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15120035-D
�C�`�'�' �]E'+ ��7�]C+]���1�� I��TIDL��l�t�l�lE]E�1D�[�7[' BUIF,DING Al)DRESS: 20085 NORTHWIND SQ CONTRACTOR:VARGAS PERMIT NO: 15120035 CONSTRUCTION OWNER'S NAME; MALUNJICAR SAN7AY C AND KOTHULE JAYA 664 RED ROME LN DATE ISSUED;12/04/2015 OWN�R'S I��NE: 6505213938 BRENTWOOD,CA 94513 PHONE NO:(925)437-9468 � LICENSED CONTRACTOR'S D�CLARATION JOB D�SCRIPTION:RESIDENTIAL � COMMERCIAL � � / �1VS'd'r�g,I�5 SK�'lL��]E�'�'S Al�I�4 S�]LE4ll�'�'�J�ES License Class `�r���_ Lic.# ���� �/L� Contractor����� �'6���s�a�`� ate'�/� ��"�� Y hereby affirm that Y am licensed under the p�isions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Frofessions 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 maiiitain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labar Code,for the formance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$2000 ' b haae and will maintain Worker's Compensation Insurance,as provided for by . Section 3700 of the Labor Code,for tlie performance of the work for which this APN Number:31638009.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is ](�]E]��][][�]E�][�+��]['+ ��]�][�1��� ��1����E� correct.I agree to comply with all city a�id county ordinances and stafe 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 g�������+'����,f������,�������+�����o mdemnify and keep harml he City of Cupertino against liabilities,judgments, � ���a,��� costs and expenses whi � y accrue against said City in consequence of tlie gssued b V VVr-��� I�ate: � grantmg of this permi. itioiia l�i�-a phcant understazids and will comply 3'�� with ali non-point s r g �on Cupertino Municipal Code,Section _ 9.18. � � RE-ROOFS: Signature Dat��� ' 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. ❑ OW. -BUILD�R D�CLARATION � 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 properiy,or my employees with wages as their sole compensation, _ will do the work,and Uie 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 HAZARI)OUS 1VIATERIAL,S DISCLOSUR]E 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)shoul I store or handle hazardous I have and will maintai�i a Certificate of Consent to self:insure for Worker's material. Additionally,should I use equip t or devices which emit hazardous Comp.ensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay A Air Quality-NYanagement District I performance of the worlc for which this permit is issued. will maintain compliance with the Cup i o M� icipal Code,Chapter 9.12 and I have aud will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections� •,25 Section 3700 of the Labor Code,for the erformance of the work for which this �`� ' � p Owner or authorized agent� IDate: �-" permit is issued. -� � / I certify that in the performance of the work for which this permit is issued,I shall nof employ any person in any tnanner so as to become subject to