Loading...
B-2016-2333CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 13-2016-2333 11050 SANTA TERESA DR CUPERTINO, CA 95014-4727 (356 17 033) UPPAL CONSTRUCTION COMPANY MILPITAS, CA 95035 OWNER'S NAME: GUNUGANTI RAMAKANTH AND DAMERLA RAMAI DATE ISSUED: 09/21/2016 KUNLAM OWNER'S PHONE: 408-5694992 1 1PHONE NO: (408) 262-3966 LICENSED CONTRACTOR'S DECLARATION License Class GENERAL BUILDING CONTRACTOR Lic. #893295 Contractor UPPAL CONSTRUCTION COMPANY Date 03/31/2017 I hereby affirm that I air 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 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. S of " " Date 2/6/2017 hereby affirm that I am exempt from the Contractor's License Law for one of the illowing two reasons: r. I, as owner of the property, or my employees withwages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) z. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 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. 3, 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. Signature Date 2/6/2017 BUILDING PERMIT INFO: BLDG X ELECT —PLUMB MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: ADDITION; CREATE (N) LIVING ROOM (480 S.F.); RECONFIGURE/REMODEL (E) KITCHEN, BATHS & LAUNDRY RM (740 S.F.); RE -ROOF (E) 25 SQ'S; UP GRADE (E) PANEL TO 200 AMP; RELOCATE FURNACE TO ATTIC & ADD (N) A/C IN REAR YARD DEF #1 - TRUSS CALCS; STRUCTURAL REVISION - ISSUED 11/14/2016 REV #1 - ADD FIRE SPRINKLERS; REPLACE EXISTING STUCCO - ISSUED 11/18/2016 REV #2 - KEEP (E) ELECTRICAL PANEL; MOVE FURNACE TO ATTIC - 2/6/2017 Sq. Ft Floor Area: 480 1 Valuation: $150000.00 APN Number: I Occupancy Type: 356 17 033 1 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: 09/21/2016 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. Signature of Al Date: 2/6/2017 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 25505, 25533, and 25534. Owner or authorized agent: Date: 2/6/2017 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 C tl P I~ RT t tit C3 (408) 777-3228 • FAX (408) 777-3333 • buildin cu e k or ❑ NEW CONSTRUCTION - n ADDITT()N AT TT -P ATT(1N / TT FDRL'VTctnhr —1 1 1111 1111TT? A T T r T PROJECT ADDRESS 16 /} SO SA -MIA _ r 92 IPcA cam; � APN n OWNERNAA '' rr /� r PHONE �( / E-k[AIL 'fe;l ICTG K-�tf} - Cs(C a �v&vnIV �� 6 b� C/� l STREET ADDRESS t Pf-1, CITY; STATE, ZIP FAX C U F =e N -f Pr ' CONTACT NAME 'Jame me V4� w�A� t / PHOnE E-MAIL —7��//bb STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWhER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR.AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME -,; `�� L LICENSENUNBER �7 ���� LTCEN TYPE BUS.LICY -v11) �IY�Ltit (j COMPAnY NAME QV i E-MAIL FAX �f� 2, Z e Z STREET ADDRESS �1 / ,> �j'F--� jn jQS a j (� / l +J TY, STATE: ZIP �tii r�� j '� 5 `�'/ 7 9 i HON p. 0r %h? J ( J 3,;?Z O 1 ARCHITECT/ENGINEER N?AA4E L`I'C(ENSE NUMBER BUS. LIC 1iT COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK L C KtC L— f 1/ 1 ice ' mn nL14 t M OYS Y iV L 1--12> j j7 C EXISTAG USE PROPOSED USE CONSTR TYPE - STORIES USE TYPE OCC. SQ.FT. V-ALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCHAREA DECK AREA�11AE TALDECKPORCH AREA GARAGE AREA: ❑ DETACH ❑ ATTACH a DWELLING UNITS: ND L IT ❑YES SECOND STORY ❑TES BEL'�G AIDED? ❑ NO ADDITION? ❑ NO PRE -.APPLICATION ❑ TES IF TES, PROVIDE COPY OF IIS THE BLDG Al ❑YES .,,-�. T LVALUATION . PLANNENGAPPL= NO PLAXNINGAPPROVAL LETTER EICHLERHOME? NO By my signature below, I certify to each of the following: I am the property owner or authorized agent to a t on th property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of \r.Tork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to b ilding construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: �� -15N ZC)t,-4— SUPPLEMENTAL INFORMATION