12060065 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20800 HOMESTEAD RD CONTRACTOR:MONTEREY PERMIT NO: 12060065
CONSTRUCTION COMPANY
OWNER'S NAME: VILLA SERRA APARTMENTS LLC 88 hIONT'F-REY-SALINAS Illl'1'STE A DA'Z'E ISSUED:0620/2012
OWNER'S PHONE: SALINAS,C\ 93908 PI IONS NO:(831)601-2659
❑ (LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class V Li Lic.q
MECH r RESIDENTIAL r COMMERCIAL r
Contractor(�fi/t`��Y ��r Date Zv Z
1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: BLDG 12-UNITS A-B R2 COMPLEX REMODEL IN PHASES
(commencing with Section 7000)of Division 3 of the Business&Professions WORK INCLUDES KITCHEN,BATA,ADD A/C AND
Code and that my license is in full force and effect. WASHER/DRYER IIOOKUP-5280 SQhT
I hereby affirm under penally 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 Sq.Ft Floor Area: Valuation:$120000
permit is issued.
APPLICANT CERTIFICATION APN Number:32609073.20800 Occupancy Type:
I certily 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 relat ng
(o building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities.judgments.
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source re' lariats per the Cupertino Municipal Code,Section
9.18. a -e l0 6Z�-
�/ ��i Issued by: Date:
Signature Date l
❑ OWNER- UILDER DECLARATION
RE ROOFS:
1 hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: - installed without first obtaining an inspection,I agree to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signature of AppliunnL lyase:
h as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code), ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penally of perjury one of the following three
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's IIA%ARDOUS MATERIALS DISCLOSURE;
Compensation,as provided fur by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I nidi maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code.Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(x)should I store or handle hazardous material.
Additionally,should 1 use equipment or devices which emir hazardous air
pemtil is issued. contaminants as defined by the Bay Area Air Quality Management District I will
I certify that in(he performance of the work for which this permit is issued.I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
nor employ any person in any manner so as to become subject to the Worker's Health&Safety Code.Sections 25505,25533,and 25534.
Compensation Inws of California. If,after making this certificate orexemplion,I
become subject to the Worker's Compensation provisions of the Labor Code,I must Ownergent:
forthwith comply with such provisions or this permit shall be deemed revoked. )V;
nrizcJ aDale: r
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state(hal the above information is I hereby affirm that(here is a construction lending agency for the performance of work's
correct. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of(his permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
9.18. 1 understand my plans shall be used as public records.
Signature Dale Licensed Professional
Ma A'e'c- stir
CONSTRUCTION PERMIT APPLICATION 12-o-3 C'C--,)L4
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 950143255 I r B
(408)777-3228• FAX(408)777-3333• buildino(G�cupertino.orG lD
CUPERTINO -
❑NEW CONSTRuc-nON ❑ ADDITION ALTERA/T(I/ON//-M ❑ REVISION/DEFEF= �-}ORIGINAL PERNET p
PROJECT ADDRESS Zo 6 w a Uw/ APN r ^J ( _- v 1 - U 7
OWNER proM� 'L t' PHONE -beg
-YS.SI �(J'
STREET ADDRESS lM \o��\� ��O�- Y, STA � 9'lYa3 AX (a 3/-�e357/
CONTACT Naa�� AN-
y li- W V�cS� drMwrt iw � Toro
SntEET ADDRESS 00 S.
-Per r I . CN 1 I_ 5 STATE IIP/ p
f`/ 8a J ?C/,(� T 9Y�fo,3 %6-o-93i-36-7
OWNER ❑ OWNER-BUHDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AG?I ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TNAYr
CONTRACTOR NAME ` ,._ 490. LICENSE E�n9 LICENSET_YLPE BAs.L[Cp27S
COMPANY NA.�rV, (l V/'� E-MAIL L beq efnr/Cbramv n.GoM FAXg3/-yss-798
1 v lt�Da'- LD(.'
