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13040107 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10245 LEBANON DR CONTRACTOR:SIERRA STRUCTURE INC PERMIT NO: 13040107 OWNER'S NAME: MR&MRS NATH 2435 SHERWOOD WAY DATE ISSUED:08/02/2013 OWNER'S PHONE: 4082309718 MEADOW VISTA,CA 95722 PHONE NO:(916)275-1971 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIALE] License Class Ligr#"" —2 b CONSTRUCT A 39 SQ FT FIRST STORY ADDITION; 99 SQ FT FRONT COVERED PORCH;216 SQ FT REAR COVERED Contractor .��/(� Date tJ — -2 — �� PATIO; 1440 SQ FT SECOND STORY ADDITION;70 SQ FT I hereby a m that I am licensed under the provisions of Chapter 9 (commen g 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. Sq.Ft Floor Area: Valuation:$180000 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:34214036.00 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.I 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 DAY FR �ALLED 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 2 granting of this permit. Addition a applicant understands and will comply Is Date: with all non-point source r ions per the Cupertino Municipal Code,Section 9.18. 19 -2—/3 _2_/ RE-ROOFS: Signature Date 'J 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 I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: 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) 1,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. 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 Code,Section 25532(x)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 Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 255 ,' ,and 534. Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Owner or authorized agent: 20 Date: g I certify that in the performance of the work for which this permit is issued,l shall 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 CO STRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction Iending 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 1** CONSTRUCTION PERMIT APPLICATION ,0 12 COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•building(cDcupertino.org CUPERTINO ❑NEW CONSTRUCTION ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS APN# Z 3�f 2 - 03 OWNERNAME tZVA—th PHONE ` Z_30 -9?1E-MAIL STREET ADDRESS f i CITY,STATE,ZIP 1 FAX lit -1J'!1 NU CONTACT NAME PHONE E-MAIL STREETADDRESS CITY,STAT ZIP F F wA vYta ls-1A ,¢ �'i�5?2 .3o9-7k—v31 5 ❑ OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT 41 CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME�t7 G � — LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANYNAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP r / PHONE 2t/35 Sh wzmp L/ c v✓ VIS Al C 7 S -2 Z 2 1 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAMEE-MAI FAX LJ 14 el STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK / ✓10 ,Cbr too rc L( T EXISTIIJC,.4SE PROPOSED USE CONSTR E #STORIES 1/,•-1> I V USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO I, TOTAL AREA ,9�/`� ARFA /` AREA NET AREA r J�� y� �j BATHROOM (' KITCHENOTHER ` // REA40DELAREA REMODEL AREA REMODEL AREA _;16q .G VO - PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH V,/ ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY YES BEINGADDED? `ISei'NO ADDITION? r[]NO PRE-APPLICATION YES IF YES,PROVIDE COPY OF 15 THE BLDG AN ❑YES RECEIVED Y: TOTAL VALUATION: PLANNING ADPL# N0�`P�ING APPROVAL LETTER EICHLER HOME'. NO � _ / / © D 00- 00 By my signature below,I certify to each of the folio : la /� th, rty owner or authorized agent to act on the property owner's behalf. I have r ad this application and the information I have provided ct. ave Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildin ct . I autpresentatives of Cupertino to enter the above property for inspection purposes. Signature of Applicant/Agent: Date: `7 - C.2 I3 SUPPLEMENT IN ORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP _New SFD or Multifamil dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER BUILDING PLAN REVIEW existing building(s). Dem ition permit is required prior to issuance of building permit for new building. 11 EXPRESS EXPRESS / PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure yQ STANDARD PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. / ❑ LARGE FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. 11 MAJOR SANITARY SERER DISTRICT ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR— BUILDING DIVISION ADDRESS: 10245 LEBANON DR DATE: 04/12/2013 REVIEWED BY: MELISSA APN: 342 14 036 BP#: *VALUATION: 1$180,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex 2nd Unit? Yes . No PENTAMATION 1 R3SFDADD USE: OTC. 0 Yes 0 N PERMIT TYPE: F ORK 2ND STORY ADDITION OF 1179 SQ FT ADD PORCH 291 SQ FT AND REMODEL 269 SQ FT E COPE IN OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,III-B,IV,V-B 1,470 $2,563.90 IR3PLNCK $1,892.65 1R3INSP TOTALS: 1,470 $2,563.90 $1,892.65 MECTfi HOURLY'` Yes No PLUMB,HOURLY ® Yes ONo ELEC,:HOURLY' 0 Yes No Li Li Li NOTE. This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addh 7 info. FEE ITEMS(Fee Resolution 11-053 Eff 7111/122 FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,563.90 EELs.f. Remodel,Other Suppl. PC Fee: Reg. I OT0,0 hrs $0.00 $400.00 1REMRESOTH PME Plan Check: $0.00 Permit Fee: $1,892.65 