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14080224CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10657 LARRY WAY CONTRACTOR: NICE & RIGHT PERMIT NO: 14080224 CONSTRUCTION INC OWNER'S NAME: KASAMSETTY KISHORE AND POTTURI SUDH P O BOX 2285 DATE ISSUED: 02/26/2015 OWNER'S PHONE: 4088321627 CUPERTINO, CA 95015 PHONE NO: (408)861-0928 W11LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ ���.�� License Class 0 Lic. # 6.24000. RE—BUILD SINGLE STORY SFDWL TO INCLUDE LIVING 3,354; ATTACHED GARAGE 7I0; PORCH 118 Contractor /Co— i, : - wate I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7400) 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: 1 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 Sq. Ft Floor Area: Valuation: $350000 ,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 APN Number: 31602011.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERAHT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITiIIN 180 D P T ISSUANCE OR to building construction, and hereby anthorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DA TJ ED INSPECTION. 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 e with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signature fl.,L Date 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. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: 1 hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, 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) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sce.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should 1 store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this't permit is issued. Owner or authorized agent: LLFVMDate:: 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18, Signature Date CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10657 LARRY WAY CONTRACTOR- KASAMSETTY KISHORE PERMIT NO: 14080224 AND POTTURI SUDH OWNER'S NAME: KASAMSETTY KISHORE AND POTTURI SUDH 10657 LARRY WAY DATE ISSUED: 02/26/2015 OWNER'S PHONE: 4088321627 CUPERTMO, CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL 0 RE -BUILD SINGLE STORY SFDWL TO INCLUDE LIVING License Class Lie. 0 3,354; ATTACHED GARAGE 710; PORCH 118 Contractor Date 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 bvo 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 Sq. Ft Floor Arca: Valuation: $350000 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 APN Number: 31602011.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this applicalion and state that The above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating building hereby to WITHIN 180 D F PERMIT ISSUANCE OR to construction, and authorize representatives of this city enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAY OM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the4 - granting of this permit, Additionally, the applicant understands and will comply Issued by: Date: with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signature Date 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. OWNER -BUILDER DECLARATION r Signature of Applicant: Dale: I here y affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, 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) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sect ns 25505, 25 3, nd 25534. Section 3700 of the Labor Code, for the performance of the work for which thisV c �Of ti<stct nr nuthgrizcd a ent: permit is issued. -f certify that in the performance of the work for which this permit is issued, I shall ` �Iol 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records, granting of this permit. Additionally, the applicant understands and will comply with all non -p 'nt source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Date ,blur CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10657 LARRY WAY CONTRACTOR: NICE & RIGHT PERMIT NO: 14080224 CONSTRUCTION INC OWNER'S NAME: KASAMSETTY KISHORE AND POTTURI SUDH P O BOX 2285 DATE ISSUED: 02/26/2015 OWNER'S PHONE: 4088321627 CUPERTINO, CA 95015 PHONE NO: (408)861-0928 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ RE -BUILD SINGLE STORY SFDWL TO INCLUDE LIVING 3,354; ATTACHED GARAGE 710; PORCH 11.8 'SV..:h Contract a iDate I herebyaffirm that I am licensed under the provisions of Chapter 9 p p RV ��ek �� � O h PL;''' RE_ OVA GE 0 (commencing with Section 7000) of Division 3 of the Business & Professions `� 'Fw+j Kr�" 4^ CO ' CRE''riLS,A�i'- Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations:REVISION p �I� �� 1 have and will maintain a certificate of consent to self -insure for Worker's �1 -- - - - Compensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: 5350000 pe ormance of the work for which this permit is issued. ro ve 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 APN Number: 31602011.