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12110155CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10695 MINETTE PL CONTRACTOR: +BE) - T BE PERMIT NO: 121 10155 ED OWNER'S NAME: KHAN REX �C, DATE ISSUED: 03/18/2013 OWNER'S PHONE: 4086670441 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL Q License Class__ Lic. i1 / ADDITION OF 765 SQ FT TO FIRST AND SECOND FLOOR; 200 SQFT GARAGE ADDITION; 25 SQFT COVERED PORCH Contractor� V-4 4L �Date -7_- _ i-7 Y ADDITION; INTERIOR REMODEL (460 SQFT);UPGRADE I hereby affirm that I am licensed under the provisio of C apter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. 1 hereby affirm under penalty of perjury one of the following two declarations: 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 Sq. Ft Floor Area: Valuation: $140000 performance of the work for which this permit is issued. 1 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 APN Number: 37532043.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is PERMIT ORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 80 DAYS OF ERMIT ISSUANCE OR 807 to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS L CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the d 6 �� granting of this permit. Additionally, the appli ant understands and will comply Issued b Date:' `• y with all non-point source regulations pe he upertino Municipal Code, Section 9.18. RE-ROOFS: Signature Date 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. ❑ OWNER-BUILDER DECLARATION 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 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) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 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(x) should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally, should 1 use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533 n 5534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: 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, 1 CONSTRUCTION LENDING AGENCY 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 per ormance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I 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 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 1 understand my plans shall be used as public records, granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date uld CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10695 MINETTE PL CONTRACTOR: TMV CONSTRUCTION & PERMIT NO: 12110155 MAINTENANCE OWNER'S NAME: KHAN REX 1659 N CAPITOL AVE APT 256 DATE ISSUED: 03/18/2013 OWNER'S PHONE: 4086670441 SAN JOSE, CA 95132 PHONE NO: (408) 313-8359 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL License Class ir, �' Lic. # g Z 7 " 7 ADDITION OF 765 SQ FT TO FIRST AND SECOND FLOOR; � Contractor _ Zi 7 /n , VC�I Date i� 200 SQFT GARAGE ADDITION; 25 SQFT COVERED PORCH ADDITION; INTERIOR REMODEL (460 SQFT);UPGRADE I hereby affirm that I am licensed under the provisions of C ap er 9 (commencing with Section 7000) of Division 3 of the Business & Professions Deferred #1- TRUSS CALLS- ISSD OTC 11/5/2013. 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 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. Sq. F our Area: Valuation: $140000 1 ave and will maintain Worker's Compensation Insurance, as provi ection 3700 of the Labor Code, for the performance of the work for rcl1t�, ,0 is issued. jj'�� APN Number: 37532043.00 Occupancy Type: permit APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYSM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the / Issued by: Date: granting of this permit. Additionally, the applicant understands and will comply .:" with all non -point sour egulations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Sigmatu Date 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. ❑ ` OWNER -BUILDER DECLARATION 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 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 & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE 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. 1 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(x) should I store or handle hazardous 1 have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertin Municipal Code, Chapter 9.12 and 1 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 the Health & Safety Code, Sections 25505 •5334 25534. Owner or authorized age Date• d � permit is issued. 1 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, 1 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must 1 hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I 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 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. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10695 MINETTE PL CONTRACTOR—TBD--M BE PERMIT NO: 121 10155 4i#ED OWNER'S NAME: KHAN REX r� (J� W DATE ISSUED: 03/18/2013 OVI'NER'S PHONE: 4086670441 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL License Class_ Lie. # 9 7 9 72 % ADDITION OF 765 SQ FT TO FIRST AND SECOND FLOOR; �— — 200 SQFT GARAGE ADDITION; 25 SQFT COVERED PORCH Contractor / NJ I/ LA�a✓� Date ADDITION; INTERIOR REMODEL (460 SQFT);UPGRADE 1 hereby affirm that 1 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 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 Sq. Ft Floor Area: Valuation: $140000 performance of the work for which this permit is issued. 