The URL can be used to link to this page

13100163 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10135 IMPERIAL AVE CONTRACTOR:BHASKARA PERMIT NO: 13100163 BANDIKALLU OWNER'S NAME: BHASKARA BANDIKALLU 10 13 5 IMPERIAL AVE DATE ISSUED: 10/24/2013 OWNER'S PHONE: 4089810992 CUPERTINO,CA 95014-3967 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ADDITION OF 242 S.F.,REPLACE 3(E)BDRM WINDOWS License Class Lic.# (WILL MEET EGRESS) REV#1 -UPGRADE(E)ELECTRICAL PANEL TO 200AMPS, Contractor Date SAME LOCATION-ISSUED 12/23/13 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:$35000 l 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:35717019.00 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.1 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 DAY' 5TtALLED 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 D Z Z3 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. RE-ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed.if a roof is installed without first obtaining an inspection,1 agree to remove all new materials for inspection. OWNER-BUILDER DECLARATION I reby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: 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) 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 nicipal Code,Chapter 9.I2 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Section 50r5,25 ,and 25534. Se tion 3700 of the Labor Code,for the performance of the work for which this (� p itis issued. Owner or authorized agent: Date:- ertify 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 APPLICANT CERTIFICATION Lender's Address 1 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 ARCHITECT'S 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.AddiU ally,the applicant understands and will comply with all non-p int source regul ions per the Cupertino Municipal Code,Section Licensed Professional 9.18. !,� Signature Date h ?� 2 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10135 IMPERIAL AVE DATE: 12/23/2013 REVIEWED BY: MELISSA 111 I APN: BP#: 13100163 "VALUATION: $0 *PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY SFD or Duplex PENTAMATION 1 REAP2 USE: PERMIT TYPE: WORK REV# 1 - UPGRADE E ELECTRICAL PANEL TO 200 AMPS SAME LOCATION SCOPE APPLIANCE(EQUIP TYPE FEE ID QTY UNITS BP FEES Services 1 ERT<200 200 Amps $47 TOTALS: $47.00 0", Elec.Plan Check 0.0 hrs $0.00 41 I'v Elec.Permit Fee: IEPERMIT Other Elec.Insp. 0.0 hrs $47.00 NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,eta). Thesefees are based on the preliminary information available and are on an estimate. Contact the De t or addn'1 info. FEE ITEMS(h(,e Resolution 11-053 Eff 7'1/13) FEE QTY/FEE MISC ITEMS VI C'r'(TA S1!111711PC Fce 'A PME Plan Check: $0.00 sul!;p1. Illsp f,C(> PME Unit Fee: $47.00 PME Permit Fee: $47.00 Administrative Feer 1ADMIN $44.00 Work Without Permit? Yes Q) No $0.00 q.v/ 1rh`cealc<'�f f'rcrnitirl!�1�'��t`.` Travel Documentation Fee: ITRA VDOC $47.00 Strong Motion Fee: $0.00 Select n Administrative It Bldg Stds Commission Fee: $0.00 ° SUBTOTALS $185.00 $0.00 TOTAL FEE:` $185.00 Revised: 10(01(2013 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10135 IMPERIAL AVE CONTRACTOR:BHASKARA PERMIT NO: 13100163 BANDIKALLU OWNER'S NAME: BHASKARA BANDIKALLU 10135 IMPERIAL AVE DATE ISSUED:10/24/2013 OWNER'S PHONE: 4089810992 CUPERTINO,CA 95014-3967 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL L1 COMMERCIAL License Class Lic.# ADDITION OF 242 S.F.,REPLACE 3(E)BDRM WINDOWS (WILL MEET EGRESS) Contractor 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. 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:$35000 [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:35717019.00 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 18 L 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. Additionally,the applicant understands and will comply ed by: eid I A te r h, with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date 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(See.7044, usiness&Professions Code) 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 M rcipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sectio 505,2553 d 25534. Section 3700 of the Labor Code,for the performance of the work for which this f Owner or authorized agent; Dater permit is issued. I certify that in the performance of the work for which this permit is issued,I shall ` t 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.Addition0q,the applicant understands and will comply with all non-point source re(gula s per the Cupertino Municipal Code,Section Licensed Professional 9.18. 1 Signature Date —C��,2Z,13 CONSTRUCTION PERMIT APPLICATION ` b \ COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION \ O 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 4 y Lo (408) 777-3228• FAX(408)777-3333•building cupertino.org �/ Ca(- UPERTINO ❑NEW CONSTRUCTION .+ ADDITION ❑ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS APN# 9-=r- } 7 OWNER NAME PHONE/,f p q-F 1-0�Z E-MAIL STREET ADDRESS 10 l �f r F `'� � CITY,STATE,ZIP OG./gr `/,./ �.4 FAX CONTACT NAME�j�V /7��.1aI/t + ,, ,] "P -4 X PHONFy„�a� R�_O^� V� E-MAIL STREET ADDRESS r•/I N rT 7fV 1�Ft" CITY,STATE,ZIP O '-j FAX OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS ,fir CITY,STATE,ZIP PHONE ARCHITECT/ENGINEER NAME ` LICENSE NUMBER BUS.LIC# COMPANY NAME O 7/_�f/ E-MAIL 1��7/�-�Iy J,(''�(�/'�,/y_�. FAX STREET ADDRESS 7 O/c �] L 0 'tel(oV G CITY,STACTE,ZIIPP ��7f/►�(X(QJ 1 yl PHONE DESCRIPTION OF WORK R7 1� Alo._ / Tel �L P��+ �60 TD I'N,� �7i — E*46 EXISTING USE PIWPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) rrili-a rArlI[. Jwrl e FAr1rlr -4.9 EXISTG NEW FLOOR DEMO TOTAL ,ry AREA I Z AREA C��7 AREA NET AREA J p O d BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ATTACH #DWELLING UNITS: IS ASECOND UNIT [i YES SECOND STORY []YES BEING