08020186CITY OF CUPERTINOr
BUILDING DIVISION PERMIT
�CONT.RACT.QRINF'ORMATION
A x yy.R!',d`Fi
BUILDIjJrAIaD IFTORRE
_
PERMIT NO. '
AVE
TBD — TO BE DETERMINED
08020186
NER''StJNAAMEu
PERMIT ISSUE DATE
TORRE AVENUE PROJECT —NO 11
02/27/2008
IrnONE:
SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Job D85CrIpC10n
1 Mmby affirm Net I am li¢nud under provisions Of Chaprer 9 (mmmuming
with Section 70M1)or Division J ofthe Business rand Prufcssiom Cade, and my license
TEMPORARY BACK—UP GENERATOR
in full forte and effect.
License Class Lle.d
Dom Contractor
ARCHITECTS DECLARATION
I mldereand my plans shall he used M public recoreh
Licensed Pmresslonal
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the
following ..on. (Section 7131.5, Business and Professions Cock: Any city ar rouray
which requires a permit to cornu act, eller. improve, demolva. or repair any structure
prior to its issuance. ars halo. tw applicant for such Permit to Brea signed midannent
that he is licensed the of the Cantrmcmri License Law (Chapter 9
Sq. Ft, Floor Area
Valuation
punuanuo provisions
10 0
(commencing with Section 7") M Division 3 of the Business and Professions Code) or
that he Is exempt therefrom and the hole for the alleged asempt Any vitt adon of
AptsJ Number
Occupancy Type
Section 70713 by any applicant for a Permit subjects the applicant o a civil Penally of
not mom than five hundred dollen ($SW).
3 6 9 0 2 0 2 7, L V
❑ LMhe.,L the progeny, withwagass
Required Inspections
sia(Sm. (1 Buatim,
remy;mployea
will PathesionsCdc so Bouts offered mama (Sec. ss
Buminten
steamsternizol
an an, of
Nd Cont LIG2 IJW MI apply lf rt
whobu Csor
Y P
uch rough is
property Willi mdomme. dmaomhwort himselfaltheea his
pommywhobuildsvkimpmt
suthereon.andwho
awn NasmhimPm not ourofoom soadusl Offered ideal
ping
ver. thea,
or withinamywofromovefortheowner-
old wit in
hawdr. the building Orden
of pmmtehat
builder will have the herder of proving that he did ret build ar improve far Pu.P^'- of
.
1.
1, as moms of the propene, em cam usively cmalmoomg with licensed ronusm. to
Imct the project (Sec. wdq Business and Professions Code:) The Conmam's Li.
eve taw Of prepent, who builds or improv thetmn. and
whOcontraamnux )licenedpunuantmtheConuacmhLicense
ta❑lam
2nP'y=7`m`
ex,B h PC fmysuimpers,
Date
WORKERTCOMPE_N5 ON DE LARATION
ihichdilaNnehisissucii.
❑Ibill mainmin aCerdfia.ofCormmmslf-insumforWmkcraCampm-
smion,ded for by Section 27Wmf the tabor Code, for the pOAurmance ofthe
workf
❑ I have and will maintain Worker's Compensation Insurance, as required by Section
770(of the labor Code, for the peRormance of the work for which this permit a instal.
My Workers Compensation Insurers prier and Policy number art:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(The section moil net w compl;.d If she Permit is fere. hundmddollus (SIOO)
nr less.)
I modify that in the perfasman c of work for which this permit is issued. I shall nos
employany'peconin anym the M-in me jeciml�e Workcrs'Compcnsad
yn
Laws or California. Dose
Applicant
NOTICETO APPLIC t making the Ceniac of Facm 'an, you W
become subject m the I is Compciiiation groat ' of the Laix r Code, you mew
(oMwith emoplY with h povisiom ar the p.rmil shall w deemed .caked.
I
CONSTRUCTION LENDING AGENCY
I herchy aRrm that trt 1... ortswaion lending agency for the perfmmamx of
' the work for which this permit is issued (Sec. 7W7, Civ. C.)
"
Lender's Name
,
,
Lender's Addmas
j I certify that I have mad this application and Sam that the eburs information is
comeel.1 agree to comply with all city and county Ordinances and sure laws misting to
building construction, and hereby awhorim.pesenlatives O(Ohis city torr pnn Ne
.hive mendmild onpeny for insmetion purposes.
(We) agree save, indemnity and luMp harmless the City of Copenino against
i Estilida,judgmc cos dexpencetwhi h may in anyway Mame against said City
in conugmntt o TITh; g n ng of lei per '
APPLICANT DE ANDS D L COMPLY WITH ALL NON-POINT
Issued by: Dale
SOURCE RE LA S.
