B-2016-1459CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-1459
22525 SALEM AVE CUPERTINO, CA 95014-5648 (342 12 096)
( WONDER HOMES
INC)
CUPERTINO, CA 95014
OWNER'S NAME: AGGARWAL ASHOK AND USHA TRUSTEE
DATE ISSUED: 03/02/2016
OWNER'S PHONE: 5105930636
PHONE NO: 4088212052
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class B Lic. #899346
Contractor ( WONDER HOMES INC ) Date 3/212016
X BLDG X ELECT _PLUMB
MECH X RESIDENTIAL _COMMERCIAL
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.
JOB DESCRIPTION:
REMOVE AND REPLACE 14 WINDOWS (8 ON 1 ST FLOOR AND 6 ON
I hereby affirm under penalty of perjury one of the following two declarations:
2ND FLOOR), LIKE FOR LIKE; INSTALL (N) RECESSED LIGHTS IN
1. I have and will maintain a certificate of consent to self -insure for Worker's
BEDROOMS AND KITCHEN (QTY 8)
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
z. 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
Sq. Ft Floor Area:
Valuation: $8000.00
this permit is issued.
APPLICANT CERTIFICATION
certify that I have read this application and state that the above
Number:
Occupancy Type:
information is correct. I agree to comply with all city and county
342 12 096
3 42
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
PERMIT EXPIRES IF WORK IS NOT STARTED
expenses which may accrue against said City in consequence of the
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally, the applicant understands and will
comply with all non -point source regulations per the Cupertino Municipal
180 DAYS FROM LAST CALLED INSPECTION.
Code, Section 9;18.
Issued by: PAUL O'SULLIVAN
*Ubo
Signature Date 3/2/2016
Date: 3/2/2016
OWNER -BUILDER DECLARATION
RE -ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of the
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
following two reasons:
1. I, as owner of the property, or my employees with wages as their sole
inspection.
compensation, will do the work, and the structure is not intended or offered
for sale (Sec.7044, Business & Professions Code)
Signature of Applicant:
2. I, as owner of the property, am exclusively contracting with licensed
Date: 3/2/2016
contractors to construct the project (Sec.7044, Business & Professions Code).
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
I hereby affirm under penalty of perjury one of the following three declarations:
1. 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
HAZARDOUS MATERIALS DISCLOSURE
performance of the work for which this permit is issued.
I have read the hazardous materials requirements under Chapter 6.95 of the
2. I have and will maintain Worker's Compensation Insurance, as provided for
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
by Section 3700 of the Labor Code, for the performance of the work for which
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
this permit is issued.
3. I certify that in the performance of the work for which this permit is issued, I
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
shall not employ any person in any manner so as to become subject to the
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
Worker's Compensation laws of California. If, after making this certificate of
the Health & Safety Code, Sections 25505, 25533, and 25534.
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
Owner or authorized agent:
be deemed revoked. I
Date: 3/2/2016
APPLICANT CERTIFICATION
CONSTRUCTION ENDING AGENCY
I certify that I have read this application and state that the above information is
I hereby affirm that there is a construction lending agency for the performance
correct. I agree to comply with all city and county ordinances and state laws
of work's for which this permit is issued (Sec. 3097, Civ C.)
relating to building construction, and hereby authorize representatives of this city
Lender's Name
to enter upon the above mentioned property for inspection purposes. (We) agree
to save indemnify and keep harmless the City of Cupertino against liabilities,
Lender's Address
judgments, costs, and expenses which may accrue against said City in
ARCHITECT'S DECLARATION
consequence of the granting of this permit. Additionally, the applicant
understands and will comply with all non -point source regulations per the
I understand my plans shall be used as public records.
Cupertino Municipal Code, Section 9.18.