the Worker's CONSTRUC'TIO NDING AGENCY Compensation laws of California. If,after making tliis certificate of exemption,I 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 revolced. work's for which this permit is issued(Sec.3097,Civ C.) Lender's N1me APPLICANT CERTIFICATION Lender's Address I certify that I have read this application a��d state that the above information is correct.I agree to comply with all ciry and county ordinances and state laws relating to'buildiiig construction;aiid 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. gianting of tliis pennit,Additionally,the applicant understands and will comply ' with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Profess�ional 9.18 Sigiiature Date -- ------ G���T'R[�CTIQ� P�f��i1`T A�PLIC�`�[�1� '� CONiI��iUNITY DEVELOPNiENT DEPAR i t��ENT^ BUILDING DIVISION •, �. . 10300'fORRE AVE�UE° CUPERTINO, CA 9�014-3255 r (408)777-3228 ^ FAX(408)7�7-3333 =buildino a(�.cuqerino.ora j �� ,�� � � CUP�ftTit�[�� ❑h�EW CONSTRUCTION ❑ ADDTTiON . ❑ ALTER;4TION/TI ❑ REVISION/DEFERRED ORIGI?�AL PER�viIT� PROTCf a.DDP.ESS �(�jl.! �� � vC��'�"1�� S I APNn � � � .� � ��—� V4� ov,�x xn�,� � . , � �C���'ll� t l.�i� �I pxo� �O� .�'��j� �-T,���, . . ' STREET P.DDRESS , � ,..('yr�— (��` �A l�n ��I C1TY, STATE,ZIP ��'��I��"� � /I Ffy�'�� f ZJ � - V.9-yv r,� � CON'tACT N.44f£ J��V,L� �^ PHONE E-NAII, � �L�..� I I STR':ti ADDILSS CITY,STATE, ZiP r� OWheR 0.O�Rv'ER-BUII.DER ❑ 011fi�AGElv'L � COhTiRAGTOR �COlv'IR/>CTORAGTT � ARCHII�CT �iNGL�c?R ❑ DEI�LOPtR ❑ Ir.I�AhT CONTRACORTTA . I ��'S' TLJ1�Fi3ER I LICEIQSETYPS I BU�IC,; � `- �Q C� !' �' COivlPANY N�� ,�- F-N�AIL P F ,P � �/ ea� ��t � .� � . ,�� - ���-�. . STRE T ADD��'sS CITY STATt,ZIP . '` ' PHO1�B /°�ti L--- �� �G� I � �� ARCHITECTItNGI2�tERNA]fE I LICE1�SEr'U?✓£ER 3US.LIC R GOMPAlh:'Tti'Ah r I E-MhIL � FAX STR.EcT ADDP.ESS I CITY,STATE;ZIP � PHOTIE DESCRiPTION OF WORK j� � � � � S�11 �p yn d'7� � l ������� � � EXISTLNG USE I PROPOSED�JSE I C01.'STR TY''t E �STORT�S USE I TY'PE I OCC. I SQ.FT. I VALUATIOl�(Sj EXlSTG hc.W FLOOR DET40 TOTF.L I hREA ( AREA t RtA � h�hREA '- BAIT�IIt00M KSTCHEls O��R - I I RE1dODEL.4REA REh40DEL AREA REA40DEL.0.REA PORCH ARr'.A DECK kREA TOTAL.DECi;IPOP.CH d.S'�A G.�,RAGE f•.RFF.: DETACH I I I I ❑AiTACH �DVrELLIhGLP.�TITS: ISASE�OI�DUIiIT ❑YES SfiCO:�DSTORY ❑1'ES ( I I I BEIItGADDED? �h0 ADDI'I'IOh? �h0 PP.E•A.D9LTCATIO*I ❑1 LS ]F 1rES,PROVID�COPY OF I IS THB BLDG.iT�' ❑�tS �C�' D BI _ — TOTr1L\%ALU.4TION: PLA�'NR�G.0.PPL R �NO PLkl�'T�G APPROV?.L LTC�R ETCHLER HOME? �?�0 ` '� �' ' --.� : . ._... _—._ , :_ � ._� .., ..».