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12110051
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21513 TERRACE DR CONTRACTOR: PARRA BUILDERS INC PERMIT NO: 12110051 OWNER'S NAME: RAMAMOORTHY SUNDARESAN 5704 COLDWATER DR DATE ISSUED: 11/27/2012 OWNER'S PHONE: 4082660558 CASTRO VALLEY, CA 94552 PHONE NO: (510) 889-0102 ❑ > LICENSED CONTRACTOR'S DECLA(RRATION BUILDING PERMIT INFO: BLDG — ELECT r PLUMB License Class'/ j Li X.4, 6 .. MECH RESIDENTIAL COMMERCIAL Contractor Date 1 hereby a m thaicc�:i:-is I' ensed under the provisions of Chapter 9 (commen mg with 7000) of Division 3 of the Business & Professions Code and that my in full force and effect. I 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 I have read this application and state that the above information is correct. 1 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 cant understands and will comply with all non -point source ulations pe a upertino Municipal Code, Section 9.18. Signature Date _ 7�L ❑ U OWAEk-BUILDER DECLARATION 1 hereby affirm that I aw exempt from the Contractor's License Law for one of the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and die structure is not intended or offered for sale (Sec.7044, Business & Professions Code) t, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 1 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, l 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, 1 must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 41 I certify that I have read this application and state that the above information is correct. 1 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 hamiless 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. JOB DESCRIPTION: CONSTRUCT A 498 SQ FT ADDITION TO M.SUITE, BATH BEDROOMS, CREATE CLOSET AND DEN AREA; REMODEL 80 SQ FT BATH, KITCHEN 120 SQ FT AND OTHER 300 SQ FT Sq. Ft Floor Area: I Valuation: $110000 APN Number: 35620011.00 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: _�✓ Date: 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 1 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(x) should 1 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 1 will maintain compliance with the Cu ertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sectiops 205, 25533, and 25534. Date: 4� 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 ARCHITECT'S DECLARATION 1 understand my plans shall be used as public records. Signature Date I Licensed Professional_ C�UPERTINO I F-1 NEW C0NSTRI ICTION CONSTRUCTION PERMIT APPLICATION C/ COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVIS Nr'"� 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-32 • FAX (408) 777-3333 • building(a.cupertino.org 1 1 V ADDITION n ALTERATION / TI n RFVISION / DEFERRED ORIGINAL PERMIT 19 PROJECT ADDRESS APN N OWN RNA E�, ` PHONE O�� ` r�� E-MAIL STREET A9 SS CITY, STATE, ZIP � ^,A FAX CONTACT NAME PHONE/,J�/�/ E MAI A4 , STREE11DREA C ATE CAL �❑ !! o p 3 QAC -99! El OWNER 11OWNER-BUILDER 1:1 OWNER AGENT El CONTRACTOR El CONTRACTOR AGENT El ARCHITECT ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC N COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITEC - GINEER NA% Wavwv D L4 LICENSE NUMBER BUS. LIC H COMPA A.i ��I , _ L" C_E-MAIL (� 10 FAX STRE ADDRESS CITY, STATE, ZIP PHONE DESCRJPTI NO WORK 12*6& z1 111x;4Z 7�y �� "0 5�w EYJSTING USE PROPOSED USE CO TR. TYPE # STORIES + P-0 USE TYPE OCC. SQ.FT. VALUATION ($) E)OSTG AREA -7 � NEW ILOQR AREA Q�. (HEN/ DEMO AREA TOTAL NET AREA 2,Zs 41 2 ,j / �/ I u7 �-Y ( l I BATHROOM REMODEL AREA. REMODEL AREA / 4REMODELAREA THER 3M vrf� PORCH Ar;E , DECKAREA TOTAL DECKIPORCH AREA GARAGE AREA: DE k DWELLING UNITS: IS A SECOND UNIT ❑ SECOND STORY ❑ YE BEING ADDED? POO ADDITION? PRE -APPLICATION ❑YE YES, PROVIDE COPY OF PLANNING APPROVAL LETTER IS THE BLDG AN ❑ EICHLER HOME? RECBI D Y. TOTAL VALUATIO PLANNING APPLH am the property owner or authorizedag t to act on the