13090110F�
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10800 MINETTE DR
CONTRACTOR: ALI'S CONSTRUCTION &
PERMIT NO: 13090110
REMODELING
OWNER'S NAME: KARKHANIS CHETAN Y AND APOORVA C
1011 S DE ANZA BLVD
DATE ISSUED: 01/06/2014
OWNER'S PHONE: 4084101763
SAN JOSE, CA 95129
PHONE NO: (408) 898-6474
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL Ej
CONSTRUCT ONE STORY ADDITION(S) (495 SQ FT);
License Class Lic. #
REMODEL (E) 1500 SQ FT; RE -ROOF WITH COMPOSITION
SHINGLES (1600 SQ FT).
Contractor 41DateU
I hereby a irm that I am licensed under the provisions of C apter 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 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: $138000
performance of the work for which this permit is issued.
1 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.
APN Number: 37531033.00 Occupancy Type:
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I 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 DAYS ED 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
4141
granting of this permit. Additionally, the applicant understands and will c
Date:
with all non -point s e regulations per the Cupertino Municipal C , cti n
9.18.
RE -ROOFS:
Signature Da
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.
114 -BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm t 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
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)
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 I store or handle hazardous
I 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 tACUino Municipal Code, Chapter 9.12 and
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
the Health & Safety Code, Secti25533, and 25534.
Owner or authorized agent: Date: 06 /
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 ofexemption, I
CONSTRU IO LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I must
I hereby affirm that there is a const n 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,
ARCHI ECT'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 APPLICAT014
COMMUNITY DEVELOPMENT DEPARTMENT ° BUILDING DIVISION
10300 TORRE AVENUE ° CUPERTINO, CA 95014-3255
(408) 777-3228 ° FAX (408) 777-3333 ° buildinga-cu ertino.org
P
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS p� i hQtte'Pr C I Q���77APN
"I
# � 3103
/03
OWNER NAME
PHONE / m� /-/0, _ /X63
^S �`� V "O
ltxn Ac a
qY
Q
c�,e . Y/411 YI / S
STREET ADDRESSCITY,
�O30 inP[t2
STATE, ZI
eq 'moo CA15c)
FAX
CONTACT NAME S' ; SP11
PHONE /j- ngbl-71 7— 00071
°Z'IPP'/ (/
E-MAIL � Q sec_
Vt
�/
STREET ADDRESS
CITY, STATE,
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT 99 ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
LICENSE NUMBER
LICENSE TYPE
BUS. LIC #
QIlT 1
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
ARCHITECT/ENGINEERNAME ; I
LICENSE NUMBER 0-663465
662 65*
BUS. LIC#
COMPANY NAME E-MAIL .554" Sec /tl1 yeah 00,Lo.,
"'
FAX
STREET ADDRESS CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK V 4.9 S 5 n i (� a 19'r�a S.F. � P .O_
9 Berl AtWq�" 03
r ��L
��4:1� Iry
slew .�+.�. '1� CGCJ4C a r-0) e-
EXISTING USE
PROPOSED USE CONSTR
TYPE
# STORIES
USE
TYPE
OCC.
SQ.FT.
VALUATION ($)
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA "s -
AREA
NET AREA
BATHROOM
REMODEL AREA 4O
KITCHEN
REMODEL AREA% oO
OTHER
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: DETACH
42,
42 C7 PgATTACH
#DWELLING UNITS:
IS A SECOND UNIT 0 YES
SECOND STORY YES
BEING ADDED! []NO
ADDITION' []NO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER
IS THE BLDG AN ❑ YES
EICHLER NOME' []NO
RECEITi
' '�®
TAL VALUATION:
1*/39,C)00-
C D
By my signature below, 1 certify to each of the following: 1 am the property owner or authorized agent to a44ct on the property owner's behalf. I have read this
application and the information I have provided is c rrect. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relatingnt�con ction. I authorize representatives of Cupertino to enter th�qi_e�3 property for inspection purposes.
Signature of Applicant/Agent: �— Date:
SUPPLEMENTAL INFORMATION REQUIRED
PL HECK TYPE
ROUTING SLIP
'EBUILDING
New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of buildlugi
OVER-THE-COUNTER
PLAN REVIEW
permit for new building.
❑" EXPRESs
PLANNING PLAN REVIEW
d
,
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
❑ STANDARD
❑. P1IBLIC WORKS
form if any Hazardous Materials are being used as part of this project.
