12090082COVERSHEET
12090082-D
4 02
I&IRODRIGUES AVE
BLDG 9-UNITS A,B,C,D,F,H,J,K, & L
PERMIT # 12-0 00�a DATE q- L5- I z
PROJECT r-o - 1-4Ken-
ADDRESS 200b "ru ge5 A-Y� Rklq 9 L f,-, ds 4,9 d E= J, k C_
APPLICANT (?ih K/5 OWNER (AI:��
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APN# E %jl Q ,-3 CO (�' RES. (LUNG)
(GARAGE)
COMM. SQ. Fr (NEW) IL SQ. FT. RES. REMODEL
CONTACT 3h (I's ct) PHONE# Ct 1(P S 3 3 55-7 FAX
VALUATION (Cost of Project) EMAIL Ch )'i 5 (J i ��C - Cont-
NOTES:
READ. PAID
CONSTRUCTION TAX (Y)
(N)
SCHOOLFEES (Y)
(N)
HOUSINGNMG M
(N)
HEART OF THE CITY (Y)
(N)
ISSUED BY DATE TOTAL FEES
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20100 RODRIGUES AVE CONTRACTOR: INTERNATIONAL PERMIT NO: 12090082
BUILDING INVESTMENT
OWNER'S NAME: LAKE BILTMORE APARTMENTS 6117 GRANT AVE DATE ISSUED: 09/12/2012
OWNER'S PHONE: 6509313400 CARMICHAEL, CA 95608 PHONE NO: (916) 716-9565
❑ LICENSEDCONTRACT R'S DECLARATION
License Class f 22Lic. H /J o
Contractor Date
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
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
permit is issued.
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
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
9.18. `�
Signature Date%l��[l !�
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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)
1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
I 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
Compensation, as provided for by Section 3700 of the Labor Code, for the
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.
1 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
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.
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
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
9.18.
BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
MECH r RESIDENTIAL r COMMERCIAL r
JOB DESCRIPTION: BLDG 9, UNITS A,B,C,D,F,H,J,K, & L-LIKE FOR
LIKE DRY ROT REPAIRS ONLY
NO GUTTER/DOWNSPOUT REPLACEMENT(THIS INCLUDES
BEAMS,& FASCIA) OR CONSTRUCTION OF MISSING PATIO
ENCLOSURES TO MATCH EXISTING ONES UNTIL DIRECTORS
MINOR MOD IS APPROVED BY PLANNING.
Sq. Ft Floor Area: I Valuation: $4500
APN Number: 36903008.20100 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS ?trLAST CALLED INSPECTION.
Issued by: Date:
RE -ROOFS:
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 "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District l will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Owner orized ages
Date:
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Add
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Signature
Date
Licensed Professional
'.1. • k
CUPERTINO
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buifding(ft toertino.ara lid tm'
❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PER1Y9r #
PROJECT ADDRESS APN q 1 03 0 Y
OWNERNAME - i� E-MAIL age, 21%*rnof C so 9 31- 3stoo
7
O d Nor K gt • 5.,. te, i So `six, srArE z� eo G4 9 �t t� 3 Soso 3 -
CONTACT NAME ` 1 Q ja:RE�L+S2,--j
L A'v i
STREET ADDRESS s+ . - CITY. STATE ZlP D 3 FAx $ Sly O
❑ OwNm ❑ OwNER-BT m ^EE A OWNER AaENr ❑ coNu ACTOR ❑ CONTRA=R Aawr ❑ ARcmTECT ❑ a4axEQt ❑ DEVELAPER ❑ TENANT
CONTRACTOR NAME W C5• ` LICENSE N MB SC�qSL, LICENSE TYPE BUS. LIC k �n
COMPANY NAME ,OnAj, -=n EMAIL Gnr�S t b1 i h C.