Suppl. Insp. Fee:Q Reg. OT F0,01 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 F71 0 Work Without Permit? Yes 0 No $0.00 Advanced Planning Fee: 1PLLONGR $191.10 Select a Non-Residential 7'va-C l F(A'S_ 1 7 Building or Structure 0 Strong Motion Fee: 1BSEISMICR $18.00 Select an Administrative Item Bldg_Stds Commission Fee: 1BCBSC $8.00 SUBTOTALS: $4,673.65 $400.00TOTAL FEE. $5,073.65 Revised: 04/01/2013 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CU PERTI NO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: Q2 45' 1- bf},nv,., PERMIT# d 0 /O� OWNER'S NAME: }der,.,q PHONE# GENERAL CONTRACTOR: ,,f a e"'f w C BUSINESS LICENSE# 3 Z y ADDRESS: -2 ,o ( A CITY/ZIPCODE: ZG�. ViiT,5--7,7z- *Our municipal code requires all businesses working Kn the city to have a City of Cupertino business 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 Date Please check applicable subcontractors and complete the following information: 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 caner/Contractor Signature Date Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: 102 qS on /l _ PERMIT# /30 '-P/ 0-7 OWNER'S NAME: 4-01 PHONE# GENERAL CONTRACTOR: Sicr-,r,¢ BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OX!7 WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALLOBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: 7 j Date Please check applicable subcontrZtorsand complete the following information: 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/Contractor Signature Date San Jose Water San Jose Water Company Company Water Services Administration 1265 S.Bascom Ave.,San Jose,CA 95128 110 W.Taylor Street Facsimile: 1 408 279-7889 San Jose,CA 95110-2131 Writer's Direct Dial: 1 408 279-7879 June 6, 2014 Moushumi Goswami 10245 Lebanon Drive Cupertino, CA 95014 ? J •1 Reference: 10245 Lebanon Drive, Cupertino Dear Ms. Goswami: The purpose of this letter is to inform you of the procedures you need to follow to finalize the installation of a new water service for this project, and to retire and abandon the existing service at this site. Basically, you will need to hire a contractor to perform the work to our standards and under our inspection. It is suggested, but not required, that you contact one of our general contractors to have the work performed. They are West Valley Construction at 408-371- 5510, and Lewis & Tibbitts at 408-925-0220. In any case, your contractor must possess a valid license for this type of work, and must obtain a permit from the City of Cuperti o-ta.-,do the job. Based on the data you supplied on our water service questions 're, o r figineering Department has determined that a 2" copper service with a check valve needs to by stalled for this residence. The piping from the check valve/meter to the house should be, in size. By copy of this letter, we are informing the City of Cupertino of our determination, and I have enclosed our standard service drawing that details an approved installation. You also need to retire and abandon the existing service by disconnecting it at the water main in the street. The meter/check valve (service connection) defines the point at which you receive service, and the point where the owner's piping begins. The owner of the property is responsible for all piping and equipment past the check valve. Please note that in addition to the check valve in the meter box, you must also install a rubber seated single check valve (property of the owner) on the internal plumbing of the house. The location of the check valve must be where the fire sprinkler piping tees off from the domestic piping. Also, the water pressure in this area is over 80 PSI (approximate range at the meter will be 88 - 93 PSI). San Jose Water Company recommends that a pressure regulator be installed on private service lines that will prevent pressure in excess of 80 PSI from entering the structure. Please contact your plumber regarding this matter. Moushumi Goswami June 6, 2014 Page Two If you would like to proceed with the work, please sign, date, and return this letter with a construction deposit as discussed below. Also include the address where the monthly billings should be sent. Monthly billings start when the meter is installed, and a copy of our rate schedule is enclosed for your information. You must also submit a deposit in the amount of $1,871 to cover the cost of our reviews, inspection, and the purchase and installation of the new meter and check valve. Please make your check payable to San Jose Water Company. At the appropriate time, you will need to provide our Construction Department at least one week notice for inspection services. Your contact is Daryl Lambert, who can be reached at 1- 408-279-7830. A San Jose Water Company inspector must witness the actual tap of the water main. Once the service lateral and meter box have been installed and approved, we can install the meter and check valve at your request. If you have any questions or require further information, please contact me at 1-408-279- 7879. Sincerely, Wanda E. Folk Water Services Representative WEF:bt Enclosures lebanon.doc cc: Building Department,City of Cupertino ACKNOWLEDGED AND AGREED MONTHLY BILLINGS TO: Responsible Party Name Signa ure Address Print Name City Date Phone Number