Loading...
11060046CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10670 MARTINWOOD WAY CONTRACTOR: MURALIDHARAN PERMIT NO: 11060046 RANGACHARI OWNER'S CUPERTINO, CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r— ELECT I— PLUMB r License Class Lie. ff MECH F RESIDENTIAL r COMMERCIAL Contractor Date 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: SFDWL FAMILY ROOM ADDITION(196SQFT) (commencing with Section 7000) of Division 3 of the Business & Professions NON-STRUCTURAL Code and that my license is in full force and effect. 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. 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 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. Signature Date OWNER -BUILDER DECLARATION 1 hereby affirm that 1 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). 1 hereby affirm under penalty of perjury one of the tollowing 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 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 � Date Sq. Ft Floor Area: I Valuation: $20000 APN Number: 36935036.00 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 Dtfte�_'_ -r— / 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 Applicant: 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 9.12 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 • 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 Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO F_� FEE ESTIMATOR - BUILDING DIVISION imlADDRESS: 10670 martinwood way DATE: 06/06/2011 REVIEWED BY: bobs. APN BP#: "VALUATION: 1$20,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Du lex USE: P 2nd Unit? Yes ', No OTC? 0 Yes 0 No PENTAMATION 1 R3SFDADD PERMIT TYPE - WORK sfd add family room structural. 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,III-B,IV,V-B 196 $965.00 /ADDPLCK $934.00 IADDINSP TOTALS: 196 $965.00 $934.00 MECH, HOURLY 0 Yes 0 No PLUMB, HOURLY 0 Yes 0 No ELEC, HOURLY 0 Yes DNo NOTFr These fees are hated an the nreliminary intarmntian availahlo and aro nnly an odimate_ Cnntarl the Dent for addn 11 infn_ FEE ITEMS (Tee Resolution 09-051 LH" 7,/1170) FEE QTY/FEE MISC ITEMS Plan Check Fee: $965.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $934.00 Suppl. Insp. Fee.0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Acoustical Fee: 0 Yes 0 No $0.00 0 0 Work Without Permit? 0 Yes 0 No $0.00 Planning Fee: PLLONGRNGR $25.48 Select a Non -Residential Building or Structure 0 0 Strong Motion Fee: IBSEISMICR $2.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1,927.48 $0.00 TOTAL FEE: $1,927.48 Revised: 04/29/2011 CUPERTINO CONSTRUCTION PERMIT APPLICATION- COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building (a>7cupertino.org ❑ NEW CONSTRUCTION ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS � � � � O APN k OWNERNAME N G�F iZ 1 PHONE Cjt CoS2 E-MAIL M. tA e A t- i p * A cta4.v STREET ADDRESS 1 (0 (0_+0 K"T IIll Vj47,0 D KlAY CITY, STATE, ZIP l tAtP&Q T ( N O, CA 6T56 1,t FAX CONTACT NAME I-N IA MA %_') fZA AJ Cat A C ++ A (t. % PHONE J (+0 Ue\ C,� " Z Z E-MAIL STREETADDRESS 1Q (P'4Q µp/Z�11JwdoD wk'< CITY, STATE` ZIP `uJv-va o,h 4150E FAX K� ❑ ❑ ❑ ❑ OWNER -BUILDER ❑ OWNERAGENr ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHITECT ENGINEER DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # (:+t A.if COMPANY NAME / E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER �" N NAME LICENSE NUMBER d 0 C7 BUS, LIC N COMPANY NAME, ,� a n ` • �J[7J LIFAX E-MAILE MAIL FZoq) q-� " Z Z 74 ! 1/ 1 STREET ADDRESS CITY, STATE�7DO) TU' �+ , A Cj 2 5-� 1 7 HE Oo - p u DESCRIPTION OF WORK Ix I M 4 , N EXISTING USE PROPOSEDUSEE CONSTR_ TYPE # STORIES E cc. c N, 11 EXISTG L S NEW FLOOR DEMO TOTAL Z, 30 a AREA Z 1 1 AREA AREA NET AREA r/l� BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑ DETACH ❑ ATTACH / DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? ❑ NO ADDITION? ❑ NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNERS NAME: RB(ZIVGD Ir(, TOTAL VA1.L:ATION: 00 PLANNING APPL Y NO PLANNING APPROVAL LETTER By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf I have read this W application and the information I have provi ed is correct.�h�avead the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to boil co .ize representatives of Cupertino to enter the above-identified 6 t`propertyfor inspection purposes. Signature of Applicant/*gelft: Date: ( ( I I SUPPLEMENTAL INFORMATION REQUIRED PEA CffFCK trPE RtsiTL c SI-A, p G rR TnE-CQU,1TMR B�tiG PLION REVIEW New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. � ,--y B�py�Ivll Z PLA-,4 m V-IE-W _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STA.`MARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project ❑ 1ARGE r I7ErT _ Copy of Planning Approval Letter or Meeting with Planning prior to ©FOR ❑ submittal of Building Permit application. SANCTARV.%7WERI)ES-MCT • �7 >W.,ti-ruon�se;r-r,u t�;rsLTH � B1dgApp_2011.doc revised 0311611A