15090081I CITY OF CUPERTINO BUILDING PERMIT I
IBUILDING ADDRESS: 19980 PEAR TREE LN I CONSTRUCT R: EDWARD I PERMIT NO: 15090081 I
OWNER'S NAME: KARTIKEYA KUMAR AND KHARE MONIKA TR
OWNER'S PHONE: 5107031275
2533 AMETHYST DR ! DATE ISSUED: 09/14/2015
SANTA CLARA, CA 95051 1 PHONE NO: (408) 985-0731
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
j� REMOVE AND REPLACE 8 FT OF CRACKED FOUNDATION STEM
License Class G4 r Lic.#[f FALL BETWEEN THE HOME/GARAGE.
Contractor C d � d 'S ay, sr/,. Date cC
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:
t. 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.
2. 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
permit is issued.
APPLICANT CERTIFICATION
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,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply with
all non -point sour lati ns per the Cupertino Municipal Code, Section 9.18.
Signature Date'2— / y — 1,5—
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
1 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)
2. 1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
t. 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.
2. 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
permit is issued.
3. 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
become subject to the Worker's Compensation provisions of the Labor Code, I
must forthwith comply with such provisions or this permit shall be deemed
revoked.
APPLICANT CERTIFICATION
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,
costs, and expenses which may accrue against said City in consequence of the
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.
Signature Date
Sq. Ft Floor Area: I Valuation: $5000
APN Number: 31631002.00 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by:Z,f/ Date:
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.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
07�r�orized agent:/ Date:
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
CUPERTINO
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(a-cuuertino.org I
❑ NEW CONSTRUCTION ❑ ADDITION . a ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT ;#
PROJECT ADDRESS /
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❑ ommR ❑. OWNER -BUILDER ❑ OWNER AGENT Ia CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑-ENGNEER ❑ DEVELOPER ❑ TENP VT
CONTRACTOR NAME - LICENSE NUMBER
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ARCMTECT/ENGINEER NAME
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BUS. LIC #
COMPANY NAME
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CITY, STATE, ZIP
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DESCRIPTION OF WORK �,
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EXISTING USE PROPOSED USE CONSTR.TYPE
4STORIES
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USE
TYPE
OCC.
SQ.FT.
VALUATION (S)
EXISTG
NEW FLOOR
DEA10
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: LJDETACH
ATTACH
# DWELLING UNITS:
IS A SECOND UNIT ❑YES
SECOND STORY ❑YES
BEING ADDED? NO
ADDITION? ❑NO
PRE -APPLICATION ❑ ITS IF YES, PROVIDE COPY OF
PLANNING APPL # ❑ NO PLAN1,7NG APPROVAL LETTER
IS THE BLDG AN ❑ YES
EICHL£R HOME? ❑ NO
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I-
TOTAL VALUATION:
x
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 have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to buildi vtruction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFORM TION REQUIRED
Q
s
g . ZAI�CHECKI�E
OUA',INGS�_'
New SFD or Multifamily d%vellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to Issuance of building
;igw
OBER THIrCOUhTER
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UII.DrAGPL`ANRE ER'" +w N'
permit for new building.
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_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
form if Hazardous Materials being
any are used as part of this project.
t �e Pi -
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_ Copy of Planning Approval Letter or Meeting with Planning prior to
-
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_ _
submittal of Building Permit application.
1JUz:
.NA1 YSEPI
BldgApp_2 011. doc revised 06121/11
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
iaADDRESS:
19980 Pear Tree Lane
DATE: 09/14/2015
REVIEWED BY: Sean
Meclr. T
APN:
l
BP#:
`VALUATION: $5,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY
USE: SFD or Duplex
PENTAMATION
PERMIT TYPE: 1GENRE
WORK
Remove and replace 8 ft of cracked foundation stem wall between the home/garage.
SCOPE
PME Plan Check:
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 preliminary information available and are only an estimate. Contact the Deptfor addn'l info.
FEE ITEMS (Fee Resolution II -033 E : 7/11131
Hech. flan Check
Plumb. Plan Checi,
Elec. Plan Check
Meclr. T
!'lamb. Permit Fee:
Elec. Permit Fees
Other 11ech. Insp
Other Plumb Insp.Lj
Other Elec. Insp.
Foundation Repair
7 tj,
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 preliminary information available and are only an estimate. Contact the Deptfor addn'l info.
FEE ITEMS (Fee Resolution II -033 E : 7/11131
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
#
$0.00
Foundation Repair
Suppl. PC Fee: (j) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee: Hourly Only? ()Yes Q No
$0.00
Suppl. Insp. Fee:Q Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
C:onstruction Tax:
A(Iminlstrative Fee:
0
Work Without Permit? ® Yes (F) No
$0.00
Advanced Planning, Fee:
$0.00
hours Inspections
$286.00 ISTINSP Inspection, Hourly
I<c ?c,c°urst,trctl,Fr�� 4
Strong Motion Fee: IBSEISMICR
$0.65
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$1.65
$286.00
TOTAL FEE:
$287.65
Revised: 07/02/2015
Edward's Construction
edwardsfoundation@comcast.net
(408)985-0731
State Contractor License #763218 Exp. 5/31/19
Cupertino Business License #64802512 10 Exp. 9/30/15
General Liability Insurance #002188-15 Exp. 3/18/16
Workers Compensation #9127547-15 Exp. 3/18/16
Foundation Footprint
One Story
Stem Wall
Area
Garage
Stem Wall Repair Detail
istine rim joist
Existing sill
8.00 in
t.\1YY M i s
0
_S�JZWVi_
518 " Hot Dippe d Galvanized MU/U&
3"x3 "x114" Hot Dimd Galvanized Washer
Existing footing
$Y
Remove & Replace a Minimum of 8" from top
with 2.800 PSI Standard Weight Concrete
#4 Rebar with Hook 0 16 " OG
Rebar & Threaded Rods Epoxy Set utilizing Simpson
S e t XP with a Minimum Embedment Depth'of 6K1 E N T
�uiLLil* l , i-)iuN - U, LATINO
APPROVED
This set of plans and specifications MUST be kept at the
job site during construction. It is unla•, ful to make any
ges or alterations on same, or to deviate
JTbe
rom, without approval from the Building Official.
tamping of this plan and specifications SHALL NOT
Id to permitor to be an approval of the violation
of an provisio s of any City Or finance or State Law.
BY f n/ Gfi
Da, g PER MT # /'S,-) 9GYi /
Scope of Work
1. Remove and replace approximately 8 linear feet of horizontally cracked foundation
stem wall beneath the home/garage wall (see stem wall replacement detail).
2. All work shall comply with the 2013 CRC and be inspected by the City of San Jose
Building Department.
Owner: Kumar Kartikeya
(510) 703-1275
kumarl9980@gmail.com