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08060004 CITY OF CUPERTINOx �+- BUILDING DIVISIONA PERMITCONTRAeTOR, ''a,,R 'IATIa,', N . PERMIT NO. emL�lgc3,Agt�RE :AXLEY CT SABA SATHYA 08060004 OWNERS NAME: PERMIT ISSUE DATE SARA SATHYA 22023 BAXLEY. CT 06/02/2008 NE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH _00 LICENSED CONTRACTOR'S DECLARATION Job Description W F 1 hereby affirm that 1 am licensed under provisions of Chapter 9(commencing MM! with Section 7000)of0ivision3oftheBusinessand ProfessionsCade,andmylicense e REPLC STUCCO & WNDOW ! in full force and eneet. j Z Licen¢Class Le.Is ==p Dmc Contrasor ARCHITECTS DECLARATION w1 unduaand my plans total W exed ss Public records ga o Licensed Professional 3 OWNER-BUILDER DECLARATION ConuxON E 2 C 1 hereby.(Err thin 1 1. exempt from IM Contractors License law for the i o o following ream,. (erne,7Rn str Business and i mfessinm Cale:Any city m county m o'' which its lima a permit re cnnmmeL alter.Wprow,demolish,ore pair any mmesum :I< bad heor WitsiensedPatm.,to me me pardaiicanl for Coit Permiuoicause Law(Chned temem ss mhmheulittnCodpurwmttoNeprovisiomofuteConuactar'sLiwnsclaw(Chapter9 Sq.Ft. Floor Area Valuation st (commencing with Section 7000)of Division 3 of use Business and Professtom Code)in 1000 Wdor he u exempt therefrom and Ne basis for the alleged exemption.My violation of Saturn 7031.5 by any applicants far a permit subjects the applicant an a Civil penalty of e, N1 not mart than TiInn,Walled dalaux OSW). 35606022 ARJN Number Occupancy P Y Type 1,u owner of tie property,or my employees with wages as ute'u role compensation, will do the work,and the structure is not intended in offered far sale(Sec.7W.Business Required Inspections and Professions Cade:The Conuacmrs Liccme law does not apply m e in owner of q P property who builds orimpmvuthermn,amW whodoes such work himselforthrough his own employees.Presided that such Impmwmenu are not intended oroReretl for We.R, however.Ne building or improvement u sold within am year of campicuou.It owner. Wilder will haw the Boden of proving that he did roe build or improve for purpose of tile.). $11.A of rhe property am eaclusiwly convecting with licensed co duww m ta examines Ih project(Sec.7014.Business and Rofessions Code:)The Conuacmrs U. cents law dors not apply to an owner of property who Wilda or impmw den on,and, _ who contracts far such projects with a conummr(s)Ecenad pursuant m the Crtnmmumer Lleeme law. ❑1 sm exempt under See B&P C for this mason Owned. I.I. WORKER'S COMPENSATIONCLARATION 1 hereby fur under pemWty of perjury,m of the foiluwing datlardamts: nocasae and will far Se Cenif te of Coventur Collte.far perf. hCa of On wort,,r provided fPe mi$s tion 3]00 of the labor Code,fa dte performanm ar the wwlr for which this Permit is isauM ❑1 haw and will ammuin Workers Compensation Insu ..as requited by Session 3700 o(Oc Latour Code.for the Performance alum work for which this permits issued. ' My Workers Compensation hamem.carrier and Polity number are: Cartier. Policy No.: _ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (ITU CoNwm need int ho Completed ilthe permit Is faro,.hundred dogam(SIM) nr less) I cuufy Nat in the parlormarrce of site work far which this permit u issued.I shall not cruployany person in any man r be ma the Wortes'Compensation Laws of Califomis. Malian, - C / NOnCE TO APPLICANT:If,once making this Cc m m¢of Exemption,you should toecnme Subject m IIIc Wo koxi a Compensation pmvisirn ref tie Laaor Code,you mum .J O forthwith comply wish such pmvitiona w this Permit shall k deemed mvoked. z CONSTRUCTION LENDING AGENCY