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B-2016-2013CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2013 7498 BARNHART PL CUPERTINO, CA 95014-5208 (366 15 056) UPPAL CONSTRUCTION COMPANY MILPITAS, CA 95035 OWNER'S NAME: Srinivasa Scum OWNER'S PHONE: 408-204-0221 LICENSED CONTRACTOR'S DECLARATION License Class 5 Lic. #893295 Contractor UPPAL CONSTRUCTION COMPANY Date 03/31/2017 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. 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 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 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. SignatureL� f%`U �(� Date 11/02/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. I, 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 & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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. 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. 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. APPLICANT CERTIFICATION 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. Signature Date 11102/2016 DATE ISSUED: 07/22/2016 PHONE NO: (408) 26273966 BUILDING PERMIT INFO: X BLDG X ELECT — PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL DESCRIPTION: 544 SQ FT; REMODEL 1497 SQ FT; M COVERED PORCH; N REPLACE FURANCE; ELECTRICAL PANEL UPGRADE 200 IS; N COMP SHINGLE (27 SQ) REV #1 - ADD COFFER CEILING TO LIVING ROOM; REPLACE COFFER CEILING IN KITCHEN, FAMILY ROOM & DINING ROOM WITH ONE COFFER CEILING - ISSUED 11/02/16 Sq. Ft Floor Area: 544 I Valuation: $240000.00 APN Number: Occupancy Type: 366 15 056 Deferred Submittal (R -3),R-3 (Custom) PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Abby Ayende Date: 07/22/2016 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. Lure of Applicant: 11/02/2016 ALL ROOF COVERINGS TO BE CLASS "A" HAZARDOUS MATERIALS DISCLOSURE. 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. 55 f Owner or authorized agent: �Lf t�Gc> " " " A- Date: 11/02/2016 CONSTRUCTION LE"ING AGENCY 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 Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, GA 95014-3255 (408),777-3228 • FAX (408) 777=3338- building(a.cupertino.org CUPERTMO NEW CONSTRUCTION 0 ADDITION ❑ ALTERATION / Ti Z REVISION / DEFERRED ORIGINAL PERMIT # 2-o 43 PROJECT ADDRESS SA.g N JA APN # OWNER NAME ` ,p� q p /� j� ���`>}' �,ry \ Y 1 N 1 \d A S.` `. 901 - ! 1✓' PHONFrIL p 04- —O ry' E-MAIL STREET ADDRESS ' - CITY TATE, ZIP ,R E• 6�0 CA '1 i FAX CONTACT NAME1# 1 S 1^ s L i PHONE �` ) E-MAIIy G�7i STREET ADDRESSr CITY, STATE, ZI FAX t� Ari 6 -NV -AV` nf'gNQ CA RI . OWNER '❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR. ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT ONTRACTOR NAME G�= I� N ��f��- 3 LICENSE ERz � LICENSE TYPE BUS. LIC # � �f � COMPANY NAME E-MAIL FAX USP 'L ,JV STREET ADDRESS ;�__F /�� �' U k2rq tY CITY, STATE, ZIP g� ! P J `To 5 �' � ' PHONEy0 �' �j � �. g��j ARCHITECT/ENGINEER NAME 0 LICENSE NUMBER �l BUS. LIC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK F�U�' L Lig' �Pfs,12Ab,c ( l� t'S a( Cc' 1 � - > `. d CeAWVVA iWOA . C V (__et � " YI D . E STING USE PROPOSED USE - - CONSTR. TYPE # STORIESI � 7 ilAi USE TYPE OCC. SQ.FT. VALUATION ($) A STGNEW P O R ' DEM U TOTAL - AREA AREA AREA NET AREA U - BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH ❑ ATTACH # DWELLING UNITS: .ISA SECOND UNIT ❑YES SECOND STORY []YES BEING ADDED? []NO ADDITION? ❑NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES ECEI BY; '� TOTAL VALUATION: PLANNINGAPPL# ❑NO PLANNING APPROVAL LETTER EICHLERHOME? ❑NO By my Signature below, I cel tify to each of the following: I am the propertyowner or authorized agent to act 6 the p6perty owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relatingx • buiS)"� gconstruction. I authorizmw� es of Cupertino to enter the above-ide�ntil d�pgr�operrty for inspection purposes. Signature of Applicant/Agent: !� ' - Date:1,1g , 1 .A 1 1 2_ l 1; - New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. \ F BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7498 BARNHART PL CUPERTINO, CA 95014-5208 CONTRACTOR: PERMIT NO: B-2016-2013 (366 15 056) UPPAL CONSTRUCTION COMPANY MILPITAS, CA 95035 OWNER'S NAME: Srinivasa Somu DATE ISSUED: 07/22/2016 OWNER'S PHONE: 408-204-0221 PHONE NO: (408) 262-3966 I&CENSED CONTRACTOR'S DECLARATION BUILDING PER.NHT INFO: License Class 1a Lie. #$93295 Contractor UPPAL CONSTRUCTION COMPANY Date 03/31/2017 X BLDG X ELECT _ PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing — MECH X RESIDENTIAL _ COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full farce and effect. JOB DESCRIPTION: I hereby affirm under penalty of perjury one of the following two declarations: ADD 544 SQ FT; REMODEL 1497 SQ FT; (N) COVERED PORCH; (I) AC; REPLACE FURANCE; ELECTRICAL PANEL UPGRADE 200 1. 1 have and will maintain a certificate of consent to self -insure for Worker's AMPS; (I) COMP SHINGLE (27 SQ) Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. r;f I have and will maintain Worker's Compensation Insurance, as provided for by on 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Floor Area: 544 Valuation: $240000.0. 