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14100155CITY OF' CUPERTINO BUILDING PERNIFT ItUiLDING ADDRKSS: UON]'RACR)i PERN111 NOr 14100155 2.1131 RAINI3MN'DR MIIL;Rl INO CA 95014 (.162 10 0.573 11FRITI't HOMES (0N S VR I ,CTION Sl,y; i0SI– CA 95130 I)NNNER'SNAME: M0HANti0V1NI)ANANI)VANIIHAV IRUSIii; 1Q.R'!'-DE'-(1;ApxA1-I)iN. I-I)i L I c e ri s e C I a s s QF-N.E.F, AALUILDIMQ-QQNIRAQ,"EQ9 L I c 0�ul Contractor EEBEE.Q.T 11QM.E.2-Q-QMaTB.U..CJ I..Q-N Date .Q.2-/.2-fIMJ 9. I herob ' V affirryl that I ant license(] under the provisions (it'Chapter 9 (coniniteneing �Olh Section 7000) of Division 3 of the Business & Protessions, Code and that my license is in full force and effect, 11 hercli affirm tinder penalty of perjury one of the following tsso declarations: I I have and will maintain a coriificIiic of'conscrit to self -insure for Wmiscr's Corripensation, as provided For by Section ;700 til'the Laboi (,ode, for the lyciTori of the work for Which this permit is iy,ued I llre :ind Will nwintain Work,n's Collipwrl'aholl Inslinince, its provided fur by Section 3700 of Labor Codc, for the pci-formaricc ol"the work for Which this i is issued. APRUCAA LMKURL.U.110.N! I certify that I have read this application and state that the above nlorinatlon is correct, I agree to comply with all city and county Ordinances and state laws relating to building construction, and hereby authorize re[-'vesentatives of this city to enter upon the above rilen(ioned property far Inspection purposes. (We) agree to save indemnify and keep harmless the City Of (D'Upertino against liabilities, judgments, costs, and exinsinses which may acctuL against said City In consequence of the grantlng of this permit, Addifonaily, the applicant understands and will convey with all non -point source regulations per the Cupertino Municipal Code, Section 9.'18. S 0natU I Data - I-OL9120-1.7 A helebv affirm that I Hill exernpi frorn the Contractor's i Law for one of the lollcming two reasons. 1 1, as owner of the property, or my ernployces With wages as their sok: compensation, will (to the work, and the structure is not attended or oflcred tor. saic, (Sec.7044. Busirios &, llrofessions Code) [' as owner of tBoc pioilcny' any oxclusivcly contracting: with licensed corill-itclors to constwul IFIC pr(jQct (Svc.70,14,13usme5s & Professions Code), I hev-0) * y affirm under penalty of perjury one of the following three declarations:, i I have and Will maintain a Certificate ofCorysent to self insure for Worker's Compensation, as provided for by Section 3`00 of the Labor Code, flan the performance of the work Joy Which this permit is issued. I have and will maintain Worker's ( - I ornihonsation Insurance, as provided for by Section 3700 of the Labol Code, for the perionmance of dic. Work for which fill, pellilit is issiled I (xi-l[ly that In thv pac.rftrrrnance 01'111C A01k for WhICII this J)CI-11111 i rslued, I shall not employ an,, person in any manner so es to become subject to lite wolke: 'S Compensation laws of Cslifoli If, after Inniing this Certificate of CXIM1111loil, 1 become sIlhjecl to Ille, wolkcr's Coillpellsatiotl provision )I 0w Labor Code, I 111yist forthwith Comply with such provisions or this Permit "hail be deell'sal revoked 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 liablifies, judgrinents, costs, and expenses which may accrue, against said City In conseq,ionce of the granting of this permit. Additionally, the applicant understands and wit comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. DAH" ISSUED! IU41M� PHONE NO: (408) R16-8.157 MALDING PERMIT INFO: BLDG ELFIGI PLUMB MECII RESIDENTIAL— COMMERCIAL ,IOB