f--"y—' Iherby afar¢this there is a eomuuction lending army fur thC perfarmaoa of C> the work fur whim this Permit Is issued(Sec.3091,Civ.C.) mLenders Name z Landers Address fJ Q 1 certify Nam 1 haw read this application arta sate Nm the show information is CL Manuel.1 agree to comply with all city and county ordinances and sum Ian relating to C) building Construction.and hereby authofM mpmxmLiws of this city to enter upon the ahovc-menuonedpmpeny for cxIxmCon purpwhich ms F y (Wee)agree to saw,indemnify and keep hamuess the City of Cupcnino apimt - Z in judgmenda.Of the wooing Of this may in anywyacerue agalvt said City _ - CJ z in eoeseq NT of the granting of this permit APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date soD�enfruLA� � � Re-roofs Sgnuurt ofApphApph HAZARDOUS MA AIS DISCLOSURE Data Type of Roof / Will the applicant or forum Wilding o[GYPULslom or handle hawrdom material as dcfined by the Cupertino Municipal Code.Chapter 9.13.and the Health and Safety Cole,Section 35533(x)? ❑Yes 7 4 `ra All roofs shall be inspected prior to any roofing material being installed. Will the applicant of loom Wilding aavwat.eavipment ar devices which If a roof is installed without first obtaining an inspection,I agree to remove Di haeasid.air conumim us as dc6ned by the Bay Arta Air Quality Management all new materials for inspection. ❑Yea tfRNo I hon mad the hxsardnuvmatedals requirements unJer Chapter 6.95 of the Califor- nuHralth&Safely Code,SecoominM5.25533 out n5M.I understand Nmif Nee Wilding does not Carmody haw a ton-L this is is my maponsihility m notify the oaumL rI Ne cnu whkh¢timed 'armi aaa Cml6cateaf Ota ry. Signature of Applicant Date O mlaraathorvsdagenl �`� ate' All roof coverings to be Class'W'or better CITY OF CUPERTINO • 3 ITEMS OF 7 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35606022 . 00 DATE ISSUED. . . . . . . : 06/02/2008 RECEIPT # . . . . . . . . . : BS000004959 REFERENCE ID # . . . : 08060004 SITE ADDRESS . . . . . : 22023 BAXLEY CT SUBDIVISION . . . . . . . ' CITY CUPERTINO IMPACT AREA . . . . . . . OWNER SABA SATHYA ADDRESS . . . . . . . . . . 22023 BAXLEY CT CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4744 RECEIVED FROM . . . . : SABA CHOCKALINGAM - CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : SABA SATHYA ADDRESS . . . . . . . . . . : 22023 BAXLEY CT CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4744 TELEPHONE . . . . . . . . : FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL -- ------ ------------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 1, 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00 1STUCOAPP SQ FEET 1 . 00 428 . 00 0 . 00 428 . 00 0 . 00 1WINREP EACH 8 1. 00 367 . 00 0 . 00 367 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 795 . 50 0 . 00 795 . 50 0 . 00 • od =- CITY OF CUPERTINO • CUPERTINO GENERAL BUILDING PERMIT APPLICATION FORM APN # Date: . SCoo (p00) oc� 0b /02-/08' Building Address: Z2 d2 3 ?,A -A L t 7 Go V P-T LUP&R—T / N' O C SO/+ Mailing Address (if different from building address): Owner's Name: Phone#: Sttgq SATMYA 4(Da� - 343 — 1299 Contractor: Phone: b W r4< P, 4�v 1 L 'Zj E-e Fax: Contractor License#: Cupertino Business License#: • Contact: Phone: Fax: Residentialjo Commercial Job Description: (ZE-� PLq C 6 5T- VCC,o v\) 1N -bO t4 Building Permit Info: Bldg [9� Elect ❑ Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ II/III/V-A ❑ IUIII B, IV-HT, V-B (--� Valuation: 10©O 1 Csa Square Footage: Pro'ect Size: Standard ❑ Lar e ❑ Major ❑ • Revised 5/21/08 ,'CSC_. CITY OF CUPERTINO CITY OF CUPEkTINO GENERAL BUILDING PERMIT APPLICATION