12090119CITY OF CUPERTINO BUILDING PERMIT
RIIILDING ADDRESS: 20800110MES'ITAD RD CON'T'RAC'T'OR: MONTEREY 1'F:RMITNO: 12090119
CONSTRUCTION COMPANY
OWNER'S NAME: VILLA SERRA API'S 88 NION I'F-REV- SALINAS IIWY ST'E A DATE ISSUED: 09/19/2012
OWNER'S PHONE: 6509313400 SALINAS, CA 93908 PHONE NO: (830601 -2659
❑ LICENSED CON'IRACFOR'S MCLARR/ATION
License Classes Lie. 9 J ` q
Contractor MQn';'(�(46r -) (Am'4 Date
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
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, a provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APPI- IC.\�YI' CER'1'IFICA'I'ION
I certify that 1 have read this application and state that the above inlbriation 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,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additional)} the appliCm t understands and will comply
with all non -point source regula 'mss per the Cupertino Municipal Code, Sedian
9.18.
Signature 'L Date / LI
❑ ON1'NER- BUIIJ)I.R DECLARA'T'ION
hereby affirm that I am exempt from the Contractor's License 1 -am for one of
the following Iwo reasons:
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 (Sce.7044,
Business & Professions Code)
1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
hereby affirm under penalty of perjury one of the following three
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 stork for which this
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
Compensation laws of California. If, after making this certificate ofexemption, I
become subject to the Worker's Compensm ion provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
%PPLICAN 1' CERTIFICATION
1 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 mid state Imes 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,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulmiais per the Cupertino Municipal Code, Section
9.18.
Date
BUILDING PERMIT INFO: BLDG (_ ELECT I✓ PLUMB IJ
1IECH C RESIDENTIAL ❑ COMMERCIAL ri
JOB DESCRIPTION: BUILDING 48- UNITS A -H 7600 SQ Fr
Sq. Ft Floor Area: I Valuation: $160000
APN Number: 32609073.20800 Occupancy'1'ypeNumber: 32609073.20800 Oceupancy'1'ype:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by_�� Date:
RE- ROOFS:
All roofs shall be inspected prior to any rooting material berg installed If a roof is
installed without first obtaining an inspection. I ngme to remove all new materials for
inspection.
Signature of
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
IIA-LARDOIIS NLCFERIAIS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Ileallh & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cuperlino Municipal Code, Chapter 9.12 and the Health &
Safey Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by. the Bay Area Air Quality Management District I will
maintain compliance with the Cuperlino Municipal Code. Chapter 9.12 and the
Health & Safety Code. Sections 25505. 25533, and 25534.
OwnOwner ar .=agent: q
✓r. /� Date:
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
ARC111TECI "S DECLARATION
I understand my plans shall be used as public records.
Licensed
09.'11!2012 14:38hitry Construction Co. (FAX)831 455 7986 P.002l003
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION f�vl�
10300 TORRE AVENUE - CUPERTINO, CA 95014 -3255 , 1D
C
I- 1UPERTIN
O (408)777 -3228• FAX (408) 777 -3333 -b1 ngAcupertlno.crp
I I NFW CONSTRIIC'InN hnITVty 10eTTPOATIn.111 M ocviernv ineeeoe er., 'n��� o... �
1ao3oo6,6
FWR F'IDmestead Road, Building #tom , Units A _
APN[ _ n (P0_01✓ •
'2'cgv
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a Apartments
HNP650) 931 -3400
13-MAIL
51`66110 "Norfolk Street, At 150
GYdn f ateo, CA 94403
FAX
`bavldTv+ir gFht
PH _(650 931.3400
drmwrlght (opromelheusreg.com
SfREETADDRES'
1800 So. Norfolk Street # 150
CrTY,STATE, ZIP
San Mateo CA 94403
FAX
❑pOWNER OWNER'e UILDER C] OWNER AOBPT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ ENot%EER ❑ DBvELOPER ❑ TENANT
Qjt❑
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LICENSFBTYre
BUS.LIC daa�s
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ontere onstructlon Company
bV61TIfyconstruction.com
p
`01) 455.7986
aDDRSSS
onterey- Salinas Hwy., Suite A
CITY, STATE, 21P
PHONE
In
831 455 -7931
ARCHITERlENGIN'EER NAME
LICENSE NUMBER
BUS. LIC a
COMPANY NAME
R•MAIL
PAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
remove 8 ro D(ace kitchen & bath cabinets. Replace electrical &
subpanel subfeed. Install new W/D & hookups.
