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15120178CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15120178 20129 SUISUN DR CUPERTINO CA 95014 (369 28 009) GLOBUS BUILDER INC NORTH HOLLYWOOD, CA 91606 OWNER'S NAME: MANTHI .1 SOUNDARARAJAN OWNER'S PHONE: 4082399866 LICENSED D ONT A TOR' DECLARATION License Class li Lic. #961380 Contractor GLOBUS BUILDER INC Date 05/31/2017 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. 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 mL -,performance of the work for which this permit is issued. 1 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 all non -point source regulations per the ertino Munici tion 9.18. Signature Date 04/07/2016 OWNER -BUILDER DECLARATION 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 DATE ISSUED: 04/07/2016 PHONE NO: (818) 760-7100 BUILDING PERMIT INFO: BLDG —ELECT —PLUMB MECH _ RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: CONSTRUCT ONE STORY KITCHEN ADDITION (322 SQ FT); MASTER BEDROOM ADDITION (456 SQ FT); REMODEL SECOND FLOOR BATHROOM (142 SQ FT); REMODEL LIVING/DINING ROOMS ON FIRST FLOOR (381 SQ FT). Sq. Ft Floor Area: I Valuation: $115000.00 APN Number: Occupancy Type: 369 28 009 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: PAUL O'SULLIVAN Date: 04/07/2016 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. sale(Sec.7044, Business & Professions Code) z. 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: 04/07/2016 I 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. 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 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 04/07/2016 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 Mu Opal Code, Chapter the Health & Safety Code, Sectiot 5059 25533, 4. Owner or authorized agent: Date: 04/07/2016 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 Professional CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15120178 20129 SUISUN DR CUPERTINO CA 95014 (369 28 009) GLOBUS BUILDER INC NORTH HOLLYWOOD, CA 91606 OWNER'S NAME: MANTHIRI SOUNDARARAJAN DATE ISSUED: 04/07/2016 OWNER'S PHONE: 408-239-9866 PHONE NO: (818) 760-7100 LICENSED NSD ONT A TOR'S DECLARATION BUILDING PERMIT INFO: License Class @ Lie. #961380 Contractor GLOBUS BUILDER INC Date 05/31/2017 —BLDG —ELECT —PLUMB MECH 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: CONSTRUCT ONE STORY KITCHEN ADDITION (322 SQ FT); I hereby affirm under penalty of perjury one of the following two declarations: MASTER BEDROOM ADDITION (456 SQ FT); REMODEL SECOND t. I have and will maintain a certificate of consent to self -insure for Worker's FLOOR BATHROOM (142 SQ FT); REMODEL LIVING/DINING Compensation, as provided for by Section 3700 of the Labor Code, for the ROOMS ON FIRST FLOOR (3 81 SQ FT). J performance of the work for which this permit is issued. / iY I have and will maintain Worker's Compensation Insurance, as provided for by REVISION #1: REMOVE FIREPLACE AND CHIMNEY IN FAMILY Section 3700 of the Labor Code, for the performance of the work for which this ROOM.- ISSUED 9/29/2016 permit is issued. APPL.ICA_NT CERTIFICATION Sq. Ft Floor Area: Valuation: $115000.00 I 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 369 28 009 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. Additionally, the applicant understands and will c6mply with all non -point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino Munic' a(Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature _ – Date 9/29/2016 Issued by: ABBY AYENDE OWNER -BUILDER DECLARATION Date: 04/07/2016 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 r. 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 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: 9/29/2016 1 hereby affirm under penalty of perjury one of the following three declarations: r. 1 have and will maintain a Certificate of Consent to self -insure for Worker's ALL 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, Sec 5505, 25533, and 25534. I will permit is issued. maintain compliance with the Cupe o Muni pal 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 532(a) sh 1 d I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally, should I e equipm or devices which a hazardous Worker's Compensation laws of California. If, after making this certificate of air contaminants as defined by t e B ea Air Quality Maria nt District I exemption, I become subject to the Worker's Compensation provisions of the will maintain compliance with t Cupertino Municipal Code apter 9.12 and Labor Code, I must forthwith comply with such provisions or this permit shall the Health & Safety C e, Sections 2550 be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date: 9/29/2016 1 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 9/29/2016 Licensed Professional � J) CONSTRUCTION PERMIT APPLICATION I, COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building ftuoertino.org CUPERTINO /�/ 7Q F NEW CONSTRUCTI I71&/D ALTERATION /TI �J ( REVISION /DEFERRED ORIGINAL PERA4IT # PROJECT ADDRESSn„ SfZ9µ I5 (, APN # OWNERNAME PHO pvIYV.APa NiY�fili-i DQ-23��5�66 E-MAIL 8 ^fir 1 5 STREET ADDRESS CITY, STATE, ZIP C 5'U FAX 20 2_ So i w r -Py . CONTACT NAME PHO E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWIv'ERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENAI,,T CONTRACTOR NAME A I , ✓ LICENSE NUMBER LICENSE TYPE BUS. LIC ,# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHrrECT/ENGINEER NAM LICENSE NUMBER BUS. LIC # C c - COMPANY NAME E-MAIL SC FAX STREET ADDRESS tftlli � CI ATE, IP C PHON - �� a J DESCRIPTION OF WORK A562o'�y ?qJW 9AZK EXISTING USE PROPOSED USE CONSTR TYPE # STORD3S USE TYPE OCC. SQ.FT. VALUATION (5) EXISTG NEW FLOOR DEMO TOTAL =s AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKTORCH AREA GARAGE AREA: DETACH ❑ ATTACH #DWELLNGUNITS: IS A SECOND UNIT [3 YES SECONDSTORY [I YES Y BEING ADDED? []NO ADDITION? ❑NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF - 1S THE BLDG AN ❑ YES RECEIVED ': TOTAL VALUATION.