❑ LARGE
❑. FIRE D$P'I
Copy of Planning Approval Letter or Meeting with Planning prior to
❑ MAJOR
❑,SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
B/dgApp_2011.doc revised 06/21/11
C�T Y OF SCUP EllSTMID oup
FEE IESTMATOR - BUIDLMN G DMR01
OCCUPANCY TYPE:
ADDRESS: 10800 Minette Dr
DATE: 01/07/2014
REVIEWED BY:
PC FEE ID
APN:
BP#: 13090110
*VALUATION: 1$138,000
*PERMIT TYPE: Building Permit
PIAN CHECK TYPE: Addition
PRIMARY
USE: SFD or Duplex
2nd Unit? Yes 0 No
OTC? 0 Yes ® No G
PENTAMATION
1 R3SFDADD
PERMIT TYPE:
WORK I
Addition 495 s ft -remodel 1500 s ft re -roof with cornp shingles 1600 s ft
SCOPE
1,600 s.f.
$256.00
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FIR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE 1D
R-3 (Custom)
II-B,111-B,IV,V-B
495
$1,579.00
/ADDPLCK
$1,284.00
/ADDINSP
PME Plan Check:
$0.00
1,600 s.f.
$256.00
Re -roof
IREROOFRES
Permit Fee:
$1,284.00
Suppl. Insp. Fee. -E) Reg. 0 OEJ
0,0 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
TOTALS:
495
$1,579.00
$1,284.00
MECH, HOURLY 0 Yes (2) No
PLUMB, HOURLY 0 Yes 0 No
EELEC, HOURLY 0 Yes Q No
MISC ITEMS
Plan Check Fee:
$1,579.00
1,500 s.f.
$4,746.00
Remodel, Other
IREMRES2
Suppl. PC Fee:) Reg. 0 OT
L1 L_
hrs
$0.00
PME Plan Check:
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.). These Pees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 UL 7/1/13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$1,579.00
1,500 s.f.
$4,746.00
Remodel, Other
IREMRES2
Suppl. PC Fee:) Reg. 0 OT
Q.Q
hrs
$0.00
PME Plan Check:
$0.00
1,600 s.f.
$256.00
Re -roof
IREROOFRES
Permit Fee:
$1,284.00
Suppl. Insp. Fee. -E) Reg. 0 OEJ
0,0 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
0
0
Work Without Permit? 0 Yes Q No
$0.00
Advanced Plannin Fee: IPLLONGR
$69.30
Select a Non -Residential
Building or Structure
G
0
d
F,-av1)oe rr;aeja'llion F(.
Strong_Motion Fee: IBSEISMICR
$13.80
Select an Administrative Item
1
Bldg Stds Commission Fee: IBCBSC
$6.001
SUBTOTALS: 1
$2,9.52.101$5,002.001
TOTAL FEE: 11
$7,954.10
Revised: 01/01/2014
CNJPER7Of`�l'
CONTRACTOR / SUBCONTRACTOR LEST
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS:it)02% e- e
PERMIT #
OWNER'S NAME: " KA It KrIl
PHONE #
GENERAL CONTRACTOR:
BUSINESS LICENSE #
ADDRESS:
CITY/ZIPCODE:
*Our municipal code requires alll husimn sse� N�orld6g in tllne city to have a City of Cu er ino l usiness'fikense.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUP1ERTIINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature
?lease check applicable subcontractors and complete the following information:
Date
V
SUBCONTRACTOR
BUSffINIESS NAME
BUSIIl SS LffC ElNS E #
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
A4 fiate
CMPERi 11NO
CONTRACTOR / SUBCONTRACTOR LEST
Buuillding Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-325 --
Telephone: 408-777-3 8
Fax: 408-777- 33
JOB ADDRESS: IJ h90% r. 57 PERMIT # 43,09dl
OWNER'S NAME:k j 006 PHONE # "10 7T0 zlOt.096SS
GENERAL CONTRACTOR: (may-1Sfj/ f BUSINESS LICENSE #
ADDRESS: CITY/ZIPCODE:
*Our municipal code requircfall businesseVworking in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY
GENERAL CONTRACTOR AND ALL SUBCONTl
BUSINESS LICENSE.
I am not using any subcontractors:
CTtON(S) WILL BE SCHEDULED UNTIL THE
RS M[AN]E OBTAINED A CITY OF CUP ERTINO
Date
]?lease check applicable subcontractor§ and compRete the ffolllloawing information:
d
SUBCONTRACTOR
BUMN ESS NAME
BUSRN ESS LI CENSE #
Cabinets & MillworkS
e! '(,L
90 9/-4 3-�
Cement Finishing
9o9-41-33
Electrical
qo 91-13 3
Excavation
9 O 9ZP .3 3
Fencing
2 3 3
Flooring / Carpeting
9 O 9 L3 3
Linoleum / Wood
Glass / Glazing
Heating
��
,✓
Insulation
Landscaping
iv
Lathing
Masonry
H
,�
Painting / Wallpaper
r
Paving
r
A/
Plastering
,ll
Plumbing
.✓
Roofing
Septic Tank
Sheet Metal
„i
/V
Sheet Rock
Tile
IlDate