10100154I CITY OF CUPERTINa BUILDING PERMIT I
BUILDING ADDRESS: 1351 POPPY WAY I RI MOD CONTRACTOR: ALPS CONSTRUCTION & LING I PERMIT NO: 10100154 I
" NER'S NAME: SHAILISH JOSHI
u vv'NER'S PHONE: 4087250540
Ati, LICENSED CONTRACTOR'S DECLARATION
License Class Lic. # C101
Contractor Date p C , 9 1( 0
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
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.
�z` -mature Date CC ,
❑ OWN -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 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
the above mentioned property for inspection purposes. (We) agree to save
:unify 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
681 E BROKAW RD
SAN JOSE, CA 95112
DATE ISSUED: 10/21/2010
PHONE NO: (408) 898-6474
BUILDING PERMIT INFO: BLDG F ELECT r— PLUMB F
MECH F RESIDENTIAL F COMMERCIAL r
JOB DESCRIPTION: REMODEL BATHROOM/REMOVAL OF EXISTING
C/ BINETS,
CC BUNTER & FLOOR;UPGRAD ELECTRICAL,CABINETS &
FL DOR; NO RE -ROOF & NO STRUCTURAL(120SQ)
Sq. Ft Floor Area:
AIN Number: 36618027.00
Valuation: $11000
Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Is! ued by: `'� Dat
RE -ROOFS:
Al 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
ins pection.
Sil nature 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
coi npliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Sa ety 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
ma intain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health& Saf ty Code, Sections 25505, 25533, and 25534.
Ov Iner tiro iz gent: m Z /1 w
Date• t
CONSTRUCTION LENDING AGENCY
Ih :reby affi that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Le ider's Name
Le ider's Address
ARCHITECT'S DECLARATION
I u iderstand my plans shall be used as public records.
Lig ensed Professional
3 ITEMS OF 3
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: ]got:
APN ........: 36618027.00
DATE ISSUED.......: 10/21,'2010
RECEIPT #......... BSO00011802
REFERENCE ID # ...: 10100:_54
SITE ADDRESS .....: 1351 :?OPPY WAY
SUBDIVISION ......
CITY CUPER-INO
IMPACT AREA ......
OWNER ............: SHAIL:CSH JOSHI
ADDRESS . 1351 :?OPPY WAY
CITY/STATE/ZIP ...: CUPERTINO, CA 95014
OPERATOR: patg
COPY # : 1
RECEIVED FROM ....: MEHRDAD A ZAMANI
CONTRACTOR .......: ALI Z"kMANI LIC # 28677
COMPANY ..........: ALI'S CONSTRUCTION & REMODELIN
ADDRESS ..........: 681 E BROKAW RD
CITY/STATE/ZIP ...: SAN JOSE, CA 95112
TELEPHONE ........: (408) 898-6474
FEE ID UNIT
QUANTITY
AMOUNT PD -TO -DT
THIS REC
NEW BAL
----------
-----------------------
1BCBSC VALUATION
----------
11,000.00
--------------------
1.00
0.00
----------
1.00
0.00
1BSEISMICR VALUATION
11,000.00
1.10
0.00
1.10
0.00
1REMRESKIT SQ FEET
120.00
-370.00
0.00
570.00
0.00
----------
TOTAL PERMIT
---------- ----------
572.10
0.00
----------
572.10
0.00
METHOD OF PAYMENT
AMOUNT
REFERENCE
NUMBER
----------------- ---------------
CREDIT CARD
572.10
--------------------
VISA
---------------
TOTAL RECEIPT
572.10
CITY OF CUPERTINO
1I FFF. F,STIMATOR - BUILDING DIVISION
A] TF• Thoco foot aro hacod an the preliminary information avai,'ahle and are only an estimate. Contact the Dept for addn 7 info.
FEE ITEMS (Fee Resohition 09-051 EL T"b"10)
ADDRESS:
DATE:
REVIEWED BY:
11) "_
APN:
BP#:
*VALUATION: 1$11,000
*PERMIT TYPE: Building Permit
PLAN C HECK TYPE: Alteration / Repair
PRIMARY
USE: SFD or Duplex
�.�.
�� . f,
PENTAMATION 1R3SFDREM
PERMIT TYPE:
WORK
PME Plan Check:
SCOPE
$0.00
A] TF• Thoco foot aro hacod an the preliminary information avai,'ahle and are only an estimate. Contact the Dept for addn 7 info.
FEE ITEMS (Fee Resohition 09-051 EL T"b"10)
7-T
FEE
QTY/FEE
11) "_
/'= 7taI t'r
L`ii'c.c. I'crtrtif 1°tit~
F-1 I_7.
t� ,;,i. t'.' I�.�,' iy}�3
_, Stl
fl�tL'r }, s..i_ jf�:.tLi 2LJ
Suppl. PC Fee: 0 Reg. 0 OT
0.0
hrs
A] TF• Thoco foot aro hacod an the preliminary information avai,'ahle and are only an estimate. Contact the Dept for addn 7 info.
FEE ITEMS (Fee Resohition 09-051 EL T"b"10)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
120 s.f.
$570.00
Remodel, Kitchen (<=300 sf)
IREMRESKIT
Suppl. PC Fee: 0 Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.0('
Suppl. Insp. Feer Reg. 0 OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
out it7wiif m Kix
Acoustical Fee. 0 Yes E) No
$0.00
Work Without Permit? 0 Yes (F) No
$0.00
Planning l;ee:
$0.00
Select a Non -Residential
Building or Structure
II~<r3E>1 Docr��m�yrrcrtir>rr f��°,,.
