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B-2017-0331 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-0331 22106 LINDA VISTA PL CUPERTINO,CA 95014-4022(356 08 009) VIA BUILDERS INC LOS ALTOS,CA 94022 ' • OWNER'S NAME: RAJARAM GOKUL TRUSTEE&ET AL DATE ISSUED:05/15/2017 OWNER'S PHONE:650-222-0165 PHONE NO:(650)948-1077 LICENSED CONTRACTOR'S DECLARATION BUILDING.PERMIT INFO: License Class a Lica#717805 Contractor VIA BUILDERS INC Date 01/31/2018 X BLDG,_ELECT _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: - (N)POOL HOUSE(373 S.F.);ATTACHED TRELLIS(185 S.F.) I hereby affirm under penalty of perjury one of the following two declarations: REV#1-ADD WINDOW-ISSUED 10/30/2017 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 • erformance of the work for which this permit is issued. I,, - ,.d will maintain Worker's Compensation Insurance,as provided for by deop / *n 3700 of the Labor Code,for the performance of the work for which this G . . rtntt is issued. Sq.Ft Floor Area:373 Valuation:$100000.00 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 ABN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 356 08 009 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. Ognature /,� Date 10/30/2017 Issued by:AbbyAyende / Date:05/15/2017 OWNER-B DER DECLARATION 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 i. 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) I 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:10/30/2017 1 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 Cede,for the performance of the work for which this permit is issued. i 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. I will permit is issued. I maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I 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 25505,255ois•,d 25534. Labor Code,I must forthwith comply with such provisions or this permit shall 77 be deemed revoked. er or authorized agent: / APPLICANT CERTIFICATION .'Date:10/30/2017` 7 I certify that I have read this application and state that the above information is CONSTRU TION 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. I understand my plans shall be used as public records. Signature Date 10/30/2017 professional ' CONSTRUCTION PERMIT APPLICATION CXtrik m.ik',,'''-' OMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO CA 95014 3255 . ,....,..,::,:, , ,:s.„...„..... (408) 777-3228 • buil ding@cupertino.org PEMIT HB'- �u, - 0 1 CUPERTINO REV it DEF tt ❑ NEW ��CONSTRUCTION ElADDITION ❑ALTERATION ❑T.1. ❑MEP ❑RE-ROOF ❑SWIMMING POOL/SPA PROJECT ADDRESS Z1 1:( APN a >. ,hcIQ- 1//Sfw f/ccce OWNER NAME PHONE E E-MAIL 22o'ja,Y (So 222 0(6 5 / ('C&)( I d C S .8n c& tf cqii STREET ADDRESSCITY,STATE,ZIP ❑CONTRACTOR N%lyfE-/❑OWNER-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE V( .6U/ l(V,e-i-'S . Y('a_duifile-vs 717 80-? ISTREET ADDRESS ' 1. CITY,STATE, ZIP / t-( 06 c/cam-,(,, a -eel.A--( 7 l©5?