M."SCRIP I ION: I I () SQ F1 ADDI I 10N 10 FRON I ()F SFDWL 10 VNCIA)t)1i, OFFiCF, SPACT'i RFSTIMOMREMODFI, BAI 1IR00M ON I S'l Ir LOO R 1MV 4t - BATHROOM LAYOUT REMAINS THE' SAMI,�' PITLAUF ALL FIXIMUIR LAKI� - I S LIKF MSSUI-D 1011912017 114 Ft Floor Aram: Valuation: $60000.00 APN Nninber: Oc c U li a 11 cy TN pe: 361' 1O €15.r PERMIT EXPIRES IFWORK IS NOTSTARTED WITHIN 180 DAYS OF]"ERMIT' ISSUANC'''E OR 180 DAYS FROM L,ASTCALLED INSPL(,'TION, IssituId by: Date: 110/14/2011 All roof,; vIiIlll he inspected prior to any toofing material heinq_! insialled 11 n I oofis I i I I ed o' I t I I o i, I 1 first o 1) t a I I I I I I g an I 11) S p c coon, I argon I o remote ell crew I I I , I t C I I a 1a for Inspection ` iam�tme ol'Applic Dato I(V19/2(717 ALL ROOP COVERINGS 10 BE CLASS "A" OR BfA- ER HAZARDOUS MATERIAL DI89AMUR_E I have read file hazardous materials requirements under Chapter 6.95 o0'the ('alifornia Health & Siffety Code, Sections 25505, 25533, and 25534, it will rriacrI conipliance with the Cupertino Morticipal ('odc, Chapter 9.12 and Idle llicailh & Safety Code, Section 25532(a) should I store or handle lv.izardous inali Additionally, �, should I use equipment or devices Nr hich egnitt hazardous ab coalloldinants ils defined bll ' � Ie Bay � Area Air QualityManagenient District I ni iH ailylain compliance with the Cupeitino Municipal Code, Chiiiiii 9.12 and the Health & Salctl, Code, Sections 25505, 25533, and 25534. Owner or authorizUSplw lEt4�QT.E.S? E1 t "yQ�fi L� _._w ed agent: Date. I hereby affirrn that there is a construction londing agency for the performance of work's for which this permit is issued (Sec, 3097, Civ C.) Lender's Narne AR A.111IN understand my plans shall be Used as pubitc records. ' Licensed Signature . .................... . . . ........ -___ .. .... . .......... . . . ...... . . Date .19219f2Q 1 7 1 Professio CONSTRUC"TION PERNIFT'APPLICAIJON COMNILM"ryI:)IsVL,i,(7I''Mi. I'T' 9.:C "IMIvBIJILDiNG DIVISION B IOND TORRE AVENUE - CINTM INO, CA 95014-3255 (4 8) 777-3228 0 -.11 PEM CG—PERTHWO 1)[.F° 7 NFW CONSI RUCTION ADDYI 1(,-)N Al XrRAI N (MNTR NAMF p� .. .... . . ... . . . . . . ......... ...... . . ...... .. ........ "Opi TRIA" kso' ("�A Sol. TTONIRACTORNA,�F. Elo(%NFRBUIIDER C'()N1PA',YNANTL 777777 7-777-7 1ACE",�,F �YPF . . ..... .. .. . .. "RE] 04 M ar .......... LyiIIMNF !"K. lk U Aw pin, (ey F] rt c I!- I IT o�\ Im AGENT hGINI INGINLF, .41,' F, 7777717471PIAVI ................... ....... . . ... .... ... ............. ........ . ...... ............... . ........ . . . ....................... .. .. . ... .... .. ..... NANF� FWAIL . ......... ...... ------ C11"Y' f A FT Xtp Pf K)NI, . ... --- - ------....... - OmmmmmN 01NEOPWAL DC0MN*,R(--'1A! .. ........... -- - 1n( SF - 7) 1-, P61�175­ i WNT-701771rrawn, R 1, N1 ()D 1, K 11 C I I E N P E Nf () i) P'L 0 H GARAoF ---- - -- oil "I ] ) - R1 N 1, .... . . . . .. . .. .. .................. . ...... ..... — ------ 000 5777)r- j ADNION ou F ------------ OOLS -77 '7 A u_mi l'rA(HiD DYE S 101A VALUAJK)\� L L� i L m L i L, a L 1. a L w � 1i WADOF 1wm"cwx)F1YPF []BUILI UPRC)OF A,',H 1ALT 4H[NC;TJ,3 ---- ---------- . ........ - - ---- - -------------- 77 I", FLACHE]!",O 11 Of LAYFI� 11CXNESS 5,18 (IT[w[", E7k-)s11 EjcDx A - - -- - ------ -- I 17Pos T i�.T r,i -(:i, L(mt LIASPI i1o"-v . i';._. INA& a s4ned com A Qc CuFFertrr ds War 0f 'okcy . .. ... ... aQ on ju pwp"W ownWs NbAh I 1" mgwwm Now I mmy Y"Wh N dw mwmw�"": Po (omply Mth all applicyalu local ordinanum and Wk Nos rubhng lo buHdmg (mWactimy JaudwnwurppmwntMTvuS ofCupertm('to (,ntur Hlcabcml ldullhfied properly for ill.INICWM P=Nnn I mTmmWdW mW m1wrve aH niqmmon cmtmwd on thk,ipnWaQM AST11 to be madcivailablc for public record r A - 11 -- - -------- -- - — - — --- SU11111.1-NEN IAL INFORMA110N RFQ1J1RFD w. -icc� of ,i 1-�ilding permn for A new con,,tructml� SFID/Spoond Dwuljng t.)rjnqMj,jjfjfaij61y Dveh�ngs: A L)cmoho ion perrh i:,,equrcd prior to 9R)!i,-Pro rde a Wor M ypnowl ham the 15me(Av"A AsmxkHon tio,vt,(j (Jd (/I /7 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: 14100155 21131 RAINBOW DR CUPERTINO CA 95014 (362 10 057) PERFECT HOMES CONSTRUCTION SAN JOSE, CA 95136 OWNER'S NAME: MORAN GOVINDAN AND VANITHA V TRUSTE DATE ISSUED: 10/14/2015 OWNER'S PHONE: PHONE NO: (408) 836-8457 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class a Lic. #556533 Contractor PERFECT HOMES CONSTRUCTION Date 02/28/2019 —BLDG —ELECT _ PLUMB MECH RESIDENTIAL COMMERCIAL 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. JOB DESCRIPTION: 319 SQ FT ADDITION TO FRONT OF SFDWL TO INCLUDE I hereby affirm under penalty of perjury one of the following two declarations: OFFICE SPACE/ RESTROOM; REMODEL BATHROOM ON 1 ST 1. I have and will maintain a certificate of consent to self -insure for Worker's FLOOR 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 Jh Section 3700 of the Labor Code, for the performance of the work for which this Sq. Ft Floor Area: Valuation: $60000.00 permit is issued. 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 APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 36210 057 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature. ate 04-13-2017 Issued by: Lesaacv - ' Date: 10/14/2015 I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is following two reasons: 1. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 04-13-2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1. 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. HAZARDOUS MATERIALS DISCLOSURE z. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the permit is issued. s. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(x) should.1 store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions ofthe the Health & Safety Code, Sections 505, 25533, and 255 4. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date: 04-13-2017 C .' CON TRUCT11LENDINGAY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance 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 of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands ARCHITECT'S DECLARATION and will comply with all non -point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code, Section 9.18. Licensed Signature Date 04-13-2017 Professional _ CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21131 RAINBOW DR CONTRACTOR: CHUEN YANG YANG PERMIT NO: 14100155 CONSTRUCTION CO OWNER'S NAME: MOHAN GOVINDAN AND VANITHA V TRUSTE 15215 GALT ST DATE ISSUED: 10/14/2015 OWNER'S PHONE: SAN LEANDRO, CA 94579 PHONE NO: (510) 213-9981 LICENSED CONTRACTOR' DECLA TION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL E 319 SQ FT ADDITION TO FRONT OF SFDWL TO INCLUDE License Class , /� Lic. # OFFICE SPACE/ RESTROOM REMODEL BATHROOM ON 1 ST Tom— P FLOOR . Contractor ate �f� • - I hereby affirm that I am 1 ensed` nder t 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: t. I have and will maintain a certificate of consent to self -insure for Worker's Sq. Ft Floor Area: Valuation: $60000 Compensation, as provided for by Section 3700 of the Labor Code, for the APN Number: 36210057.00 Occupancy Type: performance of the work for which this permit is issued. 2. 