15090124CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: 15090124
10529 JOHNSON AVE CUPERTINO CA 95014 (375 27 004)
(J S C ENTERPRISES &
GENERAL SERVICES)
UNION CITY, CA 94587
OWNER'S NAME: PENCHALADUVVURUAND KATAMREDDY
DATE ISSUED: 01/29/2016
OWNER'S PHONE: 770-295-8112
PHONE NO: 510-305-1538
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class @ Lic. #976385
Contractor (J S C ENTERPRISES & GENERAL SERVICES ) Date 01/29/2016
— 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:
CREATE (1) ADDITION (582 S.F.) WITH ('I) ATTACHED
I hereby affirm under penalty of perjury one of the following two declarations:
GARAGE (404 S.F.); Remodel (620 S.F.), Demo Carport (200 S.F.) ;
1. I have and will maintain a certificate of consent to self -insure for Worker's
UPGRADE (E) PANEL TO (I) 200
Compensation, as provided for by Section 3700 of the Labor Code, for the
AMP PANEL & DEMO (E) CARPORT
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
Sq. Ft Floor Area:
Valuation: $144400.00
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
APN Number:
Occupancy Type:
ordinances and state laws relating to building construction, and hereby
375 27 004
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
PERMIT EXPIRES IF WORK IS NOT STARTED
expenses which may accrue against said City in consequence of the
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally, the applicant understands and will
comply with all non -point rce regulations per the Cupertino Municipal
180 DAYS FROM LAST C LED INSPECTION.
Code, Section 9.18.
--. – -
Issued by: EL AM
Signature "'�� Date 01/29/2016
Date: 01/29/ 16
BUILDT
RE -ROOFS:
I hereby affirm at am exempt from the Contractor's License Law for one of the
All roofs shall be inspected prior to any roofing material being installed. If a roof is
following two rea s:
installed without fust obtaining an inspection, I agree to remove all new materials for
1. I, as owner of the property, or my employees with wages as their sole
inspection.
compensation, will do the work, and the structure is not intended or offered
for sale (Sec.7044, Business & Professions Code)
Signature of Applicant:
2. I, as owner of the property, am exclusively contracting with licensed
Date: 01/29/2016
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
m. 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
HAZARDOUS MATERIALS DISCLOSURE
performance of the work for which this permit is issued.
I have read the hazardous materials requirements under Chapter 6.95 of the
i. 1 have and will maintain Worker's Compensation Insurance, as provided for
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
by Section 3700 of the Labor Code, for the performance of the work for which
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
this permit is issued.
Health & Safety Code, Section 25532(a) should I store or handle hazardous
3. I certify that in the performance of the work for which this permit is issued, I
material. Additionally, should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the
air contaminants as defined by the Bay Area Quality Management District I
will maintain compliance with the Cup unicipal Code, Chapter 9.12 and
Worker's Compensation laws of California. If, after making this certificate of
the Health &Safety Cod esti s 5505, 25533, and 25534.
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
Owner or authorized agent:
be deemed revoked.
Date: 01/29/2016
APPLICANT CERTIFICATION
certify that I have read this application and state that the above information is
I hereby affirm that there is a c nstr ction lending agency for the performance
correct. I agree to comply with all city and county ordinances and state laws
of work's for which this permits is ued (Sec. 3097, Civ C.)
relating to building construction, and hereby authorize representatives of this city
Lender's Name
to enter upon the above mentioned property for inspection purposes. (We) agree
to save indemnify and keep harmless the City of Cupertino against liabilities,
Lender's Address
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant
ARCHITECT'S DECLARATION
understands and will comply with all non -point source regulations per the
I understand my plans shall be used as public records.
Cupertino Municipal Code, Section 9.18.
Licensed
Professional
Signature Date 01/29/2016
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15090124
10529 JOHNSON AVE CUPERTINO CA 95014 (375 27 004) J S C ENTERPRISES &
GENERAL SERVICES
UNION CITY, CA 94587
I OWNER'S NAME- PENCHALA DUVVURU AND KATAMREDDY I I DATE ISSUED: 01/29/2016
OWNER'S PHONE: 770-295-8712 1 1 PHONE NO: (5 10) 305-1538
LICENSED CONTRACTOR'S DECLARATION
License Class B Lic. #976385
Contractor J S C ENTERPRISES & GENERAL SERVICES Date 09/30/2016
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
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 5�iertino
consequence of the granting of this permit.
Additionally, the apprstands and will comply with all non -point
source regulations p Municipal Code, Section 9.18.
Date 4/5/2016
I hereby affirm that I/am exempt from the Contractor's License Law for one of the
following two yeas s:
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
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:
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.
