Loading...
B-2016-2623CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2623 21550 ADDINGTON CT CUPERTINO, CA 95014-4847 (356 22 032) HORIZON CONSTRUCTION NEWARK, CA 94560 OWNER'S NAME: GOPAL RAVI M AND PRATIBHA R DATE ISSUED: 11/18/2016 OWNER'S PHONE: 408-6584159 PHONE NO: (510) 6734769 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class @ Lic. #937861 Contractor HORIZON CONSTRUCTION Date 09/30/2017 X BLDG —ELECT X PLUMB MECH X RESIDENTIAL COMMERCIAL 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. JOB DESCRIPTION: 1 ST FLR ONLY; ENLARGE KITCHEN & FOYER ADDITION (275 S.F.); I hereby affirm under penalty of perjury one of the following two declarations: EXTEND ROOF LINE TO CREATE (N) COVERED PATIO AREA (153 1. I have and will maintain a certificate of consent to self-insure for Worker's S.F.); KITCHEN REMODEL - M,E,P (150 S.F.); REPLACE WATER Compensation, as provided for by Section 3700 of the Labor Code, for the HEATER, SAME LOCATION performance of the work for which this permit is issued. REV#1 - REDUCING WINDOW SIZE (4)- ISSUED 6/20/2017 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 Sq. Ft Floor Area: 275 Valuation: $80000.00 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 APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 356 22 032 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 of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature _ Date 6/20/2017 Issued by: ABBY AYENDE OWNER-BUILDER DECLARATION Date: 11/18/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the RF­ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is 1. 1, 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 property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 6/20/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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. 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. 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 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: 6/20/2017 — I certify that I have read this application and state that the above information is CONSTRUCTIO D AGEN 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. Licensed Signature Date 6/20/2017 Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDINGREVJSION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 #-LB CUPERTENO (408) 777-3228 •FAX (408) 777-3333 • buildin cuoertino.or - ZD, J 0 NEW CONSTRUCTION ADDITION 0 ALTERATION / TI REVISION / EFERRED ORIdIINAL PERMIT # PROJECT ADDRESS Z 15 e D I ` ! r,� ck, I APN k OWNER NAME PHONE � � � p _ � S EMAIL STREET ADDRESS 2 155 „(-j \ n CITY, STATE, ZIP I FAX l.� V -K n o CONTACT NAMEPHONE E-MAIL . 1`la 1-- bebassoc ces,c STREET ADDRESS CITY, STATE,ZJP q5n FAX �- !� C�eSi nq e•' 9 I ElOWNER 11OWNER-13=ER ElOWNER AGENT ElCONTRACTOR 11CONTRACTOR AGENT AST ❑ENGINEER 13 DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE N7J7,0ER LICENSE TYPE I BUS, LIC k COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME � Gyr LICENSE NUMBERC--7 BUS. LIC n COMPANY NAN E E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK '�fJ►S,��ns +o Pe�rrn�-�� �'�•o,v.: rht,,r,�I��;1.1 �' a�n�Q USE I TYPE I OCC. I SQ.Ff. I VALUATION (S) BldgApp_2011.doc revised 06/21111 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: B- 2016-2623 21550 ADDINGTON CT CUPERTINO, CA 950144847 (356 22 032) HORIZON CONSTRUCTION NEWARK, CA 94560 OWNER'S NAME: GOPAL RAVI M AND PRATIBHA R OWNER'S PHONE: 408-257-5716 LICENSED CONTRACTOR'S DECLARATION License Class GENERAL BUILDING CONTRACTOR Lic. #937861 Contractor HORIZON CONSTRUCTION Date 09/30/2017 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. hereby affirm under penalty of perjury one of the following two declarations: r. 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. 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 11/18/2016 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 w 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: s. 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. 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 thiscertificateof 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. r 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 11/18/2016 ISSUED: i1/18/2016 PHONE NO: BUILDING PERMIT INFO: X BLDG —ELECT X PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: 1 ST FLR ONLY; ENLARGE KITCHEN & FOYER ADDITION (275 S.F.); EXTEND ROOF LINE TO CREATE (1) COVERED PATIO AREA (153 S.F.); KITCHEN REMODEL- M,E,P (150 S.F.) REPLACE WATER HEATER, SAME LOCATION Sq. Ft Floor Area: 275 APN Number: Occupancy Type: 356 22 032 R-3 (Custom) PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. sued by: Kim Dunbar ..f,.. iIll oionic 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 Signature of Applicant:_ Date: 11/18/2016 "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)j 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: 11/18/2016 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 understand my plans shall be used as public records. Licensed CONSTRUCTION PERMIT A PPI �N COMMUNITY DEVELOPMENT DEPARTMENT • BUIL, �jVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-325b CUPERTINO (408) 777-3228 • FAX (408) 777-3333 - buildingPcupo rtino.ora � � + EG nNE"\VC0W&-rRTICTI0N . 