12070160 CI_TY OF'CLTPERTINO.BUILDING PERMIT
BUILDING ADDRESS:.7527 KINGSBURY CT CIONTRACTOR:;LUU'CONSrRUCTION PERMIT N,0: 12070160
,LNC-
OWNER'S',NAME:�.RAMAIYER.KUMARANDMEENA 331AVENIDA.PINOS :DATE ISSUED- 10/02/2012
OWNER'S:.PHONE: 4688968484 SAN JOSE,CA 95123: PHONUNO: 408)623-7558
EY 'LICENSED CONTRACTbW&DECLARATION
JOB°DESCRIPTION:':RESIDENTIAL 0 COMMERCIAL
License Class 17_ Lic.# g�� �. � SFDWL A_ DD1TI.ON(1038�SQFT,);REMODEL:KITCHEN(1.40
ii SQ
Contractor: LLt L� Date 3 , . -AND BE-DROOM(460SQQ
(hereby affirm that,l;am,licensed under the,provisions,of.Chapter 9 FT);.CONSTR_UCT/REBUILD FRONT COVERED PORCH(80
(commencing with` See tiion 7600)�of,Division,3 of the-Business_,&Professions SQ
Code.and that;.my hcenseaisim full force.and effect. k6V
. / �staffsinug�!J a r? 60c�ro.r
C�9'
-
4-vS'{vYherebY,affirm under enalty of erJur ;mix ofthe followiftg,two declarations:
Ihave
and will maintain xcertificate`of consent to self•insure for�Worker's /
Compensation,as�provided,for by Section3700:6f.the�L"ab6r Code;for'tlie u Sk y h✓hfS'
performance of the work.for whichthis'.permicis;issued. Sq.Ft Floor Area: Valuation:$275000
Iehave,and:will maintain:Worker's 1Compensation`Insurance;as;p!ov.idedfor:by
Seddon 3700 of,the.Labor'6de forthe performance of the,work for which,this
APN Number:,36229029,00 Occupancy Type:
permit is issued.
'APPL'iCANT CERTIFICATION
1 certifythat'l have read and and state thatthe;above,information is
PERMIT EXPIRES IF WORK IS NOT STARTED;
correct:I agree;to,comply with,all cityandreounty•ordinances anditate1aws relating
WITHIN-180 DAYS: PERMIT ISSUANCE OR.
u on the;ibove`memioned,prop e yfor�ins ectiepresep6sese, (Wtliis city to save
_
to building construction,and hereb authonze r
^�p p. p rty p 'on�purposes (We)agree to save 180.DAY ST CALLED,INSPECTION:
indemnify'and,:keep°harmless the City of Cupertino against liabilities;judgments;
costs•and,ezpenses�which may'accrue�agamsi�said Ciiy'iwconsequence of the,
granting of this perrnit:',Additiona ,the applicant understands,and wdl comply Date:, 45—' dl�
with,all non pointysouree re tin-s°pe upertino Municipal Code,Section
9"18 ,
7 ;RE-ROOFS:
Signature• . �t � Dates All roofs shall lie,inspect'edprioYto any,roofing material being`installed.:.lfa roofis
installed without fiiscobtaining,an.inspection,,I agree to remove all new materials for
"inspection.
❑_ OWNER-BUILDER DECLARATION
Signature of Applicant: Date:
I hereby�affrm that.Fa.ni eze_rnptifrom the Contractor's License LAW for oneof
the following two i ea"sons: ALL ROOF COV.ERINGS.TO,BE CLASS".A"OR,BEITER,
1,;w owner",of the;property,:or myeinployees with wages as their,sole_compensation,
will-do'ihe••work,and theastructure isjnot intended=or offered forsalcOec.7044,
Business;&Profe'ssions Code):
I„as,owner,ofihe.'property,am exclusively contracting withlicen_sed contract_ors;10. HAZARDOUS=MATERIALS DISCLOSURE
conshyquthe projot'.(Sec:7044j;pusiness,&°Professions Code). Ihave read the,hazardous,niaterials requirements under Chapter .,95 of,th__e
California,Health', Safety Code;Sections 25505,;25533,and 25534. I:will.
J hereby affirm ander?penalty”of perjdry'oneof the:following;three maintain compliance with the-Cupertino Municipal:`Code,•Chapter;9.12 and-the
declarations:' Health&Safety Code,Section 25532(a)should 1 store or handle hazardous,
.I have and will;maimain a,Cer[ificaie of:Consent to self-insure for Worker's, material. Additionally„should;l use equipment or devices.,which emit",hazardous .