Date 4/5/2016
BUILDING PERMIT INFO:
BLDG —ELECT —PLUMB
MECH _ RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
CREATE (N) ADDITION (582 S.F.) WITH (N) ATTACHED
GARAGE (404 S.F.); Remodel (620 S.F.), Demo Carport (200 S.F.) ;
UPGRADE (E) PANEL TO (N) 200
AMP PANEL & DEMO (E) CARPORT
DEF #1 - TRUSS CALC'S - ISSUED 4/5/2016
Sq. Ft Floor Area: I Valuation: $144400.00
APN Number: Occupancy Type:
375 27 004
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLEDINSP CTION.
Issued by: ALEX VALLELUNGA
Date: 01/29/2016
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 Applicant:
Date: 4/5/2016
ALL ROOF COVERINGS TO BE CLASS "A"
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 Cupe t ipal Code, Chapter 9.12 and
the Health & Safety Code, S tons 25 0 , 25533, and 25534.
Owner or authorized agent:
Date: 4/5/2016
I hereby affirm that there is a constr4toroending agency for the performance
of work's for which this permit is issLVec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
Professional
CUPERTINO
CONSTRUCTION PERMIT APPLICATION 1 aau-
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildino(dcuDertino.org
❑ NL -W CONSTRUCTION F1 ADDITION ❑ ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT n
PROJECT ADDRESS l/92 ` ' ok� r � . I APN 4 13 � r y lav4-
fC•�GF6
OWNERNAME *EV � IA I-1 �'(1�I1� e�_•L�� E-MAIL
(P�__��L"ems,
STREET ADDRESS f�^'�V �O�,4\�! ) � CITY, STATE,ZI
! _ r fTN�IV ' u(J eA ei'Q? FAX
PH01�CI
CONTACT NAME E-MAIL
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STREET ADDRESS
CITY, ,
STATEZIP �, 9�8'j
FAX
13 OWNER ❑. OWNER -BUILDER O\iNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTORNAME LICENSENUMBER LICENSE TYPE
BUS. LIC#
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
ARCHITECT/ENGINEER NAME LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-M/JL
FAX
STREETADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
CO i11 ►RR00M AVP1110A) MAVTM 040 0.M 19 -*-J W KTe44#-AJ
iVCu1 2 "0- C3h>t eft'• 91h, LA 9C. RAV PANtL ME&" joeA
Tb zoti 4JL4 r -
ExISTNG USE PROPOSED USE CONSTR TYPE I STORIES
I
USE
TYPE
OCC.
SQ.FT.
VALUATION (S)
EXISTG
NEW FLOOR
DET40
TOTAL
-
AREA I it) 4Y
AREA
AREA
NET AREA LA O s 4
.,
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL .AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: DETACH
+0+ ;•ATTACH
T DWELLING UNTrS: IS A SECOND UNIT ❑YES
SECOND STORY ❑YES
BEING ADDED? NO
ADDITION? NO
I )4 w0 A
i
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
PLA-NNTNGAPPL. []NO PLANNING APPROVAL LETTER
IS THE BLDG AN ❑YES
EICHLER HOME? []N0-
VED
- -
-TOTAL. VALU T N:
I
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 btlialf. I have read this
application and the information I have provided is c I have read the Description of Work and verify it is accurate. I ee t comply with all applicable local
,
ordinances and state laws relating to building c structi I authorize representatives of Cupertino to enter the above -i6 e ified rrA-perty for inspection purposes.
Signature of Applicant/Agent: Date:
0 REQUIRED
SUPPLEMENTAL INFORV'quired
PLAT`C'EZECKrIPE;-=
_ �'ROUrII3GSLIP _ -
�\>
New SFD or Multifamily dwellings: for demolition permit for
= o\ER r>�coul.rER
BUIIDL�GPL4NREVIER:
existing building(s). Demolition permit is prior to issuance of building
__7- Lik
permit for new building.ExPxEss
.' s
PLAI,I�LNG PLANREVIEwr,
_ Commercial Bldgs: Provide a completed Hazardous Materials DisclosuresrArDARD2
��
_ r�uBicvoRxs
form if any Hazardous Materials are being used as part of this project.
^� lARG1 r� s
FIREDEPTfr _ M�..-
Copy oPlanninb Approval Letter or Meeting with Planning prior to
_
submittal of Building Permit application.
..,-YQ 3vIAOR '^�
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- �SAI�'TT3IAYSER'ERDISTCT".
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Eli-VIROIa'MENTr1l FIEAY;TA , 3. "
BIdgApp_2011.doc revised 06/21/11
S
CUPERTINO
F-1 T -FW rr)NlCTRT T('TTC1N
CONSTRUCTION PERMIT APPLICATION A�A
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 ` FAX (408) 777-3333 • buildingCc1cupertino.org
n ATITITTTOV n AT TFR ATTON / TT 99V RFVTSTON DF.FA ERREn ORIGINAL PERMIT #6 S0 �7o 1 2-
PROJECT ADDRESS .aPNr
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ONMNERNAME PHONE
770 - 2AS -871'�'
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CITY, STATE, ZIP, A1 ^• � ( I FAX
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CONTACT NAME
PHONE
E-MAIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
❑ OR'NER ❑ OWNER -BUILDER ❑ u9n\ER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGNTEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME � � �.�1 LICENSE NU,, J,
JI LICENSE WE
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BUS. LIC
COMPANY NAME`yLl
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STREET ADDRESS CI STATE, ZIP Cir y Cotq gpr7
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.ARCHITECT,'ENGINEER NAME LICENSE :LUMBER ^ � � _ „� �
BUS. LIC n
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF \\'OItK I I" -U SS C-41-0-
/47 IhEXISTING
EXISTINGUSE PROPOSED USE CONSTR. TPPE STORIES
USE i TYPE
OCC.