�� ,�,��/ By my signature belo�a�,I certi"ry to each oi the fel �,�ina: I am the propetty o�amer or authorized agent to act on rope,� o�mer's behz . I have read this -- applicztion and the iniormation I hzve prov' ' cor,ect. I have rez � nption of«�ork and veri;y it is zccurz�e. I agree to comply��,�ith ali applicable loc�l ordinances and sfate laws relatin�to bui' n�' a st �o . o ' resenta#ives'of Cupertino to enfer the above-identin"ed prope�for ins ectiqr�gu�oses. S i�ziure of Appl iczndAgent: �__. Date:�� �' ���� - � . --__------_ -- -- _ _�===�=--=_- ���`� ��' ������'��� - �'+�E+ �+ ��'lIl��rI'O�—I��.TIIL��NG ���TISI[Ol�t ADDigESS: 20085 No�fhvuind Sq DA'�E: 12/04/2015 ][BEVIDEWE�]BY; Phuong �; � ' . AIPN: 316.38 009 �P#: "VA�,g1A'�'��1V: $2,000 _... _ _:: �����1vi���'���: Building Permit ���������'�'��'�� Afteration / Repair �]E2�1�][�RY ' �']EN'�'ANgA'd'��IV 1 GENRES �s�: SFD or Duplex �]ERiv��'�'�'Y�E: � w�RK Install 5 sk li hts and 4 solar tubes SC�]PlE £ a � ° z: : s � - � . ., ,:� ,-,..��. �,.�.n.,,� , -.+.,.an. , .„ ..r,u:�S f t .�r..,. .�. .<,,, , .r, E, � ��.�cCF�. r i:,tv£�;.<.�., 1'��?;t:?>, } �� ':r�tg,E,, � � ��i�tc.: e��sar�t..�f;r�t;;'�� , . t<i`2-,t, t�r�i'tid3 / ,t„ .�3f-it:t:i"�. I�.. a-ir�:'f.£>, . �I.-�c'f...3L r.�Tf�'i:i.'. � ��f''��i2i'r�r;;.`t`1=. �7�i`�. ��'��W'i"��tiE€J�ie�1J . ��t;?Es .��_�,..Y<Sj: t, s��.,,. � � ,���E{I�i?3.1 c ':;�c': � 1`��i,'f: �Y ti�r.�, z'f•f': � f��2E:;l. Is"i:t e s.. NOTE:This'estimate does not i�zclude fees due to other Departhzerxts(i.e.Pla�zning,Public Worlcs,F'ire,Sanitary Sewer District,Sclaool District; etc.). Tlaese fees are base�l on tlre relimina infornzation available cin�l are onl mz estimate. Coiatact t/ze De t for dcldiz'l in o. IF�IE l[']C�+I�1[� (h'ee.IZ.e,solaitio�t.1.1-053.F' : 7,'.I/.13) ��+]E ��"Y/�'+]E]E l�J[][S� I['�'�+1�J[S Plan Check Fee: $0.00 � # Skylight Suppl,PC Fee: €. Reg. � OT 0.0 hrs $0.00 $788.00 1SI�YL>IosF > 10 s.f. � PME Plan Check: $0.00 Perinit Fee: $0.00 Sup�l. Insp.Fee;t�; Reg. � OT Q,Q hrs $0.00 PME Unit Fee: $0:00 P1VIE Permit Fee: � $0..00 6'� q J g ��...�If�:>Ft��6i�t.f�rl�i I.�'[. - . . .lh.3.�f�::Fj=fY�:t£f .i�£�Y�� �'.F3:."�. � . . . � . .. � . � Work ViWitliout Permit? � Yes �ej No $0.00 � Advanced.I'iatlnin �'ee: Select a Non-Residential ��_ $0.00 t� � f 5 , Building or Structure � �.f.P`!dn•`�'..'t�a.�rlt:l.s`i's7f1�7�!d�TFj���`G'L'S: � � � � � � �t��oia�NI:otioxr�'cc: �BSFISMICR $0.50 Select an Administrative Item S1d17�tds Commissian Fee: IBCBSC $1,00 .;. < E� t F . " .. �y� ��T�'�'�'�'A�,s �1.50 �7 . . (S> � �.3 � t ,..,.�: ' .sr..� .�"; . 88:00 �4���]���E]E $789 50 , . � ,... ��� . .,,.� _ y�. .,a� _ .�... . __ ._. .,... __ Revised: 10/01/2015 �-.<. , .o-�. I ��[�����Q�l� �Co� ���l��f�� ����C���`�n��l �����`����� � ���8� ������ ���� 1"his �orrn mus� �e corrrpleted and submit�ed �ar review by th� Grounds and Architec�ural Commit$�ee and ap�ro�a9 by the �ma�d of �irec�a�rs before commertcer��r�t e�� a�y �rop�r�y modifica�ion� whi�� �no�u9d resulfi in: 41) a change in th� exterior ap�earance of the unif, or (2) affec��h� s�r�ct��al i�ate�r��y�f fhe b�ailding �r��crea,s��ire s�fe�y cod� r�quir�¢�nent�. Comp6�taon of this ��r� @s n�t neces�a�r far ins�alla�ion ofi: air condi�ionin� uni��, r�placement windows or sli�in�rs, ��r��e doors, and sa4�lli4e-di�h r�ceive�s. llse a ������� �i��uf�u���a�� �l��uffa���u�uv Yor fih� i��a�s listed abov�. Any ofihea� modifi�fions req�aire compl�$ion ar�d submi�sion of this���rrt. �l�as�Pa�e�a� Horneo�►�oer � i�a�e(s): ���..