Compensation,as,piovided.foi1by'Section 3,700'of the Labor Code,for.the air-containinants,as detined.by'itic:BayArea Air,Quality`Management DistrictF
performance,of the work;for,which;this permitis issued;; will maintaimcompHiinee,with,the Cupertino; unici" I Code;,Chapter 9 12,and
I have and will in- orker.s Compensation Insurance as provided for by the Health&Safety Code,'Sections2550 , 5 3 nd 25534.
Section 37.00 of the LabovCode fo_r the performance:of the work<for which this
perrrirtnis issued. , Owneror�auihorized.age it: ��G' Date.
I certify,that,inthe'peifoilnance of the work:for which this perriiit is,issued,l shall.
;not employ anyperson in anymanner so,as to become;subjectto,the Worker's
'.Compensation laws!4California: If aAcfxiaking.thrsFcertificate of exemption,I CONSTRUCTION LENDING AGENCY
become;subject,to the Worker's Compensation provisionskof the1abor Code,I.must wo`k sfor which[t-t1 ere is ai's ossuedctS rillen in C gen y for performance.of
forthwith coin I .wrtli�such rovisions;or this p6'niiit shall be deemed revoked. Lend'er's Name p (Sec.
)
PY P
AP.PLICANT-'CERTIFICATION: Lend'er's Address
.1 certify that,l.havetread this application,and siatethat the-above informationJs
co'rrectj agree to.comply'with"all;city-and.county!ordinances and state laws relating
to building eonstruction,iand hereby authorize representatives of+this city"to enter
upon the aboveementioned property for inspection purposes (W6),agree to save
indemnify and keep harmless the Cityof Cupertinoagain§diabilities,judgments; ARCHITECT'S DECLARATION,
'costs,and:expense§4fiich4nay.accrue againscsaid City in.consequence,of the I understand inyplans shall be used asipu6lic record's.
granting of6is,oeemit..Additionally;.thetapplicantunderstandsand will comply
with.alIxnon-point=source regulations,per,the Cupertino Municipal Code;-Secfion Licensed-Professional
9.18.
Signature Date
CITY OF CUPERTINO
FEE ESTIMATOR BLTILDIN.G_DIVISION
ADDRESS: 7527 KingsburyCourt DATE.. 0.21,09/2013 REVIEWED BY: .Sean "
APN: BP#': f ° _ 'VALUATION,:. $4,000
xPER1VIITT0E:. :'Building Permit PLAN CHE'CWTYPE: Alteration/ Repair
PRIMARYP,ENTAMATION
USE: SFD or Duplex PERMIT'TY.PE: 1GENRE
WORK .Revision #1::- Installation�of 2).sk li hts; remove-hardi sidin #o stucco; add 3 'beams in ara a,to
SCOPE suppo.rt'existi'ng-Adge.
M&l,17,T'1un`G'hc:�k- Plvn .P un Cbecl El�rc. Plc/rv_C;A-:rlc
;Lticlr. 1cernit;Fee:. Irunih. Permit!Fee: Rler: Permir..Fee;
ri,
l9ech.Insh., C)Ihc>r Plumb-lnsp. Li - 1 .Insp.Fee_" - I'lr�rirl7 (ir.iEr. I e : Ilec°-,Inst, F'1z ;'
NOTE:This estimated,-not include fees.due to other Departments„(i.e,Planning;Public Works;.Fire„Sanitary Sewer District„School,
Distr”ct,_eta .-These. ees,iare:based,on the° reliinin`a' ;'in ormdtion availaGle andAare,only an-estimate Contact'the_De t, or..addn'l,in o.