SQ.FT.
VALUATIO24 (S)
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOM
KITCHEN
OTHER
REN40DEL.AREA
REMODEL AREA
REMODELAREA
PORCH AREA
DECK AREA
TOTAL DECIVPORCH AREA
GARAGE AREA: L.JDET.ALCH
❑ ATTACH
4 DWELLING UNITS:
IS A SECOND UNIT ❑ YES
SECOND STORY ❑ YES
BEING ADDED? ONO
ADDITION? 0 N
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
1S THE BLDG AN ❑ 17ES
p B �
RBMW
TOTAL V.4L ' ION:
PLANTING APPL R []NO PLANNING APPROVAL LETTER
EICHLER HOME? ❑ NO
�e'
By my signature below, I certify to each of th owing: 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 pr ed ' orrect. I have read the Description of work and verify it is accurate. e o coly \vit11 all applicable local
ordinances and state laws relating to b -a c ruction. uthorize representatives of Cupertino to enter the above-i�raS,,dtPr0p-m-_1Pty for inspection purposes.
Signature of Applicant!Azent: Date:
SUPPLE\?ENTALATION REQUIRED
,'ILv cxT,cr 1�rE �.I;�c SLIP
pply for demolition permit for
N�Tew SFD or Multifamily diver iTitis�i4equired
'
❑• �
building(s). Demolition p prior to issuance of buildin«
0A�EP T?:£ -COLLIER
� .t _ � ,PLAN FEV JEWexisting
permit for new building.�rr�ss
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
! STkND_xD PUrI.Ic \\ craS
_
form if any Hazardous Materials are being used as part of this project.
—
L -J LARGE J FIRE DPT-
_ Copy of Planning Approval Letter or Meeting with Planning prior to
submittal of Building Permit application.
s_4NITA _R1 SES\ ER DIS. RIC T
£N\'IRONMENT.AL H£Ar.TI1
Bldo 4pp_?011.doc revised 06121/11
CITY OF CUPERTINO 010
I
FEE ESTIMATOR - BUILDING DIVISION
161
ADDRESS: 10529 Johnson Ave
DATE: 09/18/2015
REVIEWED BY: PAUL
PC FEE ID
APN: 375 27 004
BP#:
VALUATION: $144,400
PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Addition
PRIMARY
USE: SFD or Duplex
2nd Unit? Yes • No
OTC? ® Yes (j) No
PENTAMATION
PERMIT TYPE: 1 R3SFDADD
WORK
Create N addition 582 S.f. with N Attached Gara a 404 S.f. ; Upgrade Epanel to N 200 Am
SCOPE
Panel
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
986
$2,654.00
IR3PLNCK
$1,666.00
IR3INSP
L:iec. Irish. Pee
$0.00
Permit Fee:
$1,666.00
Suppl. Insp. Fee:O Reg. Q OT0
0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$48.00
TOTALS:
986
$2,654.00
$1,666.00
MECH, HOURLY 0 Yes 0 No
PLUMB, HOURLY Q Yes Q No
ELEC, HOURLY Q Yes Q No
ch. Plan Check
'Iremb. Plan Ckec%
Elec. Plan Check 0.0 hrs $0.00
Al�
ii-, _
Elec. Permit Fee: IEPERMIT
(AhurIle& lnsp
�r%reit'/urnb.lrw�l:>.
Other Elec. Insp. 0.0 hrs $48.00
bfech. Insp. Fe.,laimb.
Insp. Fc,
L:iec. Irish. Pee
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 (Fee Resolulion 11-053 E . L 131
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,654.00
=amps Electrical
$48.00 IBELEC200 Services
Suppl. PC Fee: O Reg. Q OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$1,666.00
Suppl. Insp. Fee:O Reg. Q OT0
0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$48.00
G. =uclion 1 a:
administrative Fee:
E)
Work Without Permit? O Yes 0 No
$0.00
Advanced Planning Fee: IPLLONGR
$138.04
Select a Non -Residential
Building or Structure
0
A
Travel Documentation Fee: ITRA VDOC
$48.00
Strong Motion Fee: IBSEISMICR
$18.77
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$6.00
SUBTOTALS:
$4,578.81
$48.00
TOTAL FEE:
$4,626.81
Revised: 07/02/2015