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02020044CITY OF CUPERTINO c PERMIT APPLICATION FORM CUPERTINO , APN # Date: B m�l /V 0 Ph one 11�0-g contractor: License C f) t c : Phone #: XIt'y 4— - p 5-/v et l 7�41 3 A,?plicant/Contractor: 1 of Quantity • Fee Description FeeGr up--- Other Appliances fullmm.. ISH 1 BBLDGFEE__ Bld-g-P-ermit sq. foot j BUILDING W4, 1 Boiler > 500K to IM Btu BBOILER4 Boiler > 1M to 1.75 m- Btu -,Boiler> 1.75M Btu CAN IM BrOOK Constraction Tax e rte_ NOW04 G Con. Tax for 22 zolle- Constax — Resi[Mobile lec E _W0V_<= I OOOA ELECTRICAL mumigam Elec 600V > 1000A 13ELEC200 li Elec Svcs 600V <= 200A U—ILDING Ene��Add�Multi BUILDING Investigation fee I I R I z Comm. Housing�it. Fee -iwjiojiijikLl 1 of w0c nM7 )z ,ow 3i3; fl as CFF OF CUPERTINO BULDING DIVISION 7-7777­�� PERMIT BUILDING ADDRESS: PERMIT NO. i o ____QLmRuBiN_ OUI_ZQN_ 02020044 OWNER'S NAME: APPLICATION SUB DATE MURUGESAN SINNASSAMY 2377 SHERMAN DR 02/12/2002 PHONE! SANITARY NO. CONTROL NO. (408)309-0822 ARCHIT',XTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH =1 L__J LICENSED CONTRACTOR'S DECLARATION Job Description -jereby affirm that I am licensed under provisions of Chapter 9 (commencing . with Section 7 000) of Division 3 of the Business and Professions Code. and my license CARPORT (345 SQ.FT.) ,a lit full force and effect. License ;,lass _ Lie. # Date Contractor ARCHITECT'S DECLARATION 1 uuidersismd my plans shall be used as public records Licenseo Professional OWNER - BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the followinf, reason. (Section 70333, Business and Professions Code; Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure $7000 prior to vs issuance, also requires the applicant for such permit to file a signed"tement Ft., Floor Ar Valuation that he i.�,Iicvasad pausuinit to the proAsions, of the Contractor's License Law (Chapter 9 !vision 3 of The Business and Professions C ion 700b) of D. ode) lccnnrn��omg wfthS�tt: 08-U54.,O'Or or Vhat he is exempt therefrom and the basis for the alleged exemption. Any violation of Socti,n 703-1.5-by my applicant for a permit subjects the applicaritio a civil penalty ofnolm,iie than fin hundred dollars ($500). AP Number Occupancy 'Type 101 FOUNDATION 0I, as c crier ofibe property, or my employees with wages as their sole compensation, In t" I'D Required Inspections 103 UFER d) dc he work, and the structure is not intended or-offered for sale (Sec. 7044, ftusiAeas and Professions Code: The Contractor's License Law does not apply to an owner os property Who builds or improves Thereon, and who does such work himself or Through his own employees, provided that such improvements at not intended or offered for sale. If, however, the building or improvement is sold within one year of 104- REBAR comme6ort, the owner-builder will have the burden of proving that he did not build or 105 ANCHOR BOLTS improve for purpose of sale. 1. 106 SEWER. &...WATER- 0, 1, as —elloftbe property, am exclusively contracting with licensed contractors to construct the project (Sec, 7044, Business and Professions Code:) The Contractor's 202 UNDERFLOOR PLUMBING License Law does not apply to an owner of property who builds or improves thereon, UNDERFLOOR MECHANICAL and woo own is f such projects, with a contriactor(s) licensed pursuant. to The Contractor's , nscLaw� �203 204 UNDERFLoof'FkAME 0I am, xe under Sec. _,B As P C for this reason Date A-, 4 205 UNDERFLOOR INSULATION 0 R'S COMP EN sAnd!