FORM Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM 1BTEMPPER Temporary Building Permit (good for B, 30 days) 1BBOILERI For the installation or relocation of ea M boiler/compressor to & including 3 horsepower, or ea absorption sys to & incl 100,000 Btu/h (29.3kw) 1BBOILER2 Installation/relocation of ea M boiler/compressor over 3 horsepower to & incl 15 horsepower, or ea absorption ss over 100,000 Btu/h 1 BBOILER3 Installation/relocation of ea M boiler/compressor over 15 horsepower to & incl 30 horsepower, or ea absorption sys over 500,000 Btu/h to • & incl 1,000,000 Btu/h 1BBOILER4 Install ation/relocation of ea M boiler/compressor over 30 hosepower to & incl 50 horsepower, or for ea absorption sys over 1,000,000 Btu/h to & incl 1,750,000 Btu/h 1 BBOILER5 Installation/relocation of ea boiler or M refrigeration compressor over 50 horsepower, or ea absorption sys over 1,750,000 Btu/h 1 BAPPLOTH For ea appliance or piece of equip M regulated by this Code but not classed in other appliance categories, or for which no other fee is listed in this code. 1 ELECINSP Other Electrical Inspections (per hour) E 1MECHINSP Other Mechanical Inspections (per M hour) 1PLMBINSP Other Plumbing & Gas Inspections P (per hour) 1MEETINGIHR Application Meeting B CITY OF CUPERTINO CITY OF GENERAL BUILDING APPLICATION • CUPERTINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM ACOUSTICAL REVIEW IACOUSFDW SFDWL/DuplexNew B IACOUSRESAD SFDWL/Duplex-Addition/Alteration B 1ACOUSCOM Multi-Family/Commercial B CHIMNEY'S 1CHIMNEY Chimney B 1CHIMNEYR Chimney Repair B FENCES 1 FENCE>6FT Non-masonry, over 6 ft in height B I FENCEMAS>6 Masonry, over 6 ft in height B FIREPLACES I FIREPLMAS Fireplace Masonry B 1FIREPLFAB Fireplace Pre-Fabricated/Metal B I FLAGPOL>20 Flag pole (over 20 ft in height) B IMODUSTRU Modular Structures B FOUNDATIONS 1FOUNDREP Foundation Repair B 1PILECAST Pile Foundation Cast in place concrete B I PILEDRIV Pile Foundation Driven (steel, pre- B stressed concrete) 3 of 5 �(KI CITY OF CUPERTINO CITY Or GENERAL BUILDING APPLICATION CUPEf�TINO FEESCHEDULE Quantity/Sf Fee ID Fee Description fee Permit Type Group 1GENRES or 1GENCOM RETAINING WALL(CONCRETE OR MASONRY 1 RETSTN Standard (up to 50 ft) B 1 RETSP310 Special Design, 3-10' high (up to 50 `) B 1RETSP10 Special Design, over 10' high (up to B 50') 1 RETCRB< Gravity/Crib Wall, 0-10'high (up to B 50 ft) 1RETCRB> Gravity/Crib Wall over 10' high (up to B 50 ft) SIDING 1 SIDEST/BK Siding, Stone & Brick Veneer B • (interior/exterior) 1 SIDEOTHER Siding all other B SKYLIGHTS 1 SKYL<l0 SF Skylight less than 10 sf B 1 SKYL>10SF Skylight greater than 10 sf or B structural 1STAIRS Stairs-first flight/ea addt'1 B STORAGE RACKS 1 SRACKS<=8 Storage Racks 0-8' high (up to 100 sf) B 1 SRACKS>8 Storage Racks over 8' high (up to 100 B st 1STUCOAP Stucco Applications (up to 400 sf) B additional stucco application 4of5 .. CITY OF CUPERTINO • CUP TYOF O GENERAL BUILDING APPLICATION FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM / 1 WINREP Replacement windows/sliding glass B ( door (ea 8 windows) 1WINMEWSTR New Window-structural shear B wall/mason (includes plan ck fee) IEPERMITFEE Electrical Permit Fee E 1MPERMITFEE Mechanical Permit Fee M 1 PPERMITFEE Plumbing Permit Fee P 1 ELCPLNCK Stand Alone Electric Pln Ck (hourly) E 1MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M 1PLMBLNCK Stand Alone Plumbing Pln Ck (hrly) P 1 STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B when not over counter) hourly-stand alone 1BSEISMICR Seismic Residential B 1BSEISMICO Seismic Commercial B ITRAVDOC Travel & Documentation B 1BUSLIC Business License g 5of5