�".�� ��� ��-�,. � �'��,�,,��. �_.��_ -, t i �, p Y r � � �, Address: -t,r t �� � ��� ��'�� Phone: � ..� �) � �--,� � .� �� /�ip(JIfCr�it90Q1 Da�L': PI�B�B1�C@ COPY➢�0�$90C1 D2i$@: �� �pii.� �� Deseriptior�o�iodification�s): � ' � �- �`'` � 4�� ' ��7�- � @ � ' ��`� � �"�•�"� r� � � ,Lm-- 5 � � � � V` �V� ���" ' 1 � � � � 1 � � � tl� � � + � �/ f � �CT ���� �-- �� � f%� ������� ' �.� g.�� ..�-:T. � � /l� 1 � ` �,,,�)4„� rb �� ���.-,��`�.'�"� � _Y� , , � �/ � �� � ���-�=' � �;.�� ���`�. �' �.. � � �- � � � � �� � � � Please lP1�IUCTIQ;, B� �0�56�fe, �o�ies of bro�hu es,�k�l epr�n�s, contrac$mr's pr��o�als, cr�y pe 'fs, s�e�`ches, � di�grarris, �f�. to facili��t� ��e rewiewr pr¢�c�ss. Vou may be ��qa��sk�d fo �ttend th� meeting ofi the �Pounds and Arahit�c��ara) Commifi�ee w6�en your applacation is reviewed. 6�1�� �1������ ��a��c��l $� ������ �� � �c��U� �� ���lo�c��itu��� �00� f��f��c� I��������r�� �����r��of�oDu$�a W�����r��rr 6� �c����m��aC��� ��� �Cm��o�aa�� ��}� rr��ao��� �oi�gy ���o�ua��o G;I�rr�r��e���p I��� �u� Q�� ��r�trG�� �� ����O��c� �����m�e� ��c�u�u���6��� �t�o� u� �c����w�u �c�ffc��m��$u��fir�� rrtr���u���m�c�cut� au��o-u �rr���c����rrr�{����Q�t�e I �� �� �� , Homeov�� ' nat�r�(s Date . C OOOOOqOGmQOOboCOOvvOqOGOL]COG�m�CGOOmbOGO00CaCCOCGOCO00vOOGOOBCG�00000O�DO0000OCObCO000Qb --O�cial Use nly— ., Arahitec4aara) f�eviewr R�com�ra�r�datio�: �� Date: s' �oard of Darectors A�tion: -,! � �` � Dat�:�� d� ._�� Completion Veri�c�t6on b�: �"��� Date: �9�f��'�QI��Di��'fl���(����(EG������C��a�'O�f� �Q880 Northpoint 1lV�y, Cupertino, CA 95014 FORMREVISED5/20D0 Q���9����3�'34 ���te Q4��� ��6-���� �� "�° �� ---�`°� . � �-��- �, � P� � � � � � � � � � �,�,- �.� .. �����. �ti,t����-- � � � � �. ��, . � �� �� ��.... � � � ��a r�..�.�--�n .� ���i��t����� ���������� �����Q��Q�� �� �������� �����0������ ������ Please indicate below which modificationts) are planned for your property. Provide brochure(s), if possible, and copy ofi any proposal(s) including the contractor's license nunnber. Any modification not expressly listed herein, or not conforming to the restrictions and requiremenfs lis�ed herein for that rr�odific�tion, will require an ��c1�6���a�u��0 ���i�� �p�p�d6���a�ua to be submit�ed to the Grounds and �'.rchifectural Committee and �he �oard ofi Direc�ors for approval. tl111ocGificataon R�S'�VIC'$l081S �PO[I R@OJL@9V�B'9'1�0'9$S Air-cort�di4ioning �an6$ Uni$ will be designed for quiet residential use. Unifi will be located within the enclosed yard of the property. There will be no parts of the unit visible to common areas. Installed by licensed contrac�or. Re�laceme�afi �iu�do�nr/ Must be same size aperture and location af existing slic6ing door window or sliding door. Any necessary touch-up painting is the responsibility of$he homeowner. Installed by licensed contractor. `��� Must be windowless and in conformity with general ,� G�page doo� ' architectural style of the complex. Repainting to con�orm fo exterior color scheme is responsibilify of the homeowner. Installed b�r licensed contractar. Sa�ke@lite e6is9�/�e��ive� Specify type and size below and include ske$ch of intended location. Ins�allation of dish in #he least type: visible location to receive signal. Cables routed inside size: a�ttic, crawlspace, or wall near the dish mounting to minimize visibility. Other guidelines may apply. G�l�u� �9aQm���� �aa.as�c� tt� p����e��� �� � ���a�9tt o� ���a�u���6��u� wu�U f�� ��� �uomr��m�u���'� �e�p�a�r�s6�6�6��. ��� �p���vfi�oaao�u�, rr�s��rac�6���, ��u��6�6�uas, �ru� �u�h�� �� tl�� ���o�u��6o�a �o�aa��rr��e� aau���� �p�o�6� � a� $�O� ��u�o�a���� ��� ��s���ec6 ��v�u���u$s, (Cou��i�omu-o� ��a� ��s��6c�a��� �� ��u� �I����ap�oe�� 6-����ow�u�rrs ���c��a�tu��u ��� �p�{�8u����� �� �voo�l��nc��a�u�� �a�o�$�6���9 1����60�. �utt� ���r�fl�� Qa�o�}� �� ���qa.d6¢���. r PJease p�in a I-iomeowner Name(s): � �.�''�' '��1''� � � �' _ �� , � �-�� �) ��rv' � f �r,.��i�'L1`���'�° � ��I �"�� ��� °� Property Address: � �� P one: ���� Date of Nofiification: ��i � F� �� ��_ Date of Completion: � Homeowner has six months to �omplete the designated modifications and is responsible for notifying management upon project completion. sme__�dmmmesmemoememeememm�emm_m___..m�,_e_�mm�.m�m�d_erm>___-_m.�_mmmeemm__�-_�____-___��__ --Official Use Only-- (Votification Received by: Date: Completion Veri�ied � Approved by: ��� Dafie: � � ~�� �"�" FORM ADOPTED 8/1 011 9 9 9 REVISED 5/00 4 � (����4��'��G�I� I��������G�� ����������� . ����8���"Q'�l��(� ������ ����������i� �fhis form must be completed and submitted for review by the Grounds and Archifecfur�l I Comrnififee anc! ap�oved by the Board of Directors before commencemenfi of any properfy modi�icafior�s which would resvlf in: (1) a change in the exferior appearance of the unif, or (2) affect fhe strucfiural integrity of fihe building or decrease fiire safety code r�quirements. Completion of fhis form is r�o� necessary for installafion of;air-conditionin� unifs; re�laeement windov�s, or slidinc� doors, _�rc��e doors, and safelli#e dish receivers. Use a �rr���s����d�����u�� ���u�u������for the ifiems lisfied aloove. Any other modlfications require completion �nd submission of this form. � p���se Prinf Ma.SanjayIVlalunjlcar Homeovr 20085 Northwind Sq YosE1v1�TE Cupertino,CA 95014 � � �'�„' �2. i � �` Property �oHSERV���Y Phone: , Applicafion afe: � � ,��,T_ Planned Complefion Daf�. � I �� ;(},�(1'1 ���e�cip o of Modi ica ion(sJ< � !1 �� SG� .