11100014CITY OF CUPERTINO BUILDING
BUILDING ADDRESS: 18890 BARNI'IART AVE CONTRACT OR: NIRAJ RAIA
I & RI I PERMIT NO: I 1100014
AGRAWAL
OWNER'S NAME:
I CUPERT'INO, CA 95014.3602 I PHONE NO:
❑ LICENSED CONTRACT'OR'S DECLARATION
License Class Lic.
Contractor
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.
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
perfomsance 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
permit is issued.
APPLICANT CERTIFICATION
I certify that 1 have read this application mid state that the above information is
correct. I agree to comply with all city and county ordinances mid state laws relating
m 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,
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,
BUILDING PERMIT INFO: BLDG r ELECT r PLUMB
MF,CH r RESIDENTIAL r COMMERCIAL f
JOBDESCRIPTION:'I-OCLEAR CODE ENFORCEMLsITCASP.: SrDBATII
REMODEL,
NONS9'RUCTURAL, REI'LACE2 WINDOWS, LIKI; I'OR I.IKE
4} i nf� c --l.. /l �l I L•. {'l 5+'l 'l- (k„( �j W C1, 1 I t� (
i A. 1 f �l l aft �^
Sq. Ft Floor Area: I Valuation: $6000
APN Number: 37533011.00 I Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Date I Issued by:
OWNER -BUILDER DECLARATION
1 hereby affirm that 1 am exempt front the Contractor's License Law for one of
the following two reasons:
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
construct the project (Sec.7044, Business & Professions Code).
hereby affirm under penalty of perjury one of the following three
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
permit is issued.
I certify that in the performance of die 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 ot'California. If, after making this certificate of exemption, I
become subject to the Worker's Compensation provisions of the labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICA'T'ION
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 stale 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
enmity and keep harmless the City of Cupertino against liabilities, judgments,
and expenses which may accrue against said City in consequence of the
ting of this pcnnil. Additionally, the applicant understands and will comply
with all non -point source regulations p v the Cupertino Municipal Code, Section
9.18.
Signature . , Dated
Date;
RF. -ROOFS:
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.
Signature of Applicant:_ Date
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
1 have read the hazardous materials requirements under Chapter 695 of the
CaIifornin Health & Safety, Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Il ealth &
Safety Code, Section 25532(1) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Day Area Air Quality Management District 1 will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Ilealth & Safety Code, Seciions 25505, 255133, and 25534,
Dale:
CONSTRIJCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance Of work's
for which this pemhit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
LIRCIIITF T'S DECLARATION
I understand my plans shall be used as public records.
Licensed
I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 18890 BARNHART AVE
ER'S NAME:
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lic. #
Contractor
Date
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.
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
permit is issued.
APPLICANT CERTIFICATION
1 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,
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.
Date
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
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
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
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
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 and state laws relating
'ilding construction, and hereby authorize representatives of this city to enter
the above mentioned property for inspection purposes. (We) agree to save
aemnify 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
CONTRACTOR: NI RAJ RAI & LORI PERMIT NO: 11100014
AGRAWAL
18890 BARNHART AVE DATE ISSUED: 10/04/2011
CUPERTINO, CA 95014-3602 PHONE NO:
BUILDING PERMIT INFO: BLDG r ELECT r— PLUMB
MECH r RESIDENTIAL r COMMERCIAL r
JOB DESCRIPTION: TO CLEAR CODE ENFORCEMENT CASE: SFD BATH
REMODEL,
NONSTRUCTURAL, REPLACE 2 WINDOWS, LIKE FOR LIKE
Sq. Ft Floor Area: I Valuation: $1000
APN Number: 37533011.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by __ _ Dater` Y li
RE -ROOFS:
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.
Signature of Appli
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
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
Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or
, Date: L o � 11-o- 11
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Add
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
CITY OF CUPERTINO
I I FFF ESTIMATOR — BUILDING DIVISION
OCCUPANCY TYPE:
ADDRESS: 10250 s. tantau ave
DATE: 10/03/2011
REVIEWED BY: bobs.
