B-2016-3250 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-3250
10500 MADERA DR CUPERTINO,CA 95014-1136(326 35 052) MAXIMUM
CONSTRUCTION INC
SAN JOSE,CA 95112
OWNER'S NAME: SESHAADRI VENKATRAMANAN AND AMRITHA ET AL DATE ISSUED:06/29/2017 •
OWNER'S PHONE:408-910-8721 PHONE NO:(888)629-2462
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#910762
Contractor MAXIMUM CONSTRUCTION INC Date 02/28/2018 X BLDG _ELECT _PLUMB
MECH XC 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:
REBUILD EXISTING FIRST FLOOR OF(E)RESIDENCE(1770 SQ FT);
I hereby affirm under penalty of perjury one of the following two declarations: CONSTRUCT FIRST FLOOR ADDITION(506 SQ FT);CONSTRUCT
1. I have and will maintain a certificate of consent to self-insure for Worker's 2ND STORY ADDITION(1781 SQ FT);WITH(2)BALCONIES(361 SQ
Compensation,as provided for by Section 3700 of the Labor Code,for the FT).
rformance of the work for which this permit is issued.
Iu- I have and will maintain Worker's Compensation Insurance,as provided for by DEF#1-09-12-2017-TRUSSES(INCLUDES REPLACEMENT OF
kw`` Section 3700 of the Labor Code,for the performance of the work for which this GARAGE ROOF W/TRUSSES-SEE REVISE"S"SHEETS).
`, permit is issued.
Sq.Ft Floor Area:2287 Valuation:$898686.00
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 APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 326 35 052 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.
Additionally,the applicant understands and will comply with all non-point WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source re•ulations pertly Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Itg'nature Date 12/12/2017
// Issued by:ABBY AYENDE
Date:06/29/2017
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
1. 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)
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:12/12/2017
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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. 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. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
a. 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
Worker's Compensation laws of California. If,after making this certificate of air contaminants as defined by the Bay Area Air Quality Management District I
exemption,I become subject to the Worker's Compensation provisions of the will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
Labor Code,I must forthwith comply with such provisions or this permit shall the Health&Safety Code,Sections 25505,25533,and 25534.
be deemed revoked.
tagMi1:
APPLICANT CERTIFICATION Dat-e:12/12//20172017 zed agent: )))
I certify that I have read this application and state that the above information is CONSTRUCTION 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 12/12/2017 Licensed
Professional
CONSTRUCTION PERMIT APPLICATION
V� COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE •.CUPERTINO,CA 95014-3255
',, I
-
S'C.19Js
..ca
(408}777-3228 • building@cupertino.org PEMIT qB-20CUPERTINO REV# DEP
0 NEW CONSTRUCTION ❑ADDITIO\N— r "
❑ALTER/'' ' ❑T.I. ❑MEP ❑RE-ROOF ❑SWIMMING POOL/SPA
.,n 5"-O o /" .--ededy--,- I)
OINNER AA.1E \` D� �stS�t'�'�C/` ( PHE �''ItO'�� VI TE
Si67*(140 tVLA.A-4.i-A.1- .4GnAle(5‘.t
STREET ADDRESS CITY,STATE,ZIP
K-71..--4
JtT)QIY v..MBU
tiLc NAME DOWNER-BUILDER COMPANY NAME LIC NSE NUMBER
LICENSE' E
STRE9T GSS C-61\3c, �lnktA\j"..11/LCITY STATEZIP
