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CITY OF CUPERTINO
BUILDING DIVISION PERNIIT
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BUILDING ADDRESS:
PERMIT NO.
7996 SUNDERLAND DR
TBD - TO BE DETERMINED
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OWNER'S NAME:
PERMIT ISSUE DATE
S A CONTROL N0.
ARCHI EC IFNGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Job Description
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business and Professions Code, and my license Is
in full force and effect.
ADD 4 2 8 ' - BEDRM , STUDY , EXTNSN OF(E)
License Class Lk:. Is
Date Contractor
MASTERBEDRM, LAUNDRY RM, POWDER RM . REMDOEL
ARCHITECTS DECLARATION
Ianderstandmyplans shall beused aspublic records
516 '-BATHRM, KITCHEN, LAUNDRY RM, PORCH, REPLACE
Licensed Professional
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the
following reason. (Section 7031.5, Business and Professions Code: Any city or county
which requires a permit to construct. alter, improve, demolish, or repair any structure
prior to its issuance, also requires the applicant for such permit to file a signed statement
Sq. Ft. Floor Area
Valuation
that he is licensed pursuant to the provisions of the Contractors Llwnw Law (Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he is exempt therefrom and the buts for the alleged exemption. Any violation of
$20QQOO
APN Number
Occupancy Type
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
not mote than five hundred dollars (5500).
36211033.00
❑ L as owner of the property, or my employees with wages as their sole compensation,
Required Inspections
es
will do the work and the structure is not intended or offered for We (Sec.7044, Business
and Professions Codex The ContractorLicense Law does not apply to an owner of
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property who builds or improves thereon, and who does such work himself or through his
own employees, provided that such improvements are not Intended ar offered for sale IL
however, the building or improvement Is sold within one year of completion, the owner -
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
L� I. as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec 7044. Busing and Professions Cale:) The Contractors Li -
cease Law does not apply to an owner of property who builds or improves thereon, and.
who contracts for such projects with a contractor(s) licensed pursuant to the Contractors
L.kense Law.
❑ 1 ore ea ptt der See ,
under penalty of perjury one of the following declarations:
❑ I have and will maintain a Certificate of Consent to self -insure for Workers Compen-
sation, 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 Workers Compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of the work for which this permit is issued
'
My Workers Compensation Insurance carrier and Policy number are:
Carrier. Policy No.:
CERTIFICATE OF E5 EMPTION FROM WORKERS
COMPENSATION INSURANCE
(This section need not be completed if the permit Is forone hundred dollars (S 100)
or less)
I certify that In the performance of the work for which this permit is Issued, I shall not
employ any person in any manncSsotyttj�g subicct to the Worked Compensation
Laws of Califomi(it gatC �Y
Isf�/
should
become subject to the Workers Compensation provisions of the Labor Code, you must
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for the performance of
the work for which this permit Is issued (Sec. 3097, Civ. C)
'
Lenders Name
,
Lenders Address
i 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
j liabilities judgments, costs and expenses which may in any way accrue against said City
in consequence of the granting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY W17H ALL NON -POINT
Issued by: Date
SOUR TIONS.
6I61
.� b7I6
Re -
of Roof
Signal o Applicam/Contractor Date
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or future building Occupant store or handle haardous material
as defined by the Cupertino Municipal Code, Chapter 9.12. and the Hcilth and Safety
Code, Section 25532(a)?
No
All roofs shall be inspected prior to any roofing material being installed.
❑Yes
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or future building occupant use equipment or devices which
emit hazardous air contaminants as defined by the Bay Area Air Quality Management
all new materials for inspection.
District?
❑ Yes 2rN.
1 have read the hazardous materials requirements under Chapter 6.95 of the Califor-
nia Health & Safety Code, Sections 25505.25533 and 25534.1 undmmnd that if the building
does not currently have a tenant, that It is my responsibility o notify the occupant Of the
re9 ts which muss be met uartcc of a Certificate of Occup
Signature of Applicant Date
lSQI�All
roof coverings to be Class 'A" or better
'
Ow tat rind agent Date,
CITY OF CUPERTINO BUILDING
BUILDING AWRESS: 7996 SUNDERLAND DR
CONTRACTOR: TBD - TO BE DETERMINED I PERMIT NO: 09050054
OWNER'S NAME:
I , I PHONE NO: I
❑ 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 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
I certify that 1 have read this application and state that the above information is
correct. I agree to comply with al I 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.
