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