� lfO cam, 7V Z E-MAIL II PHONE BUS.LIC a 0 ARCHITECT ❑OWNER;;❑OWNER AGENT 0 CONTRACTOR AGENT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTACT NAME , I E-MAIL STREET ADDRESS ' '' CITY,STATE,ZIP PHONE 111-'TC yr f CI DECRIPTON., fi, �� L✓ Lvl c10 W © /1 Ge, f 5, �/ © /i /°' 01 ' ❑SINGLE-FAMILY/DUPLEX 0 MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES I TOTAL NET SF ,USE TYPE OCC SQ.FT. VALUATION(F) REMODEL REMODEL KITCHEN REMODELOTHR GARAGE 0 ATTACHED BATHROOM SF SF SF SF 0 DETACHED EXISING ❑YES EICHLER ❑ YES SECOND STORY ADDITION 0O N FIRE SPRINKLERS 0 NO ❑ NO DWELLING SECOND DWELLING 0 YES 0 ATTACHED 0 DETACHED OTHER UNITS a UNITADDITON: ❑NO S F POOLS' 0 FIBERGLASS ❑VINYL-LINED 0 GUNITE ❑PREFABRICATED POOL-SF SPA-SF I SPA ATTACHED EYES 0 NO I TOTAL-SF REIVED BY: vqW� TOTAL ATION: Commercial or Muffi=Fmnf[y Buildings with Public Swimming Pools requires Deportment v(Errvirmmrenlul Heath approval y RE-ROOF EXISTING ROOF TYPE: ❑BUILT-UP ROOF El ASPHALT SHINGLES E WOOD SHAKES El WOOD SHIN LES❑ LE OTHER(SPECIFY) REMOVE/REPLACE❑NO IF NO PLYWOOD 01/2" 03/8" PLYWOOD TYPE: PITCH: ROOF CLASS ❑YES F OF LAYERS THICKNESS❑5/8" OTHER ❑OSB ❑CDX, OTHER •12 A PROPOSED ROOF TYPE:❑BUILT-UP ROOF DASPHALT SHINGLES 0 WOOD SHAKES❑WOOD SHINGLES ❑OTHER • 'Provide a signed copy of the Cupertino's Tear-Off Policy SF Oaf SQUARES 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 accurate. I agree , to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-identified property for inspecti . rposes. I ado ledge and authorize all information contained on this application form to be made available for public record. / Signature of Applicant/Agent: ' Date: v D^' - / - SUPPLEMENTAL INFORMATION REQU i�ED *New SFD/Second Dwelling Units/Multifamily Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction. *Commercial Buildings: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. *Copy.of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. . *HOA-Provide a letter of approval from the Home Owner's Association , • BldgApp_20/7.doc revised 08/01/17 CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 13-2017-0331 22106 LINDA VISTA PL CUPERTINO, CA 95014-4022 (356 08 009) VIA BUILDERS INC LOS ALTOS, CA 94022 OWNER'S NAME: RAJARAM GOKUL TRUSTEE & ET AL I DATE ISSUED: 05/15/2017 OWNER'S PHONE: 650-492-3525 I PHONE NO: (650) 948-1077 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class a Lic. #217805 Contractor VIA BUILDERS INC Date 01/31/2018 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 said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulokions per the Cuperipo Municipal Code, Section 9.18. Date 5/15/2017 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 sale (Sec.7044, Business & Professions Code) z. 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. 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 5/15/2017 X BLDG —ELECT —PLUMB _ MECH X RESIDENTIAL _ COMMERCLAL JOB DESCRIPTION: (N) POOL HOUSE (373 S.F.); ATTACHED TRELLIS (185 S.F.) Sq. Ft Floor Area: 373 1 Valuation:$ 100000.00 APN Number: Occupancy Type: 356 08 009 1 R-3 (Custom) PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. by: Abby Ayende 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:/15 5/2017 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 Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections25505, 2553 and 5534. O,wner or authorised agent:Ail—t— Date: 5/15/2017 N 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 ARCHITECTS DECLARATION I understand my plans shall be used as public records. Licensed Professional PROIECTADDRESS'. a k All 08, O\VNERNAME 77 CL 7 STREETADDRBSS. .'