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B-2016-2149CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2149 10481 OAKVILLE AVE CUPERTINO, CA 95014-4521 (369 12 001) PERFECT HOMES CONSTRUCTION SAN JOSE, CA 95136 OWNER'S NAME: SHANMUGASUNDARAM VENKATACHALAM AND DATE ISSUED: 09/21/2016 DANDAPAN OWNER'S PHONE: 408-725-8650 PHONE NO: (408) 836-8457 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic. #556533 Contractor PERFECT HOMES CONSTRUCTION Date 02/28/2019 X BLDG X ELECT —PLUMB MECH X RESIDENTIAL COMMERCIAL 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. JOB DESCRIPTION: CONSTRUCT 2 NEW BEDROOMS (345 SQ FT); 2 (N) BATHROOMS I hereby affirm under penalty of perjury one of the following two declarations: (345 SQ FT); REMODEL KITCHEN (36 SQ FT), MASTER BEDROOM 1. I have and will maintain a certificate of consent to self-insure for Worker's AND BATHROOM (50 SQ FT); UPGRADE ELECTRICAL PANEL (200 Compensation, as provided for by Section 3700 of the Labor Code, for the AMPS) performance of the work for which this permit is issued. 01/09/2017 REV #1 - REMOVAL OF NON LOAD BEARING WALL - I have and will maintain Worker's Compensation Insurance, as provided for by KITCHEN - ISSUED 5-24-2017 Section 3700 of the Labor Code, for the performance of the work for which this Sq. Ft Floor Area: Valuation: $165110.00 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 APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 369 12 001 R-3 (Custom) 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 05-24-2017 Issued by: MELISSA NAMES OWNEWBUILDER DECLARATION Date: 09/21/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is 1. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec. 7044, Business & Professions Code). Date: 05-24-2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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. HAZARDOUS MATERIALS DISCLOSURE z. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, SectionR5505,21 33, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: �--+ APPLICANT CERTIFICATION Date: 05-24-2017 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 I hereby affirm that there is a construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITFCT'S DECLARATION 1 understand my plans shall be used as public records. Code, Section 9.18. Licensed Signature Date 95-24-2017 Professional CUPERTINO CONSTRUCTION PERMIT AF'LICAT COMMUNITY DEVELOPMENT DEPARTMENT • BUILDINMOON 'IT 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingftcupertino.org b�__Z 0/ 61'0 — ?I— c 9 q 9 [_1NEW CONSTRUCTION [:1ADDITION [:1ALTERATION/T1 REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS Q L/ F / e _7��',,,///-/ APN OWNERNAME V f rV Y %` PHI ©w r E-MAIL STREET ADDRESS ' 1 It CI qSATE, / CONTACT NAME �Q PH NE E -MAI c SIRE T SS CIT STATE ZIP ARARCHITECT FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR 11 CONTRACTOR CONTRACTOR AGENT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NA LICENSE NUMBER LICENSE TYP� BUS. LIC # COMP NA E �- E-MAIL ) � Ft2STREE FAX MS T2_ CITY, ST E, IP PHO _ ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES I USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKTORCH AREA GARAGE AREA: DDETACH I ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? ❑ NO ADDITION? ❑NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED BY: TOTAL VALUATION: PLANNING APPL # NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO 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 buildin nstruction. utIt ize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature ofApplicant/A n e: — SUPPLE ENT L NFORMA N REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21111 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2149 10481 OAKVILLE AVE CUPERTINO, CA 95014-4521(36912 001) PERFECT HOMES CONSTRUCTION SAN JOSE, CA 95136 OWNER'S NAME: SHANMUGASUNDARAM VENKATACHALAMAND ( DATE ISSUED: 09/21/2016 DANDAPAN OWNER'S PHONE: 408-725-8650 PHONE NO: (408) 910-0779 License Class B Lic. #556533 Contractor PERFECT HOMES CONSTRUCTION Date 92/28/2017 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: 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. 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 source regulations per the Syupertino Municipal Code, Section 9.18. Signature% to 09/21/2016 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 structure 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. 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 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. 