Strom Motion Fee: IBSEISMICR
$1.1O
Select an Administrative Item
Bldg Stds Commission Fee. 1BCBSC
$1.00
SUBTOTALS:
$2.101
$570.00
TOTAL FEE:
$572.10
Revised: 10/17/2010
RESIDENTIAL PROJECT COVER SHEET
Assessor's Parcel Number:
Name of owner. a _
Project address. S _
Contact person. Phone
Fax.
Net square footage of lot.
I. r✓ i �� t � ��
Existing Proposed
Square footage: First floor: _
Second floor: t
Garage:
TOTAL: _
Are there at least two 10 foot by 20 foot clear spaces inside the garage?
Is privacy protection planting required for the project?
Build it Green Total Points
On what floor(s) is work being done?
Brief description of work.
Code editions: 2007 CBC - N)2007 CFCN)2007 CMC - N)
2007 CPC N)2007 NEC (2Y) N)
Effective 1/1/08 APPROVEL.
IN AGS JRUAN(:E WITH IHE CITY C:
CUPERTINO (,OT NU O (DINANCE',
i
DATE _t)C' I �
SIGNET)
This set of plans and tions MUS'Y
hAA kept on the job rimes and it i�
mlawtul to make any anges or alterations
on same without written permission from
the Building Department, City of Cupertino.
The stamping of this plan and specifications
a6iALL NOT be held to permit or to be an
approval of the violation of any provisions
of any City l7rdinance or 5ta!e taw.
Plan Review Process Work Book Page -8-Revised 8/05/08
�1
M
b
M. Indoor Air Quality and Finishes
B Re;;ource pts
y=yes
I.3usa bvocPWM
1IAO]Health pts
y --yes C
2. Use Low VOC, Water -Based Wood Finishes
2 IAO ]Health pts
y=yes C
3. Use l_owft VOC Adhasrves
3 W ]Health pts
y=yes C
4. Use Salvaged Materials for Interior Finishes
3 RE source pts
y=yes 0
5. Use Engineered Sheet Goods with no added Urea
4 Re;;ource pts
y=yes
Formaldehyde
61AOglHealth pts
y=yes C
6. Use Exterior Grade Plywood for Interior Uses
1 IA, ]Health pts
y --yes C
i, d v¢ed oieUoa#r irF
4 IA g/Health.is
P
Y=Y es
B. Use FSC Certified Materials for Interior Finish
4 RE:source pts
y --yes 0
9. Use Finger -Jointed or Recycled -Content Trim
1 RE source pts
y --yes 0
10. Install Whole House Vacuum System
3 IF QIHealth pts
y=yes IO
N. F{ooring
1. Select FSC Certified Wood Flooring
B Re;;ource pts
y=yes
2. Use ftapetdy Renewabla FJoDdng MaWals
4 Re,;ource pts
y=yes
3. Use Recycled Content Ceramic Tiles
4 Re!;ource pts
y --yes
4. Install Natural Linoleum in Place of Vinyl
.5 IAO ]Health pts
y=yes
5. Use Exposed Concrete as Finished Floor
4 Re ;ource pts
y --yes
6. Install Recycled Content Carpet with Low VOCs
4 Re;;ource pts
y=yes
Total Points Available: 1 1401. 130 57
Total Points Project Received: 1 01 01 0
s z
Mdata1pmp/gneenbuilcingguidelines/remodel rs/ enpointsfina1212.04protected.xls
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CITY OF CUPERTINO
ADDITION[RZEMODEL
FEE SC]HEDULE
/ -o
1001'-5v
APN# r, / Ik 0; rl
Date: 0Ct/7,_(J(0
Is a 2nd unit being added? Yes ❑ No If yes, please fill out the permit application
for 21d unit.
Building Address:
k a
Mailing Address (if different from building address):
�S 1_s(1
Owner's Name: � La � ! � � � ,..� � � 1
Phone # : C) 7
Z- O
Q
Contractor: L
E4 L I -5 CG
Phone #:
Fax #:
Cupertino Business License:
State Contractor License #:
Contact:Q
ALt ZarY7 Rji
Phone #: 4 0
Fax #:
- O 6-4-
Landscape Ordinance Compliance:
Landscape area in sq. ft. (includes all irrigated areas) :,��,15.
If 2,500 sq. ft. or less, compliance with the Landscape Water -Efficiency Checklist is required.
If more than 2,500 sq. ft., a complete Landscape Project Submittal is required.
Compliance Method: ❑ Plant Type ❑ Water Budget
Building Permit Info:
Bldg. ❑ Elect. Plumb.
Mech.
Hillside ❑
JUO ur's npuOn.
Addition -What is being added?(Be Specific):
a
What is being remodeled (not including addition)?Y_'��
C SC( 1l Cz61N�Cute c,- �;, 1`00(-/
Remodel Incl ud e -Roof: Yes ❑ No 'f yes list number of squares _
Remodel Includes Structural: Yes ❑ No 0
Do you have the pre -application planning approv:Ll? Yes ❑ No ❑
If yes, please provide a copy of your planning approval letter. Planners name:
Square Footage: -
Addition: Porch: Deck: _ Garage: Detached Attached
Remodel: KitcheL t 2c � Bath Other
Type of Construction (Usage Class): Occupancy Type:
1-A, 1-B ❑ IUIII/V-A ❑ lI/III B, IV -HT, V -B Valuation: We()
Please check this box if the project is a
Project Size: Express
[t{andard ❑ Large ❑ Ma'or ❑ second -story addition ❑
Please complete relevant portion of the Green Building;
Checklist & attach it to the application or if applicable, Green Building Points Achieved
include in plan set & the sheet index.
Revised 05/18/10