<4/ ' 1•Z7
E-MAIL PH NE i L-l.era 5-0. -,..'yig 9 c^/ Bus.LIC#
0 A TELT 0 OWNER D OWNER AGENT CONTRACTOR AGENT❑ENGINEER Cl DEVELOPER❑TENANT
C—OiNTA!!!!!!CT NAME`S E-MAIL V./
. ,t-54ee., c a L..)-^r-CY
STREP.T A KESS CITY/STATE,ZIP PHONE
_•-• -s2
2 —7 ?�� '--
DECRIPTON �
/, S.S-eS ^ D -e-F-e-v1fd
(SINGLE•FAMILY/DUPLEX ❑MULTI-FAMILY 0 INDUSTRIAL ❑COMMERCIAL
EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES S TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION($)
REMODEL REMODEL KITCHEN REMODEL OTHR GARAGE ❑ATTACHED
BATHROOM SF SF SF SF ❑DETACHED
•
EXISING DYES EICHLER El YES SECOND STORYADDITION OYES
FIRE SPRINKLERS❑NO ❑ NO ❑NO
DWELLING SECOND DWELLING ❑YL:S 0 ATTACHED 0 DETACHED OTHER
UNITS I I UNIT ADDITON: 0 NO
SP
POOLSI El FIBERGLASS ❑VINYL-LINED ❑GUNrrE ❑PREFABRICATED
POOL-SF SPA-SF I SPA ATTACHED OYES 0 No I TOTAL-SF RECB E A00BY TOTAL VALUATION:
Commercial orMulti-Family Buildings with Public Swiunuii, Pools requires Deportment of Environmental&nthnpprounl /� 1,414- 7
RE-RO OFI EXISTING ROOF TYPE: ❑BUILT-UP ROOF❑ASPHALT SHINGLES❑WOOD SHAKES❑WOOD SHINGLES❑TILE OTHER(SPECIFY)
REMOVE/REPLACE 0 NO IF NO PLYWOOD ❑'f'" ❑3/8" PLYWOOD TYPE: PITCH: ROOT CLASS
ElYgS I I OF LAYERS THICKNESS Q5/S" OTHER DOM El OTHER .12 A
PROPOSED ROOF TYPE:❑BUILT-UP ROOF °ASPHALT SHINGLES 0 WOOD SHAKES❑WOOD SHINGLES 0 OTHER
"Provide a signed copy of the Cupertino's Tear-Off Policy SP Sof 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 owners 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 .-cI'Btt: laws relating to building construction. I authorize representatives of Cupertino to
enter the above-identified property for ins ect".* pur,,o;es. I acknowledge and authorize all information contained on this application form
to be made available for public re I.
Signature of Applicant/Ag inIfi _ice - Date:r.-12.•—17.
SUPPLEMENTAL INFORMATION R tai'•''D` �
*New SED/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
BidgApp_2017.doc revised 08/01/17
I
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-3250
10500 MADERA DR CUPERTINO, CA 95014-1136 (326 35 052) MAXIMUM
CONSTRUCTION INC
SAN JOSE, CA 95112
OWNER'S NAME: SESHAADRI VENKATRAMANAN AND AMRITHA ET AL
DATE ISSUED: 06/29/2017
OWNER'S PHONE: 408-910-8721 1 1 PHONE NO: (888) 629-2462
License Class B Lic. #910762
Contractor MAXIMUM CONSTRUCTION INC Date 02/28/2018
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
BUILDING PERMIT INFO:
X BLDG _ ELECT _ PLUMB
_ MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
REBUILD EXISTING FIRST FLOOR OF (E) RESIDENCE (1770 SQ FT);
CONSTRUCT FIRST FLOOR ADDITION (506 SQ FT); CONSTRUCT
2ND STORY ADDITION (1781 SQ FT); WITH (2) BALCONIES (361 SQ
Compensation, as provided for by Section 3700 of the Labor Code, for the FT).
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? ds and will comply with all non -point
source regulations per th upertin Municipal Code, Section 99.18.-3/Z -- q� /
5�
Signature Date C� 2 ` + `OWNE BZER DECLAR,
Sq. Ft Floor Area: 2287 1 Valuation: $898686.00
APN Number: Occupancy Type:
326 35 052 R-3 (Custom)
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Phuong Devries
Date: 06/29/2017
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
1. 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, 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:
L 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. 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.
