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07010005 - PUB
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CSO 1i0 j (I +� > 1 1 ( { f f O j..�J O� :: 1i f m Z ��`IZ IZ[ �0 m Q1 1 I pp C p l j �� J.: IN f G 0�1 ��-3 �L,)p� IL I O Y ~ f O V,O„ Q , d L3 Z C? .�G. ?, 0 CD 4`i 41 . :3 N i 4? 3 �} 0 � > ItTo Q @ as v �o C) l� ti O cDt U E v v u E N 5 o� — qy a� y a u %U cn N 2 n OL q� D rt7 O a> v rU 4�i LL [L M 4 to u m CL CD o- J a- < a 0 u u CL E 77 , CITY OF CUPERTINO BUILDING DIVISION PE T 7 BUILpl �I G�� D ESS: PERMIT NO. JOLLYMAN LN-LOT 1 DIPESH GUPTA 07010005 OWNER'S NAME: PERMIT ISSUE DATE DIPESH GUPTA 05/02/2007 PHONE: SANITARY NO. CONTROL NO. ARCHITECTIENGiNEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 xLICENSED CONTRACTOR'S DECLARATION Jo Job Description � I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 urine Business and Professions Code,and my license is NEW S FDWL• 1ST FL 18431 , 2ND FL 1030 ' , GARAGE in full Z Licensforce a$d effeffect.ccLic9 441' , COVERED PORCHES 3211 , UNCOVERED LANDINGS a Date contractor ARCHITECTS DECLARATION 224 ' —ADDRESS CHANGED FROM 10752 S STELLING RD. I understand my plans shall be used as public records yV � Licensed Professional 0 S OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the 00 following reason.(Section 7031.5,Business and Professions Code:Any city or county m 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 that he is licensed pursuant to the provisions of the Contractors License Law(Chapter 9 Sq.Ft.Floor Area Valuation $ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $660362 that he is exempt therefrom and the basis for the alleged exemption Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of Number Occupancy Type not more than five hundred dollars(S500). 35922061 ❑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,BusinessRe uired Inspections and Professions Code:The Contractors License Law does not apply to an owner of 9 P property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If, however,the building or improvement is sold within one year of compaction,the owner- builder will have the burden of proving that he did not build or improve for purpose of sae.)_ 1,as owner of the propeny,am exclusively contracting with licensed contractors to construct the project(Sec 7044,Business and Professions Code:)The Contractors Li. cense Law does not apply to an owner of property who builds or Improves thereon,and. who contracts for such projects with a conuactor(s)licensed pursuant to the Contractors LicenseLaw. ❑I am exe t underSee .B&P C for this reason Owner Date WORKER'S COMP DECLARATION I hereby affirm under penilliq of perjury one of the following declarations: ❑I have and will maintain a Certificate of Consent to self-insure for Workers Compen- sation,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 Labor Code,for the performance of the work for which this permit is issued. My Workers Compensation Insurance carrier and Policy number are: Carrier. Policy No.: CERTIFICATE OFEXEMPTIONFROM WORKERS' COMPENSATION INSURANCE (Thu section need not be completed if the permit Is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued,1 shall not employ any person I=m9n ao to becom u 'ect to the Wo feet' rep bion Laws of California. V Applicant NOTICE TO APPLICAD f,after m Certificate of Exemption,you should become subject to the Worker's pe a p visions of the Labor Code,you must 0 forthwith comply with such pro ons or this permit shall he deemed revoked. N CONSTRUCTION LENDING AGENCY r►�-� I hereby a(rrtn that them is i construction lending agency for the performance of > the work for which this permit is issued(See.3097,Civ.C.) a Q Lemdces Name 3 Z Lenders Address C) I certify that I have read this application and state that the above information is d—' corm.I agree to comply with all city and county ordinances and state laws relating to Ubuilding construction,and hereby authorize representatives of this city to enter upon the y Gra above-mentioned properly for inspection purposes. y CL (We)agree to save,indemnify and keep harmless the City of Cupertino against y rA liabilides,judgmenis,costs and expenses which may in any way see=against said City Z in consequence of the granting of this permit. �— APPLICANT UNDERSTANDS AND WILL CIRMPLY WITH ALL NON-POINT Ksued by: Date SOURCE RltL= OS 9 r Re-roofs Signature of Applican Contractor Date HAZARDOeS MATERIALS DISCLOSURE Type'Of Roof Will the applicant or future building occupant store or handle hazardous material as deflned by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Ycs [�No T If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes No I have mad the hazardous materials requirements under Chapter 695 of the Califor. niaHealth&SaktyCode,Sections 25505.25533and 25534.1understand that ifthc building docs not currently have a tenant,that It is my onsibility to notify the occupant of the requirements whi muZ4 be t prior issu enifiatc o(Oceup - Signature of Applicant Date 0 � All roof coverings to be Class "B" or better Owner or authorized a t bate- °w *CITY OF CUPERTINO 0�01 0D 5 CUPEI�TINO NEW SINGLE FAMILY DWELLING PERMIT APPLICATION FORM APN# 3S-1 - 2_2- 0j ) Date: 01/02/0-. Building Address: Mailing Address (if different from building address): Owner's Name: cu-PE"RTl N o Ho M ES L.L_G Phone#: 4 DB (,-2-1 309 Lr C Contractor: License#: Contact: 3l PtSH G U-fTft Phone: 408 6Z� W ci. Cupertino Business License#: Fax: 4t>8 Jj q C 2.-121 Building Permit Info: N E tv Sri kD4 L.0 4-IkA i Ly H6 M E - DEl-r1 r B Single Story ❑ Two-Story 9 Three-Story ❑ Basement ❑ Sq.Ft. Floor Area: 6viN4 = 2.1a-I3 , 4aaAwE= y41 $/Sq.Ft.: C.ovFRXl, PoRC. 4Es = III uH C*%JU_Ey Lf*6a►a4i = 22-4 Cost of Project: eo Type of Construction: Project Size: Standard Large ❑ Major [] Quantity Fee ID Fee Description Fee Group BCONSTAXR Constax-Resi/Mobile BUILDING BELEC 1000 Elec 600V<= 1000A ELECTRICAL BELEC 1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATR Res. Housing Mit Fee BUILDING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING 1 of 3 f' t OITY OF CUPERTINO CUPERTINO NEW SINGLE FAMILY DWELLING PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinklerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfin MECHANICAL BREMARUiAN A/C Units <= 10,000 din MECHANICAL BREMAPPLI A liance'Install MECHANICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace > l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL 2 BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc. Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING I BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Insection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL 2 of 3