13010151CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10067 BYRNE AVE
CONTRACTOR: BERINGER
PERMIT NO: 13010151
CONSTRUCTION
OWNER'S NAME: INDERJEET SINGH
PO BOX 3917
DATE ISSUED: 07/03/2013
OWNER'S PHONE: 4083904650
SAN JOSE, CA 95150
PHONE NO: (408) 835-5883
❑ LICENSED CONTRACTOR'S DECLARATION
[_
�
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License ClassLic.#
Contractor C (7 _ Date 4
MECH RESIDENTIAL COMMERCIAL
JOB DESCRIPTION: NEW SCOPE OF WORK: CONSTRUCT (N) SFD ON (E)
T�
FOUNDATION & FLOOR TO CREATE 3253 SQ FT OF LIVING
I hereby affirm that I am licensed under the provisio of hapter 9
SPACE, 472 SQ FT ATTACHED GARAGE & 95 SQ FT ENTRY
(commencing with Section 7000) of Division 3 of the usiness & 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:
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
Sq. Ft Floor Area:
Valuation: $426000
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
APN Number: 35711003.00
Occupancy Type:
permit is issued.
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 FROM LAST CALLED 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
^ '
Issued by: �l� t�%fl�l� Date:
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
RE -ROOFS:
9.18. L
�� ll
Signature Date V
All roofs shall be inspected prior to any roofing material being installed. If a roof is
lh�J
installed without first obtainingan inspection, I agree to remove all new materials for P g
inspection.
❑ OWNER -BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that 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
1, 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 the Cupertino Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Secti.A 2550 X255 nd 5534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: L/ Date:
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person many manner so as to become subject to the Worker's
Compensation laws of California. If, after making this certificate of exemption, I
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I must
I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked.
w'ork'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
ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
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
I CITY OF CUPERTINO BUILDING PERMIT I
1 BUILDING ADDRESS: 10067 BYRNE AVE 1 CON TRUC ONBERINGER PERMIT NO: 13010151 I
OWNER'S NAME: INDERJEET SINGH I PO BOX 3917 1 DATE ISSUED: 07/03/2013 1
OWNER'S PHONE: 4083904650 1 SAN JOSE, CA 95150 1 PHONE NO: (408) 835-5883 1
❑ LICENSED CONTRACTOR'S
(DECLAf jRAATTION
License Class .Lic. # ro ( j`'') _ I L/ ` _
Contractor b Cat h Date
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. —'. It
I hereby affirm under penalty of perjury one WI Mat•ations:
1 have and will maintain a certificate of consent e or 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
1 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 applicant understands and will comply
with all non -points urce gulations r the Cupertino Municipal Code, Section
9.18. l /
Signature Date
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am 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 the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
1, 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:
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, 1 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.
JOB DESCRIPTION: RESIDENTIAL u COMMERCIAL
NEW SCOPE OF WORK: CONSTRUCT (N) SFD ON (E)
FOUNDATION & FLOOR TO CREATE 3253 SQ FT OF
LIVING
SPACE, 472 SQ FT ATTACHED GARAGE & 95 SQ FT ENTRY
#1- REVISE FOUNDATION- ISSD OTC 8/16/2013
Sq. Ft Floor Area: I Valuation: $426000
APN Number: 35711003.00 1 Occupancy Type: 1
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DA F OM LAST CALLED INSPECTI/ON.
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
I 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 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 2550 , 25533 d 25534.
zed
Owner or authoriagent: V// Date:_
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 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 • building(okupertino.orq
❑ NEW CONSTRUCTION _ ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS , O , ( Q
Q
APN #
OWNERNAME -y
PHONE
E-MAIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
l
CONTAC NAME
n � 1 •� , 1
/
PHONFJ`% X C �(//I�
E-MAIL
ON I a
�j
STREET ADDRESS P�
CITY, STATE,,7ZIP i
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME \�
LICENSE NUMBER
LICENSE TYPE
BUS- LIC #
COMPANY NAME •j�
E-MAIL
FAX
STREET ADDRESV6CITY,
STATE, ZIP
PHONE
ARCHITECTIENGINEER NAME
LICENSE NUMBER
BUS- LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
1v \ IBJ
' •v4 � SI `,� �
W V
EXISTING USE
PROPOSED USE CONSTR
TYPE
# STORIES
USE
TYPE
OCC.
