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08050060 - PUB70' ; U, 9/j N/, #4 4 ;d 0 F /*97 4040v/cl: oe :ile Edit Actions Details Links Favorites Help Permit Information Permit Number 08050060 1 Status C - Closed Master Number C(2k:l Notes Project Apply Date' 05/0_5/_2_008ffl_! Operator Permit Issue Date 05/13/2008 Operator Certificate Issued ; Operator Certificate Type Certificate Number L Location Information Address " 20670 GREENLEAF CT LOT 3 City/State/Zip CU PE R T I N 0 195014 APN 32633107.3 U nit ,patg Ok,,,ner Entity Information patg lOwner Name 'l GREENLEAF­ASSOC­­­­-, Use Default Address Home - 20670 GREENLEAF CT LOT 3 City/State/Zip CUPERTINO Permit Property Zoning Applicant !I Contractor Defined Fields Permit Details Permit Type 1R3SFDW SINGLE FAMILY DWELLING Usage Class L11, 111, KV - N DONT USE Applied Value 100 i SQUARE FT. Calculated Value F_ o* US C-404 Type 101 NEW: SFD, DETACHED Permit Form IAUTOPERM - PERMIT Ownership 1 -Private Project Size lermit issued 0511312008 Inter the purpose or any special conditions for this permit CA 95014 Purpose/Special Conditions REVISION -REVISE STRUCTURAL FRAME -TRUSS CALCS ORIGI i#07020040-NO NEW PERNIT- FILMED- 2011 JMAdd Default T J%/ OK 14* Back r _ Ir-1 Contractors Irliz Fees Plan Reviews Inspections 4 Print Permit jeAdjustments J!!J Hold, Copy Permit lQ Close Permit Overrides MN Supplemental Fields ,I Notes dAttachments 02 Zc ^� u W�G. UC LL f- or_ FrJ f•-r U U`e CITY OF CUPERTINO BUILDING DIVISION PERMITt�� : x ' Bu1L.q TtTMREENLEAF CT LOT 3 NEXGEN BUILDERS, INC. PERMIT NO. 08050060 OWNER'S NAME: PERMIT ISSUE DATE GREENLEAF ASSOC 225 DEMETER ST 05/13/2008 PHONE: SANITARY NO. CONTROL NO. (650) 322-5800 ARCHrfECf/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 700M ofDivision 3 of the Businessand Professions Code, and my license is REVISION —REVISE STRUCTURAL FRAME —TRUSS CALLS In full force and Off Intel to a Llc.t► 2a Date _ Contractor ti — J ORIGINAL #07020040—NO NEW PERMIT. ARCHITECT'S DECLARATION 1 undeasand my plans shall be used as public records Licensed Professional OwNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractors License Law for the following mason. (Section 7031.5. Business and Professions Code: Any city or county which requires a permit to construct. alter, improve• demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to rile a signed statement Contractor's License Law 9 Sq. Ft. Floor Area Valuation that he is licensed pursuant to the provisions of the (Chapter 3 Business Professions Code) $10 0 (commencing with Section 70f)0) of Division of the and or that he is exempt therefrom and Ole basis for the alleged exemption. Any violation of 3 2 6 3 310 7' T N Number Occupancy Type Section 7031.5 by any appfiam for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (S500). ❑ L as owner of the property, or my employees with wages as their sole compensation, Required Inspections will do the work• and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does tent apply to an Owner Of property who builds or improves thereon, and who does such work himself or through his own employees• provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of compled(n• the owner - builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑ L as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code:) The Contractors Li- cense Law does not apply to an owner of property who Wilds or improves thereon. and . who contracts for such projects with a contractor(s) licensed pursuant to the Contractors License Law. ❑ I am exempt under Sec , B & P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a Certificate of Consent to self -insure for Workers Compen- sation, 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 Workers Compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued My Workers��CCo�•ommpensati^o�nn,,ln__su^r cc carrier and Policy number am: Carrier. t5we coop Policy No.1/1'960 �27 CER71FICATE OF EXEMP170N FROM WORKERS' COMPENSATION INSURANCE (This section need notbe completed if the permit is forone hundred dollars (SI00) or less.) 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 Workers' Compensation Laws of California Dale Applicant NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers Compensation provisions of the Labor Code, you must ' forthwith comply with such provisions or this permit shall be deemed revoked. ) ' CONSTRUCTION LENDING AGENCY � I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is Issued (Sec. 3097, Civ. Q Lenders Name Lenders Address I Certify that I have read this application and sate that the above information is ' correct. I agree to comply with all city and county ordinances and sate laws relating to building convection, and hereby authorim representatives of this city to cater upon the above -mentioned property for inspection purposes (We) agree to save, indemnify and keep harmless the City of Cupertino against j liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the granting of this parmit. ' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date E SO REGULA ONS. fil 13 &% _ A '-� • Re -roofs �- Type of Roof Sig ure ol'Appli UContracwr Dam HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant scare or handle hazardous material as dcrined by the Cupertino Municipal Code, Chapter 9.12. and the Health and Safety Code, Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes 4KNo If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. Districl7 ❑ Yes Jk& 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health & Safely Code• Sections 25505, 25533 and 25534.1 understand thatif the building does not currently have a terant that it is my responsibility to nodry the occupant of the mremcntswh.chmust be a nortoissuanceofaccnirwateofOccupancy. Signature of Applicant Date 4-l3_0I'-- a All roof coverings to be Class''` or better Dam Owner o authorized agent U�3 0 0�?0 moo(0 CITY OF CUPEI�JINO CITY OF CUPERTINO REVISION/DEFERRED PERMIT APPLICATION FORM APN # (� - 5-(o - 0-2, `j Date: �-- Original Permit #: 8 7 0 Q, GC) L/10 Building Address: a Olj %O 6r cc H �evt -10 C+ Mailing Address (if different from building address):S-f- �, /0�!/0 303 Owner's Name: Phone #: �' S ._ c1LI L/ _ l r CyZ6T%►�b Gr[cN If fQT L�- Contractor: �tr�X Grit/ %�rl���s' Phone: 6' �� 3 2 Z s� 00 ex Fax: r-b - 3;�2- 5—uq06 Contractor License #: Z� - 7 0 1�1( Z 8 Cupertino Business License #: a `� y 3 Contact: �-I Q VA - Phone: o - Q Fax: 3 2 2- S p ©- Building Permit Info: Bldg ® Elect ❑ Plumb ❑ Mech ❑ Residential ET Commercial Job Description: Is the project in the Wildland- Urban Interface Fire Area? Yes ❑ No ❑ Type of Construction (Usage Class): * Occupancy Type: 1-A, 1 I-B ❑ 11, 111, V-A ❑ 11, 111, IV V-B Project Size: Standard 'V] Large Major Valuation (cost of project): /,!� 0 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.builditpreen.org CIYY OF CUPEIQTINO CITY OF CUPERTINO REVISION/DEFERRED PERMIT APPLICATION FORM FEE SCHEDULE Quantity Sq Ft Fee ID Fee Description Fee Group Permit Type 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 1* 1 DEFPLNCK Deferred Submittal not R-3 Plan Check B 1 * OR 1* TI 1DEFR3PLNCK Deferred submittal R-3 Plan Chk B 1R3SFDW 1R3SFDADD 1R3SFDREM 2 of 3