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14100067Im I CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11218 REDONDO CT I C O TRAC OR: ROSE HILL INTERIOR I PERMIT NO: 14100067 DWO I OWNER'S NAME: THAKAR ANJANEYA AND KANCHAN 1 10495 BYRNE AVE I DATE ISSUED: 10/13/2014 1 OWNER'S PHONE: 4083091581 ❑ LICENSED CONTRACTOR'S DECLARATION p' f License Class Lic. # t I Contractor-zZ.;,�t ,'1 51�� - �Wc� Date lY "iq 1 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. 1 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. 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 1 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.,.✓ �ie— Date ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1, 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 al I non -point source regulations per the Cupertino Municipal Code, Section 9.18. Date CUPERTINO, CA 95014 ! PHONE NO: (408)255-1462 JOB DESCRIPTION: RESIDENTIAL [:] COMMERCIAL E REPAIR WATER DAMAGE FROM 2ND FLR BATH, INCLUDING IST FLR KITCHEN & BATH & CEILING LIGHTING FIXTURES & DRYWALL (999 S.F.) REVISION #1:RRE�VISE THE LIGHTING LAYOUT AND REMOVE A NON - LOAD BE�=�'����N ROOM. ISSUED 10/24/14. Sq. Ft Floor Area: I Valuation: $62000 APN Number: 35621016.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. , Issued by: �� " i Date: /�'t�7/1 1`f 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. 1 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 1 use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sec-tiioon-ss 25505, 255>33, and 25534. Owner or authorized agent: 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 CUPERTIINO CONSTRUCTION PERMIT APPLI I COMMUNITY DEVELOPMENT DEPARTMENT • BUI 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinq(a)cupel ino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI REVISION / DEFERRED ORIGINAL PERMIT # (/ G 7 PROJECT ADDRESS J i , (tj' ,e CI o r\I� /' � o D l l� APN # OWNER NAME Ai a� e a c�r�cl �.ct�l c�c�v�—�y�ok4. r' PHONE 3JrI —15 E-MAIL STREET ADDRESSCITY, �l:L\g tZeclnr,<\J Ct STATE, ZIP FAX CONTACT NAME PHONEE-MAIL UJB -SriS- �3`7°1 �• STREET ADDRESS I�ti45 3 CITY, STATE, ZIP qSJ14 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ®-CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME 7UTo 1-r P� LICENSE NUMBER C6 MIQ �/ 'l6 LICENSE TYPE BUS LIC # COMPANY NAME _,a,,7�\\� E-MAIL _ FAX STREET ADDRESS \� �(C<S 3 ��� CITY, STATE, ZIP �� �� 1. 0,0 C a �t5�r PHONE S 408 L 's_- i ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS LIC k COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK 1 ( 1 - 1S��'✓i �u -CXI5l rl �QYI ii*��Ia yV_-J T7 -V—X && vv.• �� ]nik -1 v,' EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE "TYPE OCC. SQ.F"I. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA ODETACH ❑ ATTACH N DWELLING UNITS. IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? ❑ NO ADDITION? ❑ NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED TOTAL VAL ATION: PLANNING APPL d ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO By my signature below, I certify to each of the following: I am the property owner or authorized agent to acct on the property owner's behalf. I ave read this application and the information I have provided i correct. a e read�e,cr tion of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building structio I thor es tives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent' _ Date: O SUPPLEMENTAL NFORMATION RIEQUIRED PLAN CHECKTYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building � OVER-THE-COUNTER BUILDING PLAN REVIEW permit for new building. EXPRESS Oe PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ 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.❑ ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11 C. CITY OF CUPERTINO FM__7 FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 11218 Redondo Ct FEE DATE: 10/24/2014 REVIEWED BY: Sean APN: BP#: 'VALUATION: $0 PERMIT TYPE: Building Permit 0.0 PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: PME Plan Check: PENTAMATION 1 GENRES PERMIT TYPE: WORK REVISION #1: REVISE THE LIGHTING LAYOUT AND REMOVE A NON -LOAD BEARING WALL IN SCOPE DINING ROOM. 0.0 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 preliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS Lee Resnlulion 11-053 E ' 7i1.-13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes Q No $0.00 1 hours Plan Check, Hourly $143.00 ISTPLNCK Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? 0 Yes Q No $0.00 Advanced Planninu, Fee: $0.00 Select a Non -Residential 0 Building or Structure i StronpMotion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $143.00 TOTAL FEE: $143.00 Revised: 08/20/2014 Es CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11218 REDONDO CT CONTRACTOR: ROSE HILL INTERIOR PERMIT NO: 14100067 WOODWORKS OWNER'S NAME: THAKAR ANJANEYA AND KANCHAN 10495 BYRNE AVE DATE ISSUED: 10/13/2014 OWNER'S PHONE: 4083091581 CUPERTINO, CA 95014 PHONE NO: (408)255-1462 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL 0 REPAIR WATER DAMAGE FROM 2ND FLR BATH, License Class_ '7 Lic. # OWN25 INCLUDING ContractADW%kk',�, 200 1ST FLR KITCHEN & BATH & CEILING LIGHTING ecwC�Jpprlr440)ate to FIXTURES I hereby affirm that I am licensed under the provisions of Chapter 9 & DRYWALL (999 S.F.) (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. ereby 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 Sq. Ft Floor Area: Valuation: $62000 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 APN Number: 35621016.