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15030050 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10203 S PORTAL AVE CONTRACTOR:BAY AREA CUSTOM PERMIT NO: 15030050 BUILDERS INC OWNER'S NAME: KAUSHIK SANDEEP AND SHARMA DEEKSHA 1002 S DE ANZA BLVD STE AI DATE ISSUED:04/17/2015 OWNER'S PHONE: 4083387938 SAN JOSE,CA 95129 PHONE NO:(408)446-1200 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL E] ADD 492 S.F.TO SIDE&REAR TO CREATE(N)BEDROOM License Class_ Lic.# q 2 D 6 4f Li &(N)BATH,REMODEL(E)981 S.F.,REMODEL 100 S.F. 1S &REMODEL 120 S.F. KITCHEN Contractor�4`a 14✓e4 C -,N O, Date Wee" 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 erformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$140000 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:36909001.00 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 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 =A� 41 7-1 5 granting of this permit. Additionally,the applicant understands and will comply Issued by: �' G Date: / / with all non-point source regulations per the Cupertino Municipal Code,Section 9 18. ROOFS: Date�✓ � All roofs shall be inspected prior to any roofing material being installed.If a roof is Signature installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that 1 am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 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 1 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,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must 1 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 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 918. Signature Date ELM CONSTRUCTION PERMIT APPLICATION �p COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISIO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333•building(cDcupertiho.org CUPERTINO ❑NEW CONSTRUCTION ® ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS10203 S. PORTAL AVENUE AP"# 369-09-001 SANDEEP KAUSHIK&DEEKSHA SHARMA PHONE E-MAIL KAUSH KK_SANDEEP@HOTMAIL.CO OWNER NAME CITY STATE,:�8-338-7938 FAx STREET ADDRESS C'16ERTINO, CA 95014 CONTACT NAME PHONE E-MAIL SHARVILA@GMAIL.COM SHARVILA PATADIA 408-410-5946 STREET ADDRESS 18801 WOOD DELL COURT CITY,STATE. ZIP SARATOGA, CA 95070 FAx ❑OWNER ❑ OWNER-BUILDER /�❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT IR ARCHITECT ❑ENGINEER ❑ DEVELOPER 11 TENANT CONTRACTOR NAME ,Qa L�JYCLI t.W�fi4(� LICENSE NUMBER q p,0 614'q LICENSE TYPE BUS.LIC# Pvvi COMPANY NAME7 (, f E-MAIL FAX Z10,f G-� 2 y 1 STREET ADDRESS (�0 S, p e �}n 2 Q f 3 1�/�fj CITY,STATE,ZJP Co e q L f PHONE L�� ��LI Ll 6_f20 O `J 1 J l ARCHITECT/ENGINEERNAME SHARVILA PATADIA LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX f STREET ADDRESS l�-('v CITY,STATE,ZIP PHONE i{'69 DESCRIPTION OF WORK THIS PROJECT WILL EXPAND THIS 3 BED, 2 BATH HOUSE TO MAKE IT A 4 BED, 3 BATH HOUSE. THE ADDITION IS MAINLY PROPOSED ON THE RIGHT SIDE OF THE HOUSE WITH SOME ADDITION IN THE KITCHEN AREA.THERE IS SOME INTERIORREMODELING PL NNE EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG "" NEW FLOG /� DEMO TOTAL AREA AREAO/ AREA NET AREA r,h• . BATHROOM '\ KITCHEN OTHER OTHER /-!F(5/ —G 1 REMODEL ARE 6 0 REMODEL ARf9 (� REMODEL/-! PORCH AREA V DECK AREA TOTAL DECK/PORCH AREA GARAG/E!llrrrAREA: DETACH ^ ❑ATTACH 2_ __#_DWELLING UNITS: IS A SECOND UNIT 0 YES SECOND STORY ❑YES ( j. BEING ADDED? LP10 ADDITION? _9NO V PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES IS�'REC y _ �' f 1�q °h u�r` ' • ��p� �1 TOTAL VALUATION: PLANNING APPL# ONO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO t { � I°t NEI By my signature below,I certify to each of the following• I am the property owner or authorized agent to aLL4h th a wner's behalf I have read this application and the information I have p vided