REQUIRED PIS cxEc%T�PI . --ROUTINGSLIP, ❑ V BULLDL�G PLAR RESTE�i , New SFD or Multifamily dwellings: Apply for demolition permit forIi-TLI>icoiP.TER existing building s). Demolition pen -nit is required prior to issuance of building permit for new building. L7aPiiEss Cl. PLA\ �L�GPLAN REY IEty Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD PLBIIC\SORI.S, ' form if any Hazardous Materials are being used as part of this project. ; LARGE �_: FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to TMZAaoR L7 sAnLTAxr submittal of Building Permit application. sE�i IinLSTRLc I❑' ENNURO 1\TIEnTAL:�HEALTH:. BldgApp_2011.doc revised 06121/11 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR_: PERMIT NO: B-2016-2333 11050 SANTA TERESA DR CUPERTINO, CA 95014-4727 (356 17 033) UPPAL CONSTRUCTION COMPANY MILPITAS, CA 95035 OWNER'S NAME: GUNUGANTI RAMAKANTH AND DAMERLA RAMA DATE ISSUED:; 09/21/2016 KUMARI OWNER'S PHONE: 408-569-4993 PHONE NO: (408);262-3966 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: r License Class B Lic. #$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 X MECH X RESIDENTIAL `COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: ADDITION; CREATE (I) LIVING ROOM (480 S.F.); I hereby affirm under penalty of perjury one of the following two declarations: RECONFIGURE/REMODEL (E) KITCHEN, BATHS & LAUNDRY RM 1. I have and will maintain a certificate of consent to self -insure for Worker's (740 S.F.); RE -ROOF (E) 25 SQ'S; UP GRADE (E) PANEL TO 200 AMP; !;Compensation, as provided for by Section 3700 of the Labor Code, for the RELOCATE FURNACE TO ATTIC & ADD (N) A/C IN REAR YARD F performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by DEF #1 - TRUSS CALLS; STRUCTURAL REVISION - ISSUED Section 3700 of the Labor Code, for the performance of the work for which this 11/14/2016 1 permit is issued. REV #1 (11/14/16) -ADD F113E SPRINKLERS; REPLACE EXISTING APPLICANT CERTIFICATION STUCCO_fCJ C ( certify that I have read this application and state that the above Sq. Ft Floor Area: 480 Valuation: $150000.00 information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize APN Number: Occupancy Type: representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the 35617 033 R-3 (Custom) 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. PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR Signature > Date 11/18/2016 180 DAYS FROM LAST CALLED INSPECTION. OWNER -BUILDER DECLARATION Issued by: ABBY AENDE I hereby affirm that I am exempt from the Contractor's License Law for one of the Date: 09/21/2016 following two reasons: 1. 1, as owner of the property, or my employees with wages as their sole RE -ROOFS - compensation, will do the work, and the structure is not intended or offered for All roofs shall be inspected prior to any roofing material being installed. If a roof is sale (Sec.7044, Business & Professions Code) installed without first obtaining an inspection, I agree to remove all new materials for 2. I, as owner of the property, am exclusively contracting with licensed inspection. contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: Signature of Applicant: 1. I have and will maintain a Certificate of Consent to self -insure for Worker's Date: 11/18/2016 Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ALL ROOF COVERINGS TO BE CLASS "All OR BETTER 2. 