PC FEE ID
APN:
BP#:
-VALUATION: 1$500,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY SFD or Duplex
USE:
2nd Unit? Yes •% No
PENTAMATION 1 R3SFDW
PERMIT TYPE:
WORK
construct 1 Story
to sfd
SCOPE
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
R-3 (Custom)
II-B,111-B,IV,V-B
3,453
$2,889.90
IR3PLNCK
$2,963.20
1R31NSP
$0.00
PME Plan Check:
$0.00
Permit Fee:
$2,963.20
Suppl. Insp. Fee -0 Reg. Q OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
TOTALS:
3,453
$2,889.90
Constr. Tax: IBCONSTAXR
$2,963.20
new
un;ts
.iW'
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District' School
DiviriM_ otrA Th~ fooc aro hacod not tho nrefininaru ininrmatian avnilahto and aro Only an o0imnto_ rantart fho Dont far addn'I inin_
FEE ITEMS (Fee Resolution 11-053 Efl 7/1/11)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,889,90
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: Q Reg. Q OT
Fo.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$2,963.20
Suppl. Insp. Fee -0 Reg. Q OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Constr. Tax: IBCONSTAXR
1
new
un;ts
$582.00
Q
0
Work Without Permit? 0 Yes Q No
$0.00
Advanced Planning Fee: PLLONGRNGR
$448.89
Select a Non -Residential
Building or Structure
0
0
A
7rcttF r� ll x rrrrc'+lcr(rttr T=�,:
Strong Motion Fee: IBSEISMICR
$50.00
Select an Administrative Item
Bldg; Stds Commission Fee: IBCBSC
$20.00
SUBTOTALS:
$6,953.99
$0.00
TOTAL FEE:
1 $6,953.99
Revised: 10101/2011
CITY OF CUPERTINO
F -W FEE ESTIMATOR - BUILDING DIVISION
OCCUPANCY TYPE:
ADDRESS: 10250 s. tantau ave.
DATE: 06/27/2011
REVIEWED BY: bobs.
P EE ID
APN:
BP#:
"VALUATION: 1$500,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY SFD or Duplex
USE:
2nd Unit? 0 Ves j5—N—o-7
PENTAMATION 1R3SFDW
I PERMIT TYPE:
WORK
construct 1 story sfd.
SCOPE
OCCUPANCY TYPE:
TYPE .
CONSTR.
FLR AREA
s.f.
PC FEES
P EE ID
BP FEES
BP FEE ID
R-3 (Custom)
II-B,111-B,IV,V-B
3,328
-$2,787.16
IR3 LNCK
$2,834.44
IR3INSP
$0.00
PME Plan Check:
$0.00
Permit Fee:
$2,834.44
Suppl. Insp. Feer Reg. 0 OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
TOTALS:
3,328
j $2,787.16
j
1 $2,834.44
# new
units
NOTE: These fees are based on the nreliminary information available and are onlv an estimate. Contact the DeDt for addn'1 info.
FEE ITEMS (Fee Resolution 09-051 E . 7/1110)
FEE
QTY/FEE
MISC ITEMS
Po
$2,787.16
Li
l.Iri�r'<)' ,�.., i F5f1.
Li
Suppl. PC Fee: G Reg. 0 OT
0.0
NOTE: These fees are based on the nreliminary information available and are onlv an estimate. Contact the DeDt for addn'1 info.
