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13100071 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10204 S PORTAL AVE CONTRACTOR:LUU CONSTRUCTION PERMIT NO: 13100071 INC OWNER'S NAME: MR&MRS GUNJA 333 AVENIDA PINOS DATE ISSUED:04/04/2014 OWNER'S PHONE: 4082526211 SAN JOSE,CA 95123 PHONE NO:(408)623-7558 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑ CONSTRUCT A 605 SQ FT ONE STORY ADDITION; License ClassLic.# 01 7 1 7 6 REMOVE Contractor .5f-"E' LL4-(A Date- AND REPLACE(1)WINDOW IN LIVING ROOM. 1 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: 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. Sq.Ft Floor Area: Valuation:$85000 I have and will maintain Worker's Compensation Insurance,as provided for by ection 3700 of the Labor Code,for the performance of the work for which this APN Number:36909008.00 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 granting of this permit. Additio y,the applicant understands and will comply Issued by: Date: with all non-point source r at s e Cupertino Municipal Code,Section 9.18. [� t� RE-ROOFS: Signature Date -I 1 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. ❑ 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 Cuperti 4u ' ipal Code,Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25" 5 and 25534. Section 3700of the Labor Code,for the performance of the work for which this issued. permit is issued. Owner or authorized agent: Date 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,l 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. 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 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 CONSTRUCTION PERMIT APPLICATION \ 0� COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION QO 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333• building(@cupertino.orrg ❑NEW CONSTRUCTION 19 ADDITION ❑ ALTERATION/Ti ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS © /'• }X APN# 01 - 1 �, OQ Jp{ OWNER NAME PHONE J E-MAIL aA(. ZA STR ffSS .� I L AVE CITY, STAxE,ZI TI NiO V /1/, G�C n 1 FAX CONTACT NAME PHONEL1II l /'C E-MAIL 1 STREET ADDRESSCITY,STATE,ZI FAX A t J �" .S r✓ G L ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME y .f C- L LICENSE NUMBER LICENSE TYPE t� BUS.LIC# COMPANY NAME / , j� �� s E-MAIL L E�QCT FAX Lv1 t� 1V�j' �t—I �o S C (�4�► STREET ADDRESS3 AVE 1 ( � 214 V� CITY,STATE,T>�/ �\/moi S C P 1 S � 2 j PHONE,; 6 2_5_715 5_7 ARCHITECT/ENGtNEER NAME l V nom LICENSE NUMBER /' 117/.1 (/�� BUS.LIC# COMPANY NAME Wn AP/'�I n 1 liE-MAIL I w �/�A/� n/ ,elIa net FAX � STREET ADDRESS1J� eY S� , / CITILTLN - PHON (^ DESCRIPTION OF W /� r t� b57- EXISTING USE PROPOSED USE 'o S�'R.TYPE #STORIES \L/ /��p/• pV 'rv/ USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA 21- Z /n AREA &0( AREA NETAREAZ,g2.3 BATHROOM �z- KITCHEN OTHER REMODEL AREA,/' REMODELAREA ,/ REMODELAREA PO CH AREA T l$* CH AREA GARAGE AREA: DETACH `( /, ATTACH #DWELLING UNIT&I 1S A SEC YES SECOND STORY DYES BEING ADDED? ONO ADDITION? ❑NO PRE-APPLICATION YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑„YES RECEIVED BY: TOTA6VALUATION: PLANNING APPL# NO PLANNING APPROVAL LETTER EICHLER HOME? O J, SoC�D 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 inspection purposes. Signature of Applicant/Agent: Date: ��'1 Z t?) SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER BUILDING PLAN REVIEW 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 �TANDARD ! PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ((((((❑ LARGE 1�❑/jFIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR `�f�SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doe revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10204 S PORTAL AVE DATE: 10/09/2013 REVIEWED BY: MELISSA APN: 369 09 008 BP#: /6607/ `VALUATION: 1$85,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex 2nd Unit? Yes .' No PENTAMATION 1 R3SFDADD USE: OTC. 0 Yes (F)No PERMIT TYPE: WORK FIRST FLOOR ADDITION 605 S.F. TO CREATE N STUDIO HALL BATH & BEDROOM SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,III-B,IV,V-B 605 $2,577.00 IR3PLNCK $1,617.00 IR3INSP TOTALS: 605 $2,577.00 $1,617.00 MECH,HOURLY 0 Yes Q No PLUMB,HOURLY Q Yes ) No ELEC,HOURLY © Yes Q No r .. :'.�f . 1 c`cv, Lj Li Vice' '�p' c Ld , I NOTE. This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff ,'.1/131 FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,577.00 Select a Misc Bldg/Structure Suppl. PC Fee: O Reg. o OT 0.0 1 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $1,617.00 Suppl. Insp. Fee.S Reg. Q OT—Foolhrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C ovr.lJ -iwiion Ta . 0 Work Without Permit? Yes No $0.00 0 Advanced Planning Fee: IPLLONGR $84.70 Select a Non-Residential 0 1nirF 'li<,f rr�rr ;ilalrnrt 1'`� �,_ Building or Structure Strong Motion Fee: IBSEISMICR $8.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $4.00 SUBTOTALS: $4,291.20 $0.00 TOTAL FEE:'1 $4,291.20 Revised: 10/01/2013 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10204 S PORTAL AVE CONTRACTOR:LUU CONSTRUCTION PERMIT NO: 13100071 INC OWNER'S NAME: MR&MRS GUNJA 333 AVENIDA PINOS DATE ISSUED:04/04/2014 OWNER'S PHONE: 4082526211 SAN JOSE,CA 95123 PHONE NO:(408)623-7558 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL ❑ CONSTRUCT A 605 SQ FT ONE STORY ADDITION; License Class Lic.