-,aD&z_/14a� 301 ROUGH PLUMBING I hereby affirm under penalty of laeriury one of the following declarations: 302 TUB & OR SHOWER 3 03 ROUGH MECHANICAL 1 ❑ 1 have and Will maintain a certificate of Consent to self-insure for Worker's Compersation, as provided for by Section 3700 of the Labor Code, for the 304 ROUGH ELECTRICAL performance of the work for which this permit is issued, 305 FRAME El I have and will main I min Worker's Compensation Insurance, as required by Section 306 - HOEDOWNS 3700 of the Labor Code, for the performance of the work for which this permit is issued f Ay Worker's Compensation Insurance I carrier and Policy number are. 3 0-7, 7, INSULATION,. Policy No.: j348 SHEFT,�ROCK CERTMCATION OF EXEMPTION FROMWDRVERS' M.1116 COMPENSATION INSURANCE 0 (This'section he I ed not be cmitpieted if the permit is for one hundred dollars 310 - INTERIOR LATH 311 - SCRATCH COAT certify that in the performance of the work for which this permit is issued, 1 313 - ROOF NAI,L shall:rc,t employ any person in any mariner so as to become subject to the,Worken, Compa: safion Laws of California, Date 501 - FINAL ELECTRICAL ENERGY 'A I, Certificate of Exemption. you should 502 FINAL .PLUMBING ENERGY becon'e subject to the Worker's Compensation provisions of the labor Code, you must 503 FINAL MECHANICAL ENERGY fb1ih`,;M comply with such provisions or This permit shall be deemed revoked 'CONSTRUCTION �504 FINAL BUILDING ENERGY;- LENDING AGENCY "erebv affirra that there is a construction lending agency forlthe calblimmee P 505 - FINAL ELECTRICAL of a. work for which this penult is issued (Sec: 30917., Civ� C.) I , . 506 - GAS TEST Lerdsr�3 Name Leader's Address 507 - FINAL PLUMBING, , certify that have read this application and state that the above faformation is 508 - FINAL MECHANICAL comet. I agree to comply with all city and county ordinances and state laws misting tobuiid� airthonizeroresentatives of This city 19 enter upon ng construction; and bereb 509 - FINAL GRADE The zbo"e-mentioned property for inspection otion purposes. nape we) agree to save, indemnify and kiep harmless ffie City of caperiinio against 510 - FINAL PLANNING lialbilizi.s, judgments, costs and tlxpeascs which may in any way acme 6 against said city in con ence of the lfrantitig of thigpiarmit, Xv ATPLW UNDERSTANDS AND WILL "COMPLY WITH ALL NON- U R. . ULATIONS. M12-1=' S 514 NA�7jP�� WORKS fj- Issued by: Date Re-roofs 9. We clor. Date Si of.-m,- OU MATERIALS DISCLOSURE NIP the ap-p-li, or future hvildmg 6emPam store or haridle hitaxleas material deth ic u Chapter 9,12� and the Health and Safety 'ape -of Roof s, no Ktini-if"al,Cude, u a Code,' ti 5 *No. % Airpoh sballbe inspec ed pjjqr to any roofing material, being installed. Mill the applicant or funtrebuildi2 occupant use equipment ordavices which emit hazardous air contaminants as defin bythe Bay Area Air Quality Management If a roof is installed without first obtaining an,inspecti6n,'J agree to remove DistricO all new materials for inspection. Applicant understands and will comply.. with DYes allhon-point source regulations. ]rave read the hazardous'niabuitTh; requiretry;cuts under Chapt6i,2 6,V5 of the CalilbTva Health & Safety Cod6l Sections 25505,25533 and 25534. 1 understand that ifttia bniimn is not currently havo-a tenant; that it is my responsibility to notify the naus,�Juchrnast be;nsetpriair'jo issuance of a Certificing'of arent requirem otcupoc . Signature of Applicant Date , ; Owner All roof coverings to be Class "B" or better o th ] a�uth ed r ed ag, OFFICE OF Cl BUILD NG Dpv RonPERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS: PERMIT NO. WNER'S NAME: APPLICATION SUB DATE MURUGESAN SINNASSAMY2377 SHERMAN DR 02 12 2002 HONE: tI SANITARY NO. CONTROL NO. (408)309-0822 O O ARCHITECT/ENGINEER : BUILDING PERMIT