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 HAZARDOUS MATERIALS DISCLOSURE permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the 3. I certify that in the performance of the work for which this permit is issued, I California Health & Safety Code, -Sections 25505, 25533, and 25534. I will shall not employ any person in any manner so as to become subject to the maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Worker's Compensation laws of California. If, after making this certificate of Health & Safety Code, Section 25532(a) should I store or handle hazardous exemption, I become subject to the Worker's Compensation provisions ofthe material. Additionally, should I use equipment or devices which emit hazardous Labor Code, I must forthwith comply with such provisions or this permit shall 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 be deemed revoked. the Health & Safety Code, Sect'i'ons 25505, 25533, and 25534. APPLICANT CERMCATION " 1 certify that I have read this application and state that the above information is ✓ i Owner authorized agent: correct. I agree to comply with all city and county ordinances and state laws _ Date: 11/18/2016 1/ relatingto building construction, and hereby authorize representatives of this city 9 y P ty ("'ONSTRUCTION LENDING AGENCY to enter upon the above mentioned property for inspection purposes. (We) agree I hereby affirm that there is a construction lending agency for the performance to save indemnify and keep harmless the City of Cupertino against liabilities, of work's for which this permit is issued (Sec. 3097, Civ C.) judgments, costs, and expenses which may accrue against said City in Lender's Name consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Lender's Address Code, Section 9.18. Signature Date 11/18/2016 ARCHITECTS DECLARATION I understand m plans shall be used as y public records. 1 i ............ eo CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 3' Zo t� 7 3 (408) 777-3228 • FAX (408) 777-3333 bullding@ouraertlno.oria NE}'N CONSTRUCTION 0 ADDITION ❑ ALTERATION/T1 UllEvISION /DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS C -VV' _'—fTNV APA, ' ' )spi } OWNER NAM£ PHONE E-KAIII, STREET ADDRESS CITY, STATE, ZIP { I FAX 1,v � ' c — C it e CONTACT NAME �71N1 � PHONE E-MAIL } d STREET ADDRESS CITY, STATE, ZIP FAX 13 OBINER ❑ ❑ OW ERAGENT ❑ COh'TRACTOR ❑ CON'TRACTORAGER*r 11 ❑ ❑ ❑ .0UNER-BUILDER ARCHITECT BWGII:EER DEvELOPER TENANT CONTRACTORNAME LICENSE NUMBER. LICENSETYPE BUS. LIC n COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP ! PHONE ARCHITECTIENGINEER NAME LICENSE N134BER BUS. LIC L COMPANY NAME E-MAIL ! FAX STREETADDRESS - CITY, STATE, ZIP PHONE DrSCRIPTION OF WORK __ f, EXISTWO USE PROPOSED IISE CONSTR. TYPE # STORII:S _ _ - �` USE TYPE OCG SQ.FT, VALUATION (S) EXLSTG ,NEW FLOOR DE1111 . TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN - OTHER REA40DELAREA RFMODELAREA REMODELAREA PORCH AREA - DEGKARI=A TOTAL DECKTORCH AREA GARAGEAREA: DETACH - - [] ATTACH i a D4TIELLII.'G UWI S; IS A SECOND U&Tr ❑ YES SECOND STORY 0 YES ! ^� BEINGADDED? QNO ADDITION' ONO PRE -APPLICATION ` ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # ONO PLANNING APPROVAL LETTER IS THE BLDG A.h ❑ as EICIILERHOAIE7 ❑ i R FIZ' D B]y ' r4 _ E ti • TOTAL, VALUATI0. By Ivy signature below, I certify to each of the following: 1 am the property owner or authorized agent tb act on The property owner's behalf, 1 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 statclaws relating to b ' Ing construction I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signatmz afApplicanVAgentr",�P.] — Date, tt (jL ��C� SUPPLEMENTAL INFOn4ATION REQUMD �} ,�,It�.�.,-PL.4T,L`iiECI�:TLPBNew SFD or Multifamily dwellings: Apply for demolition permit forx� o �K imam.. `'"fit -C e%isting building(s). Demolition permit is required prior to issuance of building �$,',1] Oti F:R TiIE P,TEI2 .f- },, " g BUILDIIG PL41 RE1ZE+' �; TIE' :... Permit for new building. REQ 3 ;_4 E.tiP SS P%� i �T.4 t5 v REt IE , �L x n rt 5 Commercial Bldgs: Provide a completed Hazardous Materials Disclosure. X17, sralnaRn P�LBLIC ii 0R7.S is form if.any Hazardous Materials are being used as pari of this project.K. tt I aRc> LuxE D£i r _Cap} of Planning.Approval Letter or Meeting with Planning prior to rte { ' N r s r z a; Building submittal of Building Permit application. TML�so>?It: Y �' ��# SAI,I &RI :SE\iiERDISTRIC� s Y} Y�-f _`°•'=S.i '. .