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. 1 agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Issued b �i /1l"e-, Date l� granting of this permit. Additionally, the applicant understands and will comply y�� with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. t%a .� . ,• -, T .•`' r Sigrtaturo r •F 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. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I bereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, 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 (See.7044, Business & Professions Code) I, as owner of the property, am exelusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (See.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Seetions 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Cade, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Ouality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and 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 the Health & Safety Code, Sections 255059 25533, and 25534. / _ _:'� Owner ate:- permit is issued. or authorizedage n� /, _ � WW .."%[ 4i.•.i� _ri-�' = I certify that in the performance of the work for which this permit is issued, I shall7`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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, 1 must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked, work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that 1 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 • buildinq(�i)cupertirto.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION 1 TI ❑ REVISION 1 DEFERRED cab ORIGINAL PERMIT # Pfd ADDRESS O& c� —7 L A- f Zt2—. 1/v AY 71411 0 7, Q 1 60 [�Y, 4,t f� t7i0. `F;' uA°, (2 «� 7(J jLr G - MAIL STREET ADDRESS CITY, STATE, ZIP FAX taNTxrCT � v Ohl I�rlPl Wo- r E�"t3;ATL;t��. ST EET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER-BUa.DER ❑ OWNERAGEM ❑ CONTRACTOR ❑ CONrRACTORAGENr ❑ ARCHTIECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT SON, - . GT.QIU<1 ay1F , LICENSE NUMBER LICENSE TYPE BUS. LIC M COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER SUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK EXI'- ING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC, SQ,FT. VALUATION ($) E09TG NEW FLOOR R£A DEMO TOTAL AREA AREA NET AREA , 00M L AREA KITCHEN REMODEL AREA OT14ER REMODEL AREA L� KODE PO '1�.9R$A �U( DECK AREA TOTAL DECK/PORCH AREA GARGHAREA: DETACH ~}JA Co ❑ATTACH i # n LLING UNITS: IS A SECOND UN 1T [:]YES SECOND STORY ❑ YES BEINGADDED? NO ADDITION? NO Pe -APPLICATION []YES IF YES, PROVIDE COPY OF ,� L0 NO PLANNING APPROVAL LETTER NNINGAPP❑ IS THE BLDG AN ❑YESRECEIVED$ EICHLERHOME? NO ❑ , -I',1}XU VAL(.1 VNIN"P- 13y my signature below, I certify to each of t}� ]lowing: I am a pr perty owner or authorized agent to act on the property owner's behalf, I have read this application and the information I have prpde is co ecY I ere the Description of Work and Yerify it is accurate. 1 agree o comply with all applicable local property for inspection purposes. ordinances and state laws relating to b ' di cons ctian, out Ize representatives of Cupertino to enter the abov ldent�i/f114— f Iatifratplilyflii/Yt * t: Ii�tt : Y} SUPPLErMALINFON REQUIRED PLAN CHECK TYPE ROUTING SLIP _ New SFD Or Multidwelli Apply for dernolition permit for ❑ OVFR-THE-COUNTER"JILDING In PLAN REVIEW existing building(s). Demolition permit is required prior t0 issuance of building permit for new building.