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07120138CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20800 HOMESTEAD RD BLDG 5 A-H CONTRACTOR: WEST BUILDERS, INC. PERMIT NO: 09080037 OWNER'S NAME: VILLA SERRA APTS A CA LTD PARTN 1608 4TH ST STE 120 DATE ISSUED: 08/19/2009 OWNER'S PHONE: BERKELEY, CA 94710 PHONE NO: ( ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r, r— r License Class L Lic.N gzs?q�5 ELECT PLUMB T_ r � `` 1 jq `ZA T31 MECH RESIDENTIAL COMMERCIAL Contractor Vim+ �✓ Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REVISION: UTILITY CLOSET (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: $2500 performance of the work for which this permit is issued. 1 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. APN Number: 32609056.5AH Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating PERMIT EXPIRES IF WORK IS NOT STARTED to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities, judgments, 180 DAYS FROM LAST CALLED INSPECTION. 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 Issued by: Date: 9.18. /' C Signature Date RE-ROOFS: ❑ OWNER-BUILDER DECLARATION 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 I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: 1, as owner of the property, or my employees with wages as their sole compensation, Signature of Applicant: Date: will do the work, and the structure is not intended or offered for sale (Sec.7044, _ Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER construct the project (Sec.7044, Business & Professions Code). 1 hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain Compensation, as provided for by Section 3700 of the Labor Code, for the compliance with the Cupertino Municipal Code, Chapter 9.12 and the health & performance of the work for which this permit is issued. Safety Code, Section 25532(x) should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance, as provided for by Additionally, should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code, for the performance of the work for which this 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 permit is issued. Health & Safety Code, Sections 25505, 25533, and 25534. 1 certi f , that in the performance of the work for which this permit is issued, l shall not employ any person in any manner so as to become subject to the Worker's Or autho ed agent: Date: 9.7y. f Comp,:nsation 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. CON'S'TRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION for which this permit is issued (Sec. 3097, Civ C.) I certify that I have read this application and state that the above information is Lender's Name 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 Lender's Address upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply I understand my plans shall be used as public records. Vith all non-point source regulations per the Cupertino Municipal Code, Section A.18, Licensed Professional 1 Nature Date_ FY OF CUPERTINO BUILDING DIVISION PEPMM STEAD RD, BLDG 5 A -HI TBD - TO BE DETERMINED OWNER'S NAME, VS II A CALIFORNIA LIMITED ARCHnwr/ENOINEER a O 5 LICENSED CONTRACTORS DECLARATION v 1 hereby affirm that I w licensed under provisions of Chapter 9 (commencing with Section 7000) of DMzion 3 of the Business and Professions Code, and Is Is y in full forceuw effect. m r.�itractor 1 9 Dalew rcI1Con ARCHITECT'S DECLARATION 1 u deratand my plans shall be used as public records 7 e, g uCi I-- Uccnsed Professional OWNER -BUILDER DECLARATION $ I hereby affirm that 1 am exampt from the Contractors License Law for the D following mason. (Section 7031.5, Buslacss and Pmfessiom Coda. Any city or county $ which require a permit to catpruc. alter. Improve, demolish, or repair any structure z prior b is issuance, also coquina the appliaot for such permit to file a signed swamew that he is licensed personal to the provisions of the Conunctoes License Law (Chapter 9 $ (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that be Is exempt tbmdrant and the basis for the alleged exemption. Any violation of Section 7031.3 by any applicant for a permit subjects the applicant. to a Civil P=94 Of not more than five htrdaed dollen (5300). 