13120105CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10425 JOHNSON AVE
CONTRACTOR: DWK CONSTRUCTION
PERMIT NO: 13120105
OWNER'S NAME: SHIMKHADA RUPESH AND THAPA BABI
18665 LOKEE AVE
DATE ISSUED: 03/10/2014
OWNER'S PHONE: 4082426600
CUPERTINO, CA 95014
PHONE NO: (408) 996 -1186
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL
CONSTRUCT 2 STORY SFDWL 2,812 SQ FT TO INCLUDE
License Class_ Lic. tI 92r-,,02-
IST
Contractor D �};' [_"tor / rte.' — %c% - �/¢
FLOOR 945, 2ND FLOOR 879 ATTACHED GARAGE 446 AND
,t sn.r _pate
DECK AND PORCH AREA 542 SQ FT- SUNNYVALE
1 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 tinder 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: $300000
performance of the work for which this permit is issued.
have and will maintain Worker's Compensation Insurance, as provided for by
ection 3700 of the Labor Code, for the performance of the work for which this
APN Number: 37518046.00
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 L " 5TLED INSPECTION.
indemnify P Y P o judgments,
consequence
and expenses which may accrue h q of
a
Issue �I
"Date:
will o
granting ofp t Additionally, t cat understands mply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
c
RE- ROOFS:
Signature—- Date _! Q — 2--
11 roofs shall be inspected prior to any roofing material being installed. If a roof is
Iq
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 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 (See.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 Municipal Code, Chapter 9.12 and
1 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:
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
2�1%
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, l
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
FM--7 CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
w
ADDRESS: 10425 johnson ave
DATE: 12/13/2013
REVIEWED BY: Mendez
APN:
BP #: 131d_0 1b6_
*VALUATION: 1$300,000
PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY SFD or Duplex
USE:
2nd Unit? 0 Yes •% No
PENTAMATION 1 R3SFDW
I PERMIT TYPE:
WORK
construct 2 story sfdwl 2,812 sq ft to include 1 st floor 945 2nd floor 879 attached garage 446 and deck
SCOPE
and porch area 542 sq ft- sunnyvale jurisdiction
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.f.
R -3 (Custom) II- B,111- B,IV,V -B 2,812 $2,957.04 IR3PLNCK $2,877.96 IRNNSP
TOTALS: 2,812 $2,957.04 ;'; � � $2,877.96
Plan Owrk
F, h. P "i/W1 FCC.
i?alrcr 'ulr� 6a. Irrsi`.
c, la. ln'p. i`�
/'Irorrre'>. "'lra i C he ( A
C) dtrzr i °'1 +arl� Prise
F /(v. Non U hv'(V�
O�h"'r° Ocr Ins"
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District etc )_ These fees are hosed an the nreliminary information availahle and are only an estimate. Contact the Dent for addn7 info.
FEE ITEMS (Fee Resolution 11 -053 E-f 711113)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,957.04
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: Q Reg. OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$2,877.96
Suppl. Insp. Fee:Q Reg. Q OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: IBCONSTAXR
1
s new
units
$650.84
Fee:
0
O
Work Without Permit? 0 Yes No
$0.00
Advanced Planning Fee: IPLLONGR
$393.68
Select a Non - Residential
Building or Structure
Q
0
i
Ti-R vex 0oc:ziInc ateVioll Fccs:
Strong Motion Fee: IBSEISMICR
$30.00
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$12.00
;
SUBT('>�ALx;
$6,921.52
$0.00
7 -"F-
,921.52
Revised: 10/01/2013