•y� CITY,STATE, ZIP. FA CONTACT NAME 6404 PHONE E-MAIL e.-M.q ` t"ui: .�.. STRBBT ADDRESS CITY, STATE, IP : FAX -t�,3? ._ ,g O:O�m•'ER.:: ; ,O. o4PNElt:BUILDER „•. .„(]; OWNER At;HNT,• r . P,COjt7ItACTOR_ .. �.C.p.NTRACTOR AOENT .:.. O ARGmTEt T ...CL ETjGIN.bHR :,... Q .L7EYEL_OPLR: , � 7ENAIiT . CONTRACTOR AME'_' - LICENSEATiIMBER LI SE TYPE BUS. LI CDIvIP1iNYNAMEi�j;�`� fy..� t i�y -• E-MAIL q i 0's CP .40 FAX' STREfiTADI1RtiSS CITY, STATE, ZIP PHONE-. -. ARCHiTEC111ENOINEERNAMB' ' LICENSE'NUMBER - - BUS. LIC# ' COMPANY'NAME E MAtL FAX . STREET ADDRESS CITY; STATE, zIP PHONE DESCRIPTION OF WORK - --- —_ =— --- EXISTING USEPROPOSEI)USE CONSi'R.TYPE #STORIHS - n' USE TYPE. b5. SQ.FT. _ _ VALUATION (S) EX ISTO . AREA NEIA�PLOOR . AREA-Ip.' DEMO TOTAL. - AREA.: NHT.AREA - . BATHROOM - RBMODELAREA KITCHEN "-' OTHER. REMODEL ARRA.,;,-'R8MODELAREA PORCHARBADECK AREA TOTAL DECKIPORCH AREA GARAGEA"k EJ DETACH . :: ATTACH 41 DWELLING UNITS: ISASECONDUNET ]YES SEtrOt+D STORY YES - . BEING ADDED? ENO ADDETION7 PRE-APPLICATION [J YES >FYES, PROVIDE COPY OF _ ISTIM IILD'. GAN-YESpTAF V-nn i PLANNINGAPPL# NO PLANNINGAPPROVALLET'TER MMILERIIUME7 �'NO- E - By my signahire below,' I certify to each 6f the followirig: I am the property owner or authorized agent to act on the property owner's behalf. Lave read this application and the fi&rociatioii I havd provided it. eotrect. I have iii4d the I)escription of Work and verify it is acoiu'ate.; I agieC to coinpiy � 1i all applicnble local ordinances.aiid state ladts ielatiag to Sit ding cro�nsiruetio . I afuthofize representatives of Cupertino to enter the above•identifiM property for inspection purpose's.. Slgnattire of ApplicanUAgent_ . : ' ' ' :. "J h t ".' ri/ --' Ditkei SUPPL M)NT FO E RMATiON REQUIRED e s •�;,�.ri;Arr..= - ---- _ --• - _..._a V.C7' _ BUIf DIPIG:P.LAN.tiE{'IE1V-= ` i:= =: - New SFD tir i Itifamit -. iii , . —N M i y dwellings. Apply for demoi�hon permit fof - .. •.. .. , . ..StIB . eXI biHldln s . Demon roll mit e - issuance i g g{ } { permit Is required to tssi a ice oFbiutd pg ,..---..._....... . .......... .:...:_..._ "...:....: _ permitornew utidin� � _- (-�= -_-E•--�-f-_I-t=ES•'S'__'._.,:.=___-�---' =�-..: -__'_-- ' ; = �-_°-�--_ ; �- .•'A�' "-N :�_ om S' As N'�'N`- :�IIS:=_T-Gv-_.p i':.1'Y:.'.=.,'r.._=.'. "_F_' 't•:.:. :_--`_'° ::-P _U _ _ _ D1SC ercitl.Bld s; Pro-06 a com l tod Hazanis Materals 'C10SUC0 1--.,- `?Ei1'?ts'E�' '.I_ ""�Li ,PV$LiE.IVORIfS form ifany Hazardous 14 a ials are bei used as ad of this project.__.. Y g P P J : _. _._.. _ Dyg_ - "- - _ - _- OfP1A rOYAtteC V Co Hnin A I Le Ivieeth lair t o ith P nisi riot PY g Pp r o g gP _-- = _' - -- =- - - - - --- - - - - --- . �?. .�,-,.`m'-y -- - - - -- -- - " submittal of Bnildirg Permit applicafaoi.. `f�S, _;..'.