❑ XPRESS PLANNING PLANREVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD PUBLIC WORKS form if any Hazardous Materials are being used as part ofthis project. ❑LARGE FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR y1aANITARYSEWER DISTRICT submittal Of Bnilding Permit application. /❑ ENVIRONMENTAL HEALTH BIdg,4pp_2011.doc revised 06/21/11 CUPERTINO 12"1,-5101\J Al CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3226• FAX (408) 777-3333 • buildin cu ertino.ar ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI M REVISION / DEFERRED AkTCi- i�• ORIGINAL PERMIT # 72 a� PROIEC-r ADDRESS V `Y� 2,y Uv APN 9 OWNER NAME A� /� J,f/ A J ' f 1/ PHONE E-MAIL STREET ADDRESS IP 5 -A41V CITY, STATE, ZrP FAX CONTACT NAME WMZ ,AA V (�d' PHONEE�D E-MAIL ST 1 � S � �� CITY, 5 r / FAX 1 � ELUE 11 OWNER ❑ OWNER412 B DER ❑ GAWER AGENT CONTRACTOR ❑ CONTRACTOR AGENT , ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNARM LICFNS ER LICENSETVPE BUS. LIC# COMPANYNAME / E-NiA1L FAX !- STREET ADDRESS CITY, ST TE, ZIP PHONE ARCTLI=/ENGINEER NAME LICENSE NUMBER BUS. LIC N COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE } DESCRIPTION OF WORK E'SCZSTIIdG USE PROPOSED USE CONSTR. TYPE 4 STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR. DEMO OTAL AREA AREA AREA I NET AREA BATHROOM KITCHEN-- OTHER. -, REMODEL AREA REMODEL RFMODELAREA PORCHAREA - DECKAREA 7OTALDECKIPORCHAREA GARAGE AREA: LJ DETACH q ATTACH PAFVEI-LTNGUNrrs; ISASECONDuNrr ❑YES SECOND STORY []YES BEINGADDED? ❑NO ADDrrION? ❑NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THF BLDG AN ❑ YES' -`I7 CEI ON: PLANNING APPL # E] NO - PLANNING APPROVAL LETTER EICHLER HOME? I] No _N� '" r kry*- n ,- - By my signature below, I certify to eac the followi I the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I ha ov ed is cc ect, ave read the Description ofWork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relatin- uil ' g con cd . I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature ofApplicant/Age Date: SUP P MENT VttMATION REQUIRED New SFD ultifami N' flings: Apply for demolition permit for .Q .O'VL'R THF COUIVIEA B-L7ILDII�TG PL REYIEFi'�' ' " - existingbuild' g(s). Demo tion permit is required prior to issuance of building rx� permit for new building. �"PIYDTNGP-L,ANIF'T1~�i -. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure �, ;r5 r, K&wo#rx— x F, form if any Hazardous Materials are being used as part of this project. �M������``� X -I x}x MOM -,x _ Copy of Planning Approval Letter or Meeting with Planning prior to*4 '�1 LTR �. } % a SA�'iT.tY SELVF3✓;�iSTrtIC submittal of Building Permit application. 6, - Y. Z a-4Y..u-Ykv+,'3-+4'✓,+:� .Fa-:: .S�+-i 7���;. "k{ _ j _.' 0`I�#�'�Q'r��K�-"�., il_'ik .BldgApp_2011.doc revised 06121/11 CITY OF CUPERTINO 9%-7 FEE ESTIMATOR — BUILDING DIVISION 19 ADDRESS: 10657 Parry way DATE: 0812112014 REVIEWED BY: Mendez PC FEE ID APN: BPH: I Lf08"U�Z 'VALUATION: 1$350,000 PERMIT TYPE: Building Permit' PLAN CHECK TYPE: New Construction PRIMARY SFD or Duplex USE: 2nd Unit? Yes No PENTAMATION 1R3Si=DW PERMIT TYPE: WORK re -build 2 storysfdwl to include living3 354; attached ora e 790' orch 9 9 8 SCOPE hrs $0.00 OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) [I-B,111-B,1V,V-B 4,182 C-Z$8MV 1R3PLNCK $3,610.86 1R3INSP $3,610.86 Suppl, Insp. Fee.0 Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee; $0.00 naw Construction Tax: IBCoNST.4XR Fo I 4 units $0.00 c�1ilY21771$1f'GTFIVL°' E%: 0 O Work Without Permit? O Yes (j) No $0.00 TOTALS: 4,182 $3,288.46 Select a Non -Residential Building or Structure 0 A $3,610.86 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreliminary information available and are onlv an estimate. Contact the Dent for addn 7 info. FEE ITEMS free Resolution 11-053 Elf. 7/1/13} .Neth, Plan Chock 11hw1h. 7111.11('hoc'1 Elea. Pion C"I==ick ,ileclr. Penifil 1 Li" rlu'p.,I) Pa17Y,i1 Fe"'. rlec Parmil l'eu' Orhel , Itch. fnt ,T' 011ier Plumb Irlsp,E17-- Onkel, I_-lec. Insp. 14cch. Imp. Fee: Phmlb. Lisp, Fee: Elec. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreliminary information available and are onlv an estimate. Contact the Dent for addn 7 info. FEE ITEMS free Resolution 11-053 Elf. 7/1/13} FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,288.46 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. Q OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $3,610.86 Suppl, Insp. Fee.0 Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee; $0.00 naw Construction Tax: IBCoNST.4XR Fo I 4 units $0.00 c�1ilY21771$1f'GTFIVL°' E%: 0 O Work Without Permit? O Yes (j) No $0.00 Advanced Planning I'ee; IPLLONGR $585.48 Select a Non -Residential Building or Structure 0 A 7i cne! Desc rrrneka�rzlirur Fees: Stroh Motion Fee: 1BSEISMICR $45.