0z ural �z UO O t W U74 0 L as owner of the property. or my employora with wages as their sole eanpenwtlon, will do the work and the structure Is not intended or offered for sale (Sec. 7014, Business and Professions Code: The Coarawmes Lkemee Law don not apply to an owner of property who builds or improm thereon. and who does such work blmself or through his own employees, provided that such improvements ate not Intended or offered for sale. if. however. the bulling Or improvement is amid within one yen of completion, that owner - budder wM have tis burden of proving that he did not build or improve for pmrpaae of sale_)_ 0 L as owner of(SOer– erty. am exclusively contracting with licensed contractors to conawct the Pro7014. Business and Professions Coda) The Conmcwrs L•i- anse Law doerman owner of property who builds or improves thereon. andwho con=, ejets with a eonuactor(s) licensed pursuant to the Contractors Licaoae rawer 0 1 am exam B R P C for this mama Owner Data —7i&CE I hereby aRBrn unser penalty of perjury ane of the following dedantlonc 0 1 have and will maintain a Certificate of Consent to self -insure for Worker's Canpen- sation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is loaned 0 1 have and will maintain Workers Couapematim Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is Issued My Workers ompenaa_don insurance carrier and Policy number arc _bO be Cartier.^ PolieyNa. 7451021 CERTISCATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be eompkkd If the permit Is forono hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is bane. I shat( not employ any person in any maturer so as to become subject to the Wakens' Compenzation Laws of Califortda Dam App cam NQnCE TO APPLICANT'. If. after making this Ccaifirato of Exemption. you should become subject to the Workers Compemition provisions of the labor Code, you must forthwith comply with such provisions or this permit skull be deemed revoked CONSTRUCTION LANDING A(IENCY I hereby affirm that there Is a construction lending agency for the performance of the work for which this panda Is. issued (See. 3097, Civ. C) Lenders Name L.aaders Address 1 aatffy that 1 have read this application and sum that the above infammion is cones 1 apse to empty with all city and county ormoattQa and sum lava relating; to building construction. and baeby authorize representatives of this city to cols upon the above-mentioned Property for inspection purposes. agree to ave, indemnify and keep harmless the City of Cupertino apinn UabiddeaudgmCoUl. cops and expenaes which may to any way accrue Against said City In of the panting of this permit. APUNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT SO ONS. 7 si Appl uactor Date HAZARDOUS MATERIALS DISCLOSURE I�Mtbc applicant or thaw budding Occupant arae Or handle hazardous mamrial as defined by the Cupertino M pal Code. Chapter 9.17. and the Health and Safety Code, Seerfm 75532(+)1 0,102 No Will the applicant or future building occupant use equipment or devices which emit ha udous air contaminants as defined by the Bay Area Air Qslity, Managemem Disriet7 0 Ya 2 No ITL ardousmaterlals requirements underChaper6.95 ofthe Caldor- w}kaiSatiam25303.23533aid25334.1adensxdtheifsite budding den notenant, qua k b my xaoxpibility to notify the occupant ofthe IegUlea ma pilar b lasuattce of a Catifiam Of QC_ upocy. Owner or Dam REMODEL -NEW DECK RAILS, Sq. Ft. Floor Area Issued by: Re -roofs Type of Roof PARMFT NO. 07120138 PMUM MSUE DATE 07/08/2008 SANITARY NO. CONTROL NO. BUI DIM PERMTrINFO BLDG ELECT PLUMB Required Inspections Valuation TU Date ?— All 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 . All roof coverings to be Class '2,V' or better CITY OF CUPEkTINO CITY OF CUPERTINO REVISION/DEFERRED PERMIT APPLICATION FORM nil nR (f)3 -7 APN # Date: j5. &.9 �3� bG 0Sp AH Original Permit #: f97t2013la Building Address: 2,D8 0 0 "J M C S"T-C-PVC 2(3 .7 Mailing Address (if different from building address): Owner's Name: Phone #: & ?N.0^n-2rt"C�LA -S M1 4G DL4 C_0 -E7 Contractor: Phone: s Fax: y�8 " 7q Lo — 5-033 Contractor License #: 2.5 395 Cupertino Business License #: 2q 9 Contact: Phone: Fax: W 8 - 71.4 U -'5033 Building Permit Info: Bldg X Elect ❑ Plumb ❑ Mech ❑ Residential © Commercial ❑ Job Description: U7F1 ✓iTy Gt,os� S Is the project in the Wildland- Urban Interface Fire Area? Yes ❑ No ❑ Type of Construction (Usage Class): * Occupancy Type: 1-A, 1-B ❑ II/III/V-A ['� 11/III B; IV -HT, V -B ❑ Valuation (cost of project)- Praject 5aze, Express ❑ Standard ❑ Large ❑ tilajor ❑ Green Building: Please complete relevant portion of the Green Building/LEED Checklist & attach it to the application or if applicable, include in plan set & the sheet index. Points Achieved: For help, contact Build it Green at www.builditgyeen.org Revised 01 /07/09 CITY OF CUPER,TINO CITY OF CUPERTINO REVISION/DEFERRED PERMIT APPLICATION FORM FEE SCHEDULE Quantity Sq Ft Fee ID Fee Description Fee Group Permit Type 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1REVCOMNEW Revision Commercial New B 1* 1REVCOMTI Revision Tenant Improvement B 1* TI 1REVSFDWL Revision SFDWL B 1R3SFDW 1REVRESADD Revision Addition B 1R3SFDADD 1REVRESREM Revision Remodel B 1R3SFDREM 1DEFINSP Deferred Submittal not R-3 Inspection B IDS 1DEFPLNCK Deferred Submittal not R-3 Plan Check B IDS IDEFR3INSP Deferred Submittal Inspection B 1DSR3 1DEFR3PLNCK Deferred Submittal R-3 Plan Chk B 1DSR3 u, CITY OF CUPEfkI"INO CITY OF CUPERTINO ADDITION/REMODEL PERMIT APPLICATION FORM APN # � .� od� O � �14* Date:�C��br�✓ Building Address: t , ?C,�OQ twat. B to► A— Mailing Address '(if different from building addr ss): % 19oo Som 1�r 1..ee�r- Sv& 1' S••�n 3 Owner's Name: rw (f+1% �"w6 Phone #%Am w •s Contractor: Phone #: ! W'C-4- F.�n1le�C� Fax #: 610 SZS — C>S SS Contractor License #: 8Z53dT5 Cupertino Business License #: TSD Contact: Phone #: ` �, i 4�Allell Cc Fax #: 4050 Building Permit Info: Bldg. [� Elect. Y Plumb. [?f Mech. Hillside ❑ Job Description: r What is being atided? �w%, V%4 W� i11� 4f • .,� �` "PP �` �"aolt •k c.}�cl ..--� � �tv�vhbi ,n�. What is being remodeled? 14eyJ Joe4C, r�,l's j 5'��1� f aft% PCAA�- RemodelIncludes Re -Roof: YesNo [/ If yes list number of squares [ Remodel Includes Structural: Yes No ❑ Square Footage: Addition: , S4 Remodel: Garage: Porch: Deck: ;130 Other: 50 Type of Construction (Usage Class): Occupancy T e: 1 FR, 1 1F ❑ 11, 111, V-lHR [-111, 111, 1V V -N [ / K Valuation: check this box if the project is a t2Please ��second -story addition ❑ Green Building Check list must be completed and attached to the plans. Green Building Points Achieved: ***For Office Use Only*** Over -the -Counter 0 CITY OF CUPERTINO r ADDITION/REMODEL CUPE� 1N0 FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft ADDITIONS 1R3SFDADD PLLONGRNGR Long Range PL Planning/Residential 1R3INSP Dwellings Inspections B 1R3PLNCK Dwellings plan check B 1R3REPINSP Dwellings Repeat B Inspection 1R3REPPLNC Dwellings Repeat Plan B Check 1R3HINSP Dwellings Hillside B inspection 1R3HPLNCK Dwellings Hillside B plan check 1R3HREINSP Dwellings Hillside B Repeat Inspection 1R3HREPLNC Dwellings Hillside B Repeat Plan Check 1R3ALTINSP Dwellings Alternate B Materials Inspection 1R3ALTPLNC Dwellings Alternate B Materials Plan Check 1PCESS Cesspool P 1PPRSEWG Ea. Private Sewage P Disposal System 1 PR.SEWER Sewers P 1 BPSPRINK Lawn P Sprinkler/Backflow 1BPWSVCS Main Water Service P 1BSEISMICRE SeismicResidential B DECKS SFD R 71R3SFNRE �j 1DECtKW Deck (Wood) B IDECkRAIELDeck t,�.c�t Railing B CITY OF CUPERTINO ADDITON/R.EMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft GARAGES 1R3SFDADD OR 1R3SFDREM 1 GARDTW<=1K Wood Frame up to B 1,000 SF 1 GARDTM<=1K Masonry up to 1,000 B SF PATIO'S OPEN 1R3SFDADD OR 1R3SFDREM iPATIOWOOD Wood Frame up to 300 B SF 1PATIOMETAL Metal Frame up to 300 B SF 1PATIOOTHER Other Frame up to 300 B SF PATIO'S CLOSED 1R3SFDADD OR 1R3SFDREM 1PATIOENCLW Enclosed Wood up to B 300 SF 1PATIOENCLM Enclosed Metal up to B 300 SF 1PATI0_E_NCLO Other Enclosed Patio _ _ _ . __. B _ _ _ _ up to 300 SF 1COVPORCH Porch Covered B 1REROOFRES Residential Re -roof B Each 100 SF REMODELS 1R3SFDREM 1REMRESKIT Kitchen Remodel up to B 300 SF 1REMRESBAT Bath Remodel up to B 300 SF 1REMREOTH Other Remodel up to B 300 SF REMODEL PLNCK 1 STPLNCK Standard Plan Check B NOT FOR OVER THE 3 . COUNTER PLAN CKS. 3 of 3 4 CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE 4 of 3 Quantity Sq Ft Fee ID Fee Description Fee Group Permit Type WINDOW/SLIDING 1R3SFDREM GLASS DOOR 1WINREP Replacement windows (ea 8 windows B 1WIlNTNEWNSTR New Window (non- structural) B 1WI NIEWSTR New Window (Structural Shear WalUMasonry) B 1WINBAYSTR Bay Window (Structural) B 1BUSLIC Business License B 4 of 3