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15020042CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10159 S BLANEY AVE CONTRACTOR: BYLDAN CORPORATION PERMIT NO: 15020042 OWNER'S NAME: LAKE BILTMORE APARTMENTS PO BOX 60970 DATE ISSUED: 03/30/2015 OWNER'S PHONE: 6509313457 PALO ALTO, CA 94306 PHONE NO: (650) 614-1149 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL —, License Class r l Z 13 BILTMORE CLUBHOUSE- FOUNDATION ONLY Lic. # REV#1 - FOUNDATION DETAILS FOR GRID LINES C&D #5 ContractorQ!✓ Date U - issued 6/30/15 I hereby affir 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: $100000 ,PYr ance of the work for which this permit is issued. ave 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: 36903408.10159 Occupancy Type: 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 to building construction, and hereby authorize representatives of this city to enter WITHIN 180 ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save 18 F LAS ED 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 granting of this permit. Additionally, the applicant understands and will comply Issue a / , with all non -point sour a regulations per the Cupertino Municipal Code, Section All roofs shall be inspected prior to y roofing material being installed. If a roof is any 9.18. Signature i 6 .�ir4 Date r�G !1 installed without first obtaining an inspection, I agree to remove all new materials for inspection. 13 OWNER-BUILDERDECLARATION I hereby affirm that I aro exempt from the Contractor's License Law for one of Signature of Applicant: Date: 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 Municipal Code, Chapter 9.12 and 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 Cupert' o Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections , 2553 nd 25534. . Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. / Owner or authorized agent: , v Date: (f U 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 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 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 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 Date >s CUPERTINO ❑ NEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION WB COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISIO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228• FAX (408) 777-3333 • buildin cup rtino.or ❑ ADDITION ❑ ALTERATION / TI RREVISION / DEFERRED ORIGINAL PERMIT # .SU BldgApp_201 1. doc revised 06/21/11 PROJ£CfADDRESS �� /y ��•� I APN# L/lr.'I.�©� ��� ` OWNER NAME ��'Pi�'"� ALL PHONE E-MAIL ' �I CITY, ST STREET ADDRESS /i3D O ` f Cd I FAX e 'Z CONTACT NAME _ pH0 STREET ADDRESS CITY, STATE, ZIP FAX OWNER ❑ OWNTER-BUMDER OLS VWERAGENT 13 CONTRACTOR ❑COT�'TRACTORAGENT ❑ ARCHITECT ❑ ENGDZEER ❑ DEVELOPER ❑ TENAN, CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPAINY NAME E-MAIL FAX STREET ADDRESS I CITY, STATE, ZIP PHONE ARCHITECT/ENGLtiEER NAME LICENSE NUMBER, w �// BUS. LjG /,47 COMPANY NAME�-. c E-MAIL /�N FAX ,5 1014w S mss, ��. s')® � j `�.> STREET ADDRESS CITY, ST.ATE�ZIP, PHONE • - DESCRIPTION OF WORKe-;;Of- F Of &? &e%eo' V &-eaAi gexee- 4:2;� x EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXLSTG NEW FLOOR, DEMO TOTAL AP.EA AREA AREA NET AREA ,. BATHROOM. KITCHEN. OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECYJPORCH AREA GARAGE AREA: DETACH I. —YES ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT 11 SECOND STORY LYES BEING ADDED? NO ADDITION? ONO PRE- APPLICATION ❑YES IF YES, PROVIDE COPY OFIS PLANNING APPL m E] NO ' PLANNING APPROVAL LETTER THE BLDG AN YES ❑ EICHLER HOME? ❑ NO VE Ib:BY - _' 's TOTAL VALUATION: By my signature below, I certify to each of the following: I am the property owner or author' d agent to act on the property owner's behalf. I ha« read this application and the information I have provided is ct. 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 co ction. -I aut rize representati sof Cupertino to enter the above property property for inspection purposes. SignatureofApplicant/Agent: Date: SUPPLEMENTAL lI�I-V'-N ATION REQUIRED .