SQ.FT.
VALUATION (S)
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECKIPORCHAREA
GARAGEAREA DETACH
ATTACH
YDECKAREATOTAL
k DWELLING UNICOND
UNIT ❑ YES
SECONDSTORY ❑ YES
ADDED? ❑ NO
ADDITION? ❑ NO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
REG y;
PLANNING APPL At ❑ NO PLANNING APPROVAL LETTER
EICHLER HOME? ❑ NO
-
By my signature below, I certify to each of the following: 1 am the property owner or authorized agnt 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 erify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating ui ing�on ctior I authorize representatives of Cupertino to enter the abov ,identified property for inspection purposes.
� `/
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFORMATION REQUIRED!P
cx TYPE , ::'
>Nc SLIP
New SFD or Multifamily dwellings: Apply for demolition permit for
New
existing building(s). Demolition permit is required prior to issuance of build'
OVER-THE-COUNTER
LJ BUILDING PLAN REVIEW,
permit for new building.
❑ EXPRESS
❑ PLANNING 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
❑ FIItE DEPT
Copy of Planning Approval Letter or Meeting with Planning prior to
El MAJOR
El SANITARY sEWERDisTRICF -
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
Bldg,4pp_20/ l.doc revised 06/2//11
CUPERTINO
%NEW CONSTRUCTION
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(a)cupertino.org \
❑ ADDITION ❑ ALTERATION / TI ❑ REVISION/ DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS f
4t n
APN # �7 -
/ /
OWNER NAME ` ( V ^ PHONE E-MAIL
STREET ADDRESS CITY, STATE, ZIP FAX
CONTACT NAME
&XE
E -MA
STREET ADDRESS F5 3
CITY, TATE,4P I
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT (CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
NTRACTOR NAME
LIE SE $ r,
LICEhISE TYPE
BUS. LIC #
ti Co r t
J
COMP N E
t f /71 �i ��
'"^"
r�.a yam►-c�� s_ -t �. c
CITY, STATE, ZIv
FAX
STREET ADD Sn
,
`
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
fib E 4_C
r �� z a,# -r-
�Y . / covGrcc
EXISTING USE
PROPOSED USE CONSE
!
#STS
USE
TYPE
OCC.
SQ.FT.
VALUATION($)
EXISTG
AREA
NEW FLOOR
AREA
DEMO
AREA
TOTAL
NET AREA
��`•••
5
�'3
as 45
BATHROOM
REMODEL AREA
KITCHEN
REMODEL AREA
OTHER
REMODEL AREA
%
(
' f
v
V7
7
PORCH AREA
DECK AREA
TOTAL DECKIPORCH AREA
GARAGE AREA: DETACH
❑ATTACH
# DWELLING UNITS:
IS A SECOND UNIT ❑ YES
SECOND STORY ❑ YES
BEING ADDED? []NO
ADDITION? []NO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
PLANNING APPL # ❑ NO PLANNING APPROVAL LEITER
IS THE BLDG AN ❑ YES
EICHLER HOME? ❑ NO
RECEIVED.BY:
,,,�
TO AL VALUATIQN:
/'' /
J��
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 provide 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 lwqding nstruction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Ag(nt: � " Date: �
SUPPLEMENTAL INFORMATION REQUIRED
PLAN CHECK TYPE
ROUTING SLIP
❑OVER-THE-COLFNTER
BUILDING PLAN REVIEW
_ New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
❑ EXPRESS'
PLANNING PLAN REVIEW
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
STANDARD
I 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
❑,
SANrrA,RY SEWER
submittal of Building Permit application.