is corre I have read the Description of Work and verify it is accurate. agree to comply with all applicable local ordinances and state laws relating to bui 'ng constructi . I authorize representatives of Cupertino to enter the above-identified proop7errty for inspection purposes. Date Signature of Applicant/Agerit: /Iii Yui i1'' RY�i. de�'}bR�W1 ft SUPPLE?aENTknNF6JPffXTION REQUIRED 'pGiYs. PANCHECICII� E{LSgt`41S1P irK iu�f�SR_O,UTING{SLIPIx;f A 1 for demolition permit Rviii%3���91�i`5)' Ir'i, ,`'iyiu'yt Id�kH's;iitr,r`k °r'+ New SFD or Multifamily dwellings: Apply P it01.OVER o1JN'E ) R.,.BI}1Lb1I�G,rLAN4REu1Ftw 3 existingbuilding(s). Demolition permit is required prior to issuance of buildings,f?f f Vedt�S,� 7%M?'ty �ti"A 1'wg F If I �st1 `��q r iISiSY{ vu1�tJ�{s�j . permit for new building. G�t EXPRE53 i }1 U, ��}iYLAPiNIiSG PLAN REYJEW"(ilk ���j 'st lEfi} S) _ usePart project. Bldgs: Provide a completed Hazardous Materials Disclosure ;I❑us��n�Nn'lnRn��`=%�'�" ;{PLIC�aFfi h, � ��p �l�F t,7 . To—nn if any Hazardous Materials are beingd as of this ro ect. t r,Fr„f� lei tr�`<1�llr�ti R`i�I, r���,r t' p t ( 1 L7 'tREDErr�,+}� 0pi _Copy of Planning Approval Letter or Meetingwith Planning prior toUsk g Pu x �ti ISANhT,ARY SEWER DISTR[CI- submittal of Building Permit application. MAJOR ✓T1 { z}xsS`7SF�,S4{f23s�z t,' tt aY J' F yy ' ?, <}�r,,".''.� �t>>l,,i"i fir,,,,��,'_y� ESCJf;�}ENYiRONMENTr?L••;HEAL'TH.. . B1dgApp 2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10203 s portal ave DATE: 03/06/2016 REVIEWED BY: Mendez APN: BP#: J 0 -0 *VALUATION: 1$140,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Repair PRIMARY 2nd Unit? Yes No PENTAMATION 1 R3SFDREM USE: SFD or Duplex OTC? 0 Yes (E)No PERMIT TYPE: i WORK addition 492 sq ft to to side& rear of sfdwl to include 1 bedroom and bath); remodel kitchen (120); bath SCOPE 1(100 sqft); and through out(981 sq ft) OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-l3,111-B,IV,V-B 492 $1,626.00 IADDPLCK $1,323.00 IADDINSP �� � sad TOTALS: 492 $1,626.00 ksM $1,323.00 ,, , ,.,,•.v ores r,x:" ,,a.. m ry a ;,,.,: sr`..;,„,a ,� `xrsr`.:' -�$:,: 3r;R+ ,sl 7't�deis�c�:.v:..ar�+a*n u a'•+.a;..� s. ,� NM rr.:: `,.q �a�aa,UaN.,.;,dGats'y ,. ,.. 4 ,�, ,r h '�'cn_ .y�, ar4,, s !7E.,a.r r ruY 4 - - n, �;. • der ” Wwe�?.y • Q „t dy t , © YC9 y r +� ; �.�Xa �vt.,c ,r �.oaf.�AYt4��s�..l.�,a��4�.vk..t�i .1fech. Plum("heck P/1111:).Plant('lnxl Elec. P/an Check .11ech. Perini!Fee Phonb, Pe'rirul Feet: !slat, Permit Fee: (7thcr :sp. cch. /risk. EF1__1 Other'Phanb lsn. otl;er Islet.Imp. l•'cc 1,17allb. htsp. Fec: Llec,Irish.Fee: NOTE.This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,eta). These ftes are based on the prelimina information available and are only an estimate. Contact the De t or addn 7 info, FEE ITEMS (Fee Resolution 11-053 E f 711113) FEE QTY/FEE I MISC ITEMS Plan Check Fee: $1,626.00 120 s.f. Remodel,Kitchen(<=300 sf) Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $645.00 IREMRESKIT PME Plan Check: $0.00 981 I s.f. Remodel, Other Permit Fee: $1,323.00 $647.00 IREMRESOTH Suppl. Insp.Fee G Reg. Q OT 0,0 his $0.00 100 s.f. Remodel,Bath(<=300 sf) PME Unit Fee: $0.00 $645.00 1REMRESBAT PME Permit Fee: $0.00 ConsirUCtion 7'ar: Adnzinistreltir"t Fee: 0 Work Without Permit? Yes (F) No $0.00 G Advanced Planning Fee: IPLLONGR $68.88 Select a Non-Residential E) Building or Structure 0 7`ruvel Ur�cr.�.rrcc tzlalirn� Fees: i Strong Motion Fee: IBSEISMICR $18.20 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $6.00 s&�.�: v 1��...xa rA s._w•4'3'..�ir��L to �,'7s Lr-,i uNr ft a�^Nka?t 2k 4 �-+r,+�'t�'t1 y lY Y'r� N�f{,� $3,042.08 $1,937.00r �'tOAL FSE $4,979.08 :3`^s.,t?. ';r.:.:r.,.�At.�i%Y<T•-.c:ox..�r...,_,,.�'" .,t€...'�.rstm�'s*+:ca*t,..�,�.,....�K Revised: 02/14/2015