�E��P,L•_Ai��HECK�'t1P����' �x�.�,�zutI�GSLI1; , New SFD or Multifamily d -Wellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building for new buildinag. �� OYER THE COUNTER �ifB7JIYDL�G LREYfEi4# permit -lam- _ Commercial BldgS: Provide a completed Hazardous Materials Disclosure D ��� -❑' PUBL�c� form if any Hazardous Materials are being used as part ofthis project. z ARGEi`�=�' `� _Copy of Planning Approval Letter or Meeting with Planning prior to 6 I` submittal of Building Permit application. MA70R"s ��S1�TTAtIgSERG .� � ,a-� �-���'� .� .___��-RDIST RIC ��-� BldgApp_201 1. doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION NU7E: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the nreliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef. . 7/1113) ADDRESS: 10159 S. Blaney Ave DATE: 06/26/2015 REVIEWED BY: Paul :Meeh. Pernrrl Fee: APN: 369 03 008 BP#: Q "VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: --[PERMIT PENTAMATION 1GENRES TYPE: WORK Revision #1 Biltmore Clubhouse - Revise foundation detail at Grid Lines C&D #5 SCOPE NU7E: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the nreliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef. . 7/1113) i9ech. Plan Check P11w1h. Plcua ('hccc'k 1.lec. Plan Check :Meeh. Pernrrl Fee: Phj"nh. Permit J'A" Fc Other tlec•h. /nsP 01her Plumb Ins, .ELI Ofher lilec. Ins.,?. 14ech. /nap. Fecc. 1'171101, hrsh. Fee. L:lc,c- Insp, Fe(!. NU7E: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the nreliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef. . 7/1113) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? () Yes (F) No $0.00 2 hours $286.00 Plan Check, Hourly ISTPLNCK Suppl. PC Fee: E) 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 ( Onsirliclion 1(Lv: Administrative F(?UU Q G Work Without Permit? Yes (j) No $0.00 Advanced Plannin Fee: $0.00 Select a Non -Residential Building or Structure � Trex�el Dcic°errrre�z�Jalinn 1�'e+e.5: Strong Motion Fee: $0.00 2.0 hrs $286.00 Inspections ISTINSP Inspection, Hourly Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 1 $572.00 TOTAL FEE: $572.00 Revised: 05/07/2015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10159 S BLANEY AVE CONTRACTOR: ZB8-449-BE PERMIT NO: 15020042 DF_.TEE D OWNER'S NAME: LAKE BILTMORE APARTMENTS DATE ISSUED: 03/30/2015 OWNER'S PHONE: 6509313457 PHONE NO: ❑ !l /LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL BILTMORE CLUBHOUSE- FOUNDATION ONLY License Class Lic. # 71CF/ `/Z— Contractor Date f% / 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 ensation, as provided for by Section 3700 of the Labor Code, for the rformance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $100000 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: 36903008.10159 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 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 F LAST CALLED INSP C ION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the l�6 Issued by: Date: granting of this permit. Additionally, the applicant understands and will comply with all non -point so ce regulations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signature 1-� Date 3 .30 f _ 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 Municipal Code, Chapter 9.12 and 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 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: 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 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 Date CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - building�or�-cupertino.org M NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / Ti ❑ REVISION / DEFERRED ORIGINAL PERMIT # B PROJECT ADDRESS 10159 South Blaney Avenue APN # 369-03-008 OWNER NAME Lake Biltmore Apartments, a California limited partnership PHONE 650 931-3457 E-MAIL mducote@prometheusreg.com