1 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 APN Number: 37532043.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WIT 80 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 D OM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Q/ j� Issued 1/ _! granting of this permit. Additionally, the applicant understands and will comply by: Date.y u with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. ROOFS: Signature Date � r All roofs shall be inspected prior to any roofing material being installed. If a roof is any installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that 1 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 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) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE 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. 1 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(x) should 1 store or handle hazardous 1 have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should 1 use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 255.0f , 25 33, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agen . © Dater permit is issued. I certify that in the performance of the work for which this permit is issued, l 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, 1 must 1 hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct. 1 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CITY OF CUPERTINO rm-7 FEE ESTIMATOR - BUILDING DIVISION t�f��clr. f'Ir+r�a (-'ba<:r:�: ADDRESS: 10695 minette pl DATE: 11/05/2013 REVIEWED BY: Mendez --L— APN: BP#: 'VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: 111 1rtj rrrbl, l PENTAMATION 1GENRES PERMIT TYPE: WORK deferred #1- truss calcs SCOPE Suppl. Insp. Fee -.0 Reg. Q OT t�f��clr. f'Ir+r�a (-'ba<:r:�: FEE l'h�rrrh 1'lran i`/reef Ia�r !'",�ca,F �'�ar+cls --L— 'raids, 'erarw 1" IFIcc +"errrrtt VC(!= C)ti`rr.�r' Prrc ft. Ira.t�p. f 7 hc�r� l'h rs,b lnv< EI—L— C)l/wr)"/ r Inv). $0.00 111 1rtj rrrbl, l /"'Icc' l co NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # Deferred Submittal $278.00 iDEFSUBM Suppl. PC Fee: (j) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -.0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Conslrochon 1cCrrzrat .trra,.i��C'��.. Q � Work Without Permit? C) Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential E) Building or Structure 0 i Travel /-"ces Strong Motion Fee: $0.00 Select an Administrative Item 1 Bldg. Stds Commission Fee: $0.001 8J3TQTALSi $0.00 $278.00 T©TACE $278.00 Revised: 10/01/2013 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 10695 Minette Place DATE: 11/29/2012 REVIEWED BY: Sean PC FEE ID APN: BP#: *VALUATION: 1$140,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: 02nd Unit? 0 Yes No OTC? 0 Yes •.No PENTAMATION 1 R3SFDADD PERMIT TYPE: A wORKConstruct 765 s ft of additions to first and second floor 200 s ft garage addition 25 s ft covered SCOPE porch addition; interior remodel (460 sq ft); upgrade electrical panel 200 amp, replace furnace. OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,111-B,IV,V-B 990 $2,468.00 IR3PLNCK $1,549.00 IR3INSP {,IC'f b,(vj PME Plan Check: $0.00 80 1 s.f. $600.00 Remodel, Bath (<=300 sf) IREMRESBAT Permit Fee: $1,549.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 = s.f. Remodel, Kitchen (<=300 sf) $600.00 IREMRESKIT PME Unit Fee: $0.00 PME Permit Fee: $90.00 TOTALS: 990 $2,468.00 $1,549.00 ME H; H(3►IJR '„ "; 0 Yes, Q tic,' -PLUMU'HOIJRLY C) Yes'' "O No ,1LEC, H0URL,' Mech. Plan Check 0.0 hrs $0.00 Nww, P/ao (_ hcc Elec. Plan Check 0.0 hrs $0.00 Mech. Permit Fee: IMPERMIT 1/1111 , Vcr ma I'<<c': Elea Permit Fee: IEPERMIT Other Mech. Insp. 0.0 hrs $45.00 C)(/w/, `/l onh /)ly , Other Elec. Insp. Ers�$4 WcG, 1. Imp, 1'cc I'lu1HI;. 11) O. /'cc: {,IC'f b,(vj NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the preliminary information available and are only an estimate Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution II -053 Eff. 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,468.00 200 s.f. $400.00 Remodel, Other IREIVfRESOTx Suppl. PC Fee: (j) Reg. 0 OT FO.0 hrs $0.00 PME Plan Check: $0.00 80 1 s.f. $600.00 Remodel, Bath (<=300 sf) IREMRESBAT Permit Fee: $1,549.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 = s.f. Remodel, Kitchen (<=300 sf) $600.00 IREMRESKIT PME Unit Fee: $0.00 PME Permit Fee: $90.00 0 # Mechanical $133.00 IMFR=<100 Furnace, Forced -Air 200 lamps $45.00 Electrical IERT<200 Services 0 Work Without Permit? Yes E) No $0.00 Advanced Plannini4 Fee: IPLLONGR $128.70 Select a Non -Residential Building or Structure Q 0 i Travel Documentation Fee: ITRA VDOC $45.00 Strong Motion Fee: IBSEISMICR $14.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $6.00 SUBTUTALB; $4,300.70 $1,778.00 TO►TA.F9E:' $6,078.70 Revised: 10/01/2012