0 APPLICANT CERTIFICATION certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 366 15 056 Deferred Submittal (R -3),R-3 (Custom), 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 IF WORK IS NOT STARTED may accrue against said City in consequence the granting this permit. Additionally, the applicant understands and willl comply with all non -point all WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino nicipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signatu _ Date 7/22/2016 Issued by: Abby Ayende Date: 07/22/2016 ER- ' R DE ARATION 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 without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sec.7044, Business & Professions Code) = :. 2. I, as owner of the properly, am exclusively contracting with licensed Signature ofApplicant: contractors to construct the project (See.7044, Business & Professions Code). Date:7/22/2016 -14P I hereby affirm under penalty of perjury one of the following three declarations: 1. I have and will maintain a Certificate of Consent to self -insure for Worker's ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 s. 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. 1 will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally, should I use equipment or devices which emit hazardous Worker's Compensation laws of California. If, after making this certificate of 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 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 APPLICANT CERTIFICATION Date:. 7122/2016 I certify that 1 have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct, I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction 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 ARCHITECT'S DECLARATION Code, Section 9.18. i understand my plans shall be used as public records. Signature Date 7/22/2016 - Licensed. Professional CUPERTINO N4R -. FrF O ` ^y �4� [per Ry `{ C [/y T [{ O COMMUNITY DEVELOPMENT DEP/, TMENT BUILDING DIVISION 10300 T ORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 FAX (408) 777-3333 • build! ng(a)cuaertino.org ❑ I10V CONSTRUCTION- 9 ADDITIO\ ❑ AIrTERATION / TI ❑ REV�SIOri / DEFE'.=D ORIGII�TAL PERMIT X13 s--6 I P j PROJECT ADDRESS7+ os --6 �'[ lCV i► tnY - 0`ArNTERNANE Vnn> o 0 `�p PHONTF���� sr. S CA)) I t aVry ---- 4�pZ STREET ADDRESS CITY, STATE, ZIP FAX CONITACT MME 0 tui VASA t 0 PHONE C32 9 4 y I E-1` A.IL �-^ 0 2,2/ i STREET ADDRESS ®�� n� ltA� C 'Ar CITY, STATE, ZIP y p �s [ , e [ v O �CT t 3 i FAX OVJNER ❑ WNWEER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE IQUAiBER LICENSE TYPE BUS. LIC n COMPANY na-mm g � //�� C, E-NA.IL FaX l y A L L.4 N&Tf lic,�T�/ o m . c ca ' 6ruk('d CA STREET ADDRESS � CITY, STATE; ZIP I � PHONE 5'167 � . ITAs c,%) 5 . RCHITECT,'ENGLNr.ER :SAI iE LICENSE N'UTiBER 9 0 Q BUS. LIC r COMPANY NAS, A LI (f� TRUC 1,ONS E-1<`LAIC ( FAX - STREET ADDRESS ` ® 1 P q yZ p �Z-v 9 - / '✓ C / P` CITY, STATE, ZIP�� ' , t ^ y j C A T 11 +� r ! V I L 11 PHOI E ((r `(' �) DESCRIPTION of NVORK i, - ` 4 S" �t 1`1 �T 11 1 i` r d 1 �1" f.� i I V 1 %t � I`y "`f 0 EXISTING USE PRQPOSED USE CONSTR. TI PE _ STORIES V / A! i USE TYPE OCC. I SQ.FT. V anti ? TIO T (S) Efi1STG r� AREA },,, , NFW FLOOR- AREA �' %�; DEMO AREA TOTAL NET AP:EA _ BATHRO01\1 P,ITCHEN REMODELAREA REMODELAREA OTHER REMODELAREA 1DET'ACH PORCHAREA DECK AREA TOTAT D-CKIPORCH?.REA G?3AGEARTA: ❑ATTACH D\i%ELLiNG UNITS: IS A SECOND UNIT ❑.YES SECOKD STORY ❑ Y"ES BEING ADDED? E)No ADDITION' E) NO PRE-APPLICATlO\' ❑YES IF _S; PROVIDE ?DP COPY OF PLANITII�G APPL ` []NO PLr.NNING APPROVAL LETTER IS THE BLDG AEl 5\ tS EICHLER HOME? ❑ ?'O RE EI1 D B -- - d�%' T.AL VALUATION- n. _ :g ®Kw ? - By my signature below, I certify to each of "the following: I ani the property owner or authorized agent1to act o` the property ovmer's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work: and verify it is accurate. I agree to comply -with all applicable local ordinances and state 121,vs relating to building construction.AAl authorize representatives of Cupel Lino to enter the above -d entifice property for inspection purposes. Signature of Applicant/Agent: R E'� Date: e SU`PPLE",lEIITAL IIS""FORR4_ATIOINT REQUIRED ?.> , PLA CHECK I1 PE . t` ( ROUTING SLIP:: New SFD or DFLltifamily dr ellings: Apply 101' demolition pel7Illt for Oti-ER TIDE COD\TER r BUILDIZGPLAI RETIE\§ existing building(s). Demolition pe I nit is required prior to issuance of building � �E1�RESS s � . e=it for ne-w building. Pr 'i.Tt REi IEii _ Commercial Bldgs: Provide a Completed Hazardous Materials Disclosure f T is bel I G sT�tD�RD P Ic`�oRI.� w are used pzI of 1 s ro ct. form if any Hazardous >\_z.eri g 1C C p je LARGE Copy of Planking Approval Letter or Meeting lwIth Planning prior to xEPT a L� �LA.TOR �ESiERDISTRICT -; submittal of Building Permit application. zsSA_\IT5.R7 -�� E\'IRO\�iE?�TALHE.SLTH v Bldg pp_2011.doc revised 06/21/11