ADDED? _,PMO ADDITION? ANO PRE-APPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES :FIVE - TAL VALUATION: PLANNING APPL# [ NO PLANNING APPROVAL LETTER EICHLER HOME? 0 13❑ Z O By my signature below,I certify to each of the following: I am the property owner or Ize agent to e erty owner's be 1. d this application and the information I have provided is correct. I have read the Description of Work an verify it� urate. I agree to comply with all applicable local ordinances and state laws relating t b dolling co struction, II authorize representatives of Cupertino to enter the above-identif}e�perty for inspection purposes. Signature ofApplicant/Agent: �f//z �il�?1�/ _ Date: "U�/r` 3 SUPPLEMENTAL INFORMATION REQUIRED PLANCHECKTYP El ilNcs%Ir. y _New SFD or Multifamily dwellings: Apply for demolition permit for ❑; ov�x THE COUNTER ❑ sulLDuvGrLANREVIEw existing building(s). Demolition permit is required prior to issuance of building permit for new building. EW z _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ r1 "w 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 El:�_mIAaOR ❑ SANITaRY SEwERDzsTRtcr submittal of Building Permit application. ❑�'ENVIRONkiNTAL HEALTH BIdgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10135 IMPERIAL AVE DATE: 10/24/2013 REVIEWED BY: MELISSA APN: 357 17 019 BP#: 'VALUATION: 1$35,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex 2nd Unit? Yes = No PENTAMATION 1 R3SFDADD USE: OTC. Yes ®No PERMIT TYPE: WORK ADDITION OF 242 S.F. REPLACE 3 E BDRM WINDOWS WILL MEET EGRESS 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 242 $1,059.00 IADDPLCK $1,026.00 IADDINSP TOTALS: 242 $1,059.00 $1,026.00 MECH,HOURLY 0 Yes 'o No pLVMB,HOURLY 0 Yes (� No ELEC,HOURLY � `Yes QIVo 1 `"In CL'h"(4: Li 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 on an estimate. Contact the De t or addn'l info, FEE ITEMS (Fee Resolution 11-053 Eff 7/1!13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,059.00 3 # Window/ Sliding Glass Door Suppl. PC Fee: E) Reg. C) OT 0.0 I hrs $0.00 $418.00 1WINREP I Replacement PME Plan Check: $0.00 Permit Fee: $1,026.00 Suppl. Insp. Fee-0 Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? 0 Yes (E) No $0.00 0 Advanced Planning Fee: IPLLONGR $33.88 Select a Non-Residential Ti cncl� �rttuiinr� he�c�.�: Building or Structure Strong Motion Fee: IBSEISMICR $3.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 SUBTOTALS:" $2,124.38 $418.00 TOTAL FEE: 1 $2,542.381 Revised: 10/01/2013 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Lal Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: 10135 /IMP95X l I►L AVCPERMIT# t 10 ` r3 OWNER'S NAME: SHA-,S ICkf_4 AAjJj0j klA LLU PHONE# GENERAL CONTRACTOR: 7-L3 _D BUSINESS LICENSE# ADDRESS: CITY/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 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: 6/ 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 '+- © Zai 3 Owner/Contractor Signature Date Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: ,` ''' ' ' PERMIT# d OWNER'S NAME: '_•, o r ° a_ 7 _ PHONE# ! GENERAL CONTRACTOR: 7 ,:? BUSINESS LICENSE# 34 5`l ADDRESS: CITY/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 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: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical n 2- 5 a L/ Excavation Fencing L// Flooring/ Carpeting Linoleum/ Wood Glass / Glazing Heating ✓ Insulation Landscaping Lathing Masonry Painting/ Wallpaper Paving ✓ Plastering Plumbing c/ Roofing Septic Tank Sheet Metal / Sheet Rock Tile Owner/ tractor Signature Date OWNER-BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•building(a-cupertino.ora Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SITE ADDRESSJ 10 135' I P-1W,r n,A-✓� 777N3JC7-/-7 _ 0 1 BP# �� OWNER NAME 11 1j*4 Y 9A n �1i1V J OWNER ADDRESS ' O � I l .rmmle p*vE DESCRIPTION OF WORK: 2t7l 1� ,�' 'Ned ✓ CIE We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIR CTIONS:Please read and initial each statement below to signify you understand or verify this information.) 1. 1 understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- ilder"building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my tance coverage for injuries to workers on my property. 2. 1 understand building permits are not required to be signed by property owners unless they are responsible for onstruction and are not hiring a licensed Contractor to assume this responsibility. 3. 1 understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may ct myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her /Name instead of my own. 4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license mbers on permits and contracts. 5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the tal value of my construction is at least five hundred dollars ($500), including labor and materials, I may be sidered an"employer"under state and federal law. 6. 1 understand if I am considered an "employer"under state and federal law, I must register with the state and deral government,withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each"employee." I also understand my failure to abide by these laws may subject to serious financial risk. ksice7. 1 understand under California Contractors' State License Law, an Owner-Builder who builds single-family insed ntial structures cannot legally build them with the intent to offer them for sale, unless all work is performed by subcontractors and the number of structures does not exceed four within any calendar year, or all of the work erformed under contract with a licensed general building Contractor. . I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for n financial or personal injuries sustained by any subsequent owner(s)that result from any latent construction defects in the workmanship or materials. OwnerBuilderFonn 2010.doc revised 04114110