Re-roofs
SignammO anU anus r am
% HAZARDOUS MATERIALS ISCLOSURE
Type of Roof
Wil) theapplicantor future Wilding om l+mr; or handle h+ralloua material
as deflncdby ft Cupertino Municipal Code, Chapter 9.12, and the Health and Safety
deise tion 255320)?Yes
All roofs shall be inspected prior to any roofing material being installed.
XNa
If a roof is installed without first obtaining an inspection, I agree to remove
Will he applicant ar mtrm wilding «mean( as gtripm;ret or devices which
colt havardous air contaminants as defined by she Bay Ansa Air Quality Management
all new materials for inspection.
District?
❑ Ya u
I have mel dy hamN ma.rlals rCwp.r6.95 arthe Glifory
ria HcaWgs SafmY 'ons2 5,2unthcrsand thatirthc building
dons not artcnth ant, It a m wtify the mapent n the
meet
reyuLmcnuw It mt ilate arca r.
&.I
Signature of Applicant Date
AI I roof coverings to be Class "B or better
-
owner ar tha..ed Mgo,, D .
•
•
EAJ
4 ITEMS OF 4
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 36902027.00
DATE ISSUED.......: 02/27/2008
RECEIPT #.........: BS000004043
REFERENCE ID # ...: 08020186
SITE ADDRESS .....: 10150 TORRE AVE
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
OWNER ............: TORRE AVENUE PROJECT -NO 11
ADDRESS ..........: 10150 TORRE AVE
CITY/STATE/ZIP ...: CUPERTINO, CA 95014
RECEIVED
FROM ....: CHATEAU CUPERTINO
CONTRACTOR .......: TBD
- TO BE
DETERMINED
LIC # 00096
COMPANY ..........:
TBD
- TO BE
DETERMINED
ADDRESS ..........:
CITY/STATE/ZIP
.... ,
TELEPHONE
........:
FEE ID
UNIT
QUANTITY AMOUNT
PD -TO -DT
THIS REC NEW
BAL
----------
1BSEISMICO
-------------
VALUATION
--------------------
1,000.00
0.63
----------
0.00
---------- ----------
0.63
0.00
1ELECINSP
HOUR
1.00
122.38
0.00
122.38
0.00
1EPERMITFE
FLAT RATE
1.00
..40.79
0.00
40.79
0.00
1TRAVDOC
FLAT RATE
1.00 -
40.79
0.00
40.79
0.00
TOTAL PERMIT
-7
--------
204.59
----------
0.00
---------- ----------
204.59
0.00
METHOD OF
-----------------
PAYMENT
---------------
AMOUNT
REFERENCE NUMBER
CHECK
204.59
--------------------
#018861
TOTAL RECEIPT
---------------
204.59
a � 1
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m715 ooh`
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a2 CITY OF CUPERTINO
C o
CUPEkTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN # 3 (PqD a o ; I OO
Date: —D
Building Address: Ci ff�/ept) (?,vP5✓L71-1,00
/Oln U / 02/LeAijC , �-N U 6
Mailing Address (if different from
om building ddress):
Owner's Name:
Phone #:
Age -E Avcxlae Pte-- G� A _ --
(Llwo- 366
Contractor:
AjoAj e
Phone: /
Ai(
Fax:
Contractor License #: �—
Cupertino Business License #: �--
Contact:
7Fax:
T /
Residential ❑ Commercial
Job Description:
Building Permit Info: n ,/
,
Bldg ❑ Elect ❑ Plumb ❑ Mech ❑
Type of Construction (Usage Class):
Occupancy Type:
1 FR, 11FR ❑ 11,111,V -IHR ❑ 11, 111, 1V V -N
P--
Valuation: Square Footage:
Project Size: Standard ❑ Large ❑ Major ❑ /�
/Il.
CUPEf�TINO
CITY OF CUPERTINO
GENERAL BUILDING
PERMIT APPLICATION FORM
0
Quantity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
]GENRES or
1GENCOM
1BTEMPPER
Temporary Building Permit (good for
B
30 days)
1BBOILERI
For the installation or relocation of ea
M
boiler/compressor to & including 3
horsepower, or ea absorption sys to &
incl 100,000 Btu/h 29.3kw)
113BOILER2
Installation /relocation of ea
M
boiler/compressor over 3 horsepower
to & incl 15 horsepower, or ea
absorption ss over 100,000 Btu/h
1BBOILER3
Installation/relocation of ea
M
boiler/compressor over 15 horsepower
to & incl 30 horsepower, or ea
absorption sys over 500,000 Btu/h to
& incl 1,000,000 Btu/h
IBBOILER4
Installation/relocation of ea
M
boiler/compressor over 30 hosepower
to & incl 50 horsepower, or for ea
absorption sys over 1,000,000 Btu/h to
& incl 1,750,000 Btu/h
IBBOILER5
Installation/relocation of ea boiler or
M
refrigeration compressor over 50
horsepower, or ea absorption sys over
1,750,000 Btu/h
IBAPPLOTH
For ea appliance or piece of equip
M
regulated by this Code but not classed
in other appliance categories, or for
which no other fee is listed in this
code.
