12010175 CITY OF CUPE TINO BUILDING PERMIT
BUILDING ADDRESS: 10122 BRET AVE CONTRACTOR:VIVEK KARNATAKI& PERMIT NO: 12010175
DEEPTI NAIK
OWNER'S NAME: VIVEK KARNATAKI&DEEPTI NAIK 10122 BRET AVE DATE ISSUED:02/10!2012
OWNER'S PHONE: 4086674018 CUPERTINO,CA 95014 PHONE NO:
❑ LICENSED CONTRACT'OR'S DECLARATIONF j""""""
BUILDING PERMIT INFO: BLDG ' ELECT PLUMB
License Class Lie.# r
MECLI RESIDENTIAL COMMERCIAL 1
Contractor Date
I hereby atIfirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:CONSTRUCT 322SQFT POOL,HOUSE WITH BATHROOM
(commencing with Section 7000)of Division 3 of the Business&Professions AND
Code and that my license is in full force and effect. MECHANICAL ROOM;PLUMBING AND ELECTRICAL.NO
HEATING&NO ELECTRICAL PANEL
I hereby affirm under penalty of perjury one of the following two declarations:
l 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.
have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of(lie Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$40000
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:37511040.00 Occupancy Type:
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, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature Date Issued by:, Date:
*C OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any rooting material being installed.If a roof is
I,as owner of'the property,or my employees with wages as their sole compensation. installed without first obtaining an inspection,I agree to remove all new materials f6r
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Code)
1,as owner of'the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date:
construct the project(See.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
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 read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. 1 wilt maintain
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(x)should I store or handle hazardous material.
permit is issued. Additionally,should I use uipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by lie B+ Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's rrr'ntain compliance with t .Cu ertino Municipal Code,Chapter 9.12 and the
Compensation laws of California, If,after making this certificate of exemption,l ea h ety Code,Secti its 2 05,25533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,l must
forthwith comply with such provisions or this permit shall be deemed revoked_ O tt u o iz d
Date: 1 �2 Z
APPLICANT CERTIFICATION j CONSTRUCTION LENDING AGENCY
I certify that l 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 I hereby affirm that there is a construction lending agency for the performance o[wvuk's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cup rtino against liabilities,judgmenLc,
costs,andTst
accru agains said City in consequence of the Lender's:Address
!ranting onally,t e app!cant understands and will comply
ith all nations p.r rhe upertirro Municipal Code,Section ARCHITECT'S DECLARATION
'8.
l understand my plans shall be used as public records.
ature Date Z
Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10122 bret ave DATE: 01/30/2012 REVIEWED BY:
1
APN: 3 -75 -//-0 V6 I BP#: /,:R0/0/ 7 5� "VALUATION: $40,000
PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction
PRIMARY SFD or Duplex 2nd Unit? 0 Yes (F)No PENTAMATION 1 R3SFDW
USE: PERMIT TYPE:
WORK 3�22s ftli)ool house with bathroom and mechanical room. plumbing and electrical, no heating. no
SCOP electrical
panel
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. is.f.1
R-3(Custom) 1l-B,l11-B,1V,V-B 322 $2,420.00 IR3PLNCK $1,519.00 IR31.7VSP
TOTALS: 322 $2,420.00 $1,519.00
FT
I-
NOTE: This estimate does not include fees due to other Departinenh, (i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . TheseLees are based on the 1yelinina inforination available and are only an estimate. Contact Ilse De 3t or addnl info.
F E E ITEMS L! , j o,, 1-0,S'3 al FEE QTY/FEE MISC ITEMS
Plan Check Fee: $2,420.00 Select a Misc Bldg/Structure
Suppl.PC Fee: 0 Reg. 0 OT LEI hrs $0.00 or Element of a Building
PME Plan Check: $0.00
Permit Fee: — 1 $1,519.00
Suppl. Insp. Fee.,@ Reg. 0 OT F00hrs $0.00
PNIE Unit Fee: $0.00
PME Permit Fee: $0.00
-A
IBCONSTAXR $583.80
L r
Y0
Work Without Penn it? 0 Yes (j) No $0.00
'_......._?.,.. 3,n 1 PLLOVGRNGR $41.86 Select a Non-Resi
ntI
Building or Structure 0
IBSEISAI]CR $4.00 Select an Administrative Item
Fe IBCBSC $2.00
EI - J c' 1 'M i0'::1':1 C
SUBTOTALS: 1 $4,570.661 $0.00 TOTAL FEE: 1 $2±70.66
_j
Revised: 1/19/2012
From:
Vivek Karnataki
10122 Bret Avenue,
Cupertino, CA
vivek@karnataki.com
408 667 4018
To:
The Building Department,
City of Cupertino,
Cupertino, CA
August 26, 2014
Subject: Building Permit Application#12010175 Renewal
Dear Sir/Madam,
I would like to apply for an extension of the Building Permit Application#12010175 that is about to
expire on August 30, 2014.The work under the permit (a pool house in my backyard) is almost complete
and I am waiting on the contractor to complete and finish the items identified by the Inspector in the
last inspection. Due to some family emergency,the contractor had to leave for his native town in
Mexico and hence didn't get a chance to complete the pending work.
If granted an extension, I will hire another contractor to complete the pending items so that the building
will comply with the items Jenified in the previous inspection and I can obtain a completion permit.
Thank you for your tim
Viv k,Karn �ta�l i