STREET ADDRESS 1900 South Norfolk Street, Suite 150 CITY, STATE, ZIP San Mateo, CA 94403 FAX 650 931-3657 CONTACT NAME Michael Ducote PHONE 650 931-3457 E-MAIL mducote@prometheusreg.com STREET ADDRESS 1900 South Norfolk Street, Suite 150 CITY, STATE, ZIP San Mateo, CA 94403 FAX 650 931-3657 ❑ OWNER ❑ OWNER -BUILDER LJ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Michael Kaizoji LICENSE NUMBER 719142 7 LICENSE TYPE B BUS. LIC # COMPANY NAME Clarum Communities E-MAIL mlchael@clarum.com FAX 650 681-9521 STREET ADDRESS 412 Olive Avenue CITY, STATE, ZIP Palo Alto, CA 94306 PHONE 650 322-7069 ARCHITECT/ENGINEER NAME Ray Welter LICENSE NUMBER On file BUS. LIC # On file COMPANY NAME Studio T -SQ., Inc. E-MAIL rwelter@studiot-sq.com FAX 510 451-2850 STREET ADDRESS 304 12th Street, Suite 2A CITY, STATE, ZIP Oakland, CA 94607 PHONE 510 2860 DESCRIPTION OF WORK We are requesting a foundation only permit for this development. EXISTING USE PROPOSED USE CONSTR TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG AREA NEW FLOOR AREA 5,000 DEMO AREA TOTAL NET AREA BATHROOM REMODEL AREA KITCHEN REMODEL AREA OTHER REMODEL AREA PORCH AREA I DECK AREA TOTAL DECKRORCH AREA I GARAGE AREA: n DETACH ❑ ATTACH # DWELLING UNITS: ] ISA SECOND UNIT YES BEING ADDED? NO SECOND STORY ❑ YES ADDITION? ONO PRE -APPLICATION []YES IF YES, PROVIDE COPY OF PLANNING APPL # []NO PLANNING APPROVAL LEITER IS THE BLDG AN YESCEIVED EICHLER HOME? NO BY: r TOTAL VALUATION: $100,000.00 By my signature below, I certify to e c e following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I ha v ed 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 u 1 construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: Februrary 6, 2015 SUPPLEMENTAL O ATION REQUIRED _ New SFD or Multifamily dellings: pply for demolition permit for existing building(s). Demolition ermit i required 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. _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER BUILDING PLAN REVIEW ❑ EXPRESS P ING PLAN REVIEW STANDARD BLIC WORKS ❑ LARGE RE DEPT ❑ MAJOR ❑ SANITARY SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH BldgApp_201 1. doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR —BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the nreliminary information available and are only an estimate- Contact the Deptfor addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef. 711.113) ADDRESS: 10159 s blaney ave DATE: 02/06/2015 REVIEWED BY: Mendez 117 !omit F11"i . F APN: BP#: ® "VALUATION: 1$100,000 %PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY SFD or Duplex USE: _T Ph!wh. I;r p. PENTAMATION 1 GENRES PERMIT TYPE: WORK biltmore clubhouse- foundation only SCOPE NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the nreliminary information available and are only an estimate- Contact the Deptfor addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef. 711.113) Ah..'Ji I,hoI i'i"1c(iY Ptllnlb. Pktfl T 1-Jec. Phis 117 !omit F11"i . F umh /'cr"mil /'ec. L'Cf Fcc C?;lrer 'ilr�h lrr.ct, 01her Plumb h'ap Other Li'!(. h2sp. LJ I ll: chlee Ph!wh. I;r p. 0.0 NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the nreliminary information available and are only an estimate- Contact the Deptfor addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef. 711.113) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? () Yes Q No $0.00 4 hours $572.00 Plan Check, Hourly ISTPLNCK Suppl. PC Fee: Q Reg. B 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 1 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXR 0 ]units # new $0.00 _ldlninistrative Fee: Work Without Permit? Yes (F) No $0.00 Advanced Plannin Fee: $0.00 Select a Non -Residential Building or Structure � Tran -fl I)c�cttmctivutirll� I-��.�: Strong Motion Fee: IBSEISMICR $13.00 4.0 hrs $572.00 Inspections INSP Inspection, Hourly IST Bldg Stds Commission Fee: 1BCBSC $4.00 SUBTOTALS: $17.00 $1,144.00 TOTAL FEE: $1,161.00 Revised: 01/06/2015