13040119 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 912 NEW HAVEN CT CONTRACTOR:CEVOLA CUSTOM PERMIT NO: 13040119
HOMES
OWNER'S NAME: RAVI VARANASI 832 CHYNOWETH CT DATE ISSUED:0510212013
OWNER'S PHONE: 4083980725 SAN JOSE,CA 95136 PHONE NO:(408)6444351
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIALE]
License Class Lic.# ADDITION OF FRONT BEDROOM AND BATH 289 SQ FT,
ADD FRONT PORCH 32 SQ FT,REMODEL 2 BATHROOMS
Contractor Date 180 SQFT,]KITCHEN REMODEL 299 SQ FT,OFFICE 90 S.F.
I hereby affirm that I am licensed under the provisions of Chapter 9 REVISION#2-RAISE UPSTAIRS 2ND B DRM WINDOW TO
(commencing with Section 7000)of Division 3 of the Business&Professions 5' FROM FINISHED FLOOR-ISSUED 7/15/2013
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:$0
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:35611050.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that 1 have read this application and state that the above information is PERMIT EXPIRES Ei S IF WORK IS NOT STARTED
D
correct.1 agree to comply with all city and county ordinances and state laws relating WITHIN 18®���� ®�PERMIT��������®�
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 1180)(DAYS 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
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date:
with all non-point source regulations 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). 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
1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25 33 and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authorized agent: Date:
permit is issued.
I certify that in the performance of the work for which this permit is issued,l 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 1 have read this application and state that the above information is
correct.1 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 CU PIER')<'INO ]BU)III.,➢DING PERMIT
BUILDING ADDRESS: 912 NEW HAVEN CT CONTRACTOR:CEVOLA CUSTOM PERMIT NO: 13040119
HOMES
OWNER'S NAME: RAVI VARANASI 832 CHYNOWETH CT DATE ISSUED:05/02/2013
OWNER'S PHONE: 4083980725 SAN JOSE,CA 95136 PHONE NO:(408)644-4351
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 13 COMMERCIALU
License Class Lic.# ADDITION OF FRONT BEDROOM AND BATH 289.SQ FT,
ADD
Contractor re vO l Q Date l FRONT PORCH 32 SQ FT,REMODEL 2 BATHROOMS 180
1 hereby affirm that I am licensed under the provisions of Chapter 9 SQ
(commencing with Section 7000)of Division 3 of the Business&Professions FT,KITCHEN REMODEL 299 SQ FT,OFFICE 90 SQ FT,
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations: DEFERRED#1-TRUSS CALCS-ISSD 7/23/2013
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
performance of the work for which this permit is issued. Sq.F oor Area: Valuation:$0
I have and will maintain Worker's Compensation Insuran o O tded for b
Section 3700 of the Labor Code,for the performan Nork for wnAt�s APN Number:35611050.00 Occupancy Type:
permit is issued.
e
APPLICANT CERTIFICAT
I certify that I have read this application and state tha Gl ove information is PERMIT]EXPIRES IFF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating �I�)( ������®� PERMIT ISSUANCE ®�
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 1801<D� Il�OM IL AST CA LILlE1<D 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 Issued by: IDate:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
/ RE-ROOFS:
Signature - C e-yQ Q Dale 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
II hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date:
the fallowing two reasons: 1 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: I 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.
Section 3700 of the Labor.Code,for the performance of the work for which this
Owner or authorized agent: Dater
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 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
BUILDING ADDRESS: 912 NEW HAVEN CT CONTRACTOR:CEVOLA CUSTOM PERMIT NO: 13040119
HOMES
OWNER'S NAME: RAVI VARANASI 832 CHYNOWETH CT DATE ISSUED:05/02/2013
OWNER'S PHONE: 4083980725 SAN JOSE,CA 95136 PHONE NO:(408)6444351
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIAL
ULI
License Class Lic.#- T2I) ADDITION OF FRONT BEDROOM AND BATH 289 SQ FT,
ADD(FRONT PORCH 32 SQ FT,REMODEL DE]L 2 lBATHRMS
Contractor L U1 t .0(: V 0&1 Date 180 SQ]FT,KITCHEN REMODEL 299 SQ FT,O FlFICE.90 SQ
I hereby affirm that I am licensed under the provisions of Chapter 9 FT
(commencing with Section 7000)of Division 3 of the Business&Professions REVISION#I -ADD 3(N)WINDOWS TO SECOND STORY—
Code and that my license is in full force and effect. ISSUED 6/20/2013
1 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:$0
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:35611050.00 OccupancyT
permit is issued. Type.:
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.1 agree to comply with all city and county ordinances and state laws relating ��� . ll�®����®�PERMIT ISSUANCE ®�
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save ](80 DAYS FROM AILILED 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 Issued by: Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
J RE-ROOFS:
Signature „( Date 2 t'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
II hereby affirm that II 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
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
1 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
1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: L� Date:0,�-A3
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,1 CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must 1 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 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 cCUP ERTINO
FEE ESTIMATOR— BUILDING DIVISION
JAPN:
DDRESS: 912 NEW HAVEN CT DATE: 06/20/2013 REVIEWED BY: MELISSA
356 11 050 BP#: 13040119 "VALIDATION: Iso
*PERMIT TYPE: Building Permit )PLAN CHECK TYPE: Alteration / Repair
PRIMARY PENTAMATION
USE: SFD or Duplex PERMIT TYPE: 1GENRE
WORK REVISION # —ADD 3 N WINDOWS TO SECOND STORY
SCOPE
Ltech.Flan Check Plumb. Plan Check Elec.Plan(."heck
Mlle. Permit Fee' [Plumb. Permit Fee: Elec. Permir FCC::
Other A9ech.Insp. Ell L_ Other Plumb Insp. Other Elec.Insp. EJ I
Ifech,Insp. Fe-e: Plumb. hrsp. Fee. Elee.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 onl an estimate. Contact the De t or addn'l info,
FEE ITEMS (Fee Resolution 11-053 Eff. 711112) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 = # Window/Sliding Glass Door
Suppl. PC Fee: E) Reg. 0 OT 0.0 hrs $0.00 $1,401.00 IWINNEWNST New(Non-Structural)
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Feer Reg. 0 OT p p hrs $0.00
PME Unit Feer $0.00
PME Permit Fee: $0.00
Conorfiction Tax:
Admin is irat i ve.Fee:
Work Without Permit? Yes E) No $0.00
Advanced Planning Fee. $0.00 Select a Non-Residential
Travel Documentation Fees: Building or Structure
A
Strong Motion Fee: $0.00 Select an Administrative Item
Bldg Stds Commission Fee: $0.00
SUBTOTALS: $0.00 $1,401.00 TOTAL FEEL 1 $1,401.00
Revised: 04/29/2013