1 have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this � permit is issued.. PERMIT EXPIRES IF WORK IS NOT STARTED APPLICANT CERTIFICATION I certify that I have read this application and state that itie above information is WITHIN 180 DAYS T ISSUANCE OR correct. I agree to comply with all city and county ordinances and state laws relating 1$Q DA CALLED INSPECTION. to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to saved indemnify and keep harmless the City of Cupertino against liabilities; judgment slued Date: costs, and expenses which may accrue against said City in consequence of e granting of this permit. Additionally, the applicant understands and will comply w' all non -point source regulati p r 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 HAZARDOUS MATERIALS DISCLOSURE compensation; will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) - 2. I, as owner of the property, am exclusively contracting with licensed contractors to I have read the hazardous materials requirements under Chapter 6.95 of the construct the project (Sec.7044, Business & Professions Code). California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & I hereby affirm under penalty of perjury one of the following three declarations: Safety Code, Section 25532(a) should I store or handle hazardous material. 1. I have and will maintain a Certificate of Consent to self -insure for Worker's Additionally, should I use equipment or devices which emit hazardous air Compensation, Compensation, as provided for by Section 3700 of the Labor Code, for the 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 ante of the work for which this permit is issued. p p Health & Safety Code, Sections 25505, 25533, and 25534. 2. 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 Owner h rite ag nt: permit is issued. I Date f 3. 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 I hereby affirm that there is a construction lending agency for the performance of work's become subject to the Worker's. Compensation provisions of the Labor Code, I for which this permit is issued (Sec. 3097, Civ C.) must forthwith comply with such provisions or this permit shall be deemed Lender's Name revoked. Lender's Address APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is ARCHITECT'S DECLARATION correct. I agree to comply with all city and county ordinances and state laws relating I understand my plans shall be used as public records. to building construction, and hereby authorize representatives of this city to enter capon the above mentioned property for inspection purposes. (We) agree to save Licensed Professional 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. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 10300 TORRE AVENUE CUPERTINO, CA 95014-3255 (408) 777-3228 ° FAX (408) 777-3333 bt�i(clier cu�e�iirl :Oro ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED PROJECT ADDRESS f;�°JOSW $ e y t1 JJ 65-7-60 OWNER NAME _ - PHONE.. - _. _ E MAII, MV . afkA Mrs. o STREET ADDRESS CITY, STATE, ZIP _ FAX 211 iiA10riv ° 1509 CONTACT NAME C.9 PT4nmr�N{pn STREET ADDRESS. —21131 i r lv CITY; STATE, ZIP �.0 vt � c A v i FAX OWNER ,. OWNER-BI.11R ❑ OWNERAGENT ❑ CONTRACTOR ® CONTRACTOR AGENT ❑ ARCHITECT 0 ENGINEER 1:1 DEVELOPER ❑ TENANT CONTRACTOR NAME o g LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS - - CITY, STATE, ZIP PHONE .. ARCHITECT/ENGINEER NAME LICENSE NUMBER " BUS. LIC # COMPANY NAME I ® E-MAIL I FAX STREET ADDRESS &L � � �. CITY, STATE,ZIP calD40*0 q 11 C7;) PHONE * °G DESCRIPTION OF WORKAA D t 1 LMYo EXISTING USE ' PROPOSED USE CONSTR. + . TYPE # STORIES a USE TYPE Oct. SQ.FT. VALUATION ($) EXISTGpy AREA ® NEW FLOOR ��} AREi �:- " \ DEMO AREA TOTAL NET AREA. BATHROOM RFMODELAREA4osf KITCHEN - REMODEL AREA 95 OTHER REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA LJDETACH - - - 60 I a{ . ATTACH #DWELLINGUNITS: ISASECONDUNrT []YES SECONDSTORY YES - - - BEINGADDED? RNO ADDITION? NO - PRE -APPLICATION []YES IF YES, PROVIDE COPY OF PLANNINGAPPL# VNO PLANNINGAPPROVALLEITER IS THE BLDG AN YES EICHLERHOME? NO RECEIVED By^^_ ,. - TOTAL VjA/LjUA IT, ON: By my signature below, I certify to each of the following: I am the property owner or authorized age to on the property owner's behalf I have read this lis application and the information I have provided is correct. I have read the Description of Work an nfy it 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-identifiedp operty for inspection purposes. Signature of Applicant/Agent, Date- M ✓% I SUPPLEMENTAL INFORMATION REQUIIMi D PLAN CHECK TYPE ROUTING SLIP Cl OVER -TIE -COUNTER DIXGFLAN 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. E EXPRESS � G PLAN REVDE _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑' STANDARD PUBzac WORKS form if any Hazardous Materials are being used as part of this project, 0. LARGE Q FIRE D _ Copy of Planning Approval Letter or Meeting with Planning prior to MUOR SANUARI! SEWER DISTRWT submittal of Building Permit application. ©_NViltaiVMENTAi HEALTH BldgApp_2011.doe revised 06/21/11 FEE ESI ;JAADDRESS: 21131 rainbow dr N: PERMIT TYPE: Building Permit PRIMARY SFD or Duplex USE: WORK 319 sq ft additiori to front of SCOPE CITY OF CUPERTINO [MATOR - BUILDING DIVISION DATE: 1012712014 REVIEWED BY: Mendez %0TC0? AVALUATION: $60,000 HECK TYPE: Addition ADD Yes °' No PENTAMATION 1 R3SF[ 0 Yes ) No PERMIT TYPE: 4-1• ramnrlal hnthroom on 1st floor_ TYPE OF FLR AREA OCCUPANCY TYPE: CONSTR. s.f. R-3 (Custom) 11-B,111-B,IV,V-B 319 TOTALS: 319 PC FEES I PC FEE ID I BP FEES I BP FEE ID IADDPLCK I $1,323.001 IADDINSP $1,626.00 I $1,323.00 0 Yes No PLUMB, HOURLY Yes • No ELEC, HOURLY . ® Yes No MECH, HOURLY ` D ., - Of `wr .., - Pub a cc: f s c Works, Sanitary District, , NOTE: This estimate does nodue to addn'l into. i tavalilablle and are onlla an estim te.eContact the Deptr prelim District, etc .These ees are based on then marion MISC ITEMS FEE ITEMS (Fee Resolution II -053 L'ff. 7.�`L.'I3) FEE Q TY/FEE $1,626.00 40 s.f. Remodel, Bath (<=300 sf) ' Plan. Check Fee: Suppl. PC Fee: Q Reg. OT 0.0 hrs $0.00 $645.00 IREMRESBAT PME Plan Check: $0.00 Permit Fee: $1,323.00 Suppl. Insp. Fee -.(j) Reg. 0 OT LO,0 hrs $0,00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 LLL Work Without Permit? 0 Yes) No $0.00 Advanced Planning Fee: IPLLONGR $44.66 Select a Non -Residential Building or Structure $7.80 Select an Administrative Item Strong Motion Fee: IBSEISMICR Blds� Stds Commission Fee: IBCBSC $3.00 _ _, TOTAL FEE• —, $3 649 99 C 'SUBTOTALS: 1 $3,004.46 $645.00 , Revised: 08/20/2014 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228. . Fax`. 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: c�O_► 13 / jl S P_?O db l2-- PERMIT # 1CQ/S7S OWNER'S NAME: ( D,I PHONE # GENERAL.CONTRACTOR: HOMES C _ ,Us i BUSINESS LICENSE # ADDRESS: _C,;Ap,,j077T CITVZIPCODE �_ w SU3S- *Our municipal code requires ,all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR: F' INAL..00CUPANCY 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; 0 Signature Date Please check applicable subcontractors land complete the following information: �/ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &.MillWork Cement.Fimshing Electrical. Excavation Fencing Flo oringlCarpeting ' Linoleum/ Wood Glass / ,Glazing Heating Insulation + " Landscaping'! Lathing .. Masonry Painting / Wallpaper Paving. Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet, Rock Tile r Owner !,:Contractor Signature l -/g/47 Date