-�--�; �, s �--1,-� c�{-� � r� 2 . � -f- ��if� e � � �C � ,r_� -(�� C��'G � �� � � i� t �� � Please include co�oies of��� P���u$��, brochures, contracfor's proposals,sketches, diagrams, � efic., fio facilifafe the review process. You may be requested to at#end�he meefing of the Grouncls and Archifectural Cammii`tee vvhen your applicafion is reviewed. `r�'� � � �X-U � mCa� ��� ������� �����r��� ������� c�� � g���@f�����c�u����a��a� �aaE� ���6�� �����es��ac��°� P����ff��@�8fl9��� ����������� p������e��������������a� �r�� ��c�����c� �������u��o 6�������ac��° �ic� �6���� �����i��� ��r��@��� ��������� ��c��������� ��� a� ���p���u��� ���° ���B��r�� ���a����s�� ���� �����������6�����, � °I '�-�' / `----' S H ow ature Dafe -------------------------0�fiicial Use Only-+------------____________ Archifectura! Review Recomr�endation: Date: � Boc�rd o#Directors Rci-ion: . � � �� � �" � Campietion Veri�ic�fion da��e: 6 mof�th�s Dai�e: ` , ,� ��������E��'���������G�r�������.����9 10��4 Norfhpoinf Wc�y, Cu�eri�ino, CA 95014 ����e�e����� �I���-��'��� ���o �4��� ��'�����F � �, - � ;��i�'� ..•< .4�,;,- ��C�(B'VBO�E6���dI Sk�/I9��➢�S�Z��A'9��'$ � �9A9'B�9'9'➢OL9�B���SQC�/�@�I��S9Z�C�1�G'$ � e�? 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NEW Smarf LED Da li htin S stem $550.00 )�2��D����Il��uak��II��yflaglta4flaag�ys4�un HI�IS'II'Ab.g.IEIl�(�.�&"D includes tax l[�u�g�Illl�Qil Solatube kit w/tax&labor includes 4 feet of tubin &Vusion Diffuser $849.00 Li hf Kit 0 tion incanclescent or fluorescent ............................................... $1 75.00 Da li ht I)immer w/ cable&wall switch wirin not included ........................................ $345.00 Exfension Tubin 1f�.Len ........................................................................... $39.00 Vusion Diffttser If purchased seperately $45.00 Glass O tiview Upgrade Pricin $99.00 Just Frost U rade Pricin $�0.00 Tier D�o U ade Pricin $95.00 Qtaadra Frost Up �ade Pricin $130.00 Auro Glo Up ade Pricin $130.00 Vivicl Shade Up ade Pricin $130.00 Soft/Warm Lens ..................................................................................... $30.00 2��Il��+��II��-a�-y�xa�s��ff gS][['B"'�fl4")PiuS taX °t➢]��gtr 1Y�bu�'��Ilffn Solatube kit includes 4 feet of tubin Vusion I�iffuser........................................... $4 49.00 Li ht Kit O tion incandescent or fluorescent ............................................ $8 5.00 Da li ht Dimmer w/ cable&wall switch............................................... . $2 89.00 Extension Tubin 2f�.Len th .................................................... . . $5 5.00 ....... .. ........... 1�1:f O aT f�YC 111 Labor-co�np roo£ $220 ZCOO ZZ W1f� SOI1Y'Atf:1C F1ri Labor-comp coof $220 $510.00 ***'Tile�Flat rollecl I�oofs Additional$195-Metal, Tar&Gravel$225 per unit insfalled*** ***Aclditional charge Woocishake$95 ***Adclitional$50-$95 charge for 2-story homes�tall ceilings 10ft-14ft. 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