13060177M
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20303 CARTWRIGHT WAY
CONTRACTOR: BAY AREA CUSTOM
PERMIT NO: 13060177
BUILDERS INC
OWNER'S NAME: NEENA BHATNAGAR
1002 S DE ANZA BLVD STE Al
DATE ISSUED: 08/30/2013
OOW/NER'S PHONE: 4084805348
SAN JOSE, CA 95129
PHONE NO: (408) 446-1200
Ld LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL EI
License Class_ Lic. # 2 (7 `� `4
CONSTRUCT A 461 SQ FT ONE STORY ADDITION;
/ 2 I
Contractor GI i AreM L��' t h r ��I t°. V) c//3
INTERIOR
REMODEL OF 80 SQ FT.
I hereby affirm at 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
Sq. Ft Floor Area:
Valuation: $50000
'Nrformance of the work for which this permit is issued.
ave 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: 31642006.00
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. l 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 FRO 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
Date: �f[.?o //3
granting of this permit. Additionally, the applicant understands and will comply
Issue
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
RE -ROOFS:
Signature Date ,.,
E���� --i��
All roofs shall be inspecte 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
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
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(x) 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, Sections 25505, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: Date:�0
g )
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
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 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
/3
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
OCCUPANCY TYPE:
ESS: 20303 CARTWRIGHT WAY
DATE: 06/21/2013
REVIEWED BY: MELISSA
W
316 42 006
BP#:
'VALUATION: $50,000
Building Permit
PLAN CHECK TYPE: Addition
PRIMARY
USE: SFD or Duplex
2nd Unit? Yes No
OTC? 0 Yes 0 N
PENTAMATION
PERMIT TYPE: 1 R3SFDADD
WORK
461 S.F. ADDITION TO REAR OF PROPERTY TO CREATE N KITCHEN & DINING AREA.
SCOPE I
REMODEL FRONT AREA FROM DINING AREA & KITCHEN TO (N) HALL BATH (80 S.F.) AND
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
R-3 (Custom)
II-B,III-B,IV,V-B
461
$1,512.00
IADDPLCK
$1,230.00
IADDINSP
�( . In P' Fcc
$0.00
Permit Fee:
$1,230.00
Suppl. Insp. Fee -0 Reg. Q OT
F0,0Thrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
TOTALS:
461
1 $1,512.00
$1,230.00
MECH, HOURLY 0 Yes 0 No
PLUMB, HOURLY 0 Yes 0 No
ELEC, HOURLY 0 Yes 0 No
:Tech. Plan Check
"lunib. Pluu Checi, FT
.Zc, Plan Check
Mech. Permit Fee:
Plumb. Permit lee:
Elee. Permit Fee:
Other Mech. Insp
kher Plumb Insp.
her Elec. Insp.
f,' h In a FAY"
andb 1 ,',
�( . In P' Fcc
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Pire, Sanitary Sewer District, 5choot
tlictrint otr 1 Thoce font aro hacod on tho nroliminary information available and are onlv an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff LJ 12l
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$1,512.00
80 s.f.
$600.00
Remodel, Bath (<=300 sf)
IREMRESBAT
Suppl. PC Fee: 0 Reg. 0 OT
0.0
1 hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$1,230.00
Suppl. Insp. Fee -0 Reg. Q OT
F0,0Thrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Ttzr:
Administrative f'ee:
0
Work Without Permit? Yes 0 No
$0.00
Advanced Planning Fee: IPLLONGR
$59.93
Select a Non -Residential
Building or Structure
0
0
A
]ravel Documentation Fees:
Strong Motion Fee: IBSEISMICR
$5.00
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$2.00
SUBTOTALS:
$2,808.93
$600.00
TOTAL FEE:
1 $3,408.93
Revised: 04/29/2013
B ilding Department
City Of Cupertino
10300 Torre Avenue
L Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
CONTRACTOR / SUBCONTRACTOR LIST
JOB ADDRESS:" Q 5 { (� PERMIT #
OWNER'S NAME: \ PHONE #
GENERAL CONTRACTOR: t 1errs BUSINESS LICENSE #
ADDRESS: JU0Z \ CITY/ZIPC0DE.6C:t,n.1t_ -e `�'1S 1 2.01
*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 Date
Please check applicable subcontractors and complete the following information:
Owner / Contractor Signature Date
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing
i/
Heating
�,(� Cbn,'
Insulation
Landscaping
Lathing
Masonry
Painting!' Wallpaper
Paving
Plastering
Plumbing
Roofing
tjjnhyq> 4c)
5,2 -
Septic
Septic Tank
Sheet Metal _
Sheet Rock
Tile
Owner / Contractor Signature Date
CUPERTINO
CONTRACTOR / SUBCONTRACTOR LIST
Building Department
City Of Cupertino
10300 Tone Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: Z 3 c, 3 Cay 1,.. ..,moo,
PERMIT # `S &
OWNER'S NAME: r*
PHONE # �o YqK, ( 7-Zd-o
GENERAL CONTRACTOR: ,,�AC�
BUSINESS LICENSE # 2 p 4
ADDRESS: „
c c CITY/ZIPCODE: Ck
*Our municipal code requires all businesses working ifi the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) 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 Signature
^,?,_-S o- \'s
Date
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
Owner /. Contractor Signature
^,?,_-S o- \'s
Date