FEE ITEMS (Fee Resglution 11=053 Ef:'7f 1142),7 FEE QTY/FEE MISC ITEMS
Plan.Check'_Feec Hourly Only? Q Yes E) No $Q.00 1 hoursi Plan.Check,Hourly
Suppl oPC:Tee: Reg.,, (:). OT 0°.0 hrs $0.00 $1.33.00 IsTPLNCK
PME'Plan Check, $0.00
Permit;Eee °Hourly Only? '0 Yes, &No• $.0.00
S`upj,.Insp'..F6e:Q'.Reg. Q:.OT 0 0 hrs $0,,00
PME'Unit,.F.ee:
P•ME Permit.Fee: $0'_00
T7-
Con,'qr'ucli h.h is
A(Jjhin'istrative.Pee:
Work Without Permit?- 0 Yes• o, No $o.00, G
Advanced•'Plaiiriing Fee: $0.00 hours Inspections E
T,uvel 190culnentul'ion b'ees': $°399:00. ISTINSP Inspection,Hourly
Strom Motion'Feer IBSEISMICR $ Select an Administrative Item
Bldg Stds•Comm`ission Feet, ZBCBSC $1;:00 ,�{U
R5,1 ,-
` SUBTOT�is: $1,.50 $532.00 .tiTOT�,><,FEE $533
� � � .. �
Revised: 01/0,112013'
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7527'KINGSBURY CT CONTRACTOR:RAMAIYER KUMAR.AND PERMIT NO: 12070160
MEENA
OWNERS NAME: RAMAIYER,KUMARAND MEENA 7527 KINGSBURY CT DATE ISSUED: 10/02/2012
OWNER'S PHONE: 4088968484 CUPERTINO,CA 95014 PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING.PERMIT INFO: BLDG-F, ELECT 17-= PLUMB
License Class Lic.#
MECH RESIDENTIAL COMMERCIAL "
'Contractor Date
I Hereby affirm that'l ain'licensed'under the provisions°of Chapter 9 JOB DESCRIPTION: SFDWL ADDITION(1038 SQFT);REMODEL KITCHEN(140
(commencing with Section 7006)of Division 3 of the Business.&Professions SQ
Code and thaLmy license isiin full force and effect. FT)BATHROOM(200,SQ FT)DIN1NCrAND:BEDROOM(460 SQ
FT);CONSTRUCT/REBUILD,FRONT COVERED'PORCH(80 SQ
1 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
performance.ofthe work for which this permit is issued.
d-have;and will.maintain Worker's Compensation Insurance,.as provided for by
Section 3700 of the Labor Code,for the performance bf the work:for which this
permitiis issued. Sq.,Ft Floor Area: Valuation:$275000
APPLICANT CERTIFICATION
l certify that 1`have;read'this application and state that the above information is APN.Number:36229029'00 Occupancy Type:
correct.I agree to comply with,all city and county ordinances-and state laws relating
to building construction,and hereby authorize representatives of this.city to enter
upon,the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep,harmless the City of Cupertino against,liabiIities,judgments, PERMIT EXPIRES.IF WORK IS NOT STARTED
costs,and expenses which may-accrue against said City in consequence of the
granting ofthis,perm it. Additionally,the applicant understands.and will comply WITHIN180 DAYS OF PERMIT ISSUANCE OR
with 611 non-point,source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature Date, Issued by: Date:," �Z/
❑ � �, OWNER-BUILDER DECLARATION
I,hereby affirm that.I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two:reasons: All roofs shall be inspected prior to any roofing material.,being installed.If-a roof is
I,as,owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will d'o;the work,and thee-structurelis n6fintended orbffered',for sale($e1c.7044, inspection.
Business&Piofess_ions•Code)
I,.as owner of the;property,.am exclusively contracting with licensed contractors tol Signature of Applicant: Date:
construct the project(Sec,7044,Business&Professions Code):
hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
declaration s•
I have and will maintain a Certificate of Consentto self=insure'for Worker's HAZARDOUS MATERIALS DISCLOSURE
Compensation,as<provided for by Section,3700 of the Labor.Code,for the
performance of the work for which chi's permit is issued. 1 have read the hazardous materials requirements under Chapter 6.95�of the
I have and Will Worker's Compensation Insurance,.as provided for by California Health&.Safety Code,Sections 25505,25533,and 25534. I will maintain
Section 3700 of the Labor Code,for the performance of the work for which this compliance with iheCupertino Municipal Code;,.Chapter>9:11and,the Health_ &
Safety Code,Section 25532(a)should 1 store or handle hazardous material.
•permitis issued. Additionally,;should I use-equipmenior devices which emit hazardous;air
I certify that in the performance of the-work for which'this permit'is issued,l shal l contaminants as defined by the Bay Area Air Quality Management District 1 will
not.employ,anyperson in anymanner so as_to become°subject to the,Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.1.2 and the
Compensation laws of California. If,after making this certificate of exemption,I Health.&.Safety Code,.Sections 25505,25533,and'25534.
become subject to the Worker's Compensation_provisions of the,LaborCode,I must
Owneror-authorized agent:forthwith comply with such provisions or this permit shall be deemed revoked.