�-<'^�[.;.�"�-.:STItI6��^ :__.,=,-IA:tOR_.;___.:.-_;.::.._.:___._._-�::_SANZfiAR,:..__..:.-.__..: _ to B1dg,4pp_2011.doc i•eWsed 06!27!11 r i. I I 1144 &� ;d N I a I a 1:1 1 MWAO&Z Giuliani & Kull, Inc. - San Jose - Oakdale - Auburn May 17, 2017 Job No. 17134 City of Cupertino Building Inspection Dept. 10300 Torre Avenue Cupertino, CA 95014 Subject: /7 J-�-�201 7 - e'33 / This letter is to confirm in writing that Giuliani & Kull Inc., provided construction staking for the new pool house location for the residence at 22106 Linda Vista Place, in the City of Cupertino. The house was staked in accordance with the plans provided to us by Via Builders. We have subsequently performed a foundation certification for the pool house, and have determined that they have been placed in general conformance, both horizontally and vertically, with the plans. Specifically, the forms are 6.0 feet from the Northwest side property line, and 13.5 feet from the East rear property line. If you have any questions please do not hesitate to contact our office. Sincerely, GIULIANI & KULL, INC. Ve 4��' Rodd Rowalt, P.E., P.L.S. cc: Viabuildersprimo@gmail.com 0R10FESS CD "'No. 61807 m cc X �& Exp. ----3,047 � �� CtVIV qT� OF C AU�Q�' Rpr'j' kJ CL No. 7999 Exp.12-31�15 O ON FQ RECEIVED MAY 2 3 2017 4880 Stevens Creek Boulevard, Suite 205 • San Jose, California 95129 • (408) 615-4000 • Fax (408) 615-4004 AdINAL r TESTING ENGINEERS, INC. 2811 Teagarden St. 510-835-3142 San Leandro,,, CA 94577 800-660-3142 , 2 ' ?7 -Sari Leandro San Jose IvIai iez -1 INSPECTION REPOYt,T� f 510-834-3777 fax Week Ending: 6/23/17 PROJECT # 61961 TYPE OF INSPECTION: Reinforcing Steel Placement PROJECT: PLACE OF INSPECTION: 22106 Linda Vista Place Jobsite (Rajaram) �._ _Cupertino, CA . Permit #s: B-2017-033'; BP15080049 DATE 6/19/17 HOURS 4 INSPECTOR M. Ardizzone Reported to Primo of Via Builders at the jobsite as requested. Inspected the placement of reinforcing steel for pool deck; and visually verified four (4) ground wires connection at a 20'-00" long # 4 reinforcing steel, one (1) at each corner. The preceding work was, to the best of my knowledge, in compliance with approved plans and specifications, including revisions by engineer. Reviewed by: Davi Chippero Special Inspection Division Manager 1cc: Via Builders, Inc. / P. Perez MS Engineering City of Cupertino / Bldg. Inspection Dept. RECEIVED JUL 2 4 2017 BY ____* The results presented in this report relate only to the item(s) tested/inspected and can be reproduced only in its entirety unless written permission from TEI is obtained. Page 1 of 1 :�t1 exttIrt�iiwcrtk G€aiu+ is ; ,.t • t 43('t. y. • 4c I ,:::„.:_,. , ,..,, . ,l ca 4 Sr ` Planrtar. -. .-.. dA r . 14kj o t t t 1 t i 3 - � � ..:,,,,-,,.,,,.. -,:„.,,,,. ..:,_,,,,,..., .„, . .....,... „ ..,... � .„,, .„:: ,, -, ..,:s.,„.,,, , , , ��, < „.a 11 1,' MYkC ,: , .,:-.,,-,,-;;',,,,:.-,:=„-,,...-,•,f ,-= --. ,-,t. lin()•11 '''.:,;.:'..:..'.,..'.''':'1::I ''.:.'1::':::..',,,: .'..t'..'''''''t,:e;t'Id,ti.1:.6(17 7'k4 ''',. ,1' ...',,,, :„,,r,1..:'.'':: '' '' ',:. 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