JIELECINSP
Other Electrical Inspections (per hour)
E
1MECHINSP
Other Mechanical Inspections (per
M
hour)
IPLM 3INSP
Other Plumbing & Gas Inspections
P
(per hour
1MEETINGIHR
Application Meeting
B
son CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
CUPERTINO
FEE SCHEDULE
Quantity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
1GENRES or
1GENCOM
ACOUSTICAL
REVIEW
IACOUSFDW
SFDWL/Duplex New
B
lACOUSRESAD
SFDWL/Duplex-Addition/Alteration
B
1ACOUSCOM
Multi-Family/Commercial
B
CHIMNEY'S
1CHIMNEY
Chimney
B
1CHIMNEYR
Chimney Repair
B
FENCES
1FENCE>6FT
Non -masonry, over 6 ft in height
B
1FENCEMAS>6
Masonry, over 6 ft in height
B
FIREPLACES
1FIREPLMAS
Fireplace Masonry
B
1FIREPLFAB
Fireplace Pre-Fabricated/Metal
B
1FLAGPOL>20
Flag pole (over 20 ft in height)
B
1MODUSTRU
Modular Structures
B
FOUNDATIONS
1FOUNDREP
Foundation Repair
B
1PILECAST
Pile Foundation Cast in place concrete
B
1PILEDRIV
Pile Foundation Driven (steel, pre-
stressed concrete
B
3 of 5
CITY OF CUPERTINO
CUPEI�F GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
1GENRES or
1 GENCOM
RETAINING
WALL(CONCRETE
OR MASONRY)
1RETSTN
Standard (up to 50 R)
B
1RETSP310
Special Design, 3-10' high (up to 50 `)
B
1RETSP10
Special Design, over 10' high (up to
50'
B
1RETCRB<
Gravity/Crib Wall, 0-10'high (up to
50 ft
B
1RETCRB>
Gravity/Crib Wall over 10' high (up to
50 ft
B
SIDING
1 SIDESTBK
Siding, Stone & Brick Veneer
(interior/exterior)
B
1SIDEOTHER
Siding all other
B
SKYLIGHTS
1SKYL<l0 SF
Skylight less than 10 sf
B
1 SKYL>10SF
Skylight greater than 10 sf or
structural
B
1STAIRS
Stairs -first flight/ea addt'1
B
STORAGE RACKS
1 SRACKS<=8
Storage Racks 0-8' high (up to 100 sf)
B
1 SRACKS>8
Storage Racks over 8' high (up to 100
st
B
1STUCOAP
Stucco Applications (up to 400 sf)
additional stucco application
B
4of5
a410
• CUPEkTINO
r
L
CITY OF CUPERTINO
GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf
Fee ID
Fee.Description
Fee
Group
Permit Type
IGENRES or
1GENCOM
1 WINREP
Replacement windows/sliding glass
door ea 8 windows)
B
1WINMEWSTR
New Window -structural shear
wall/masonry (includes plan ck fee)
B
/
1 EPERMITFEE
Electrical Permit Fee
E
IMPERMITFEE
Mechanical Permit Fee
M
IPPERMITFEE
Plumbing Permit Fee
P
IELCPLNCK
Stand Alone Electric Pln Ck (hourly)
E
1MECPLNCK
Stand Alone Mechanical Pln Ck (hrly)
M
IPLMPLNCK
Stand Alone Plumbing Pln Ck (hrly)
P
1 STPLNCK-(3 Hr Min
when not over counter)
Standard Plan Check (when no E/M/P)
hourly -stand alone
B
1BSEISMICR
Seismic Residential
B
/
IBSEISMICO
Seismic Commercial
B
1TRAVDOC
Travel & Documentation
B
1BUSLIC
Business License
B
5 of 5
/11 1 r (41 -3 00
0
C1
r1
U
i�
CITY OF
OUPER,TINO
0
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
Building Department
JOB ADDRESS:
PERMIT #
OWNER'S NAME:j p
PHONE # —
GENERAL CONTRACTOR: Q f t DE
FAX # 4 - 13
I am not using any subcontractors:
Signature
Please check applicable subcontractors and complete the following information:
Date
D e
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
She t Metal
S et ck
D e