7 Aff)MON 7 A.T.TIRRATTOMITr RFVTCT(1TTITTFPT:RRFlI 7lRTRTiTLT DrDMIT44 PROJECT ADDRESS Z} (' f -D D i L4 � � 1 o Aj 1.7'- L/V\ APN # r t //J I✓ I/ Tvp ! D 3 OWNERNA1111 flj(�J r + ! J Q tl PHONE 2- �'-4 — f {W STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAME � � 1nC1t Iit iZ. PHONE - ©12 fold r a E-NL41L�. I t�-j+� `_ 1 I/— E) Ao, L. LDt 1 L /`� 'STREET ADDRESS S � � r-4 j rye, CITY, ST ATE, ZIP Si C�`�j- ')- , CA qS FAX ❑ OWNER ❑ 0W ER-BtMDMt 17LO 1NERAGENT ❑ CONTRACTOR. ❑ CONTRACTORAGENT ❑ ARCH17ECT ❑ ENGINEER ❑ DEVELOPER ❑ TE7QA1-IT CONTRACTORNAME y �t) 7 LICENSEN`UMHER LICENSETYPE BUS. LIC N COMPAIt'Y NTAME E-MAIL FAX STREETADDRESS CITY, STATE, ZIP PHONE AR(MITECTlENIGINEE'RNAME LICEAtSENUI BER BUS. LIC 9 COMPANYNAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ' Ck LCGllittt,}I Qfr �rUnk !tC n U-ct-e c� P C l� , t 155 $ `'- ��' 1`� � -tom_ 4 p O _ or'— �ct---P-�+ ra!` 4vf`1 EXISTII.G USE PROPOSED USE CONSTR. TYP . N STofas USE TlTE OCC, SQ,FT, VALUATION (S) EXISTG ARBA NL -W FLOOR AREA +7 L► DENIO AREA TOTAL N[CNtL•A �. - - - BATHROOM MCHEN OTHER - REMODELAREA REMODELAREA 150 REMODELAREA f PORCH AREA DECK AREA TOTAL DECKIPORCH AREA.. GARAGE AREA: ❑ DETACH - ATTACH i 0D\i'ELLING UNITS: ISA SECOND UNIT E] YL•S SECO1�'B'S ORY M 7 BEMGADDED? E]IaD ADDI IS:lA ISTHE BLDG Ari (D ".Es - 1Ep b,Y ,y - TOTAL VALUATION: PRS -APPLICATION ❑ YES IF ITS, PROVIDE COPY OF " PLARMINGAPPLR []NO PLANNING APPROVAL LETTER EICHLER HOME? E]NO .s _ _ By my signature below, I certify to each of the following- I am the property owner or authorized agent to act on the property 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 a0awate. I agree to ccxmply with all applicable local ordinances and state laws relating t building coJnstruction. I authorize representatives of Cupertino to enter the above-identiti d propel'ty for inspection purposes. 9J3) I Signat�re of AppIicant/Ageni: U I Date: I L I�tIRMATIflN RE LiIRED SIJPPLEIIIENTAL IF Q `:~'=�-=-- CFIECK i 1PEY - s : ROUTIr G`SLSP , s;!-�_,_,3;_:��::i�,:��.>;�a_,i�_-.=�:��-::�- ]01 EA THE CflUr rER l� BUD DING PL4\RES ER New SFD or Multifamily dwellings; Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building At Permit for new building. p RS PRESS PLA�t�t%GPL4iRESTER Commercial Bldgs Provide a completed Hazardous Materials Disclosure Msran0RD i� PU&LTC S;olzi.s r " ' forst 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 ❑ T9A7UR LL`: � S�1SIT�R1 SEiiERDZSTRICT s::s submittal of Building Permit application. _ _ .. _,... � � ..:->,r_,. . -- _ _ -_ _.-_.._�• ldgApp 2011.doc revised 06/27/11 E Date: February 6, 2017 Proiect No: 2850 Chief Building Official City of Cupertino Subject: Dear Sir, Epoxy Grouting Rod and Dowels For Residential Building 21550 Addington Court, Cupertino, CA 95014 Permit #: B-2016-2623 k Based on owner representative's request we visited the above job site on February 2, 2017 and observed the progress of all -threaded rods and dowels embedment into the existing concrete footing for additional deck and kitchen located in the back yard and main entrance of the building according to the following Table: TYPE Length Diameter(In.) Hole Size(ln.) Min. EMBEDDED (In.) Quantity All -threaded Rod 21" 5/8" 3/4" 12" 3 Dowels 36" #4 5/8" 5" 30 I ne type of epoxy was 5t I -AP with expiration date on 09/01/18. In general work was in compliance with details 3 and 5 on page SD4, detail 6 on page SDSand shear wall schedule requirement on page SD2 dated 07/27/16. Inspection was p performed periodically and on call basis as -- requested�' by -fhe" owner's---` representative. We claim no responsibility or liability for damages from improper use of the results or findings. We do not undertake the guarantee of construction nor do we relieve the contractor of his primary responsibility to produce a completed project in accordance with plans and specifications. Our findings refer to locations that were inspected by Achievement Engineering representative. If you have any questions or need any additional convenience. Sincerely Yours, Farshad Safaian, P.E. State of California Licensed Civil Engineer CC: The Owner /M feel free to call us at your Address: 2455 Autumnvale Drive, Unit E, San Jose, CA 95131 - Tel: (408) 217-9174, Fax: (408) 217-9632 www.achieveng.com Form R-11