1 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 BUILDING PERMIT INFO: BLDG X ELECT _ PLUMB MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: CONSTRUCT 2 NEW BEDROOMS (345 SQ FT); 2 (I) BATHROOMS (345 SQ FT); REMODEL KITCHEN (36 SQ FT), MASTER BEDROOM AND BATHROOM (50 SQ FT); UPGRADE ELECTRICAL PANEL (200 Sq. Ft Floor Area: l Valuation: $165110.00 APN Number: Occupancy Type: 369 12 001 1 R-3 (Custom) PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. 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: 09/21/2016 TO BE CLASS "A" 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 Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505,25533. and 25534. Owner or authorized agent: Date: 09121/2016 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 ARCHITECTS DF.CLA_R ATION I understand my plans shall be used as public records. Licensed Date 09/21/2016 93-f ..i, CONSTRUCTION PERMIT APPLIT, ION COMMUNITY DEVELOPMENT DEPARTMENT • BU. )IV{SION 10300-'TORRE AVENUE • CUPERTINO, CA 95014-"c-255 ' CUPERTINO (408) 777-3228 •FAX (408) 777-3333 • bulldlnafc�cuperlino.ora PROJECT ADDRESS ' ji 1�1 aecViatvavlUErbltKtu URLUINA.LPERMIT #i APN # �7 ► iA t 11�/✓t" "'��l�fff� OWNGR]VAME t ff• %� ley- '�G7 I �IW � I 1� � 1+� • �� �� �. 1^ f+T s STREET ADDRESS 6 bj .0CITY' M P FAX CONT _ 4#S3Z• 17 �_ E'r�1G•. LY�p W"_,W CITYP 4$6,0 FA*S ...p ❑ OWNER ❑ OWNLR-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR d CONTRACTORAGENT A ARCHITECT 0 ENGINEER ❑ DEVELOPER I] TENANT CONTRACTOR NAME LSCENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME R -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ttt j qpm AR ]Ip�'�NGINEEI4��I row 11{{�•�� {{,�� h/��t lfi EUS; LIC# TP-M7AIL FAX STREET ADDRESS E, ZIP PHONE. DESCRIP 10M0.1016 I��� P`ir/ 101lIsGf 64*) 4 lk,*. A6rFel -;,,P 4YV,04 W�� V"(PN.� creat . P EXIST S�$ PROP D U CQN�TYPE �T N $ STQ S TYPE - OCC, SQ.177; - - VALUATION($) TOTAL A1thALO l AREA NEETARF&II �DWO BATHROOM KITCI•lEN ' OTHER REMODEL AREA 61D REM6PEL AREA - REMODEL Ala ++++DDECKAREA PORCHAREA TOTALDECKIPORCHAR&A GARAGEAREA; ❑,_,_�DErT�ACH _ - - - -- LlI"A7"r'ACH #DWELLING UNITS: ISASECOKDUNIT DYES BEING ADDED. NO SECOND STORY []YES ADDITION. NO --- PRE -APPLICATION UVES IF YES, PROVIDE COPY OF I'LANNINGAPPLff []NO PLANNING APPROVAL LETTER 1S'f111;BLDGAN- ES EICELERnO.mE7les. RECEIVEDBY;= TOTALVALUATION: x1c) By my signature below, I Certify to each of the following: I am the property owner or authorized agent to act on the pi operiy owners 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. aeCUrate. I agree to comply with all applicable local ordinances and state laws relatin o Iti] trig conch do . authorize .. resentatives of Cupertino to enterthe above -identified property for inspection purposes. Signature of ApplicantlAgent: Date: f SUPPLEMENTAL INFORMATION QUTRED -" ... p- PLANCHECI{TI'P..E _ '.-•_...'� . ROUi'IivG SLIP;. New SFD or Multifatnily-dwellings: Apply for demolition pennit for- existing building(s). Demolition ❑ QVFR THE COUNTER +{ E3D1i:DI1\6 PLAN REl'IE�} - permit is required prior to issuance of building permit for new building, Tt..❑-•gXPRESS,. AiVN1IV.GPLANREVIE7 Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STAADARD ver rUBLICSIORKS Form if any Hazardous Materials are being used as Bart ofthis project' ] LARGE Li�rn _ Copy of Planning Approval Letter or Meeting with Planning prior to suUmittal of Building Pcnnif application. ©1,A vox �snilfTARY sE�� ER DIST�ucT .- 2 3-T6. C ,81dgr4yp 2011:(7ocreWsed06121111 M40 Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone 408-777-3228 ICUPERTINO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS /0 Ac_ PERMIT# e.„90/(,-, OWNER'S NAME stAtsvjgc3611- nric A.N14 C 'P4SA I PHONE# efi-OR — 7 o n4-79/ GENERAL CONTRACTOR. tE--e* BUSINESS LICENSE# 3 401 1°1'1)6 ADDRESS r hoc)0-7-7- Liv CITY/ZIPCODE qs-7 *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBC, NTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. C?//c/1 I am not using any subcontractors. X./ Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE# Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date L . REQUEST FOR PERMIT EXTENSION sit9442, Please e-mail the completed form to building@cupertino.org CUP RTIN 9/11 /20/ 0 Under Plan Review Process issued Permit i"2W Building Address: (C, (M.C)t�K UtL . �11 Permit Number: e) 20/& "�f cz_. Owner Name: &L*Ai�lt4 OCTA-- r /1 C7' 1�T/ iNh/ Owner Address: !0t O7 /G)I -Atem Phone: Contact Name: )-E- it E-mail Address: 1/4 i:(S C. E C1/ Phone: el-0 3 s,c 9 Reason(s) (please be specific): 00LigLi-91l 77?.Q /4 ...( R ]"7')'1cC6 uC�©gidEL Of— C r Signature: Date: I/// (CITY OF CUPERTINO USE ONLY) Yes No ``ii,, Approval: _' 0 Expired Date: Fee:$ �`I' Revised 7/25/2017