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07110134- PUB r >� 0 i1 `oE E ti m {i( 0, or 5 a E IL 4 v (D N ro o v 4 a o o a � o o„ LO 0 f �(( 1 CD LO x LO U i I }• �{ {r 0 JY �l; V Cc: i N <,. Ifw ,� � N C7 Q u 10 1 1 W �1 (}1 I�0 U U) N O co k 1! �,,,.,., � m z 1 a y N N( I a 0 C, q ,, "? �� ,., .� j�,� El [zm �1Gtin w D f m a xy (D u Z 2 LD �.. .:41.1 4l N y C'J aCj Ll i J ol { j N { Lu in Z1 j 0 ( 'o S a f a a a Z a v m +v o O J_0, ,II wl ;Lo CD oll� +vi ,.J; i I f. 1 a ip l Z} CQ N t ){101' t f ( a �I a I j� ot � Fr� w i I 1 l( e� r ffYWI ali { QJ i' cm, m 7 LL- vl ! L C"l �d41 _ N N coBj N CYY �, =I `j 1 O. CIS O tA kA I I r M i r r J r Cf'l a a� v v q o y m o a ++ x LP CL a 7 w v v Lu y LO o f "ti U v W E 0 'a =) L) V E c v o c E - :y a� a`) ti a c o cn 0) 3 0 > a`s w ra a`l N 4J. 4? I� 41 [a- � Q G7 U Z) (L O R+ OL J) fI Lb c [� Q 0 Q U u 0 � R >- w CITY OF CUPERTINO BUILDING DIVISION PERMIT �•x^dS.;»Y 'os;L. s'r,ti,.. P .a aks's��s�; BUILDING ADDRESS: PERMIT NO- 1197 CANDLELIGHT WAY TBD — TO BE DETERMINED 07110134 OWNER'S NAME: PERMIT ISSUE DATE RATHNAGIRI ARUNAGIRI 03/26/2008 PHONE: SANITARY NO. CONTROL NO. ARCHI7ECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 00 LICENSED CONTRACT'OR'S DECLARATION W I hereby affirm that I am licensed under provisions of Chapter 9(commencing Job Description zwith Section 700D)of Division 3 of the Business and Professions and my license is SFDWL—2 STORY 2, 240 LIVING, ATTACHED GARAGE 443 - -c y in full force and effect -Q �� Z License L� Lie.x F Date o Contractor �erY �✓C t ARCHITECTS DECLARATION "c 1 understand my plans shall be used as public records roU 'a a y Licensed Professional O< OWNER-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractors License Law for the ;20 following mason.(Section 7031.3,Business and Professions Cale:Any city or County Pi which requires a permit to construct alter,improve,demolish,or repair any structure Z y prior to its issuance,also requires the applicant for such permit to file a signed statement G dtat he is licensed pursuant to the provisions of the Contractor's license Law(Chapter 9 Sq.Ft.Floor Area Valuation i $ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $480000 that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 70315 by airy applicant for a permit subjects the applicant to a civil penalty ofNumber Occupancy Type not more than rive hundred dollars(ssoo> 3 6 2 2 4 0 5 4�� 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 and Professions Code:The Conuactors License Law does not apply to an owner of Required Inspections pmpeny who builds orimproves thereon,and who does such work himself or through his own employers,provided that such improvements are not intended or offered for sale.If. however,the building or improvement is sold within one yew of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of SAC.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec 7044,Business and Professions Code:)The Contractor's Li- cense taw does not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License taw. I am exempt under Sec B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑I have and will maintain a Certificate of Consent to self-insure for Workers Compen. radon,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the tabor Code,for the performance of the work for which this permit is Issued My Workes's Compensation Insurance carrier and Politynumber are: _ Carriers �� kms"`��olicy No.: /-5�L'� CERTIFICATE OF EXEMPITON FROM WORKERS' COMPENSATION INSURANCE (-his section need not be completed if the permit Is for one hundred dollars($100) or fess.) 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 Workers'Compensation Laws of California.Dare Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should became subject to the Worker's Compensation provisions of the tabor Code,you must �Z forthwith comply with such provisions or this permit shall be deemed revoked. a CONSTRUCTION LENDING AGENCY rA 1 hereby affirm that there is a consuuctinn lending agency for the performance of Y 7 the work for which this Permit is issued(Sec,3097,Civ.C.) QLender's Name 7 2 Lender's Address 0 1 certify that 1 have read this application and state dot the above information is " correct-1 agree to comply with all city and county ordinances and state laws relating to kU building construction,and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. y Clr (We)agree to save,indemnify and keep harmless the City of Cupertino against to liabilities,judgments,costs and expenses which may in any way accrue against said City Z in consequence of the granting of this permit �. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULAIT Re-roofs Sig pp hcam/Co r ate HAZA MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant store or handle hrzardous material as deAncd by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Cock,Section 25532(a)7 ❑Yes All roofs shall be inspected prior to any roofing material being installed. o Will the applicant or future building occupant erre equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air caii.inants as defined by the Bay Area Air Quality Management all new materials for inspection. DuuictT // ❑Yes �No I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health do Safety Code,Sections Z5505,25533 and 25534.I understand that if the building does not currently have a tenant that it is my responsibility to notify the occupant of the requucmcnes which must be met ortoi&wwccofaCcrtificaicoifOc5ppancy, Signature of Applicant Date owner nr au a Ba a Dare All roof coverings to be Class"A"or better CITY OF CUPERTINO NEW SINGLE/MULTI FAMILY DWELLING CUPEkTINO PERMIT APPLICATION FORM APN # Building Address: // � 7bL ,d- Mailing Address (if different from building address): Owner's Name: 157 0 C��f - Phone# Contr ctor: Phone#: � � Fax#: Contractor License#: Cupertino Business License#: Contact: Phone#: 4o7 g --0 Z Fax#: Alternate Contact: Phone#: Fax#: Single-Story Two-Story LV Three-Story Basement Ej Hillside Multi-family ❑ Apartment ❑ Condo ❑ Townhouse ❑ Sq.Ft. Living Area(Including Basement &Attached Garage: Sq. Ft. Garage(Detached Only): Valuation: C f Job Descriptio Type of Construction (Usage Class): Occupancy Type: 1 FR, I IFR ❑ 11, 111,VAHR ❑ 11, 111, 1V V-N [ 1t Project Size: Standard Lld" Large[] Major❑ Green Building: Must attach completed Green Building Checklist to the plans Green Building Points Achieved: For help, contact Build it Green at www.builditgreen.org CITY OF CUPERTINO NEW SINGLE/MULTI FAMILY DWELLING FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type BCONSTAXR Constax—Resi/Mobile BUILDING BMITIGATR Res. Housing Mit. Fee (Chrg. PLANNING only if lot is vacant or it is a subdivision) BPSEWER Sewers PLUMBING BPSPRINK For ea. Lawn Sprinkler Sys. PLUMBING / on any one meter, incl. backflow protection device BPWSVCS Main Water Service PLUMBING RPWS V/ BSEISMICRE Seismic Fee Residential BUILDING BSWIM Swimming Pool BUILDING RBSP PCESS For Ea. Cesspool PLUMBING GARDTW<=1K Detached Garage Wood BUILDING GARDTM<=1K Detached Garage Masonry BUILDING R3ALTINSP Dwellings Alternate BUILDING Materials R3ALTPLNCK Dwellings Alternate BUILDING Materials R3INSP Dwellings Inspection BUILDING R3PLNCK Dwellings Plan Check BUILDING I R3REPINSP Dwellings Repeat Inspection BUILDING R3REPPLNK Dwellings Repeat Plan Check BUILDING R3HINSP Dwellings Hillside Inspection BUILDING R3HPLNCK Dwellings Hillside Plan BUILDING Check R3HREINSP Dwellings Hillside Repeat BUILDING PATMOBF For Atmospheric Type PLUMBING RPBF / Vacuum r Breaker/backflow not included in item 1 (1-5) (5+ 2 of 3 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 CUPERTINO Building Department JOB ADDRESS: PERMIT # O R'S NAME: A4 n-r,,,a l; Ae vnNAc, ,ePHONE # 4 n F- z sS-_ -7 Ov GENERAL CONTRACTOR: FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile er/ Date Community Development 10300 Torre Avenue r ` Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 CUPEKTINO Building Department JOB ADDRESS: PERMIT # //97 p7 //0 /,34 OWNER'S NAME: PHONE # -9,'90. S1?- GENERAL CONTRACTOR:"/-,.4FAX# 7-5 zo s � v I am not using any subcontractors: Signature Da Ke Please check applicable subcontractors and complete the following information SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork /4z:,-s cQ.✓s c 7& Cement Finishing Electrical Z 7 R Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating -5,5 z Insulation ✓Z;..�j /�✓,rc� ,ten/ Z o j Landscaping Lathing -Soo j Masonry Z S'S z `j Ornamental Sheet Metal Painting/ Wallpaper :r- a� J�c ✓ Z,G/.tf ,i Paving Plastering Plumbing ,(3n/�Li�✓ mow'�6'^�"¢' 02(7 1 �- Roofing '7 Septic Tank Sheet Metal Sheet Rock Tile oq ►��s .� i'/.6+R s�E ._33 �/ er/Con r Signature bate