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Home My WebLink About13080187 Permiti� ��J CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10661 CARVER DR CONTRACTOR: RICCARDO FORLEO & PERMIT NO: 13080187 DOROTHY LIN OWNER'S NAME: RICCARDO FORLEO & DOROTHY LIN 10661 CARVER DR DATE ISSUED: 09/23/2014 OWNER'S PHONE: 4088288426 CUPERTINO, CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL CONSTRUCT 2 STORY SFDWL TO 1ST FLOOR 2019 License Class Lic. # SQFT,2ND FLR 717 SQFT TO INCLUDE ATTACHED CAR GARAGE 427 SQFT Contractor Date REV # 1 - SHORTEN GARAGE ADDITION BY APPROX. 1 I hereby affirm that I am licensed under the provisions of Chapter 9 S.F. TO MEET SIDE YARD SET BACK - ISSUED 2/9/15 (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 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. Sq. Ft Floor Area: Valuation: $250000 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 37534050.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS D INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the 2— granting of this permit. Additionally, the applicant understands and will comply v: a e: with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. RE-ROOFS: Signature Date 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. OWNER-BUILDER DECLARATION Signature of Applicant: Date: _ I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Muni Code, Chapter 9.12 and the declarations: Health &Safety Code, Section 25532(a) shoal I st re or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally, should I e equipme t or evices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by h Bay Area it ality Management District I performance of the work for which this permit is issued. will maintain compliance wit he Cupertin Mu cipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health &Safety Code, Se 'o s 25505, 2 3 and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Dater � permit is issued. 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 CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address-- I certify that I have read this application and state that the above information is correct. I agree to comply with all city an ounty ordinances and state laws relating to building construction, and hereby au ri representatives of this city to enter upon the above mentioned property for nspe tion purposes. (We) agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City f Cu ertino against liabilities, judgments, costs, and expe which may accru agai t said City in consequence of the I understand my plans shall be used as public records. granting of thi pe it. Additionally thea licant understands and will comply with all non- int ource reg tion a Cupertino Municipal Code, Section Licensed Professional 9.18. Signature DateW_- 5%' " �J Rf 1 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10661 CARVER DR CONTRACTOR: RICCARDO FORLEO & PERMIT NO: 13080187 DOROTHY LIN OWNER'S NAME: RICCARDO FORLEO & DOROTHY LIN 10661 CARVER DR DATE ISSUED: 09/23/2014 OWNER'S PHONE: 4088288426 CUPERTINO, CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ CONSTRUCT 2 STORY SFDWL TO IST FLOOR 2019 License Class Lic. # SQFT,2ND FLR 717 SQFT TO INCLUDE ATTACHED CAR GARAGE 427 Contractor Date SQFT 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 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 Sq. Ft Floor Area: Valuation: $250000 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 APN Number: 37534050.00 OCC upancy "I'ypc: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the ^ / ni f a j Issued by: ��! V T/ % /� Date: 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. RE -ROOFS: Signature Date 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. 14 OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1, 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) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will 1 hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Muni ' a ode, Chapter 9.12 and the declarations: Health &Safety Code, Section 25 a) shoal I stor or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should use quipm t or vices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the y Are Air ality Management District I performance of the work for which this permit is issued. will maintain compliance wit he perti Mu cipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, S ons 5505, nd 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date:19424DJ permit is issued. 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT"RTI Lender's Address I certify that I have read this app"catio and sta that the above information is correct. I agree to comply with all city d co ty ordinances and state laws relating to building construction, and hereby thoriz representatives of this city to enter Zp upon the above me Toned property r ction purposes. (We) agree to save ARCHITECT'S DECLARATION indemnify and p armless the,City of pertino against liabilities, judgments, costs, and exp ses hich ma cc e a Inst said City in consequence of the l understand my plans shall be used as public records. granting of th pe t. Addi applicant understands and will comply with all non- nt s rce re ti s r the Cupertino Municipal Code, Section Licensed Professional 9.18. gyp Signature Date N CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, rubuc wortcs, pore, sanirary,3ewer tirsrrncr, acnoot .. r.,...ed , " fhanrotiminani irJnrmatinn aVailahlP and are only an estimate. Contact the Dept for addn 7 info. [/{J!/161, CLI.. . �/f GJG Gcu uiG �uuvu v.• ..... .......»..». FEE ITEMS (Fee Resolution t 1-053 Eff 7/1/132 DDRESS: 10661 CARVER DR DATE: 02 9/2015 REVIEWED BY: MELISSA W PN: 375 34 050 BP#: -VALUATION: $0 PE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: p 0.0 PENTAMATION 1GENRES PERMIT TYPE: WORK REV # 1 - SHORTEN GARAGE ADDITION BY APPROX. 1 S.F. TO MEET SIDE YARD SET BACK - SCOPE ISSUED 2/9/15 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, rubuc wortcs, pore, sanirary,3ewer tirsrrncr, acnoot .. r.,...ed , " fhanrotiminani irJnrmatinn aVailahlP and are only an estimate. Contact the Dept for addn 7 info. [/{J!/161, CLI.. . �/f GJG Gcu uiG �uuvu v.• ..... .......»..». FEE ITEMS (Fee Resolution t 1-053 Eff 7/1/132 h a r. Niue t >!cc Ptnrnb. Plan Check Check heck .ltech. Peruta 1 mumb. Permit mit Fire: Othcr a/ec h. Insp. Other Plumb Insp )rhet. P1ec. Inst ED �Wech. Insp. Fee: 0.0 hrs NOTE: This estimate does not include fees due to other Departments (i.e. Planning, rubuc wortcs, pore, sanirary,3ewer tirsrrncr, acnoot .. r.,...ed , " fhanrotiminani irJnrmatinn aVailahlP and are only an estimate. Contact the Dept for addn 7 info. [/{J!/161, CLI.. . �/f GJG Gcu uiG �uuvu v.• ..... .......»..». FEE ITEMS (Fee Resolution t 1-053 Eff 7/1/132 -_1_...____ .- __. FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Yes Q No $0.00 2 hours Plan Check, Hourly $286.00 ISTPLNCK Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? ()Yes Q No $0.00 Suppl. Insp. Fee -0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax. Administrative Fee: Work Without Permit? Yes E) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure A T''mwel Documentation Fees: Strong Motion Fee: $0.00 0.0 hrs $0.00Inspection, Inspections Hourly Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $286.00 TOTAL FEE: 1 $286.00 Revised: 01/06/2015