- ALUATIONPLANNING PLANNINGAPPL # ❑ NO PLANNING APPROVAL LEITER EICHLER HOME? ❑ NO By my signature below, I certify to each of the following: la the erty owner or authorized agent to act on/thee property owner's behalf. I have read this application and the information I have provided is correct I ha d the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construct thorize representatives of Cupertino to enter the above entified property for inspection purposes. Signature of Applicant/Agent: SUPPLE:dENT ORMATION REQUIRED PLA^ CHECK TYPE ROUTING SLIP ER -THE -COUNTER L BUILDING PLas Rei IeW New SFD or Multifami dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building°V permit for new building. ❑ EXPRESS y PLANNING PLAN REVIEIV —Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ElSTANDARD ElPUBLIC NN"ORNS 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 ❑ NL4JOR ❑ SANITARY SE\N"ER DISI "RIC "I submittal of Building Permit application. ❑ ENVIRON9IENTAL HEALTH B1dgApp_2011.doc revised 06/2111 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(ftypertino.org ❑ NJRW CONSTRI INION It ADDITION I +ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS z o /Z 9 APN # JF6 /�/ OWNER NAME SOV J> JC �� w P� MgNj PHONE �� �Z3n_cj�� E-MAIL STREET ADDRESS CITYCvSTATE, ZIPFAX I CONTACT NAME �/J a"r PHO E-MAIL STREETADDRESS / L� L f V CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ( LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME CE SE NUMBER BUS. LIC # COMPANY NAME E -MAH. FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK C���� EXISTING USE PROPOSED USE CONSTR. TYPE �� #OR _S USE TYPE OCC SQ F"F. VALUATION ($) �E'�•� S %�►'E' EXISdd AREA NEW FLOOR AREA DEMO AREA 6 TOTAL NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA /► REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH C) U G7 ATTACH # DWELLING UNITS: IS A SECOND UNIT SECONDSTORV YES / BEING ADDED? O ADDITION?'WES IIlV10 PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RE IVED BY- TOTAL VALUATION: C'f PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO d //� _, ,YJ 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 read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construe ' . authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Y Date: X 40 to Signature of Applicant/Agent: SUPPLEMENT FORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP OVER-THF-COUNTERI BUILDING PLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure -4STANDARD 'ip PUBLIC WORKS _ 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 ❑ MAJOR SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENNIRONMENTALHEALTH BldgApp_201 1. doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 20129 Suisun Dr DATE: 12/21/2015 REVIEWED BY: Sean PC FEE ID APN: BP#: "VALUATION: 1$115,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex 2nd Unit? 0 Yes No I 0 E)No PENTAMATION 1 R3SFDADD PERMIT TYPE: USE: OTC. Yes $0.00 WORK Construct one story kitchen addition 322 sq ft); Master bedroom addition 456 sq ft); Remodel second SCOPE floor bathroom (142 sq ft); Remodel living/dining rooms on first floor (381 sq ft). 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 778 $2,654.00 1R3PLNCK $1,666.00 IRMNSP PME Plan Check: $0.00 381 1 s.f. $503.00 Remodel, Other /REMRESOTH Permit Fee: $1,666.00 Suppl. Insp. Feer Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 778 $2,654.00 $1,666.00 MECH, HOURLY © Yes 0 No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY Q Yes Q No MISC ITEMS t, I E ; T__1_ NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School &trirt_ otr_ 1_ Thoce feoc are haled an the nreliminary information available and are only an estimate. Contact the Dept for addh7 info. FEE ITEMS (Fee Resolution 11-033 t f 7/1,/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,654.00 142 s.f. $645.00 Remodel, Bath (<=300 sf) IREMRESBAT Suppl. PC Fee: Q Reg. 0 OT FO.OThrs $0.00 PME Plan Check: $0.00 381 1 s.f. $503.00 Remodel, Other /REMRESOTH Permit Fee: $1,666.00 Suppl. Insp. Feer Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 T7_ 0 Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: IPLLONGR $108.92 Select a Non -Residential Building or Structure A rz, Strong Motion Fee: IBSEISMICR $14.95 Select an Administrative Item 1 Bldg Stds Commission Fee: IBCBSC $5.001 SUBTOTALS: $4,448.871$1,148.001 TOTAL FEE -T $5,596.87 Revised: 10/01/2015 I 4Ss.ry:r CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Toile Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: 20129 SUISUN DRIVE PERMIT #15120178 O'AT(ER'S NAME:SOUNDARARAJAN MANTHIRI PHONE 4 406-239-9866 GENERAL CONTRACTOR: GLOBUS BUILDER, INC BUSINESS LICENSE## 961380 ADDRESS:6350 LAUREL CANYON BLVD #400 CITY/ZIPCODE:NORTH HOLLYWOOD, 91606 *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTOp E BTA a+12l16/2016 OINO BUSINESS LICENSE. -� b < l am not using any subcontractors: S Signature Date 'Pl , .n nhar-lc annttrnhip snheantractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # � Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / good Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock --� Tile - Owner,, Contractor Signature L'd 12/16/2016 Date 292 Ll'9L9L0@0