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15050048I CITY OF CUPERTINO BUILDING PERMIT I 1 BUILDING ADDRESS: 11790 UPLAND WAY I CONTRACTOR;:, �,{ )J , l JY r I PERMIT NO: 15050048 =� / U K I OWNER'S NAME: AMIT GOEL I I DATE ISSUED: 05/08/2015 I I OWNER'S PHONE: 4089669002 1 . I PHONE NO: LICENSED CONTRACTOR'S DECLARATION License Class 4916A Lic. # 9 ( gap Contractor Date S- 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: 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. ave 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 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 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. _ Date 4 '.,-.2 '/S-- ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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) 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: 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. 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 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 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. Date JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL E] CONSTRUCT (N) ATTACHED OPEN ROOF PERGOLA (225 S.F.) Sq. Ft Floor Area: I Valuation: $8000 APN Number: 36603034.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF T ISSUANCE OR 180 DAYS AS D INSPECTION. by: 4>// +C/ 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 255%05,, 25533, and 25534. Owner or authorized agent: 9�.- =��°'/ Date: CONSTRUCTION LENDING 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 Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERTINQ CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 - 3228 • FAX (408) 777 -3333 • building L-cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT ## PROJECT ADDRESS I a 90 !® ], '. APN 9 366 ® ­03 h OWNER NAME PHONEI JO O (O o EMAIL Q I r L, ( e C_0 w, STREET ADDRESS CITY, STATE LL FAX Ll na o 1 CONTACT NAME % u PHONE E -MAIL j� ��u ✓� `✓t� ���5 r ?i� !% ) ( ) �7 `'11- ( k-, s L1 '6 f- STREET ADDRESS / CITY, STATE, ZIP FAX C —7 rr LJ ❑ OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT ❑ CONTRACTOR 56emRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME LICENSENUMBE LICEN TYPE BUS. LIC9 COMPANY NAME E -MAIL FAX STREETADDRESS / /�c5 /n} f_ J V u CITY, STATE, ZIP YS-12, PHONE ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS. LIC 9 COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK C) EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEWFLOOR• DEMO TOTAL AREA AREA AREA NET AREA -. BATHROOM. KITCHEN. OTHER, . REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: LJ DETACH ' [:]ATTACH 9 DWELLING UNITS: IS A SECOND UNrT ❑ YES SECOND STORY ❑ YES BEING ADDED? []NO ADDITION? []NO PRE - APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL -, E] NO ' PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? RECE ' - - T VALUATION: __ By my signature below, I certify to each of the following: I am the property owner or C aeent to ac th o mer's behalf. I halve read this application and the information I have provided is correct. I have read the Description of Work and veri e. I agree to comply with all applicable local ordinances and state laws relating to building constrUction . I thorize representatives of Cupertino to enter the above- identified property for inspection purposes. Signature of Applicant/Agent: Date: S �� SUPPLEME AL INFORNTATIOWREQUIRED New SFD or Multifamily dl,vellings: Apply for demolition permit for 4 fl BUILDII�GPLAhREVIEFi existing