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10100108 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: NILE DR BLDG K CONTRACTOR:AXIS CONSTRUCTION,INC PERMIT NO: 10100108 OWNER'S NAME: CUPERTINO WATERFALL HOA 2566 BARRINGTON CT DATE ISSUED: 10/19/2010 TIER'S PHONE: 4084483080 HAYWARD,CA 94545 PHONE NO:(510)732-6111 ❑ LICENSED CONTRACTOR'S DECLARATIONr— r BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class ( Lic.# � kEpter MECH r— RESIDENTIAL [— COMMERCIALContractor 4yIS 4( • Date I hereby affirm that I am licensed under the provisions of 9 JOB DESCRIPTION:CUPERTINO WATERFALL-NILE DR BLDG K REPLACE (commencing with Section 7000)of Division 3 of the Business&Professions DECAYED STAIR STRINGERS. 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 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 Sq.Ft Floor Area: Valuation:$2633 permit is issued. APPLICANT CERTIFICATION APN Number:36950000.K Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source re lations per the Cupertino Municipal Code Section 9.18. Issued by: Date: Signature Date ❑ J OWNER'BUILDDECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance ith the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Co ,Sections 25505,25533,and 2 534. 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 Ow ey or ut or' d forthwith comply with such provisions or this permit shall be deemed revoked. Date: CON RUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name v--n the above mentioned property for inspection purposes.(We)agree to save mify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address _ i,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 24 PERMI" RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN 36'350000 .K DATE ISSUED. . . . . . . : 10,119/2010 RECEIPT #. . . . . . . . . BS )00011783 REFERENCE ID # . . . : 10100108 SITE ADDRESS . . . . . : NINE DR BLDG K SUBDIVISION . . . . . . : CITY CU?ERT I NO IMPACT AREA . . . . . . OWNER CUPERTINO WATERFALL HOA ADDRESS C/0 CORNERSTONE COMMUNITY MGMT CITY/STATE/ZIP . . . : SAA JOSE, CA 95125-5635 RECEIVED FROM . . . . : AXIS CONSTRUCTION CONTRACTOR . . . . . . . : CHRISTOPHER DURKIN LIC # 32093 COMPANY . . . . . . . . . . : AXIS CONSTRUCTION, INC ADDRESS . . . . . . . . . . : 2556 BARRINGTON CT CITY/STATE/ZIP . . . : HAYWARD, CA 94545 TELEPHONE . . . . . . . . : (510) 732-6111 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 2, 633 . 00 1.00 0 . 00 1. 00 0 . 00 1BSEISMICR VALUATION 2, 633 . 00 0 .50 0. 00 0.50 0 .00 1SUPINSFEE HOURS 1. 00 126 . 00 0 . 00 126 . 00 0 .00 ---------- ---------- ---------- ---------- TOTAL PERMIT 127 .50 0.00 127 .50 0 .00 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: NILE DR-BLDG K DATE: 10/14/2010 REVIEWED BY: APN: BP#: *VALUATION: 1$2,633 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY PENTAMATION USE: SFD or Duplex t PERMIT TYPE: 1 GENRE WORK SCOPE NOTE: Thesefees are based on the preliminary information a railable and are only an estimate. Contact the De t or addn'l info. FEE ITEMS(Fee Resolution 09-051 Ef. 7/1/10) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 0 # Stairs Suppl. PC Fee: (F) Reg. 0 OT 0.0 1 hrs $0.00 $0.00 (Specify#of Flights of Stairs) PME Plan Check: $000 Permit Fee: ISUPINSFEE $000 Suppl. Insp. Feed Reg. 0 OT 1.0 hrs $12600 PME Unit Fee: $0.00 PME Permit Fee: $000 Acoustical Fee: 0 Yes 0 No $0.00 0 Work Without Permit? 0 Yes 0 No $0,00 0 Planning Fee: $0,00 Select a Non-Residential :` Building or Structure 0 i Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $127.50 $0.00 TOTAL FEE: $127.50 Revised: 9/29/2010 CUPERTINO WATERFALL HOMEOWNERS ASSOCIATION coo Cornerstone Conimuni.ty Management 1804 Hamilton Il.venue, Suite#210 San.lose, CA 95125-5635 (408)448-3080 x 218 Ftx(408)448-3084 Rocclielle Ayers,Association Managcr roe@wrncmtnncm gt.hiz October 14,2010 City of Cupertino Building Department Fax: (403) 777-3333 Re: Stair Stringer Project/Axis Construction To Whom It May Concern; This letter con.firms that Cupertino Waterfall. i4omeowners Association. has contracted and gives permission to Axis Construction, Inc to work on the stair stringer repair project. Sincerely, Rom elle Ayers Association Manager On behalf of the Board of Directors CC: Urxird of DirectorsX.nntract Pi1c 10272 N 10270 Z s C * 10268 m ON O ON ON O O N IJ N N IJ a N �N _ _ 10288 X .o v U W O < W v U W 10284 201 82 NILE DRIVE N 10280 10258 iv t o o cd 10222 10220 Z M `� p 10216 T O pyo � \ OZ►1 �/ m 10214 10212 m \ J 10210 \ N 10208 ,pe �- � \dye ANO (n m � w \ A 10 X 0 o v O,Q�c CD01 '� p GFS \ x \ N Cl) , SIR \ � o 0 o a d` m # c to m � ovi C w M !! C m 10194 # 0 v 10192 0. S �C Z at 101:90 r Z G 10165 m C m rn �U C N o S w � 101e4 m 0 N 10162 i A r loteo m < � = m � ' �. D 1 v s r r O m m N j . �_— CITY OF C JPERTINO Fry aF Cv FEK INO GENERAL BUILDING PERIN11T APPLI CATION FORM APN# �CfJ 5� ��� � • Date: Building Address: >> Mailing Address (if different from b ' ding address): Are Hazardous Materials being used as part of this project? Yes No HOA: (Exterior work only) Yes No ❑ If yes, provide letter from HOA Owner's Name Cf'�Id,E Phone#: E A�r�e ��' 7-Mo Contractor: Phone: S'1 U--:F3 z-!n M XI5 A-A I Fax: 5"Iv--t3,Z,-6zZ1 z Contractor License t (p I '?-(p I ertino Business License Contact: �,�� ���� F�one: ."esidential K Commercial ❑ Job Description: Building Permit Info: Bld � Elect ❑ Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: D- 1-A, 1-B ❑ II/IIIlV-A ❑ II/III B, IV-HT, V-B Valuation: Square Footage: Project Size: Express Standard ❑ Large ❑ Major ❑ Green Building: Please complete relevant portion of the Green B ' ding/LEED Checklist& attach it to the application or if applicable, iaclude in plan set & the sheet index. ints Achieved: r'or help, contact Build it Green at www.builditgreer-or Revised 07/14/09