property owner's behalf. I have read this By my signature below, I certify to each e4cec application and the information [avedehave read the Description of Work and verify it is accurate. I gree to comply with all applicable local ordinances and state laws relating di cauthorize representatives of Cupertino to enter the above -i ntif property for inspection purposes. Signature of Applicant./Agent: Date: SUPPLE T RMATIONREQUIRED PLSN'CFIEC TYPE° R©uTlGslr _ New SFD or Multifamily d ellings: Apply for demolition permit for [� ` OVER -TIM -COUNTER BUILDING PLAN REVIEW existing building(s), Demolition permit is required prior to issuance of building permit for new building. EIXPRESSPL90NJNG 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 SAMTARY SEWER DISTRICT, Submittal Of Building Permit application. ❑ ENVIRONNIENTALHEALTH. . BldgApp_2011.doc revised 06/21111 CITY OF CUPERTINO 9W FEE ESTIMATOR — BUILDING DIVISION JA DDRESS: 21513 terrace dr FAPN: DATE: 11/09/2012 REVIEWED BY: sylvia PC FEE ID BP FEES BP#: *VALUATION: $110,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: 2nd Unit? Yes ' No OTC? O Yes ONo PENTAMATION PERMIT TYPE: 1 R3SFDADD WORK Add 498 sq ft to m.suite bath bedrooms create closet and den area remodel 80 sq ft bath kitchen 120 SCOPE sq it and other 300 sq ft to family, living entry kitchen, panel upgrade 200 amp 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 498 $1,512.00 IADDPLCK $1,230.00 IADDINSP $0.00.00 PME Plan Check: $0.00 200 1 amps $45.00 Electrical IERT<200 Temporary Power Permit Fee: $1,230.00 Suppl. Insp. Fee.S Reg. O OT 0,0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $45.00 TOTALS: 498 $1,512.00 $1,230.00 ' 1Ic' ' Ph"In (h('('Jti Plwuh Prw Glace/', Elec. Plan Check 10.0 1 hrs $0.00 F":h' Elec. Permit Fee: IEPERMIT Ir1s� l f/�`w4 ' J'/ orb { v'pI F1 Other Elec. Insp. 0.0 hrs $45.00 I lay"r NOTE: This ,estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School Metrirt otr_ L Thoco faoc aro hacod an tho nroliminary infnrmntinn availahlo and are nniv an ectimnto_ Cnntart the Dent fnr addn'1 infn_ FEE ITEMS (Fee Resolution II -053 Eff 7/I/I2) FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,512.00F67 s.f. Remodel, Other IREMRESOTH Suppl. PC Fee: 0 Reg. OOT 0.0 hrs $0.00.00 PME Plan Check: $0.00 200 1 amps $45.00 Electrical IERT<200 Temporary Power Permit Fee: $1,230.00 Suppl. Insp. Fee.S Reg. O OT 0,0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $45.00 T7 VCC.' 0 0 Work Without Permit? O Yes 0 No $0.00 Advanced Planning Fee: IPLLONGR $64.74 Select a Non -Residential Building or Structure 0 O i Travel Documentation Fee: ITRA VDOC $45.00 Strong; Motion Fee: IBSEISMICR $11.00 Select an Administrative Item Bld Sg tds Commission Fee: IBCBSC $5.00 SUTUTALB. $2,912.74 $512.00: TOTAL FEE: $3,424.74 Revised: 10/01/2012 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: 2 !S/ -G GZ-- PERMIT # OWNER'S NAME: /51?M,YIdO� PHONE GENERAL CONTRACTOR: p,~ �W4,V6X.6 -Isle. BUSINESS LICENSE # ADDRESS: ' D eZ - GL, CITY/ZIPCODE: G,4 'Our municipal code requires all businesses working in the city to have a City of Cupertino business license."'7�'!� 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 Date Please check applicable subcontractors and complete the following information: / Contractor Signature -7, Z - 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 / Contractor Signature -7, Z - Date CUPERT'INO 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: al'513 TeXjraQY h PERMIT # 12 < < d © S OWNER'S NAME: S r PHONE # GENERAL CONTRACTOR: RUIDN PARKABUSINESS LICENSE # ADDRESS: \j CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SU ONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: © Signature Date Please check applicable subcontractors and complete the following information: Ow 1 Contractor Signature (��l©)ao 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 Ow 1 Contractor Signature (��l©)ao Date