� 1:.. Y•-'-f-`5�. ,��. s�.W--•++Y. %1ZI 1 N1'iRO1,919N Ai:HEALTIi. - - _ B1dg4pp_2011.doc revised 06111111 i e CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2333 11050 SANTA TERESA DR CUPERTINO, CA 95014-4727 (356 17 033) UPPAL CONSTRUCTION COMPANY MILPITAS, CA 95035 OWNER'S NAME: GUNUGANTI RAMAKANTH AND DAMERLA RAMA DATE ISSUED: 09/21/2016 KUMARI OWNER'S PHONE: 408-5694992 PHONE NO: (408) 262-3966 LICENSED COW-RACTORIS DECLARATION License Class GENERAL BUIL DING CONTRACTOR Lic. #893295 Contractor -UP-PAL CONSTRUCTION COMPANY Date 03/31/2017 hereby affirm that I am licensed under the provisions of Chapter 9 (commencing ith Section 7000) of Division 3 of the Business & Professions Code and that my cense is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations i. 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. SignatureDate 11/14a016 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: t. 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: i. 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. 2. 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 9.15. Date 11/14/2016 BUILDING PERMIT INFO: X BLDG X ELECT _ PLUMB X MECH X RESIDENTIAL — COMMERCIAL JOB DESCRIPTION: ADDITION; CREATE (I) LIVING ROOM (480 S.F.); RECONFIGURE/REMODEL (E) KITCREN, BATHS & LAUNDRY RM (740 S.F.); RE -ROOF (E) 25 SQ'S; UP GRADE (E) PANEL TO 200 AMP; RELOCATE FURNACE TO ATTIC & ADD (N) A/C IN REAR YARD DEF #1 - TRUSS CALCS; STRUCTURAL REVISION - ISSUED 11/14/2016 Sq. Ft Floor Area: 480 1Valuation: $150000.00 APN Number; Occupancy Type: 35617 033 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 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: 11/14/2016 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 25505, 25533, and 25534. Owner or authorized agent: ff4, Date: 11/14/2016 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 _ CONSTRUCTION PERNUT APPLIGA i [O COfiWUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION r—'—:0 10300 T ORRE AVENUE • CUPERTINO, CA 95014-3255 N. CUPER i INO (408) 777-3228 • FAX (408) 777-3333 • bui1dina5cu0ertin0orq KIEW CONSTRUCTION ❑ ADDITION ALTEk • T ON'/ TI REZ%ISIO- 1DEFERRE OP:IGIN LPERIi4IT- PROJECTADDRESS ®ry �g LeJ tl esa OWNER 1`AlIE ` PHONE E-MAIL 6jvtju, 'R i� STREETDDPESS �j—&q 1 try I CITY; STATE, ZIP FAX '�-fe� . �.� �`'FiS� �� • b`�� aft i 1 � � n �. ' �1 � �- I CONTACT ?\. J E Pri0\E F STREET ADDRESS I CITY, STATE, ZIP FAX ❑ OWNER ❑ OR^.\-BuLDER ❑ Owi't 'AGE -N7 ❑ COI\7R,4CTOR. ❑ CO>\-TP.ACTORAGTT ❑ A-RCHITECT ❑ ENGNEER ❑ c ER TENANT COXTRACTOR\A-hS I LICENSE2\7LJMBER LICENSE TYPE J3liS. LIC g, COWAKY 1 LME E -I i�SL L FAX STREE TADDRESS I CITY, ST. -".TE: Zip PiIOhE ARCHffFCT/E-? G12,,EEP 7\.AI,4E I LICENSEE Nb flBER BLS. LIC'. CO:vTA'\Y AAI,�F _ I E-1`�iatL I FAX �. STREET ADDRESS CITY, STATE, TP PHO _. NE .. DEcCP,]PTIOA' Or 1i%CRI: "�h•�.�is C'�'L�i� [�rti � e I���-- , U — - S—TF—V r AL 'I tT.1J aKlr USt - PROPOSED LSE CONSTP i'?PE i =2 EXISTG NEW FLOOR I DEI\40 TOTAL .AREA I AP.FAF.itEA I\7ET AP.EA BATT-LROUM - KITCHEN - OTHER.. P-11,40DELARE.A REQ\?ODELAREA I REAiODELAREA USE I n PE I OCC. I SQ.FT. I VALUATION (S) Bldgfp.P_2011.doc revised 05121=11 ❑.ATTACH D1it L'\`G UNITS:I ISA SECOND LKIT [:] YES SECOND STORY -: r SELNG ADDED' [F] NO ADDITION? 02,0 I. I. PRE ! I`LICATION []YES r YES PRO EDE COPY OF I]\0 ?L.=�.'