• F / to
STREET ADDRESS CITY, , � P NE
coll� STATEC4 533-ss94
ARCHrrEC IENGINIIIZ NAME LICENSE NUMBER BUS. LSC #
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY, STATE, ZIP PHONE
DESCRIPTION OF WORK J — , I-,—) e r S Q
EMSMO USE I PROPOSED USa I coxslx TYPE I � srORrEs I USE I TYPE I OCC. I SQ.FT. I VALUATION (5)
E rff NEW FLOOR DEMO TOTAL
' AREA AREA AREA NET AREA �Q�1
BATHROOM IC[TCBEN OnnR ��1100
RFMOI>Fi AREA REMODEL AREA REMODEL AREA
BEMADDEDT ❑NO ADDMONY []NO
PRE-APPLICAIION ❑ YES 7 YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES TOTAL VALUATION:
PLANNWGAPPLe ❑NO PLA11WINGAPPROVALLE EICH=HOME' [jNO
By my signature below, I certify to each of the following I am the property owner or authorized agent to act on the property owner's bebal£ I have read this
app] ication and the information I have provided is correct I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I A -*authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent % Date: q/ 1('/ / 12---
B1dgf4pp_2011.doc revised 06/21/11
The Biltmore Apartments
Building 9
20100 Rodrigues Ave.
Scope of Work:
"Like for like" dry rot repair
A 2x4x12 bottom rail
A 2x2x24 lattice trim
B 2x6x10 trim
B 2x6x8 fascia
B 2x2x16 trim at fascia
B (2)scrape, treat and bondo 4x6 rafter tail end
C 2x4x1 window trim
D (2)scrape, treat and bondo 4x6 rafter tail end
F scrape, treat and bondo 4x6 rafter tail end
H 2x6x12 fascia
H 2x2x12 trim at fascia
J 2x4x6 bottom rail
J 2x2x12 lattice trim
J 4x6x12 rafter
J 2x6x4 fascia
K 2x4 rafter tail
L 4x10x8 beam scrape and treat
L scrape, treat and bondo 4x10 beam end
L 2x4x8 corner trim
L 2x2x10 trim at fascia
L 4x6x12 rafter
L 2x4x16 corner trim
L 4x12x14 beam
Patio Enclosures:
Construct and install missing patio enclosures to match adjacent ones at 3 locations
Gutter/Downspout replacement
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ao "?o avo3o, �Oloo, aaob�, o�ooYo, aooGo/ duo/6
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CUPERTIN0 !Dl6o9, 1"'V'4 /o094j /o/!S� !olds, /Dl3S.i
CONTRACTOR / SUBCONTRACTOR LIST
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax:408-777-3333
JOB ADDRESS:
PERMIT #
OWNER'S NAME:
PHONE # 4/6, • 7/6 • �; 6 $
GENERAL CONTRACTOR:
BUSINESS LICENSE #
ADDRESS:
CITY/ZIPCODE:
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS RAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
/ ; 12--
1 am not using any subcontractors: a��
Signature Date
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Ti le
Owner / Contractor Signature
Date
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: CZ/UV rj
DATE: 09/11/2012
REVIEWED BY: suew/Albert
'VALUATION: $4,500
APN: #: dt%9 -
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY
USE: Multi-Farriily Dwelling
Buildina is
>3 Stories 0 Yes (D- No
PENTAMATION
PERMITTYPE: 1GENRE
WORK
LIKE FOR LIKE DRY ROT REPAIRS GUTTER/DOWNSPOUT REPLACEMENT & CONSTRUCT
SCOPE I
MISSING PATIO ENCLOSURES TO MATCH EXISTING ONES
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District_ etc-)- Thoco (noc tyro hncod nn dio nroliminary i"Mrmatinn availahlo tynd tyro nnly tyn octimalo_ Cnnityrt tho I)ont !nr addn'l in(n.
FEE ITEMS (Fee Resolution 11-053 Ef. 711111)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
=#
$467.00
Deck / Deck Railing
IDECKRAIL Deck Railing
Suppl. PC Fee: (D Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee-.0 Reg.
0 OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
1
O
0
Work Without Permit? 0 Yes Q No
$0.00
Advanced Plannin Fee:
$0.00
Select a Non -Residential
Building or Structure
E)
0
A
Strong Motion Fee:
IBSEISMICR
$0.50
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$1.50
$467.00
TOTAL FEE:
r $468.50
Revised: 07/01/2012
REMODEL FOR BILTMORE APTS
THE PLANS FOR THIS JOB ARE WITH
PERMIT #12090057
10099 S BLANEY AVE