Signature
BUILDING PERMIT INFO: BLDG r ELECT F PLUMB r
MECH F RESIDENTIAL F COMMERCIAL I —
JOB DESCRIPTION: ADD 428'-BEDRM,STUDY,EXTNSN OF(E)
MASTERBEDRM,LAUNDRY RM,POWDER RM.REMDOEL
516'-BATHRM,KITCHEN,LAUNDRY RM, PORCH,REPLACE
3/29/2011-REV# 1- REVISE NEW#4 BEDROOM ADD 9" TOWARD REAR YARD,
MODIFY #4 BEDROOM TO ADD BATHROOM-3/29/11 REV#1 ISSD
Sq. Ft Floor Area: I Valuation: $200000
APN Number: 36211033.00 1 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
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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
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 shal I
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
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:
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
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. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.I2 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 authorized agent -
Date:
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of %ork's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
Signature Date
I understand my plans shall be used as public records.
Licensed Professional
.b _ , CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7996 SUNDERLAND DR
CONTRACTOR: RAHUL & RIYADA
PERMIT NO: 4G29' Tr
,: IINKRE
OWNER'S NAME:
^996'FUNDERLAND DR
DATE ISSUED: 03/29/201 l
OWNER'S
CUPERTINO, CA 95014
PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION
r r r
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic. #
r r
MECH RESIDENTIAL COMMERCIAL
Contractor Date
1 hereiby affirm that 1 am licensed under the provisions of Chapter 9
JOB DESCRIPTION: REVISE NEW#4 BEDROOM ADD 9" TOWARD REAR YARD,
(commencing with Section 7000) of Division 3 or the Business & Professions
MODIFY #4 BEDROOM TO ADD BATHROOM
Code and that my license is in full force and effect.
LL
M p1AA'% p«m Ii- ND: 0 90,7005V
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: $4000
1 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.
APN Number: 36211033.00
Occupancy Type:
APPLICANT CERTIFICATION
I certify that I 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
PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs, and expenses which may accrue against said City in consequence of the
180 DAYS FROM LAST CALLED INSPECTION.
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.
Issued by: Date �Zy��
Signature Date
Ca OWNER -BUILDER DECLARATION
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. if a roof is
I hereby affirm that I am exempt from the Contractor's License Law for one of
installed without first obtaining an inspection, I agree to remove all new materials for
the following two reasons:
inspection.
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,
Signature of Applicant: Date:
Business & Professions Code)
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
1 hereby affirm under penalty of perjury one of the following three `
declarations:
HAZARDOUS MATERIALS DISCLOSURE
I have and will maintain a Certificate of Consent to self -insure for Worker's
I have read the hazardous materials requirements under Chapter 6.95 of the
Compensation, as provided for by Section 3700 of the Labor Code, for the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
performance of the work for which this permit is issued.
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
I have and will maintain Worker's Compensation Insurance, as provided for by
Safety Code, Section 25532(a) should 1 store or handle hazardous material.
Section 3700 of the Labor Code, for the performance of the work for which this
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
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued, I shall
Health & Safety Code, Sections 25505, 25533, and 25534.
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of Califomia. If, after making this certificate of exemption, 1
LENDING AGENCY
APPLICANT CERTIFICATION
I hereby affirm that there is a construction lending agency for the performance of Aork's
I certify that I have read this application and state that the above information is
for which this permit is issued (Sec. 3097, Civ C.)
correct. I agree to comply with all city and county ordinances and state laws relating
Lender's Name
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
Lender's Address
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
ARCHITECT'S DECLARATION
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
I understand my plans shall be used as public records.
9.18.
Date 3 Z I j
Licensed Professional
Signature
CITY OF CUPERTINO v OFM_7 FEE ESTIMATOR.- BUILDING DIVISION
ADDRESS: 7996 sunderland dr.
DATE: 03/29/2011
REVIEWED BY: bobs.
APN:
BP#: Mt (j j VqA . , yeLNk Sl
"VALUATION: 1$4,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE:
Addition
PRIMARY SFD or Duplex
USE:
PENTAMATION 1GENRES
PERMIT TYPE:
WORK
revise new #4 bedroom add 9" toward rear yard, modify #4 bedroom to add bathroom.
SCOPE
(llitf'r: 1, ,,Lj
!"Ic .. law i. lo'
NOTE. These fees are based on the vrelindnary information available and are only an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution 09-051 Eff' 711110)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee: Hourly
Only? 0 Yes 0 No
$0.00
0 hours
$126.00
Plan Check, Hourly
ISTPLNCK
Suppl. PC Fee: 0 Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee:0 Reg.
0 OT
FO.OThrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
�, r,{3.1'lYllr.'t�fJi1
Acoustical Fee:
0 Yes 0 No
$0.00
0
Work Without Permit? 0 Yes 0 No
$0.00
Planning Fee
$0.00
Select a Non -Residential
Building or Structure
0
7i tr',�;! 1..>n,:nlrtt:reatptif�lr I'<<y.�
Strong Motion Fee:
IBSEISMCR
$0.50
2.0 hrs
$252.00
Inspections
IINSPAfIS Standard Inspections
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$1.50
$378.00
TOTAL FEE:
1 $379.50
Revised: 01 /15/2011