12060144 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 951 NOVEMBER DR CONTRACTOR:HANIWAY COMP. PERMIT NO: 120601.44
OWNER'S NAME: MANOJ JAYADEVAN&MANOJ SREELEKHA 3973 ALTADENA LN DATE ISSUED:09/12/2012
OWNER'S PHONE: 4088389026 SAN JOSE,CA 95127 PHONE NO:(408)733-3755
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL[]
License Class Lic.# Kis
ORY ADDITION NEW MASTER BEDROOM SUITE
Contractor44niniv�it Date 3 SQFT STORY ADDITION FAMILY ROOM 230 SQ FT, .
I hereby affirm.that I am lid used under the provisions of Chapter KI EN REMODEL 250 SQFT,NEW FRONT PORCH 75
(commencing with Section 7000)of Division 3 of the Business& sewj sions
Code and that my license is in full force and effect. � 1/16/13-DEFERRED#1-TRUSS CALCS-ISSD 2/12/13
I hereby affirm under penalty of perjury one of.the folav-g two ecla ions:
I have and will maintain a certificate of consent to self-insure for s
Compensation,as provided for by Section 3700 of the Labor C'� or the
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$137500
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:36213043.00 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
correctA agree to comply with all city and county ordinances and state laws relating WITHIN 1D YS 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 R LAST CALLED IN SP CTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the rrt,
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: ✓✓
with all non-points a reg ulafons 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
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(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 C_tWertinplflunicipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Secti s 25 0 and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this �/
permit is issued. Owner or authorized agent: Date:
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 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 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: 951 NOVEMBER DR CONTRACTOR:HANIWAY COMP. PERMIT NO: 12060144
OWNER'S NAME: MANOJ JAYADEVAN&MANOJ SREELEKHA 3973 ALTADENA LN DATE ISSUED:09/12/2012
OWNER'S PHONE: 4088389026, SAN JOSE,CA 95127 PHONE NO:(408)733-3755
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL IJ COMMERCIAL❑
License Class Lic.# 2ND STORY ADDITION NEW MASTER BEDROOM SUITE
521
Contractor Date �`y l2 SQFT, IST STORY ADDITION FAMILY ROOM 230 SQ IT,
I hereby affirm that I am licens under the provisions of Chapter 9 KITCHEN REMODEL 250 SQFT,NEW FRONT PORCH 75
(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:$137500
1 have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for die performance of the work for which this APN Number:36213043.00 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 FR61' 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 I f Z/r 2
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: 11
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
Q RE-ROOFS:
Signature Date 1 �Z �Z 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 1 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. 1 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 25505,2 33, d 25534.
Section 3700 of the Labor Code,for the performance of die work for which this Gj ( 2
permit is issued. Owner or authorized agent: Date: 1
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 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 counti 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
CI'T'Y OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 951 november dr. DATE: 06/25/2012 REVIEWED BY: bobs.
APN: BP#: 0 62 `VALUATION: 1$137,500
TPERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition
PRIMARY 2nd Unit? Yes •- No PENTAMATION
USE: SFD or Duplex OTC? 0Yes E)No PERMIT TYPE: 1R3SFDADD
WORK �sfd addition master suite 521 s.f. family room 230 s.f. porch 75 s.f., remodel kitchen 250 s.f.
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,111-B,IV,V-B 826 $2,420.00 1R3PLNCK $1,519.00 1R3INSP
TOTALS: 826 $2,420.00 $1,519.00
MECH,'HOURLY ".O Yes' E), No PLUMB,HOURLY Q Yes. Q No ELEC,HOURLY Q Yes E)No
L>ech. Plari(.:'ht:k llhavb, 1'ao Ci;eek Elec. Plan Check
iLf,c/i. Perwil T'ec>.. 1111,1m, Pe:mil Fee: laec.Perrnai Fee:
Otliei-,L ech.,Tr,.;p. other Plum%Insp, Other Flec.Insp.
ldech.I;s `' Piur;ib. Insp; Vee: Fslcc.Insp Fee:
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc.). These ees 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: 7,/1/11) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $2,420.00 F250 s.f. Remodel,Kitchen(<=300 sf)
Suppl. PC Fee: (D Reg. 0 OT 10.01 hrs $0.00 $588.00 1REMRESKIT
PME Plan Check: $0.00
Permit Fee: $1,519.00
Suppl. Insp.Fee:Q Reg. Q OT 0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
A'dininistrarive 0
Work Without Permit? 0 Yes (j) No $0.00 E)
Advanced Planning Fee: PLLONCRNCR $107.38 Select a Non-Residential
7i-urei Docuu;teiatuYion
Building or Structure
Strong Motion Fee: IBSEISMICR $13.75 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $6.00
SUBTOTALS: $4,066.13 $588.00 TOTAL FEE: $4,654.13
j Revised: 06/30/2012