13100146CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 22245 REGNART RD
CONTRACTOR: SUNSATIONAL
PERMIT NO: 13100146
SUNROOM
OWNER'S NAME: SEKHAR SAKUKKAI
1825 MAPLEGROVE LN
DATE ISSUED: 12/04/2013
OWNER'S PHONE: 4088965377
TRACY, CA 95376
PHONE NO: (408) 439-4514
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
❑ LICENSED CONTRACTOR'S DECLARATION
S9,3 ,�6%6
ENCLOSE (E) BALCONY ON 2ND STORY (203 S.F.)
License Class Lic. #
Contractor(J/7S� i,,,/=. ,,�/Ovl✓, Date / u &97 �
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
Valuation: $10500
performance of the work for which this permit is issued.
Sq. Ft Floor Area:
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
APN Number: 36647006.00 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 DA O1VI LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
said City in consequence of the
costs, and expenses which may accrue against
Issued by: Date:
granting of this permit. Additionally, the applicant understands and will comply
with all non-poin urce regulations per the Cu ino Municipal Code, Section
9.18. i �
RE -ROOFS:
Signature Date 0 3
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
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)
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
the Cu ertino Municipal Code, Chapter 9.12 and
performance of the work for which this permit is issued.
will maintain compliance with
the Health & Safety Code, Sections 505, 25533, and 25534.
I have and will maintain Worker's Compensation Insurance, as provided for by
for this
�Z
Section 3700 of the Labor Code, for the performance of the work which
Owner or authorized agent: 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
CONSTRUCTION LENDING AGENCY
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
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
CUPERTINO
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • build incl(Qcupertino.org
❑ NEW CONSTRUCTION Ff�, ADDITION ❑ ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL . PFRMTT M
PROJECT ADDRESS
APN # 36-,6
OWNERNAME /'
PHONE
E-MAIL —1_
a 83 7 7
STREET ADDRESS
CITY, STATE, ZIP
FAX
CONTACT NAME
J Ste,
PHONE
19/9
E-MAIL
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y s 7
STREET ADDRESS
CITY, STATE, ZIP S J
l� OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT "�-CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
❑
CONTRACTOR NAME
LICE NS$3�
LICENSE E
BU I Ott �v
s2 U
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COMPANY NAME /
E-MAIL
FAX
STREET ADDRESS / ,/
/u
CrrY, STATE, ZIP
PHONE
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME /
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK A3
EXISTING USE
PROPOSgp
TYPE
# 'TO S
TYPE
OCC.
SQ.FT.
tj_USE
VALUATION (S)
EXISTG
NEW FL nnR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOM
AREA
KITCHEN
REMODEL AREA
OTTER Z)_3REMODEL
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: DETACH
❑ ATTACH
# DWELLING UNITS:
IS A SECOND UNIT ❑ YES
SECOND STORY ❑YES
r`
BEING ADDED? NO
ADDITION? NO
)"❑
PRE -APPLICATION DYES IF YES, PROVIDE COPY OF
PLANNING APPL# NO PLANNING APPROVAL LETTER
IS THE BLDG AN YES
EICHLER HOME?
RECEIVED Y:
TOTAL VALUATION:
Wo
-V
5-00
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 ovided 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 Iding construction. thorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENT INFOfMATION REQUIRED
PLAN CHECK TYPE
ROUTING SLIP
El OVER-THE-COUNTER
_ New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
BUILDING PLAN KFVIEIV
permit for new building.
❑ EXPRESS
PLANNING PLAN REVIEW
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure�I
STANDARD
/❑'
❑ 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
submittal of Building Permit application.
❑ MAJOR
SANITARY SEWER DISTRICT
❑ ENVIRONMENTAL HEALTH
B1dgApp_2011.doc revised 06/21/11
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��������,,,,���� CITY OF CUPERTINO
1i�4/W Trr FCTiIViATnR — RITii,DING DIVISION
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Puottc Proms, rtre, aurtttury —wvl ams sa 9
-1 _ I-- *-.r-.--#;-- a a;ta6to and oro Doty an octimolP_ Contact the Dent for addh7 info.
District, eIG . mese eu ure uu3eu vu 111V.cu..u..u.
FEE ITEMS (Fee Resolution 11-053 Eff 7.%1:'13)
1�
Phunb. ('.r.,r i ,., ,
cicc. Plan Check
Llrch. Permit f.
ADDRESS: 22245 Regnart Rd
DATE: 10/22/2013
REVIEWED BY: Sean
BP#: 'VALUATION: $10,500
10
APN:
PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY
SFD or Duplex
Insp. Fee:
PENTAMATION 1 R3SFDADD
PERMIT TYPE:
USE:
PME Plan Check:
WORK
Enclose an existing balcony on second floor 203 sq ft).
SCOPE
$0.00
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Puottc Proms, rtre, aurtttury —wvl ams sa 9
-1 _ I-- *-.r-.--#;-- a a;ta6to and oro Doty an octimolP_ Contact the Dent for addh7 info.
District, eIG . mese eu ure uu3eu vu 111V.cu..u..u.
FEE ITEMS (Fee Resolution 11-053 Eff 7.%1:'13)
1�
Phunb. ('.r.,r i ,., ,
cicc. Plan Check
Llrch. Permit f.
Plumb
Fler Permit Fere'
Other Aiec:h. Insp
Other Plumb Insp.
her Elec. Insp.
A�ech. Insp. Fee:
Plume) lucp. Fee:
Insp. Fee:
hrs
$0.00
PME Plan Check:
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Puottc Proms, rtre, aurtttury —wvl ams sa 9
-1 _ I-- *-.r-.--#;-- a a;ta6to and oro Doty an octimolP_ Contact the Dent for addh7 info.
District, eIG . mese eu ure uu3eu vu 111V.cu..u..u.
FEE ITEMS (Fee Resolution 11-053 Eff 7.%1:'13)
.,...,...»...,.. .
FEE
-.--- -- -
QTY/FEE
---- --- ----. -..
MISC ITEMS
Plan Check Fee:
$0.00
203 1 s.f.
$695.00
Patio Cover / Sun Room
IPATIOMETA Metal
Suppl. PC Fee: Q Reg. Q OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee O Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
I
Construction Ta.v:
F_T_
Adrninistrativv Fee:
Work Without Permit? O Yes E) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
T ravel Docinnentation Fees:
Strong Motion Fee: IBSEISMICR
$1.05
Select an Administrative Item
BidyStds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$2.05
$695.00
TOTAL FEE:
$697.05
Revised: 10/01/2013