\LtiG_;.PPR OVAL LETTER I IS THE BLDG A.';❑ 1 5 EICHLERHOME? ❑�\O RE iZ ED BY - ` _- Y -_ \ _ IO gLlt.T10\: By n;i s gnatu e below, , I certill tD each of the folloi, in!z: I am the proper)L , ov nei or Futhonzed went to z t on the propaLyowner'sbehalf I have read this application and the L7torinatlon I have e provided is correct. I have read Lbe Description of lwork and verity it is accurate. I agree to comply with all applicable local ordinances and sate laws i la i7E Lg� Idin+s construction. I authorize representatives of Cupertino to enter the abov -ide tified property for inspection purposes. Signature of Applicant/Azent. r�siov, it - Date: LP SUPPLE -MENTAL INFOR4ATION REQUIRED t I ' �- PT i\ CAECI, TIPS R01 -'TI G SLIP �e,i SFD or &vellings Apply for demolition permit for y st'n c u:. m, a lits n -l. _ , _•issuance 1_ b .lam 7 (S�. D2I?IO:ItiOr1 p t 7� r"'QL� .,� priorto Of�uilding - SLiLDISGPLA.'\ RE11ETi peri, t for nein building. T ems, `cc iii i 1�°= n:t »eLLrc•a] Ble_ i Ovi a carp ..d ), azardous \2 ral D;Sclosll E x A � LA I GPLAR PE\ IE1i _Co fo STA D RD 1 1I PLS LIC t ORDS r-ni lI an1 Hazardous Materials are being used as Dalt OI Lhi._ project. _ Copy Planning ❑ r 4RGE ❑ FIRE DEPTf v of Approval Letter Or I\ eeting with Pj'znninzprior to . Submittal of Building Permit application. _ LJOR SiiIT9R1 SE\3ERDiSTRICT Bldgfp.P_2011.doc revised 05121=11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11050 SANTA TERESA DR CUPERTINO, CA 95014-4727 (35617 033) CONTRACTOR: UPPAL PERMIT NO: B-2016-2333 CONSTRUCTION COMPANY _. OWNER'S NAME. �q t / y/.�� ' MILPITAS, CA 95035 DATE ISSUED: 09/21/2016 OWNER`S PHONE: 408-564-4 2 Gt l l t PHONE NO: (408) 262-3966 LICENSED CONTRACTOR'S DECLARATION BUILDING PERNUT INFO: License Class Ia Lic. #893295 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 X MECH X RESIDENTIAL _ COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: I hereby affirm under penalty of perjury one of the following two declarations: ADDITION; CREATE (N) LIVING ROOM (480 S.F.); RECONFIGURE/REMODEL (E) KITCHEN, BATHS & LAUNDRY RM m. I have and will maintain a certificate of consent to self -insure for Worker's (740 S.F.); RE -ROOF (E) 25 SQ'S• UP GRADE (E) PANEL TO 200 AND; Compensation, as provided for by Section 3700 of the Labor Code, for the RELOCATE FURNACE TO ATTIC & ADD (N) A/C IN REAR YARD 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. Sq. Ft Floor Area: 480 Valuation: $150000.00 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 356 17 033 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 l the granting. this permit. Additionally, the applicant understands and will comply with all ll non -point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION._ Signature t �t Date 9-21-2016 Issued by: Kim Dunbar OWNER -B iii D R DECLARATION Date: 09/21/2016 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 isnot intended or offered for inspection. sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 9-21-2016 I hereby affirm under penalty of perjury one of the following three declarations:ALL 1. I have and will maintain a Certificate of Consent to self -insure for Worker's 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 2. 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. I 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 air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of 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 agent: APPLICANT CERTIFICATION Date: 9-21-2016 I certify that I 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. 1 understand my plans shall be used as public records. Signature Date 9-21-2016 -I Licensed Professional Cz5 Q NEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARR7-MENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 + FAX (408) 777-3333 • buildin-gg-.cupertino.ora WADDITION �—IF�i3-- 26 t 6 1 I ALT&RATION I TT i k RRyiSTnw / nR.FF.RRAi] 11R r[ user -p z mT �l PROJECT ADDRESS � 11i C+' S: 1J'C V J*P.2T Ak) 7 `� � APN # y- ffy � ]�� � �s � 3 � y CA 501S SU Ci OWNERNAME W* A �PAN'T I) %V tl� I!' y, -� PHONE f nay, t J- E-MAIL VQIrAC4 F 1+�y* }y 4• S'TREETADDRESS'1 t ,AWTA �! &11 CITY, STATEZIP UpEf u-tio, ( A `. 