INFO ii.i BLDG EI.ECr PLUMB MECH IJ r_t L_I U ora-, z - LICENSED CONTRACTOR'S DECLARATION Job Description I hereb firm that I am licensed ander f Chapter 9 (comrtuncin thereby prad Pomo p nJanheesame..anaprnfeadmnsceae.anemvi_en." e wimsatRo,can CARPORT (345 SQ. FT. ) -� effect. in full farce and effect. i 6 Dis.mD Linnu Claaa Lic. a FINALE® 3 Data Cnntraaur ARCHITECT'S O a `ao, DECLARATION = I understand my pans .shall ore used as panic records FEB 21 2002 ,o o L,ittnsJ Professional u R LL OWNER BUILDER DECLARATION v. 1 hereby aff fin that 1 am exempt from the Camra tur's License Law far the - a following match. (sailors ]03L3, Business and oli Code Any city oreounry tlnnaliah, or repair any duvaure ss, de E D which requiresit permit reconstruct. ohea impress, W� BUIL�IPYIT Q - ......_ - its is .trio ( t 1.requiresthe applicant for chpc 'uo Emasigned for such 5 PD PJOOPA[ea .. ��t dt a_¢:` • Valuation (atatemem. - (hath I n -epee lion) pro'.(s fthe t ( ('dad ProluwfmCod9 (cord g- tnsem fD 'i J Code) Business andi'mi. or that n_,s exempt mecerroto a,e m_ basis for me alleged _u...... Anti slam)..„ ori'm the Any ,>•° V ,4'1.'�S 3 2 0 80'54' ` 0`0' -ofStt(ion4031.3 by airy applicant for a pmni(aubjata (he vpplicam m v civil penally mrnot,mrctn,nEvehnndrcadmmm(ssWl. APN Number yr .,, Occupancy Type 101 - FOUNDATION ❑1,.d mwmer mime ro n.mm m tts P=nea wan.se ed.. fiadr oleamm, eon. P per rernp Y s ' win Je the work, and the ode:Tstructure is norm., I Li erofmae for dee apply I. and Code: The Contractor's Licence Low Joss net apply to Required Inspections, " - q p 103 UFER emyWhProfession, owner of work hied_.if owner or tmpeny who buds, or impreves thereon, who sees - improvements ares or througgh his wn employees. provided that such vementemeots ere no( intended_.,iiaar -'fei-sole.,(( M1ewever, the FuilAin--" rtis sold -within otic -�f offered _ 104 -- _ - REBAR -----�-�` ------ 'completion, the ownerbuilder will have a,bura n of proving the; he did not build or 105 - ANCHOR BOLTS improve roti parre'e of'old'), _. .. __.-._..._...._... --- - - .6--=..SEWER._&_.WATER.. -- _....._...__.. -..... -'--...10 _ - O 1, as ow nor of the property. am ex msively contracting with licensed contractors to 202 - UNDERFLOOR PLUMBING e eastract the Project fsa. 7044. Business and Pm@ssmo, Code:) The Centacerd License wd«. not apply ,aanmwnetarpmp_nywho bmIds improves 203 - UNDERFLOOR MECHANICAL t.to_an, h pursuant.to tae_ -- an w o cont B or sue Prelate with a eonwno � cen,d cnnna_mrx nuww. "' 204 - UNDERFLOOR, FRAME , )- ' Olemexe code, Sec. .B&P Cfonnis rtason �'✓�7.�i17i' 205 - UNDERFLOOR INSULATION o ER's COMPENSATIOMIJEC A.licenxd _ own Dme' ATIN 301 - ROUGH PLUMBING I hereby.lino uaderpenalD or perjury, more of the following declarations: 302 - TUB & OR SHOWER 'maintain 303 - ROUGH MECHANICAL ❑ 1 have and will a'cctii0crie of consent to self-msum for Worker's Compensation, as -provided -for by Section 37W of the Labor Cade. for the 304 - ROUGH ELECTRICAL perfomance of the wmk for watch this pormit is lorded. - 305 - FRAME ❑ I have end`will maintain Worker'. C.. .cation Insurance, ss required by Section 306 - HOLDOWNS J]W of the Labor Code, .'or the Performance of the work for which this permit is .. _ _ -. ..._ ....... -. ve: (sued. MY Worker's Compcndvtian lnsumne ca "er end Pmliry number.,, ,..,. ..30.7... -...INSULATION_. ., --_.-._:_...•..-_,.+-_�.--.-:..--_.r.:----�---.-�—_�--:�. cam t' ' i . n'vPobcyN.i' { €3b8s-• •6;SHEETROCK-,:rpa. Lm r. WORKERS" 1 CI RTIFICACOMPENSATION OMOI ATION INSURANCE - coanver+snnoN�nsuRANce` .-t +l. 3,09-_.