XVia�p—e Date: 10-7'11
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I certify that I havelread this application and state thatthe_abov6riformation is
correct.I agree to comply with all city and county ordinances and state laws relating I hereby%affirm that there is a construction lending agency forthe performance of work's
to building construction;and hereby authorize,representatives,of this city to.enter for which this permitis,issued(Sec.3097,Civ C:)
upon the above mentioned property for inspection purposes.(We)'agree'to save Lender's Name
indemnify and keep,harmless'theCity ofCupertino°agaifist liabilities;judgments,
costs,and expenses which may accrue,against said 6ty'in consequence of the Lender's Address
granting of this permit.Additionallythe applicant understands,and will comply
with.all non-point source,regu[at ions per the'Cupertino`Ivlunicipal Code,Section ARCHITECT'S DECLARATION
9.18.
p I understand my plans shall be used as public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR=BUILDING DIVISION
,ADDRESS: 7527 kingsbury ct. 7
DATE: 074912012' REYIEWED BY: bob:s..
APN: BPm cW0 6, 'VALUATION: 1$275,00,Q
FPERMIT°TYPE: Building.Per,nit PLAN'CHECK TYPE: Addition
PRIMARY 2nd Unit? Yes ° 'No PENTAMATION
SFD or Duplex 1 R3SFDADD.
USE: OTC., -OYes G No PERMIT TYPE:
WORK sfd add famil kitchen .master,suite 1038 s.f. remodel kitchen dining, bedroom .bath 8Q0 s:f:
SCOPE
OCCUPANCY TYPE: TYPE OF FLR AREA PG FEES; PCFEE ID BP FEES BP FEE ID
'CONSTR, (s:f.
R-3 (Custom) II-B,III-B,IV,V-B 1;038 $2;487.18 1R.3PENCK $1;617';73 IR3INSP
TOTALS: 1,038 $2,4.87.1831
$1,;617 73 r
f
MECHII®UR`LY Q Yes Noy PLUMB kmH,®URLY QYes x� No: EI.EC HOURLY = Q YesNoy��
,. ,d&` ) _. •..w" .x� t t ..s �1n 5 , :Mea✓.w:k rts;Sa�ie, a,..� ar
.�. ,y a'!!i1,17. 1'.lr.,l(.-'liL'i.'n' - ''ff'"Pt'an i..HtiC(r.
iVlec;lr. 1 tar,"C iecr F 1.
i`�°r'.�.1�,. i' Ynrt•,F�z.. i"t irr3i.1,'c .rn rle.<�: Eire. F'¢t-'n..,,f�ee:
F%,is er;19c-cdt.7i�sp.. �)1l,<r l'iarrz b.:i rd s p: Ll
(';ii:f•Gl tic-.Inst;.
11ech.Irsp: tz c: P;'r-;rill)..Inst;.
NOTE: This,estimate does not'include fees due"to other Departments(i:e.Planning;Public Works,Fire,Sanitary.Sewer District,School
District,ete. .: These ees;:are'based�on the,, relimina, in ormation-availabl .arid are onl',an,estiinate. Contact ihe.De"t' or addn'1 info.
FEE ITEMS,(Pee Reso'lut'ion 1,1=053 Eff 7/1/17) FEE QTY/M 'MISC.ITEMS
Plan.Che&Tee: $21A8.7.18 200 s.f- Remodel,.Bath(<=3,0,0,sf)
9uppl. K_Fe"e: (D Reg. 0 OT 0.0 hrs $0.00 $600.00. iREURESBAT
PME.Tlan.Check $0.00. 140 s.£ Remodel,Kitchen,(<=300 sf)
Permit F,ee $11,6. 117.73• $600:00 1-RENIRESKIT
SuppL lns.p:,Fee;Q Reg. QOT 0.0 hrs $0.00` 460 S1, Remodel,.Other
PME Unit Fee;. $:0.00' $;4:67.00 1RE;vrRESOTH
PME Permit Fee:, $0.:00"
Con.lovciion Ta,:.
�9cf�ni.�r�istr.arive.Fec� 0
Work Without Pefmit? 0 Yes (j) No $,0:00 G)
Advanced Planning, Fee: IPLLONGR 1$134.94; Selectallori-Residential, Q.
Travel L),or:Iahe retell.; i (eEas, Building or Structure 0
A
S'tron Motion Fee: IBSE]SiY1ICR $2'7.'.5Q Select,an Administrative Item
Bldg S'tds Commiss'ion,Fee:. iBCBSC $11:00
= BUBT,®TAT.SF $4,278.35. $1,667:00 °
_.
TOTAL�FEE:. $5,94:5.35
Revised: •071011201,2