked. Owner or authorized agent: f 9a/ � �J /9�- APPLICANTCERTIFICATION `"Date:5/5/2016 certify that I have read this application and state that the above information is CONSTRUCTMN LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a consi ruction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal AR T'S DECLARATION Code,Section 9,18. L understand my plans shal1l1 bbe e a us d as public records. Licensed Signature Date 5/5/2016 Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION 10300 TORRE AVENUE 4 CUPERTINO,CA 95014-3255 (408) 777-3228•FAX(408)777-3333•building aQcupertino.org CUPERTINO ❑NEW CONS'T'RUCTION eADDITION ❑ ALTERATION I TI ❑ REVISION/DEFERRED O GINAL PERMIT# PROJECT ADDMS 3�) ( I/®1� L) ��Ir�.I� G D SGL '� � + l„J� OWNERNAME v C"-T-t'A„W wr"*N PHONE E-MAIL STREET ADDRESS {? ?ta Lg_t"4 D 1F�—L t_ PR CITY, STATE,ZIP C�p�� )8�} � e AFAX aro r CONTACT NAME PHONEaa�r `\ �[� - E• �[ STREET•ADDRESS CITY,STATE,ZIP FAX ❑O}t-r,,ER ❑ omgER-BUII.DER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ARCETTECT 0 ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSENUMBER LICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITE•CTIENGINEER NAME �� fi LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK i i EXISTING USE PROPOSED USE. -CONST T1TE #STORIES USE. TYPE CC. SQ.FT. VALUATION(S) 5` /&'�h/// 1�l / °I _ EXIST(3 WFLOOR DEMO TOTAL AYlf AREA r?i/�� AREA G �- BATHROOM KIIT'CHEN OTHER V REMODELAREA REMODELAREA [) REMODELAREA - PORCH AREA DECKAREA TOTALDECIUPORCHAREA I GARAGE AREA: DETACH do 6 []ATTACH #)wBLLINGUNITS, IS A SECOND UNIT []YES SECOND STORY ❑YES BEING ADDED? 0 ADDITION? re0 PRE-APPLICATION ©YES IFYES,PROVIDE COPY OF IS THE BLDG AN �"❑YES , : _IVEI?BY'" 's- '�== _ -=.� TQTALVALUATIQ}�j• PLANT SMGAPPL# WNO PLANNING APPROVAL LETTER BICHLERHOME? By my signature below,I.certify to each of the following: I am the property owner or authorized agent to act on the propert}i ow'ner's behalf. I have read this application and the inforniation T have provided is correct have read the Description of Work and verify It is accurate. I agree to conlply with all applicable local ordinances and state laws'selating to building constro n. I authorize representatives of Cupertino to enter the above-identi ed property.for inspection purposes. Signature of ApplicandAgent:: Date: SLIPPLEALEIdT ATIONRE UTREI3 x<--= Q CAECK:TPPE,,.""-„,� _ New SFD or Multif ly dwellings: Apply fol•demolition permit for �❑ -01 ER THE COU\TER I �BUILDI\G�LA13tE]it w existing buildin,(s). Demolition permit is required prior to issuance of building r = t T•344Y permit for new building. 1] 1xEss PL41\Ie\G PLA1t REY�IESi. _ Commercial Bldg Provide a completed Hazardous Materials Disclosure �sT�\DARD r i ❑PUBLIcwORhS form if any HazardousMaterials are being used as pall of this project. - t ❑_`SIRE Dt rT �..❑ LARGE `' o _ Copy of Planning Approval Letter or Meetinga with Planning prior to Iyifi 1{11t_ � ❑ SA_\ITAR]SE}}ER DISTkICT submittal of Building Perruit application. }-i _:,: ....... -:; __=j- ❑-.:E.\}'IRO\AYET,TALIIEALT73_= _:_- B1dglpp_.2011,doe revised 06/21/11 CITY OF CUPERTINO -� FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 7480 ROLLINGDELL DR DATE; 03104(2016 REVI WED BY: PAUL APN: 359 31 061 BP#: *VALJATION: 1$40,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY :2nd Unit? Yes No PENIAMATION $FD or Duplex 1R3SFDADD USE: OTC? Q Yes Q No PERMIT TYPE WORK CONSTRUCT N SIDE YARD ADDITION 245 S.F. SCOPE TYPE OF FLR AREA OCCUPANCY TYPE: P FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3(Custom) II-B,111-B,IV,V-B 245 $1,091.00 1 DDPLC'K $1,057.,00 1ADDINSP i I TOTALS: 245 $1,091.00 $1,057.00 MEC011-1 0- KEY Yes, No PLUIVII3�HOUI2L ' Vit;dos o N , KLEC,�HQV Yep �No !%a a Cheer; i :ISC✓z7. i'.*`itt i 1`f:s"•. �'iu=ml8 11£,rxil Pea: F;, �. t 3C?i'ie3J%IBL. Li0%ber rif�,'. Imp, � A'k- rh.lay fief:, lswk f€:.. 1"'ec.tn.51. Fee: NOTE:This estimate floes not include fees(hie to otherDeparinzents(i.e.Planning,Pablie Works,Fht Sanitary Sawer District,School District,etc. . These ees are Lased on the prelindua in ormatiotl tzva laLle and are ortly an estimate. Cozztact the De t or afldzz'1 liz o. FE I,ITEMS JI=ee Resolution 11-053 Ef. 7/1/13, FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,091.00 Select lviiscBldg/Structure Suppl.PC Fee: (F) Reg. 0 OT 0.0 his $0,00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $1,057.00 SuppI.Insp.Feer Reg. 0 OT 51 his $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 iarY?t7'77:ti13"e.1fFY`c.''1`a.'s.': 0 Work Without Perinit? 0 Yes (j) No $0.00 ' G Advanced Planning Fee: IPLLo1VGR $34.30 Select a Non-Residential M l l,:,.. Building or Structure c atl ter €kn i Strong Motion Fee: IBSEISMICR $5.20 Selec an Administrative Mein Bldg Stds Commission Fee: 1BCBSC $2.00 St�ETOT $2,189.50 $0.001"' :. oTa .FEE $2,189.50 Revised: 0110112016 FILE SC Oesign Group,. 203:70 town Center Ln. Cupertino CA,95014 Project:7480 ltollingd11 Dr.Cupertino, CA: The epoxy holdowh/anchors where installedper given documentation Cation provided by SC Design` Group.The current set anchors and holdowns are set With SET-XP EPDXY ata proper depth into the<E> concrete foundation. please feel free to contact my Firm for any further questions regarding the project. Zuishuahg Che SChen. , ter �tom. x. d ^ EN ,.� �"9„01t ID III; .