Licensed
Professional
Signature Date 3/2/201
CONSTRUCTION PERMIT APPLICATION
CON1h1UN1 lY DEVELOPIti4ENT-D=PARTIVIlEN i BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
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CITY UPERTINO
R W -7W7 FFF F,STiMAT RF C99016—BUiLDTNG DIVISION
i9
ADDRESS: 22525 SALEM AVE
DATE: 03/02/2016
REVIEWED BY: PAUL
--h
APN: 34212 096
BP#:
*VALUATION: 1$8,000
,,'PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Addition
PRIMARY SFD or Duplex
p _TA
Suppl. PC Fee: _ Reg. 0 OT
PENTAMATION 1 GENRES
USE:
$0.00
PERMIT TYPE:
WORK
REMOVE AND REPLACE 14 WINDOWS 8 -1ST FLOOR AND 6 ON 2ND FLOOR),LIKE FOR LIKE;
SCOPE
INSTALL (N) RECESSED LIGHTS IN BEDROOMS AND KITCHEN (QTY 8)
NOTE: This estimate does not include fees due to other Departments (i.e. Ytannmg, .Dubuc wor/is, Pire, Janira/y Delver L/strlct, acifuut
1--1 nni/ nro nn/v nn octimaty_ ('nntact dte Dent for addn'l info.
FEE ITEMS (Fee Resolution .1.1-053 .eft. 7,!1;':13}
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
14 #
$574.00
Window / Sliding Glass Door
1 hI,'INIZEP Replacement
Suppl. PC Fee: _ Reg. 0 OT
0.0
1 hrs
$0.00
PME Plan Check:
$0.00
=
$72.00
Electrical
1BREMFIXT Fixtures, Lighting
Permit Fee:
$0.00
Suppl. Insp. Fee:Q Reg. Q
OT
Fo , 0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$48.00
Administrative Fee:
(ADMIN
$45.00
e-'
0
E'
Work Without Permit? 0 Yes (F) No
$0.00
Advanced. Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
a
Travel Documentation Fee: 1TRAVDOC
$48.00
Strong Motion Fee:
IBSEISMICR
$1.04
Select an Administrative I
Bldg Stds Commission Fee: 1BCBSC
$1.00
SUBTOTALS:.'
$143.04
$646.00
TOTAL FEE:.
$789.04
Revised: 0
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-------
--GMM-UNITY DEVELOPMENT' -DEPART 'NIENTI_---
BILDING DIVISION - CUPERTINO
APPROVED
This, set of plans anis specifications P�IUST be kept at the
iob site during construction. It is unlawful to make any
changes or alterations on same, or to deviate
therefrom, without approval from the Building Official.
The. Stamping of this plan and specifications SHALL NOT
be held io permit or to be an approval of the violation
of any visions of any Ci , Ordinance or State Law.
BY
DATE I ' -----
PERMIT # - --
1 °rXbo
C W�
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i
C
W&I X001
42S
PLOT P S CH
3
®ATE z CEIVE
PLANNING DEPT
CUPERTINC► ;
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To
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CU
Building Department
2916
REVIEWED FOR CODE COMPLIANCE
Reviewed BY: eyj
UFFIC"'""
ry
NTZI
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_ 1
I F L,00 P, P L-A 1 �___._-_ ..-...__
-------
--GMM-UNITY DEVELOPMENT' -DEPART 'NIENTI_---
BILDING DIVISION - CUPERTINO
APPROVED
This, set of plans anis specifications P�IUST be kept at the
iob site during construction. It is unlawful to make any
changes or alterations on same, or to deviate
therefrom, without approval from the Building Official.
The. Stamping of this plan and specifications SHALL NOT
be held io permit or to be an approval of the violation
of any visions of any Ci , Ordinance or State Law.
BY
DATE I ' -----
PERMIT # - --
1 °rXbo
C W�
Go "X6 -
i
C
W&I X001
42S
PLOT P S CH
3
®ATE z CEIVE
PLANNING DEPT
CUPERTINC► ;
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CUPERTINO
.;. Building Department
REVIEWED FOR CODE COMPLIANCE
Reviewed By: qkl a o�i