FEE ITEMS (Fee Resolution 09-051 E . 7/1110)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,787.16
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: G Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$2,834.44
Suppl. Insp. Feer Reg. 0 OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Constr. Tax: IBCONSTAXR
1
# new
units
$569.36
Acoustical Fee: 0 Yes (F) No
$0.00
0
0
Work Without Permit? 0 Yes 0 No
$0.00
Planning Fee: PLLONGRNGR
$432.64
Select a Non -Residential
Building or Structure
Q
0
li �n eT 1�cr::rir,cnstjtic�,r .T
Strong Motion Fee: IBSEISMICR
$50.00
Select an Administrative Item
Bldy, Stds Commission Fee: IBCBSC
$20.00
SUBTOTALS:
$6,693.60
$0.00
TOTAL FEE:
1 $6,693.60
Revised: 04/29/2011
RF927
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District. eta). These fees are hated an the nrelfninary information available and are only an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution 11-053 E . 7/1,/11)
ADDRESS: 18890 barnhart ave.
DATE: 10/04/2011
REVIEWED BY: bobs.
APN:
BP#:
*VALUATION: 1$1,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
Suppl. PC Fee: Q Reg. Q OT
PENTAMATION 1 R3SFDREM
PERMIT TYPE:
WORK
Code Enforcement Case:sfd bath remodel rion structural
[ig-Clear
SCOPE
NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District. eta). These fees are hated an the nrelfninary information available and are only an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution 11-053 E . 7/1,/11)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
35 s.f.
$588.00
Remodel, Bath (<=300 so
IREMRESBAT
Suppl. PC Fee: Q Reg. Q OT
F67o
hrs
$0.00
PME Plan Check:
$0.00
F2 # Window / Sliding Glass Door
$392.00 1WINREP Replacement
Permit Fee:
$0.00
Suppl. Insp. Fee -0 Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
;.rN�,Sa?tt('iJ(r77 1'ca.L
Work Without Permit? 0 Yes 0 No
$980.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
0
0
f;--ov, !! l
Strong. Motion Fee: IBSEISMICR
$0.50
Select an Administrative Item
------
Btdg Stds Commission Fee: 1BCBSC
1 $1.00
SUBTOTALS:
1 $981.501
$980.00
TOTAL
FE $1,961.50
Revised:
FW -
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District; School
District, etc.). These fees are based on the vrelinsnary information available and are on/v an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/11)
ADDRESS: 18890 bamhart ave.
DATE: 11/18/2011
REVIEWED BY: bobs.
Mech. Permit Fee: IMPERMIT
APN:
BP#:
"VALUATION: 1$5,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
i-:.�,G l,,.r,, Idt:
PENTAMATION FURN/AC
PERMIT TYPE:
WORK
revise scope of work to include insulation and drywall installation add new furnace.
SCOPE
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District; School
District, etc.). These fees are based on the vrelinsnary information available and are on/v an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/11)
Mech. Plan Check 0.0 hrs $0.00
QTY/FEE
Mech. Permit Fee: IMPERMIT
!°e
Plan Check Fee:
Other Mech. Insp. 0.0 hrs $44.00
r> E. - t°�:,�,;,; ,t:,r;
���,<� F.l.;r:. i,r�t,.Li
;'.... in _
i-:.�,G l,,.r,, Idt:
f;�'e�. Imp, Fn,.
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District; School
District, etc.). These fees are based on the vrelinsnary information available and are on/v an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/11)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
F 1-1 # Mechanical
$130.00 /MFR=<100 Furnace, Forced -Air
Suppl. PC Fee: Q Reg. Q OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee: Hourly Only? Q Yes 0 No
$0.00
Suppl. Insp. Fee -.0 Reg.
Q OT0
0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$44.00
7�",
Administrative Fee:
IADMIN
$41.00
Q
0
Work Without Permit? 0 Yes (F) No
$0.00
Advanced Planning Fee:
$0.00
=hours Inspections
$260.00 ISTINSP Inspection, Hourly
E)
0
i
Travel Documentation Fee: ITRA VDOC
$44.00
Strona Motion Fee:
1BSEISMICR
$0.50
Select an Administrative Item
L
-
Bldg; Stds Commission Fee: 1BCBSC
$1.001
SUBTOTALS:1
$130.50
$390.00—_::
TOTAL FEE:
$520.50
Revised: 10/01/2011