Signature
Date
Signature of
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. 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, Sectio 05, 25533, and 25534.
Owner or authorized agent:
Date:
LENDINGAGENCY
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
Professional
CUPERTINO
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildingta)cupertino.orq
�j- CL) I(Q_
❑ NEW CONSTRUCTION Lei ADDITION TR ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS 10500 Madera Drive
APN# 326=35-052
OWNERNAME Venkatramanan and Amritha Seshaadri
PHONE 650-906-8350
E-MAIL asi778@yahoo.com/
408-910-8721
vseshaadd@yahoo.com
STREET ADDRESS 10500 Madera Drive
CITY, STATE, ZIP Cupertino CA 95014
T;A;
CONTACT NAME Eugene Sakai
PHONE 4089980983
E-MAIL esakai@studios2arch.com
STREET ADDRESS 19 N Second St
CITY, STATE, zip San Jose CA 95113
FAX 4084040144
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR, AGENT IM ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
LICENSE NUMBER
LICENSE TYPE
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
ARCHITECT/ENGINEER NAME Eugene Sakai
LICENSE NUMBER C27,719
BUS. LIC #
cOMPANYNAME Studio S squared Architecture
E-MAIL esakai@studios2arch.com
FAX 4084040144
STREET ADDRESS 19 N Second St
CITY, STATE, ZIP San Jose CA 95113
PHONE 4089980983
DESCRIPTION OF WORK REMODEL AND ADDITION OF AN EXISTING 3 BR 3 BA SINGLE FAMILY RESIDENCE WITH 1,769.80 EXISTING LIVING
S.F. ON A 10,000 S.F. LOT. A 2,286.96 S.F. ADDITION OF NEW LIVING AREA WILL RESULT INA 5 BR AND 6 BA
RESIDENCE WITH 4,056.76 LIVING S.F. WITH AN (E) GARAGE OF 426.67 S.F. TO REMAIN TOTALING 4,483.43 S.F..
A 15.56 S.F. AREA IS RESERVED TO ALLOW FOR A FULL 20' CLEAR WIDTH IN THE EXISTING NON -CONFORMING
GARAGE TO REMAIN. 2.-� L 2nuc�t-
EXISTING USE
PROPOSED USE CONSTR.
TYPE
# STORIES
SINGLE FAMILY RESIDENCE
SINGLE FAMILY RESIDENCE TYPE
V
2
USE
TYPE
OCC.
SQTT.
VALUATION (S)
EXISTG
AREA 1769.0 S.F
NEW FLOOR
AREA 2,886.96 S.F
DEMO N/A
AREA
TOTAL 4056.76R
NET AREA
SINGLE FAMILY
TYPE V
-3/U 4483.43
(WITH
S.F
896,686
RESIDENCE
GARAGE
BATHROOM
N/A
WA__J
KITCHEN
OTHER
N/A
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: DETACH
N/A
N/A
I
N/A
ATTACH
# DWELLING UNITS:
IS A SECOND UNIT ❑ YES
SECOND STORY S
BEING ADDED? :RT0
ADDITION? ❑NO
PRE -APPLICATION 85MS IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
RECEIVBY:
TOTAL VALUATION:
PLANNING APPL # [3 NO PLANNING APPROVAL LETTER
NO
EICHLER HOME? [3 NO
n.
$ 896,686
By my signature below, I certify to each of the following: I am the property owner or authorized agent to A 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 inspection purposes.
12/05/2016
Signature of Applicant/Agent: _Cyt_� Date:
SUPPLEMENTAL INFORMATION REQUIRED
PLAN CHECK TYPE
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
PLANNING PLAN REVIEW C��e\ 1
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
MARE DEPT
i<Copy of Planning Approval Letter
1:1 MAJOR
CI SANITARY SEWER DISTRICT
❑ ENVIRONMENTAL HEALTH
BldgApp_2011.doc revised 06/21/11