STIKEET ADDRESS �e I'KT J([ 1'(t
t 0.Il 0.� h• 9 908' PHONE C�/-�/-•��^
ARCHTTECDLNGINEER NAME LICE4SE NUMBER C /`I 1 BUS.LICO4 7
'rt
COMPANY NASD; 7 E-MAII.. J .fi
/QSS FAX
1L6i cdB.r� Trop[ r5sarcly:� e cLee.�o G>sti oeZ o/O7
STREET ADDRESS r 464 7 QTY.STATE 7 PHONE
so 1J� •( ••'-`` ('tL mo -,�,`/s, C%/ 9�f� � �� 6�� •GREs
DESCRZMON OF WORM O 6V. / LL „
I / h15 � ln� �ra,t $
Innv''[-s+-nll ��sk«- rL r ��tT�eJI .e'atrs�J: �CtTc•i,c%v /AS�'a.fl Ae. i�
f .Crn �u cG r ox L�c�h (1v1r rp��i lcv llrr�r
EXLSTCIyC,��SE PROPO EDU CON TYP ASTORIES
V� - . .� USE TYPE OCG SQFT. VALUATION(S)
EXISTG NEW MOORffF" _ DEMO TOTAL
AREA AREA AREA NET AREA V
BATHROOM KITCHF?f OTHER
REMODELAREn - REMODE.AREA - REMODEL AREA
PORCH AREA DECKAREA TOTALDECK/PORCHAREA GARAGEAAEA ODETACH
❑ATTACH
B DWELLMG 11NTS: ISASECONDDNR ❑YES SECOND STORY ❑YES
BEING ADDED? �NO ADDIrIOM 'NO
PRE-APPLICATION ❑YS H YES,PROVIDE COPY OF 0 THE BLDG AN ❑YES
RECEIVED BY: ///��� TOTAL VARA(([UATION:
PLANMNGAPPLH CINO PLANYHIGAPPROVALLETTER EICHLERBom? r3N0 / /S�U�
By my signature below,I certify to each of the following: 1 BID the property owowner or authorized anent to act on the pr,tyertyowner's behalf.,I have read dns
application aid the information I have provided is correct Ahave read the Description of Work and verify it is accwate. I agree to comply w:th all applicable local
ordinances and state laws telaoo 'ding eoasmnedon. orize repteseatatves of Cuperdno to enter the abave�ide f d ptop'eLry far msyeron pu.eoses.
Signattm of AppGcanJAgear Dare: 3 /S/
SUPPLLNENTALrNFORMATIO QUUEED PIAN CHECK TYPE ROLTLNGSLIP
New SFD or Multifamily dwellings: Apply for demolition permit for -
❑ OVER-THE-COUNTER �HVILDLNG PLAN REVIEW
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. ❑ EXPRESS Q PLAhFLYG PLAN REVIEW
_rm Commercial Bldgs: Provide a completed Hazardous Materials Disclosure G�-sEamARn
foif any Hazardous Materials are being used as partof this project ❑ LARGE Q FrREr.
_Copy of Planning Approval Letter or Meeting with Planning prior to ❑ nwDR ❑ s,u�NITARY SEWER OISCRICT
submittal of Building Permit application.
❑ ENVDIoN mNTAL HEALTH
B1dgApp-2011.doc revised 06/21/11
�C7 Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
ON OF Fax(408)777-3333
CUPEkTINO
Building Department
JOB ADDRESS: 2D�00
1'romeSo�o� ,QQac� 2 0 6 0 0 5
OWNER'S NAME: e7salm+e PHONE # yo — r-
GENERAL CONTRACTOR: /4n4e4< 4Z.,6 . FAX # 660 -t4-31 -35-71
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
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/C tractor Signature Date
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: Building 12(Units A-H) DATE: 06/12/2012REVIEWED BY: Sean
APN: 326-09-073 BP#: -VALUATION: $120,000
PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY Multi-Family Dwelling Buildina is PENTAMATION 1R2REM
USE: >3 Stories Yes (D No PERMITTYPE:
WORK Buildin 12 - Remodel and add A/C to units A thru H 5280 sq ft
SCOPE
Meeh. Plan Check 0.0 hrs $0.00 Plwnb. Ph",(/1'"4 E/r�,. Ph,"ch,'<k
Mech. Permit Fee: IMPERMIT TIumh. Permit 14',�� 1."fir. lleorri�h�,-:
Other Mech. Insp. 0.0 hrs $44.00 o l,,, 17unrL/nap. lA6.r Oe' 6n p.
El
1/,�/r. Imp. Ftr' PluruL, Leap. bac: llhr. In.rp. l5'rr
NOTE: This estimate does not includejees due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School
District,etc. . Thesefees are based on the prelinddna information available and are onl v an estimate Contact the Dept for adrdn7 info.
FEE ITEMS (Fire Resolution lI-053 L'lX 711111) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 5,280 s.f. Remodel,Other
Suppl. PC Fee: Q Reg. 0 OT FO.0 hrs $0.00 $7,102.00 IREMRFS3
PME Plan Check: $0.00 8 # Mechanical
Permit Fee: $0.00 $520.00 IBRFMA1R A/C Units(<=I OK cfm)
Suppl. Insp. FeeQ Reg. Q OT 0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $44.00
('onst I'tlrpoll 7tn,
Administrative Fee: (ADMIN $41.00 O
Work Without Permit? O Yes 0 No $0.00 E)
Advanced Planning Fcc: $0.00 Select Non-Residential E)
Travel Documentation Fee: ITRA VDOC $44.00
Building or Structure O
A
Slrong Molion I'l'l': IBSEISMICR $12.00 Select an Administrative Item
Bldg Slds Commission Fce: IBCBSC $5.00
SUBTOTALS: $146.00 $7,622.00 TOTAL FEE: $7,768.00
Revised: 06/05/2012