# Fj�7 ? REMOVE AND REPLACE (1)WINDOW IN LIVING ROOM. Contractor � Date WIt/ I q— rREV#1 -INSTALL STUCCO OVER(E)WOOD SIDING I hereby affirm that I am licensed under the provisions of Chapter 9 1000S.F.-ISSUED 8/11/14 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. 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. Sq.Ft Floor Area: Valuation:585000 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 .4PN Number:36909008.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRE RK IS NOT STARTED correct.1 agree to comply with all city and county ordinances and state laws relatingj180 THIN AYrLLED IT 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 SFR INSPEC ION. 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.non- point source Add ally applicant understands and will comply Date: with all gu ti s r the Cupertino Municipal Code,Section 9.18. pp�� RE-ROOF Signature ��� Date(/ ( All roofs shall e inspe o a a eri eing installed. If a roof is installed witho st obt spec move all new materials for inspection. ❑ OWNER-BUILDER DECLARATION �ature of ant: � ate: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF C VERIN O 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) 1,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 performance of the work for which this permit is issued. will maintain compliance with the Cuperti u ' pal Code,Chapter 9.12 and t have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 2550 and 25534. Section 3700 of the Labor Code,for the performance of the work for which this 8 (� Owner or authorized agent: y 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 in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,1 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. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that 1 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, ARCHITECT'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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION S 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX(408)777-3333• building(a)cuaertino.org CUPERTINO , ii ❑NEW CONSTRUCTION ❑ ADDITION LTERATION/TI REVISIO T DEFERRED ORIGINAL PERMIT 4 131�C7 PRO(( ZQ OPTA Vt! A3N 36 ( —O9 ®V OWNERNAME PHONE I E-M.AIL STREET ADDRESS CITY, STATE,ZIP FAX CONTACT NAME P E E-MP, b f ` 'I U ` tit (& STREJAD RESS �� Z O CITY,STA E, Z1P F.AX 3 ❑ 0WNTR ❑ OWNER-BUIl.DER ❑ OWNER AGENT YIZONITRACTOR ❑CONTRACTOR AGEN71 ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME )it LICENSE NUMBER -? � ! LICENSE TYPE BUS.LIC 50"e-7 LA, ASCOMPANYNAME Luu E-N.AIL S*�CG FAX STREET ADDRESS `f�� CITY,STATE,ZIP PHO _L A - RCHITE � CrGINAM EER NE ` LICENSE NUMBER BUS.LIC COMPANY NA14E E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP I PHONE DESCRIPTION OF WORK AoU '3 ce ` D `aa,a Vg-v � id y -F 1� � � EXISTING USE PROPOSED USE CONSTR TYPE STORIES USE TYPE OCC. SQ.FT. I VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCHAREA DECKAREA TOTAL DECKRORCHARE A GARAGE.AREA: LJ DETACH ❑ATTACH DWELLING UNTITS: IS A SECOND UNIT ❑YES SECOND STORY []YES BEING ADDED? NO ADDITION? NO _ --- -ARE-APPLIc.4noN-��Es---ra s.Pxov�E�oPioP _IST�IE stpc. n 1]YE -ft - TOTAL VALUATION: C PLANMNG APPL m ❑NO PLA.NNLNG APPROVAL LETTER EICHLER HOME? ❑N = _ - —'----- By my signature below,I certify to each of the folio\ain� I am t e property owner ora orized agen e property owner's behalf. I have read this application and the information I have provided i rT a read the Description of Work and rt is accurate. I agree to comply with all applicable local ordinances and state laws relating to/budding r. on. authorize representatives of Cupertino to enter the ab -id71q ified property for inspection purposes. SignatureofApp]icant/Agent: `- - Date: �� SUPPLE? ENTAL INFOR.NIATION REQUIRED � a.cE4ECKriPE_ �_€ p._:xouTL�c`sLIP. 3 k t, New SFD or Multifamily dwellings: Apply for demolition permit for ` M MI 0\ER TAE COiJt<TER BUIL�INGPZ4'�RE� FV :sem existing building(s). Demolition permit is required prior to issuance of building NE permit for new building. E,PRES3 s PI .GFMg L�iiEii) i ` x 3^ L saw .� `r _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure )] sT ,DA�tD :ruBLic�FORKs '' 4 } form if any Hazardous Materials are being used as part of this project. i �` vNng �� �"� � _Copy of Planning Approval Letter or A4eeting with Planning prior to z n x 4AI2 t hDSA�iTARI SEP ER DISTRICT submittal of Building Permit application. wJO� Bldogpp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10204 S PORTAL AVE DATE: 08/11/2014 REVIEWED BY: MELISSA APN: 369 09 008 BP#: 13100071 'VALUATION: Iso PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1GENRES USE: PERMIT TYPE: WORK REV# 1 - INSTALL STUCCO OVER E WOOD SIDING 1000S.F. - ISSUED 8/11/14 S F-1 ED7-- _L_ NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-0.53&.' 7%1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? O Yes G No $0.00 L 1 hours Plan Check, Hourly Suppl. PC Fee: (j) Reg. 0 OT 1 0.0 1 hrs $0.00 $143.00 tsTPCNCK PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OTJ 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 T_T__ 0 Work Without Permit? © Yes 0 No $0.00 0 Advanced Planning Fee: $0.00 Select a Non-Residential G Building or Structure i Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $143.00 TOTAL FEE: $143.00 Revised: 0711012014