MAJOR
DISTRICT
H
❑ ENVIRONMENTAL HEALTH
B1dgApp_2011.doc revised 06121111
r)
CITY OF CUPERTINO
FM_7 FEE ESTIMATOR - BUILDING DIVISION
1AADDRESS:
10067 Byrne Ave
DATE: 01/30/2013
REVIEWED BY: Sean
PC FEE ID
APN:
BP#: �'42Z Sr
`VALUATION: 1$426,000
%PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY SFD or Duplex
USE:
2nd Unit? Yes • No
PENTAMATION 1 R3SFDW
PERMIT TYPE:
WORK
Rebuild and add to existing residence (3225sq ft); attached garage (475sq ft • covered porches 103
SCOPE
sq ft).
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
3,803
$3,024.24
1R3PLNCK
$3,200.06
1R3INSP
$0.00
PME Plan Check:
$0.00
Permit Fee:
$3,200.06
Suppl. Insp. FeeQ Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.0
TOTALS:
3,803
$3,024.24
Construction Tax: IBCONSTAXR
$3,200.06
# new
units
NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
Dictriet otr 1. Thoco fooc aro hacod an tho nroliminary infnrmatinn availahlo and aro aniv an odimato_ rantart tho Dont far addn'l infn_
FEE ITEMS (Fee Resolution 11-053 Eff. 711112,)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$3,024.24
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: Q Reg. Q OT
TO.OThrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$3,200.06
Suppl. Insp. FeeQ Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.0
Construction Tax: IBCONSTAXR
1
# new
units
9.29
A dIninistral4v 1-Fcc
Work Without Permit? Q Yes 0 No
$0.00
Advanced Planning Fee: IPLLONGR
$494.39
Select a Non -Residential
Building or Structure
Q
7rin<�l Dce�f�narr�rit»? /'�rfs_
Strong Motion Fee: IBSEISMICR
$42.60
Select an Administrative Item
Bldp, Stds Commission Fee: tBCBSC
$18.00
SUBTOTALS:
$7,408.58
$0.00
TOTAL FEE: '
$7,408.58
Revised: 10101/2012
CUPERTINO
Q 6 A,. f K �g erg
3ss'w3
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: Y✓l w(,.&
PERMIT # o 10 1
OWNER'S NAME: �,y51 VV"k
PHONE # 9-- 3 O
GENERAL CONTRACTOR:
BUSINESS LICENSE # Z
ADDRESS:
CITY/ZIPCODE:SaM,St i
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
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
Please check applicable subcontractors and complete the following information:
Date
Owner / Contractor
ature
FJ
ho
IU(at-e
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
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Cabinets & Millwork
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Cement Finishing
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Electrical
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Excavation
V, �/�-; Q�
3 Q >1 L4
Fencing
Flooring / Carpeting
,pay -y1 4WCA110-Y,
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Linoleum / Wood
Glass / Glazing
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Heating
Insulation
30 L o
Landscaping
,� h eAp 2-1*L
Lathing
Masonry
Painting / Wallpaper
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Plumbing
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Roofing
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Septic Tank
Sheet Metal
Sheet Rock
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Tile
Jwzk011' U4Y
Owner / Contractor
ature
FJ
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IU(at-e
Permit Number '13010151
♦ Add
APN
I Update
Address
10067 BYRNE AVE
Release
Event
Inspections Hold Inspections
.
(� Next
Reason
TCO GOOD THRU 6112114 - NO INSPECTIONS
�"`
� Previous
Contact Info
AFTER THAT
Allow Bypass
Location Link
Faf` Exit
Created By
.counter Date 03/12/2014 Time X11:59
Released By
Date_, Time
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: �: Q, PERMIT #
OWNER'S NAME: TO p )L- u r- 1 S t 4 G i4 PHONE # 6 �^ S
GENERAL CONTRACTOR: T� i'l r.%m cp �. ' , BUSINESS LICENSE #
ADDRESS: WS 7NI inCITY/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 INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBC NTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:3
Signa ure Date
Please check applicable subcontractors and complete the following information:
0wner / Contractor
ature
�--1 Date -s
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
0wner / Contractor
ature
�--1 Date -s