13020044 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20800 HONESTFAD RD CONTRACTOR:MONTEREY - PERMIT NO:13020044
CONSTRUCTION COMPANY
OWNER'SNAME:VILLA SERRA AP.TS 88 MONTEREY-SALINAS HWY STEA DATE ISSUED;02/082013
OWNER'S PHONE: 4086881581 SALINAS,CA 93908 PHONE NO:(831)601-2659
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL LJ COMMERCIAL
lime Class Lic.0 REMODEL BLDG 37(UNITS A-L,9000SF)REFER TO
'/�/� / /, Q i3 MASTER PLAN SET(PERMIT#12030068)
Contractor V/ `6✓1�"V La hS)'Date Ci
1 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.
1 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:$180000
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:32609073.20800 Occupancy Type;
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 T 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 ' CALLED INSPECTION.
indemnify and keep hamiless the City of Cupertino against liabilities,judgments, pp
costs,and expenses which may accrue against said City in consequence of the Date: Z O f
granting of this permit. Additionally,the applicant understands and will comply ism
with all non-point sour regulations per the Cupertino Municipal Cc e,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-BUILDERDECLARATION
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). 1 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 Municipal Code,Chapter 9.12and the
declarations: - Health&Safety Code,Section 25532(a)should I store or handle hazardous
I have and.will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. - will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 5505 25533,and 25534. gg{{
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: V
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,atter 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 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 ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18. -
Signature - Dare
CONSTRUCTION PERMIT APPLICATION DOS
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION /1 ,
10300 TORRE AVENUE•CUPERTINO,CA 95014.3255
CUPERTINO (408)777-3228•FAX(408)777-3333•buildinonD cuoertino.oro I
❑NEW CONSTRUCTION ❑ ADDITION L ALTERATION/TI ❑ REVISION/DEFERRED ORIGINALPERMIT#
PROJECT ADDRESS APN
OWNERNAME (.'J1
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STREET ADDRESS CITY.STATE -71
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CONTACT NAM P NEWAIL
STREET DRFSS„� AA( ATE,CFFY, Z�
OWNER Cf❑(JOWNFR.BUDDER 13 OWNER AGENT ❑.CONTRACrOR ❑CONTRACTORAGENT E3 ARCHrrECT ❑ENGwEER ❑ DEVELOPER ❑ TENANT
CONTRA R IICENSENUMB LICENSETYP BUS.LIC
CO ANYN MAIL - IAA �� 'CGVIh F
S REST ADD S SCiTYAr ZIP
ARCHITECT/ENGINEER 14 LICENSENUMB (�( BUS.LIC#
COMPANY NAME EXAM F
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STREET ADDRES ' CrrY,ST TE, PHO
DESCRIPTION OF WORK 1
EXISTING[JOE\ PROP SID' CONSTR.TYPE #STORIES
I I 0.1 (C{� USE TYPE OCC. SQ.FT. VALUATION(S)
EXISTDEMO
AREA G fAREA R AREA
BATHROOM KHCHEN OTHER III l/t
REMODELAREA I REMODELAREA PE40DELAREA
PORCN AREA DECKAREA TOTALDECMORCH AREA GARAGE;395 DETACH
[]ATTACH
#DWELIINGUNn5: ISASECONDUNIr ❑YES SECOND STORY YES
BEINGADDED? [3NO ADDITION? E]NO
PREAPPUCATION DYES 7 YES,PROVIDE COPY OF ISTHEBLDGAN OYES14
TOTAL VALUA770�':
PLANNINGAPPL# E]NO PLANNINGAPPROVALLEITER EICHLERHOME? EjNO
By my signature below,I certify to each of the following: I am the property owner or autho ' a act o e er's behalf. I h e read this
application and the information I have provided is oorrea IIVNe 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 co cti autho9ze rewtsentanveS of Cupertino to enter the above-identified property for inspection purposes.
SignatureofApplicam/Agent: Date: 2
SUPPLEMENTAL INFORMATION REQUIRED c scx.YP " ex'o'ot7m s`T3L P
_New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required OVE b TEIt i{�].BU"6h'D�II�+G�Iggh:�ANR�E\'fiery^e.
prior to issuance of building
permit for new building.
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
form if any Hazardous Materials are being used as part of this project :xC
_Copy of Planning Approval Letter or Meeting with Planning prior to ,
II ERD ST T,
submittal of Building Permit application. ' _C
"e EN17R0 T'IEN7AEH Atii
B1dgApp_2011.doc revised 06/21111
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 20800 HOMESTEAD RD DATE: 02/0812013 REVIEWED BY: MELISSA
APN: 32609073.20800 BP#: 'VALUATION: $180,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY I Building isPENTAMATION 1R2REM
USE: Multi-Family Dwelling >3 Stories 0 Yes 0 No PERMIT TYPE: A.
WORK REMODEL BLDG 37 UNITS A-Q REFER TO MASTER PLAN SET PERMIT# 12030068
SCOPE
M 4�
fib ''rgi,{4 n,4' 1
+,'S'$
Meeh.Plan Check 0.0 Ins $0.00 Plumb. Plan Check Dec. Plan Check
Meeh.Permit Fee: IMPERMIT Plumb. Permir Fee: Flee, Permit Pce
Other Mech.Insp. 1 0.0 hts $45.00 Other Plumb Insp. Lj
Ocher Elec.Insp.
ELI
Alech. Insp.Fee.' - Plumb. hup.Fee: Elec.Insp. Fee'
NOTE.This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District etc.). These ees are based on the prelfWnarp information available and are only an estimate Contact the Dept for addn't info.
FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/121 FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 F9,0001 s.f. Remodel,Other
Suppl.PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 $9,539.00 IREMRES3
PME Plan Check: $0.00 12 # Mechanical
Permit Fee: $0.00 $804.00 1 IBREMAIR A/C Units(<--I OK cfm)
Suppl. Insp. Feer Reg. 0 OT 0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $45.00
Cvnsiruction Tax:
Administrative Fee: IADMN $42.00 0
Work Without Permit? 0 Yes 0 No $0.00 O
Advanced Planning Fee: $0.00 Select a Non-Residential 0
Travel Documentation Fee: ITRA VDoc $45.00
Building or Structure 0
Strong Motion Fee: IBSEISMCR $18.00 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $8.00
' T'OTALFEE $10,501.00
$158.0 10,343.00
n \ Revised: 01/01/2013
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: 408-777-3228
CUPERTINO Fax: 408-777-3333
CONTRACTOR/SUBCONTRACTOR LIST'
JOB ADDRESS: PERMIT# 02-00 t/
OWNER'S NAME: PHONE#.
GENERAL CONTRACTOR ah A S�7 ` ` 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 HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
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
Tile
Ow&4 Contractor Signature Date