15030021CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10481 CASTINE AVE
CONTRACTOR: BROTHERS HOME
PERMIT NO: 15030021
IMPROVEMENT
OWNER'S NAME: SATYA SRINIVAS AND KATURI SASHIKALA
2510 DOUGLAS BLVD
DATE ISSUED: 03/04/2015
OWNER'S PHONE: 4084601400
ROSEVILLE, CA 95661
PHONE NO: (408)295-0680
JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL
❑ LICENSED CONTRACTOR'S DECLARATION
REMOVE AND REPLACE (10) WINDOWS AND (3) PATIO
y�
1 Li,. #"1"/Vd�1
DOORS TO MEET EGRESS IN BEDROOMS
License Class
Contractor &I l Date4/469'
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
rmance of the work for which this permit is issued.
Sq. Ft Floor Area: Valuation: $11600
ave 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: 32641034 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
the above mentioned property for inspection purposes. (We) agree to save
180 DAYS F O LAST CALLED INSPECTION.
upon
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
//11�
costs, and expenses which may accrue against said City in consequence of the
Issued by: Date:
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9 18.
RE -ROOFS:
Signature Date 3
All roofs shall be inspected prior to any roofing material being installed. If a roof is
inspection, I to remove all new materials for
installed without first obtaining an agree
inspection.
❑ER -BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
the following two reasons:
1, as owner of the property, or my employees with wages as their sole compensation,
do the work, and the structure is not intended or offered for sale (Sec.7044,
will
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. 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
Code, Section 25532(a) should I store or handle hazardous
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
Health & Safety
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
compliance with the Cupertino Municipal Code, Chapter 9.12 and
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
will maintain
25505�
ecs , 3, an
the Health & Safety Code, St* d 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agen 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
CONSTRUCTION LENDING AGENCY
Compensation laws of California. If, after making this certificate of exemption, I
I
I hereby affirm that there is a construction lending agency for the performance of
become subject to the Worker's Compensation provisions of the Labor Code, must
work's for which this permit is issued (Sec. 3097, Civ C.)
forthwith comply with such provisions or this permit shall be deemed revoked.
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,
which may accrue against said City in consequence of the
I understand my plans shall be used as public records.
costs, and expenses
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
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTtNO 1
(408) 777-.3228 • FAX (408) 777-3333 • building a(kupertino.org 1
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS�'
DqA1 Alk-.#
APN
OWNER NAME 4,,5APHONE
E-MAIL
N `t 0 It4w
STREET ADDRESS I
AALCONTACT
CITY, STATE, ZIP n �6I,1I FAX
J,ntZ
NAME
PHONE E-MAIL
'`ate
Y
yob' 2 6 6S
STREET ADDRESS �I /
CITY, STATE, ZIP C / FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT E) CONTRACTOR &CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
,�r_`/'L / �, •,� LICENSE NUMBER I.✓1Q� / LICENSE TYPE C1
CONTRACTOR NAME 4L! ( "i l'
BUS. LIC #
FAX
COMPANY NAME E-MAIL
STREET ADDRESS A -1O Aw" �S
Y` 'T
CITY, STATE, ZIP �f
((�
PHONE I 7 777
G
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
w/l't,
EXISTING USE
PROPOSED USE CONSTR
TYPE
# STORIES
I
USE
TYPE
OCC.
SQ.FT,
VALUATION (S)
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: DETACH
[]ATTACH
# DWELLING UNITS:
IS A SECOND UNIT []YES
SECOND STORY []YES
BEINGADDED? []NO
. ADDITION? ❑NO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
PLANNING APPL # E]NO PLANNING APPROVAL LETTER
IS THE BLDG AN ❑ YES
EICHLER HOME? ❑ NO
a RECEIVED Ys�
' '--�
':•
TOTAL VALUATION:
IVw:
&
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I hav�)S ave read the Description ofWork and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws re ' authorize representatives of Cupertino to enter the above-'denti ted property for inspection purposes.
S ignature of Appl icant/Agent: Date:
SUPPLER NTA ORMAT . REQUIRED
— M" a` �_
2
�P
Roiriu.c s iP
New SFD or Multifamily dwellings: Apply for demolition permit forA
�
�-W
s1�1:BUILD 'd'
existing building(s). Demolition permit is required prior to issuance of building'
�a
G.Pi REv1EI'i� s, n
permit for new building.'-xP
a
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
form if any Hazardous Materials are being used as part of this project.
_ Copy of Planning Approval Letter or Meeting with Planning prior to
submittal of Building Permit application.-
0 -.
SAINT SE VER:DISTRICT
��; ENVIRO7�'1�'IE T AZTH�'
BldgApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
91 ADDRESS: 10481 castine ave DATE: 03/02/2015 REVIEWED BY: Mendez
APN: BP#: *VALUATION: $11,600
FPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY PETIT 1GENRES
USE: SFD or Duplex PERMIT TYPE:
WORK remove and replace 10 windows and 3patio doors to meet egress in bedrooms
SCOPE
L9ech. Plan Check
Alech. Permit Fee:
Offer ;i levh. Insp.
P&unh. Plan Check
Plumb. Permit
Other Plumb Insp.
l:iec. Plan Check
laze. Y<<ritait l-ee'
Ofl..er I,Jcc. Insp.
I'lzamb hiss Fee. 1 Ilec. Insp. Fee: (ttsh C�� l�
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fare, Sanitary Sewer District, School
District, etc). These fees are based on the prelimina information available and are only an estimate. Contact the Dept for addn'l into,
FEE ITEMS (Fee Resolution 11-053 E . 7ff 11113) FEE QTY/FEE L MISC ITEMS
Plan Check Fee: $0.00 13 # Window / Sliding Glass Door
Suppl. PC Fee: Reg. ®OT 0.0 hrs $0.00 $574.00 IWINREP Replacement
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Fee O Reg. ® OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
E'osastruetion Tax:
a Non -Residential
lcirninlstrative Fee:
Building or Structure 0
Building
Work Without Permit? ® Yes (j) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential 0
Building or Structure
7=— 0
7iavel Documeniaflon Fees:
Strong Motion Fee: IBSEISMICR
$1.51
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
rt
$2.51 $ 574.00 T AL F)EE• ^ $576.51
,.
Revised: 02/14/2015
33X� PM1 b*qI
P !co
Mf
ONi.Lw-;dno
ld3a E)NINNV
m
U
Q
.c_
o
L1j C'
IL
O v
U
uJ
—�
m
5riody"MQIF
� CZ'
cn a
1':#
OCL
W
X
M
4
I '
M
v [:t C3
a0
U
=
ONi.Lw-;dno
ld3a E)NINNV
m
U
Q
o
L1j C'
IL
O v
U
uJ
m
5riody"MQIF
MIN
cn a
1':#
W
3
4
¢
�
co •N � p
v [:t C3
jai
U
=
Qy CO
C'S
C U O�
k
••
OL
t�
v
Q ami
Z �
U
Q
cryC•
~
o
L1j C'
IL
O v
U
uJ
m
5riody"MQIF
MIN
ei 1
W
Q ami
Z �
U
Q
cryC•
~
L1j C'
IL
O v
U
uJ
m
70
ei 1
W
a
T-
X