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13010064 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18985 BARNHART AVE CONTRACTOR:ALPS CONSTRUCTION& PERMIT NO: 13010064 REMODELING OWNER'S NAME: PRASHANT TOMAR 1011 S DE ANZA BLVD DATE ISSUED:07/02/2013 OWNER'S PHONE: 4082572887 SAN JOSE,CA 95129 PHONE NO:(408)898-6474 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL E] COMMERCIAL NEW SINGLE FAMILY DWELLING (1944 SQ FT)WITH 459 License Class Csi. Li,.# C10qZ13 SQ FT ATTACHED GARAGE AND 47 SQ FT COVERED PORCH. SANITARY IS SUNNYVALE'S JURISDICTION Contractor Nil DateREVISION#2-CHANGE BAY WINDOWS TO REGULAR& I hereby affirm that I am licensed under the provisions of Chapter 9 REMOVE 4 WINDOWS- ISSUED 3/11/2014 (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: 1 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 erl'ormance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$200000 ave and will maintain Worker's Compensation Insurance,as provided for by I Section 3700 of the Labor Code,for the performance of the work for which this APN Number:37509029.00 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 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 / granting of this permit. Additionally,the applicant understands and will comply Issu ate: with all non-point source regulatirs 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 I hereby 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 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). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will 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 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. i q �� Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent:ZtXDater permit is issued. I certify that in the performance of the work for which this permit is issued,I shall l' 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 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 liabilities,judgments, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the 1 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 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 18985 BARNHART DATE: 03/11/2014 REVIEWED BY: MELISSA APN: 375 09 029 BP#: 13010064 `VALUATION: Iso PERMIT TYPE: Building PermitPLAN CHECK TYPE: Alteration / Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1 GENRE WORK REVISION # 2 - CHANGE BAY WINDOWS TO REGULAR & REMOVE 4 WINDOWS - ISSUED SCOPE 3/11/2014 NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These fees 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: Hourly Only? 0 Yes d No $0.00 hours Plan Check, Hourly Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $278.00 ISTPLNCK PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. FeerQ Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? 0 Yes ) No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential G Building or Structure Strony, Motion Fee: $0.00 Select an Administrative Item Bld�4Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $278.00 TOTAL FEE: $278.00 Revised: 01/15/2014 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18985 BARNHART AVE CONTRACTOR:ALI'S CONSTRUCTION& PERMIT NO: 13010064 REMODELING OWNER'S NAME: PRASHANT TOMAR 1011 S DE ANZA BLVD DATE ISSUED:07/02/2013 OWNER'S PHONE: 4082572887 SAN JOSE,CA 95129 PHONE NO:(408)898-6474 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL License Class Lic.# q REBUILD SINGLE FAMILY DWELLING (1944 SQ FT)WITH 459 SQ FT ATTACHED GARAGE AND 47 SQ FT COVERED Contractors (�C�I Date PORCH. I hereby affirm that I am licensed under the provisions of hapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions REVISION#1-ADD ALL NEW CONCRETE SLAB AND Code and that my license is in full force and effect. FOUNDATION-ISSD 91 /2013 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. t Floor Area: Valuation:$200000 I have and will maintain Worker's Compensation Insurance,as provided for Section 3700 of the Labor Code,for the performance of the work for which�thsp APN Number:37509029.00 Oecupancy 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 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 z granting of this permit. Additionally,the applicant understands and will comply Issued by: C�� Date: `? U with all non-point source egulations per the Cupertino Municipal Code, ection 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. 13 OWMaUILDER DECLARATION I hereby affirm t t m 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) 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 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 5 6,25533,and 25534, Section 3700 of the Labor Code,for the performance of the work for which this C 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 Compensation laws of California. If,after making this certificate of exemption,I CONSTRUGTIOD ENDING 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 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18985 BARNHART AVE CONTRACTOR:ALI'S CONSTRUCTION& PERMIT NO: 13010064 REMODELING OWNER'S NAME: PRASHANT TOMAR 681 E BROKAW RD DATE ISSUED,07/02/2013 OWNER'S PHONE: 4082572887 SAN JOSE,CA 95112 PHONE NO:(408)898-6474 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG If— ELECT[_ PLUMB License Class__ Lic.# , I MECR r- RESIDENTIAL r- COMMERCIAL F ContractorDate •— Ihereby affirm that I am licensed under the provisions o Chapter 9 JOB DESCRIPTION:REBUILD SINGLE FAMILY DWELLING(1944 SQ FT)WITII (commencing with Section 7000)of Division 3 of the Business&Professions 459 SQ FT ATTACHED GARAGE AND 47 SQ FT COVERED Code and that my license is in full force and effect. PORCH. 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. 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 Sq.Ft Floor Area: Valuation:$200000 permit is issued. APPLICANT CERTIFICATION APN Number:37509029.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS F AST LLED INSPECTION. with all non-points r regulations per the Cupertino Municipal C de,Sect n 9.18. 77 Is by: Date: Signature Date ❑ O E -BUILDER DECLARATION RE-ROOFS: I hereby affirm tha am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed. If a roof is the following two reasons: installed without first obtaining an inspection, 1 agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 1 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,l shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Sa Code,Sections 25505,25533,and 2553 . Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,1 must Ow orized agent: forthwith comply with such provisions or this permit shall be deemed revoked. Date: V / APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby of=that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 18985 BARNHART AVE DATE: 01/09/2013 REVIEWED BY: MELISSA APN: 375-09-029 BP#: `�Gi �����'" *VALUATION: 1$200,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY SFD or Duplex 2nd Unit? Yes ' No PENTAMATION 1 R3SFDW USE: PERMIT TYPE: WORK REBUILD SINGLE FAMILY DWELLING 1944 SQ FT WITH 459 SQ FT ATTACHED GARAGE AND SCOPE 47 SQ FT COVERED PORCH. OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,111-B,IV,V-B 2,450 $2,755.70 IR3PLNCK $2,579.95 1R3INSP TOTALS: 2,450 $2,755.70 $2,579.95 711� 7111 El NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These fees are based on the prelimina information available and are only an estimate. Contact the Dept for addn'1 info, FEE ITEMS(Fee Resolution 11-053 Eff' 7%1112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,755.70 Select a Misc Bldg/Structure Suppl. PC Fee: 0 Reg. 0 OT FO.OThrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $2,579.95 Suppl. Insp. FeeQ Reg. 0 OT0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXR 1 #new $ 29 units Work Without Permit? 0 Yes ID No $0.00 0 Advanced Planning,Fee: 1PLLONGR $318.50 Select a Non-Residential 0 7�ca�cl UnrinncttlCtltrui 1`cr��: Building or Structure 0 Strong Motion Fee: IBSEISMICR $20.00 Select an Administrative Item Bldy,Stds Commission Fee: IBCBSC $8.00 SUBTOTALS $6,311.44 $0.00 TOTAL FEE: $6,311.44 Revised: 10/01/2012