1 FAX CONTACTNAME R'11M Ry- O'Tk1 `2iQW9G) IivT PHONB 6-t t EMAu �! STREETADDRESS - CITY, STATE, ZIP - FAX ❑ OWNER. ❑ OWNER-EUMDER I�. OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTORAGENT ❑ ARCHITECT 0 ENGINEER ❑ DEVELOPER Q TENANT CONTRACTORNAME . a LICENSENWBFR go,LICENSE TYPE BUS- LIC# COMPANYNAMP. 9 V � ppAL_ �k*'ygUntLW ty�� pp 1 f E-MAIL 4i w( Co'i)9 '1"tf_ iOn ( 3MCii • FAX STREETADDRESS �Z � �^�j`� �` CITY,STATE,ZIP MIL-FIT05j CA q5-0315- PHONE 4og 456-* All CHITECTIENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE -DBSCRWY10114-OF-WORK ._ _, 6 6j) AkPii)!Q0JTIt1 7612 1 Ilk �,PlL 1AJcI ii \,>IAIA (W) .Q -T 046AI. N r Y -J 10 6 _baln,6NN_ t - ,- j EXISTINGUSE -SSNL7 - CONSTP.TYPE PROPOS -U-,�P"0 V— 1jfIJ�+LG #STORIES. f USE 'TYPE -OCC. SQ.FT. VALUATION EXISTG` ky AREA Q NEW FL00 AREA i 6c) DEMO AREA TOTAL NET AREA „ BATHROOM KITCHEN REMODELAREA REMODEL. AREA 0 0 OTHER REMODEL AREA POR HAREA - DECK AREA TOTALDBCK!lIPORCH AREA GARAGEAREA: ❑DETACH - . '�I ._..:' j ,jy `7� ��/J _.y� ATTACH � J $DWELLING UNITS;: ISASECONDUNrr [3YEs SECOND STORY .DYES - - I BEING ADDED? NO ip ADDITION? tr NO PRE -APPLICATION []YES IPYES, PROVIDE COPY OP -PLANNING ADPL# 5„ NO PLANNING APPROVAL LETTER ISTHE BLDG AN [J YE EICHLERHOME? 0 - E - TOTALALUATION: I y my signatuie below, I certify to each of the following: I am the properly owner or authorized a ct on the property owner's behalf. I read this application and the information I have provided is correct: I have read the Description Of Work a verify it is accurate. l agree to comply with all applicable local ordinances and state laws relating to b Ing constiliction. I authorize -presentatives of Cupertino to enter the above -identified property for inspection purposes. Signatw-e ofApplicant/Agent: V( Date: SUPPLEM -WAL INFORMATION REQULREI? -- -.-FLA N.0 CKTYPE _ :_.:;:: • ::: -IYOUTINGSI.IP:: �. - - - - - ❑' O� EI; THE-COUl\TER - - - _= - = - = UILDIRG PLAN. REl'AE�Y,_;�,; ;- — New SFD or Multifamilydwellings: Apply for demolition pen -nit for existing building(s). Demolition permit is required prior to issuance of building -: :.._� parnitfor new building. ; =; Commercial Bldgs: Provide a completed Ha7ard0US Materials Disclosure ;-0.=_ STANDARD m-ni if any Hazardous Materials arc being used as part of this project. `LARGE _ Copy of Planning Approval Letter or Meeting with Planning prior to ©sIir►nRsI RIN T submittal ofl3uliding Permit application.'oR - f:Z; _::r- :-a--. ==-� -_e �::- ;�_.:_.:�. '�;::..•:: - ,-.:,•;:ENVIRONMENTALH.EAhTH B1ddApp_2011.doc revised 06121111 t"jcsvT -A-TN 'mss DISTRICT MANAGER-ENGINEER �`�fl SI Tggyo''s BOARD OF DIRECTORS MARK THOMAS&COMPANY,INC. C f� JOHN M.GATTO RICHARD K.TANAKA v WILLIAM A.BOSWORTH PATRICK S.KWOK DISTRICT COUNSEL ANGELA S.CHEN ATKIN ON•MARC FARASSS, LLP. (Tsrge1ISNEO'1546 TAGHI S.SAADATI HYNE20863 STEVENS CREEK BOULEVARD,SUITE 100 CUPERTINO,CALIFORNIA 950142154 PHONE(408)253.7071.Fax(408)253-5173 September 27, 2017 City of Cupertino Building Department 10300 Torre Avenue Cupertino, CA 95014-3255 Subject: Property Line Cleanout Install Address: 11050 Santa Teresa Drive, Cupertino APN: 356-17-033 Permit No: B-2016-2333 ■ Videotape and Property Line Cleanout inspected and passed on July 3,2017. No additional conditions/requirements by the District. Inspector• Signatu e Brian Chu Print Name Date: 07-03-2017 Cc: Property Owner SUPPLYING SANITARY SEWERAGE SERVICES FOR:CITY OF CUPERTINO,PORTIONS OFTHE CITIES OF SARATOGA,SUNNYVALE,LOS ALTOS AND SURROUNDING UNINCORPORATED AREAS