12010159CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21230 HOMESTEAD RD
CONTRACTOR: CLADDAGH
PERMIT NO: 12010159
CONSTRUCTION INC
OWNER'S NAME: VILLAGE GREEN ASSOCIATES
1438 LUPTON AVE
DATE ISSUED: 02/15/2012
OWNER'S PHONE: 4082045367
SAN JOSE, CA 95125
PHONE NO: (408)294-2924
d LICENSED CONTRACTOR'S DECLARATION
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License Class 13— Lic.4 158SCAG
BUILDING PERMIT INFO: BLDG ELECT PLUMB
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Contractor 1 `— �Date 2 S
MECH RESIDENTIAL COMMERCIAL
1 hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: BLDG 3-APTS UNITS 45-52 FIRE DAMAGED REBUILD
(commencing with Section 7000) of Division 3 of the Business & Professions
EIGHT(8)UNITS (7636SQFT)LIKE FOR LIKE.
Code and that my license is in full force and effect.
hereby affirm under penalty of perjury one of the following two declarations:
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.
I have and will maintain Worker's Compensation Insurance, as provided for by
Sq. Ft Floor Area:
Valuation: $800000
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APN Number: 32605085.00
Occupancy Type:
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
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 regulations per the Cupertino Municipal Code, Section
9.18.
%�OuWIssued
by: � Date:Signature
—J Date
P
❑ OWNER -BUILDER DECLARATION
RE -ROOFS:
1 hereby affirm that 1 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.
wiI I 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
1 hereby affirm under penalty of perjury one of the following three
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
HAZARDOUS MATERIALS DISCLOSURE
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. I 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 1 will
I certify that in the performance of the work for which this permit is issued, I shall
maintain compliance with 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 Code, Sections 25505, 25533, and 25534.
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
Owner f4 aytpor' a n
forthwith comply with such provisions or this permit shall be deemed revoked.
� Date: oZ`/�
APPLICANT CERTIFICATION
CONSTRUCTION LENDING AGENCY
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
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
Lender's Address
costs, 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
ith all non -point source regulations per the Cupertino Municipal Code, Section
..
1 understand my plans shall be used as public records.
I8
ture Date
Licensed Professional
9ft7��CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
iaADDRESS:
21230 homstead rd bldg 3
DATE: 01/26/2012
REVIEWED BY: bobs.
APN:
BP#:
"VALUATION: 1$240,000
r PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY Multi -Family Dwelling
USE:
Building is
3 Stories ® Yes ® No
PENTAMATION 1 R2
PERMIT TYPE:
WORK
r02 fire dana a re -build 8 units 45-52= 7636 s.f. 4 decks total 400 s.f.
SCOPE
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
R-2 (Apartment)
II-B,III-B,IV,V-B
q'S
$5,182.76
IR2PLNCK
$1,063.28
IR2INSP
R-2 (Apt - Repeat Unit)
II-B,III-B,IV,V-B
J9
$2,640.96
IR2REPPL
$1,063.28
IR2REPIN
TOTALS:
1,908
$7,823.72
$2,126.56
NOTE: This estimate does not include fees due to other Departments (Le Planning, Public Works, Fir anitary Sewer District, School
Aictrict_ etc L Thaco Foos aro hncod Yin tho nrolininary infarmatinn availahlo and aro nnh7 an ostimnt _ ! nntnrt tho Aont fnr addn'f Infn_
FEE ITEMS (Fee Resolud n 11-053 E. 7/1/11)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$7,823.72
F-4-1 #
$1,828.00
eck / Deck Railing
1 ECKWOOD Deck (wood)
Suppl. PC Fee: Q Reg. Q OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$2,126.56
SuppL Insp. Fee:Q Reg.
Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0,
Construction Tax: IBCONSTA;R
1
# new
units
$5 .80
Q
0
Work Without Permit? C) Yes No
$0.00
Advanced Plannin& ee:
PLLONGRN91C
$496.08
Select a Non -Residential
Building or Structure
G
0
Strong Motion Fee:
1BSEISMICR
$24.00
Select an Administrative Item
Bldg Stds Commission Fee: 116CBSC
$10.00
t�B -.
11,064.16
$1,828.00
*Of *i d
$12,892.16
Revised: 111912012
I FEE ESTIMATOR CITY OF CUPERTINO
- BUILDING DIVISION
ADDRESS: 21230 Homestead Rd Units 45-52
DATE: 01/26/2012
REVIEWED BY: A. Salvador
APN:
BP#:
'`VALUATION: $800,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY
USE: Multi -Family Dwelling
Buildina is
>3 Stories O Yes (F) No
PENTAMATION
PERMIT TYPE: 1 R2RE
WORK
Fire Damage Rebuild: Rebuild 8-units of existing 2-story 16-unit apartment building.
SCOPE
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
R-2 (Apartment)
II-B,III-B,WN-B
954
$5,182.76
IR2PLNCK
$1,063.28
IR2INSP
R-2 (Apt - Repeat Unit)
II-B,III-B,IV,V-B
6,682
$2,901.14
IR2REPPL
$3,695.16
IR2REPIN
TOTALS:
7,636
$8,083.90
::
$4,758.44
NOTE. This estimate does not include fees due to other Departments (he. Planning, Public Works, Fire, Sanitary Sewer District, School
District. etc.). These fees are hated on the nreliminary information availahle and are only an estimate_ Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution 11-053 E '. 711111)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$8,083.90
=#
$1,828.00
Deck / Deck Railing
IDECKWOOD Deck (wood)
Suppl. PC Fee: Q Reg. O OT
0,0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$4,758.44
Suppl. Insp. Fee:Q Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
E)
Work Without Permit? O Yes (F) No
$0.00
Advanced Planning Fee: PLLONGRNGC
$ 36
_
elect a Non -Residential
Building or Structure
E)
Strong Motion Fee: 1BSEISMICR
$80.00
Select an Administrative Item
d,
Blde Stds Commission Fee: 1BCBSC
$32.00
.
T .;.
;�? . A L lla ;
/071V-5% 3V Revised: 1/19/2012