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $14.00 SUBTOTALS: $7,544.30 $0.001 TOTAL FEE: $7,544.30 Revised: 071012014 CITY OF CUPERTINO lal FEE ESTIMATOR — BUILDING DIVISION 9ADDRESS: 10657 Larry Way DATE: 06102/2015 REVIEWED BY: Sean --m I APN: BP#: *VALUATION: Iso "PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration 1 Repair PRIMARY SFD or Dl USE: Duplex Pluarh. Insp. Fee: PENTAMATION PERMIT TYPE: 1GENRES� WORK REVISION #1: PER SURVEY SHIFT LOCATION OF RESIDENCE ON SITE PLAN; REMOVE AND SCOPE REPLACE CONCRETE SLAB AT GARAGE. NOTE: Tlis estimate does not hrclude fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreliminary information available and are only an estinnate. Contact the Dept for addn'l info. EEE ITEMS (Fee Resolution I1-053 Ef. 711113) Hech. Plarr Check Plumb. Plant Check Elec. Plan Check Mech. Ile, wi! Fee: Phonh. Permit Fee: Elec. Permit Fee: Other kfech. Insp. Other Planmh lisp. Other Elec. Insp. kfech. Insp. Fee: Pluarh. Insp. Fee: Elec. Insp. Fee: NOTE: Tlis estimate does not hrclude fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreliminary information available and are only an estinnate. Contact the Dept for addn'l info. EEE ITEMS (Fee Resolution I1-053 Ef. 711113) EEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? ® Yes Q No $0.00 1 hours Plan Check, Hourly $113.00 ISTPLNCK Suppl. PC Fee: O Reg. ® OT0.0 hrs $0.00 PME PIan Cheek: $0.00 Permit Fee: Hourly Only? ® Yes Q No $0.00 SuppI, Insp. Fee:() Reg. Q OT O,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administralive Fee: 0 G Work Without Permit? ® Yes 0 No $0.00 Advanced Planning e: $0.00 2 hours Inspections $286.00 ISTINSP Inspection, Hourly Q O Travel Documentation Fees: Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $429.00 TOTAL FEE: $429.00 Revised: 05/07/2015 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C O P E RT I N O Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: PERMIT # OWNER'S NAME: PHONE # -- GENERAL CONTRACTOR: USTNESS LICENSE # ADDRESS D CITY/ZIPCODE: *Our munic pal code requires all businesses w4(rking in the city to have.a City of Cupertino b— usKess license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date ✓ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing' Septic Tank Sheet Metal Sheet Rock Tile Owner / Cont a or Signature Date ��i 2- c. 9 ss ; t o � s L-� I&&r Sr- /mom daw 1 I r� �� -�-v e f ! I i C e �Cc� Z� �¢,�Z y- mor co `14"a �e C� L`eet--(�OA for ht(ere , i3,en� i }ct Name: f oject Address: 1 Project Description: / CAL REEN SIGNATURE DECLARATIONS b Y nQ KASAMSE\TTY RESIDENCE 10657 LA Y WAY, CLIPERTINO PER W NEW-SKGLE FAMILY RESIDENCE 3 6 SECTION 1 - DESIGN VERIFICATION Complete all lines of Section 1 — "Design Verification" and submit the completed checklist (Columns 1 and 2) with the plans and building permit application to the Building Department. The owner and design professional responsible for compliance with CalGreen Standards have revised the plans and certify that the items checked above are hereby incorporated into the project plans and will be implemented into the project in accordance with the requirements set forth in the 2013 California Green Building Standards Code as adopted_ by the City of Cupertino. T `,: �r f Owner's Signature KISHORE KASAMSE-TTY rgn Prof soffal's Signature DY WARRA ign Proj4sional's Na (e Ylease Print) Professional responsible for CalGreen compliance Name of License Professional responsible for CalGreen compliance (Please Print) PARRABU I LDERS@AOL.COM Email Address for License Professional responsible for CalGreen compliance SECTION 2 - IMPLEMENTATION VERIFICATION Gt+ti 2P 17-01 Date IJZIlls- 11124I201 4 Date a;gl5 r .,-t Date 510.715.7691 Phone Complete, sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in cordance with this Green Building Checklist and in accordance with the requirements of the 2013 California G Building rd a as adopted by the City of Cupertino. Signature of nse Profession I responsible for (Green compliance Date Name of License Professional responsible or CalGreen compliance (Please Print) Email Address for License Professional responsible for CalGreen complia ce 6 Phone Pap -e 5 of 5 CalGreen 2014.doc revised 0l ,15114