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. 1 agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DA LLED INSPECTION. 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 IssueA with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date l(7({vj �� 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. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1, 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 HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should 1 store or handle hazardous 1 have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sectio T 2550_>, 2 33, end 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: permit is issued.l`a 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, 1 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION O 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 \� (408) 777-3228 • FAX (408) 777-3333 • building() cupertino.org A ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PER]vI1T # PROJECT .ADDRESSC ' / APN # -3 �/a — Z_+ r I O ( f it Z,% ev OWNER NAME PHONE E-MAIL do ^ :C�, a. -e ��alnop.� STREET ADDRESS god do CITY STATE, ZI J01 FAX M_k% c3, CONTACT NAME PHONE v�d 7-e)y-tr,5 0 E-A9AIL STREET ADDRESS t TS CITY, STATE, ZIP FAX c e ,h� a�so► I6 6_' kZ_ ❑ OWNER ❑ OWNTR-BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME-,--,t� LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME1 E-MAIL FAX STREET ADDRESS, CITY, STATE, ZIP �� PHONE�a t)�Or- 1 l `� D ARCMTECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK ` C t e y� (r LA NJ o-- 6�-,e7 Jf 6,-,,A ,ortA o *\ EXIS N USE PROPOSED USE I CONSTR. TYPE # STORIES USE TYPE OCC. SQ FT, VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA I PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH # DWELLING UNITS: IS ASECOND UNIT ❑YES SECOND STORV ❑YES BEING ADDED? ❑ NO ADDITION? ❑NO /--' PRE -APPLICATION I] YES IF YES, PROVIDE COPY OF 1S THE BLDG AN ❑ YES REC ,&Y' TQTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOAIE? ❑ NO By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on th perry owner's behalf. I have read this application and the information I have pro ed is correct. I h ve Tea the Description of Work and verify it is ac rate. I agree to comply With all applicable local ordinances and state laws relating to buil n construction. I ari e xpresentatives of Cupertino to enter the above -identified pr pegfor inspection purposes. SignatureofApplicant/Agent Date: SUPPLEMENTAL INFORMATION REQUIRED PLAIN CHECK TYPE i ROUTING SLIP ❑' OVER-THE-COUNTER `` ' ❑ B_UILDING PLAN New SFD or Multifamily dwellinas: Apply for demolition permit for — existing building(s). Demolition permit is required prior to issuance of building REVIEW permit for new building. ❑, EaPREss ❑ PLANNIAGPLAN REVIEW' Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑~ 'TAi'TnA tD ❑ ` 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 LiMAJOR "` ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. „. ❑ ENVIRONMENTAL HEALTH ' BldgApp 2011.doc revised 06/21/11 A, CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 11218 REDONDO CT DATE: 10/13/2014 REVIEWED BY: MELISSA APN: 356 21 016 BP#: `VALUATION: 1$62,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY USE: SFD or Duplex EESS. $647.00 PENTAMATION PERMIT TYPE: 1 R3SFDRE i WORK REPAIR WATER DAMAGE FROM 2ND FLR BATH DOWN TO 1ST FLR INCLUDING KITCHEN 1ST SCOPE FLR BATH & CEILING FIXTURES & DRYWALL (1200 S.F.) 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 preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Dee, Resolution 11-053 Et': 7%1-731 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 EESS. $647.00 Remodel, Other IREMRESOTH Suppl. PC Fee: Q Reg. Q OT 0 .01 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -E) Reg. © OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 G Work Without Permit? 0 Yes E) No $0.00 Advanced PlanninL Fee: $0.00 Select a Non -Residential Building or Structure E) 0 i Strong Motion Fee: IBSEISMICR $8.06 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $3.00 SUBTOTALS: $11.06 $647.00 TOTAL FEE: $658.06 Revised: 08/20/2014 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: L '• PERMIT # OWNER'S NAME: PHONE # Aba. GENERAL CONTRACTO :'Re -7 1� 'w.�c �� ecky BUSINESS LICENSE # ADDRESS: d R �.y�pC& q CITY/ZIPCODE: Co *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 SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date Lo ks I'g& 1� -""' 0" - Owner / Con rac or Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Lo ks I'g& 1� -""' 0" - Owner / Con rac or Signature Date CUPEIRT INO CONTRACTOR / SUBCONTRACTOR ITS'll Building Department City 01" (Atpertinci 10300'rorre AvCIILIC C Upertino, CA 95014-3255 relephone: 408-777-3228 F,ax: 408--777-3333 JOB ADDRESS: P E RM I'l' . . . . . . ... . . ............. . .. OWNER'S '�N�A,Nff`l PHONE 9 GENERAL CONTRAC' I OR: LJ SINSS [Cf� SII 4- . B .. . ........ . .......... ADDRF'SS: CITY/77`1 K ()DI ur numicipal code recluires all businesses Ivorking, ill the city to have a City of Cupertino business ficense. I NO BUILDING FINAL OR FINAL, OCCUPIANCA' INSPE(TiON(S) WILL BE SCIMEDU1,H) UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE, OBIAI'ED ,.k CITY 01, CUPERTINO BUSINESS, LICENSE,