building(s). Demolition permit is required prior to issuance of building OVEItTHE COi7JVTER for new building. Q EXPRESS } ©pLnl�I.ihcrLANxEVrEw permit Commercial Bldgs: Provide a completed Hazardous Materials Disclosure sTnNnATtD s❑ruBLlcolzxs" } _ form if any Hazardous Materials are being used as part of this project. LARrr Copy of Planning Approval Letter or Meeting with Planning prior to �` Y _ submittal of Building Permit application. .A1A70R s t-� SAhTTARx SI'R'ERS)ISTRTC BldgApp_2011.doc revised 06/21/11 Fm,_� CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION e ADDRESS: 10790 UPLAND WAY DATE: 05/08/2015 REVIEWED BY: MELISSA �bleclr. Permit Fee: APN: 366 03 034 BP #: VALUATION: 1$8,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: p Phunb. hasp. Fee; PENTAMATION PERMIT TYPE: 1 GENRE WORK CONSTRUCT N ATTACHED OPEN ROOF PERGOLA 225 S.F. SCOPE e ;bfech. Plan Check Plumb. Plan Chec/ I F Elec. Plan Check �bleclr. Permit Fee: Plumb. Permit Fee: Uec. Permit Fe,. Other Alech. Insp. Other Plumb InsP. other Elec. Imp, .ldech. Insp. Fee: Phunb. hasp. Fee; Elec. Insp. Fee: 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 areliminary information available and are only an estimate- Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Eff 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 0 # $359.00 Awning / Canopy (Support'd by Bldg) IAWNA7TBLD Canopy Suppl. PC Fee: Q Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: T-T Administrative Fee: Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure i Travel Documentation Bees: Strom Motion Fee: IBSEISMICR $1.04 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 m -SUBTOTALS• $2.04 $359.00 TOTAL FEE: $361.04 Revised: 04/01/2015 Landscape Plan For 1 h Gael Family 11790 Upland Way Cupertino, CA 95014 .. ..... .......... [AIM; T 7 S — R 2 W 358 p o� S P, M. w9 z 6g,_�3. 5cale fig * Nature WorLs Landscare 17360 gland Prix a,, Mdlq- Rill,� 95037 Phone: 800-758-;020 COI: 40&314-0282 A—RQV�,) wvi GUPEnNO o4" —a K ca, G"'t— 0,0—, PPY Gesi�rea' 6u Homeowner: Amit Goel J. C:Aw-RO 5-G-; 5 [Cover Page SPAN5 3 PI E, O!MPSON HVC2�0 -3 HANGER FA BEAM {ISE A 2ti ON A t'IECt FOR @LOGK!NG AND SECURE TO JN' LS WtTI' SCREWS tNp OF X3 0` -- fir! HANG R.00P _AVE Of CAVE .1 ASS ,' 14 ��JT �� ELEVATION. ._PERGOLA______ - -- HIDDEN ROL-I UNTtir TO LEDGER GBSQGG 51MPSON COWMN (ATTICS ON 51, DE 2XIOI,.A'E Pf DG E,R. On BASC -t O' KAI5EJ CONC E IEK STEM ".RIM @ONDO A5AND�, — I'LFICAL 2'X 2' SQ 2'MUtC �Y 'T,AWIJ A4,EA #3 REBAR SQUARE CARL, v., , -( ii ...PLAI.T' R MX BACK, SILL 1 T TO' FLAYING �I (SECTION: PERGOLA �a��,, I[L 3UNKSCRD16 NER GRACE " (A(,TUA. DIM) TRIM &SECTION: LINTEL CONNECTION TO POST (ATTICS ON 51, DE 2XIOI,.A'E USE D CIT 5GREA5 / ..__.__.J' COUh LA SUNK AND Liam —_— BELT SIDES 4 SCREW5 EA 5AE tED TO SECURE BRAGS (SLOT &p;—T%:--CORNER BRACE___ 2X10 1 0151 (ATTICS ON 51, DE 2XIOI,.A'E 2X10 LEU [K —?Xb COK% R. DRAC _ f� LOITL ORN R BR.ACE - ON RETURN LADE N0 2 Mlty - -,'�M1 TO' FLAYING �I 3/3'X A" LAG 50115 COUNTER. SUNK AND HLL HOLE TO CAULKING RMW n .- ZX 10 LEDGEI "'R6 PT PG 111 BOTTOM PLA51INt BONDD COAT AND SAND 1NATtK`ROOF, MDRAN tY SIU W r LADHS HEIenTOP LEDGER IO HAVE MIN CLEARALT k OP 2" BETWEEN 8070 OP 2X31 A710E AND KC WE HAVE 22" TO ALLOW FOR (6 )—ft CTION : LEDGER PLA5L1ING NUIt M,t IM t D P -J4 { IL e p t d r and a..cc Po. th are GxG G..dv L` vJ �W N d Q} A M m ju U{{ �N C E ct `T' J fv rte, r j•� -G u SHEET TITLE. COricept �- i Deta115 REVISIONS k -23- i S J.CASTRO PAGE 4 -2I -15 OF As Shown