-_EXTERI.ORLATH' _ _ _ -;', _ ,(Thidde6,onndanmtbeemmpl<ted finepetm,tidfar on_natarcdmuars _ 310-' `INTERIOR LATH J r,, , 41000tr'e,A) 311 -_ SCRATCH COAT_ ccndr that in the ori= work tar whim t rake; 1 s oyn 313 - ROOF NAIL •., t i;, ' ! I' in u b ub ct om not employ am person Cm any manner so as to become iuM1leet m thb Workers' cmmicaut n<wsotcaufmmia:uam Compensation 501 - FINAL ELECTRICAL ENERGY ApidNOTICE TO APPLICANT: If, after makingthis CeniGcme of Exemption. pen. you anoglp - 502.._- FINAL-_ .. PLUMBING Z become subjectmthcWorker'sCompcnsationprovisionsofthel3almrCode,youmust 503 - FINAL MECHANICAL ENERGY forthwith comply with such provisions or this permit shall be deemed revoked. -'---504 -= 'ENERGY z0 .. ... ... .. .........__ VI "!"> "'• '•' 'CONSTRUCTION LENDING AGENCY. (hereby afrm,the, note is. canstracome lending asenry tar the;erfirmance "_ FINAL- BUILDING .,-.-:-.�.:-,i,-.-;,--.._....... 505 - FINAL ELECTRICAL -tiof the work for which perjnit, is issued Sec. 309], Co C. , 'TJ '..,- ( .,.- I .._ t __..._. .506---- GAS. -TEST-_....-. Leadec'iName >.Z Lene_andeaxs' 507 - FINAL PLUMBING.,' Icenify that1 have aced this applica(ion .nd state thenhe above information is 508 - FINAL MECHANICAL .gra ,o _comply with all city and tacountyordinances auction, l,aws rc.ating Jme Id' g lon M1d h rchy mho z representatives of this 'tytser 509 FINAL GRADE lince-arriantioned pro,sm,r peetpurposes. p.(We) ogreem solve, demmy keepCu,'mfCu,om'iaoo,mmI 510 FINAL PLANNING W .iab 1 t es judgments, costs and esp=nscs which may in any ay c gams( said .7 Z City' f the g nt ng f this perms 514 NA P WORKS / U v 'APPLIC UNDERSTAYDSAhDWILLCOMj LYWITHALLNON INT Issued by: r Date Y S U EGULATION, L Y - ' sign re of pli oatmc(or .: '. "' 'ti' . Da!e -:., . ',' Re -roofs ' AZARDOUS MATERIALS DISCLOSURE '' ..• 'o;i;I (Ibsr topiphearm aware b6ildir,a p t some orhandle haluddicas material Type Of Roof,..,, ' as defned by thec pen r M r c pal cad Chapter 9 11, and the Health and Safety Cad SOY n253JI4a1 - -(y i( v 1 t. y t i[ q,No •I, d ( s ec t• T 7 = k. All roofs,shall, be inspected prior to any_roofing material being installed__ Will the app),uses or future building occupant use equipment or devices which .._. -.. _ If a roof is installed without first obtaining aminspec[idri';'I•agree'to remove emit standards air communism, as defineby lh_ Bay Arca An Quality Management District? . all new materials for inspection. Applicant understands and will comply with Oyes • 01, No. all holt-point source regulations, •_ „ f h 'reaJ the h d seri req roam undo Ch pte fi 93 iif lore, @I f Health & Safety Code, scion 233(13 13373 and 33374 I demand that - if the Wildin s not currency have a unseat, mato is my respomibility m notify he ucdup ( of eequircmenta which armi bemc( trill, to issuance of o CeniGcate'of Signature of Applicant Date ._.. . _. s f _. All roof coverings to be Class "B" or better t: owae r.ud, ea as '' ate ;L ,. 1. 2. .-OFFICE .... ..... .... . . H� uc- f4at fiooe total UMn9 Araa 1 bY. tt. PeoposeG AaUten e< U 125' % '� FAR. Tobl fhoe Aeea 16'T3 oav IO6.t9 ceoao of oa' mow' �l } 1 3eiP.oP =aaa arnart : Rtt � p � i � Number of SMeY IU f!� 1 f�' w.en .o e..v of e:uv e.a�n, oPma eoe a *,7 ''�'�MNitlN .„,ae ki t rzv, _ �iyl E{ 'lJl lldl r A ............. t 1 jL - rraadh r7 �lI�g@ ! Va , 711> 1 nw- 4 a xx tivw- e -� t'nr���V� �� irk t,.u�� v a",>ca•... r6etall ity map C I• I I !C53rr7 w6T5rw" ra. PG t D n� 4 ( ! rc � 'ex �W k.- u ads p� c ,e^• -; l i Alot ola� 3A6° Detail - A n r I f t K O � I P .,, rFelaes � I t � IIY FLOOR PLAN '14" d_ ROOF FRAMING PLAN 'l4' I r .III l dS3 G- r�tt.PURT � � I P .,, rFelaes � I t � IIY FLOOR PLAN '14" d_ ROOF FRAMING PLAN 'l4'