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B-2016-1495CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1495 22442 CARNOUSTIE CT CUPERTINO, CA 95014-3949 (356 03 028) BAYAREA CUSTOM BUILDERS INC SAN JOSE, CA 95129 NAME: ARUNACHALAM PRAKASH AND KANAPATHY SUGANYAA OWNER'S PHONE: 408-306-2632 LICENSED CONMCTOR'S DECLARATION License Class GENERAL BUILDING CONTRACTOR Lic, #22DO44 Contractor BAY AREA CUSTOM BUILDERS INC Date 08/31/2016 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. 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. I have and will maintain Worker's Compensation Insurance, as provided for by U 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 source regulationsa he-CupeFMG-Municipal Code, Section 9.18. Date 7/20/2016 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 stricture is not intended or offered for sale (Sec.7044, Business & Professions Code) 2. I, 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: 1. 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 f 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 7/20/2016 DATE ISSUED: 07/20/2016 PHONE NO: (408) 446-1200 BUILDING PERMIT INFO: X_ BLDG —ELECT —PLUMB MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: ADD 271 S.F. TO EXTEND (E) FAMILY ROOM. a ,s r' Sq. Ft Floor Area: 271 Valuation: $45000.00 APN Number Occupancy Type: 356 03 028 Deferred Submittal (R -3),R-3 (Custom) . PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: AbbyAyende Date: 07/20/2016 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: 7/20/2016 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. I 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 Munic1 al Code, Chapter 9.12 and the Health &Safe ection`— s 25505, 25533, and Owner or authorized agent. Z_ Date: 7/20/2016 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 Professional CUPERTINO NRW CnNCTRTTCTTrIN r, CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 buildingecupertino.org I—I mnn �j7 lT I P 1 e ilil7nwr I I n t � mr�wr. i �I ✓ PROJECT ADDRESS 2 APN # OWNERNAME 0,1aYYL- qC�� ?koto 3�;_) EMAIL r�lrr5�.cc2ahczGt�alcc`t2 STREET ADDRESS CC CITY,. STATE; ZIP FAX CONTACT NAME n �6 VS' y PHONECiZU ��j C)29 E-MAIL G% YZOIII �5�� CIWyI CGWI✓ STREET ADDRESS, - 5a W '5 Apt- t_ CITYSTATE, ZIP FAX ,_ � � o� cA- ❑ OWNER ❑. OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.. LIC # l COMPANYNAME ...E-MAIL FAX STREET ADDRESS _ CITY, STATE, ZIP _ - PHONE - ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIP_TIONOF__WORK-- l� 40W& EXISTING USE - PROPOSED USE - CONSTR TYPE # STORIES - - - - - USE TYPE OCC. SO FT. VALUATION ($) EX1ST6r NEW FLOOR DEMO TOTAL - AREA. -2,:;r,50 AREA. 7_ 1 AREA G NETAREA. BATHROOM KITCHEN .. AREA REMODELAREA OTHERREMODEL REMODEL AREA 6 PORCHAREA_ .[�DECKARFA_ ...._TOTAL-DECK/P.ORCH-AREA—�—GARAGEAREA:_— DETACN_ ffATTACH G CJ fJ # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? /0110 ADDITION? /0110 PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # O PLANNING APPROVAL LETTER. IS THE BLDG AN ❑ YES EICHLER HOME? - OTAL VALUATION: ,ONO By my signature below, I' certify to each of the following: I am the prop�wner or authorized agent to act on ro owner's behalf. I have read this application and the information I have provided is correct. I have re. file Description of Work and verify it is ate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I a rize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature ofApplicanUAgent: Date: a. SUPPLEMENTAL, I1 MATION REQUIRED rxAri C>cr e> RGI rl S1 Ip New SFD or Multifamily dwellings: Apply for demolition permit for ovErx rtl cI IJ�uT I SII)LDING rILAI� II> vrE ry existing building(s). Demolition permit is required prior to issuance of building permit or new building. p ifbig• EXPRESS: CI PLA1tiININCri'AhT1CtF"Ej°IF"CV _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure Li 'STANDAj PusrtCw ... r form if any Hazardous Materials are being used as part of this project. FIIZI?PT . Copy of Planning Approval Letter or Meeting with Planning prior to I+IAro>x .' Q' sANIxAIzs �Jt nxxi�Icx submittal of Building Permit application. ©. m]RONNIENTAL1IESliTH BldgApp_2011. doc revised 06121111 2-e:)LG - ( SC Design Group. 20370 T� wn Center Ln. Cupertir0 CA. 95014 Group. concret Project: 22442 Carnoustie Court, Cupertino CA The epoxy holdown / anchors where installed per given documentation provided by SC Design The current set anchors and holdowns are set with SET -XP at a proper depth into the <E> foundation. Please feel free to contact my Firm for any further questions regarding the project. Che SuscwChen. DATE: ti^ V .1 {VM r '�QQ