Run new hot & cold water lines for all exIstIng fixtures. Add additional full bath wlthin existing apartment footprint.
vG1 cal '6' IcaO.pOO.°� Cg o o p.p 7600
EYISttNO Uad
PROPOSED VS CONS
ASE v,
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a
-OFF[**
AMA WSTO !/a 10
AREA `�
A� iLOOR
AD
TOTAL
r.ET AREA
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Y �.^ ,I+
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U
BATHROOM
KITCHEN
OTHER
...
REMODEL AREA
REMODEL AREA
REMODRLARP.A
PORCH AREA
DECK AREA
TOTAL DECKNORCH AREA I OARAGE AREA: ❑ DETACH
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rl ACH
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1a Aa[Rl]9 LT'IT 13/Yaa
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By my signature below, f certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. f have reed thls
application and the Inrormalion I have provided Is correct. 1 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 construction. I authorize representatives of Cupertino to enter the above- Identllled property for inspection purposes.
Signature afApplicant/Agcnt: Date:
SUPPLEMENTAL INFORMATION REQUIRED
:.RUN
':.;rtourwcsi.iP';
C11i ekTYPZ . -' ::'.:
< [: i •.
_ Now SFD or Multifamily dwellings: Apply for demolition permit for
building(s).
•[;oveaallUCtsUNfee"
.[.� •'
existing Demolition permit is required prior to issuance of building
r'
'`DVILD[NG PLAN REVIEW ; ;
permit lbr new building,
O�PGSNr•7N'O PLAN REVIEW,.-
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
:O•sT�nuAaD !% "; �•
❑: PUBLIC WORKS:
form irany Hazardous Materials are being used as part ofthis project.
.'
O� i,nace'. .'
.OI vTREDevr •.
—Copy of Planning Approval Letter or Meeting with Planning prior to
❑ • ',
,
• . '..' ..
submittal of Building Permit application.
' MAJOR
❑1 SANfTARV S£WERDISTRICT :
O: ENVIRONMENTAL HEALTN.
HldgApp_2011.doe revlJed 031/6111
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
19ADDRESS:
20800 Homestead Rd
DATE: 09/13/2012
REVIE\VED BY: Sean
NIAPN:
Phunh. Permit Fee.:
BP #:
'VALUATION:
1$160,000
*PERDIIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY Multi - Family Dwelling
USE:
Buildina is
>3 Stories O Yes (F) No
PENTAMATION 1R2REM
PERAHTTYPE:
WORK
Buildin #48: Remodle units A thru H 950 sq ft each = 7600 sq ft). See Master Plan: 12030068.
SCOPE
$0.00
NOTE: This estimate does not include fees due to other Departments (i.e. Planning. Public Works. Fire. Sanitary Server District. School
District, etc.). These fees are based on the preliminan information available and are onh, an estimate Confact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11 -053 ER 711111)
Alech. Plan Check
Phunh. Plan Check
Elec. Plan Check
Mach. Perin! Fee:
Phunh. Permit Fee.:
Elec. Perm@ Fee:
01he.r Afeeh. Imp.
Other Phnmb It
Other Elec. Imp.
wewh. insp. Fx:
Phanh. hap. Fee:
Elec. hasp. Fee.:
NOTE: This estimate does not include fees due to other Departments (i.e. Planning. Public Works. Fire. Sanitary Server District. School
District, etc.). These fees are based on the preliminan information available and are onh, an estimate Confact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11 -053 ER 711111)
FEE
QTY /FFE
MISC ITEMS
Plan Check Fee:
$0.00
7,600 s.f.
$8,584.00
Remodel, Other
IREAIRES3
Suppl. PC Fee: (2) Red. Q OT
0.0 1
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee Q Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Pennit Fee:
$0.00
Consn-uclion .Tens:
AtIntinictrulive Fee:
O
G
Work Without Pennit? O Yes 0 No
$0.00
Advanced Planning Fee:
$0.00
Select a Non - Residential
Building or Structure
G
0
A
Travel Documentation Fees:
Strong Motion Fee: IBSEISMICR
$16.00
Select an Administrative Item
1
Bldg Stds Commission Fee: IBCBSC
1 $7.001
SUBTOTALS:
1 $23.001$8,584.001
TOTAL FFI::
$8,607.00
Revised: 07/01/2012
�St. i ysyS�
Building Department
City Of Cupertino
10300 Torre Avenue
` n „r��i.��. as n�n1.�_�r,�►
Fax: 409-777-3333
CONTRACTOR / SUBCONTRACTOR LIST
JOBADDRESS: Z &R Ob
PERMIT' #.
OWNER'S NAME: a
PHONE #
GENERAL CONTRACTOR: 1'Kzy' L a
BUSINESS LICENSE #
ADDRESS: be
CITY /ZIPCODE: t W/rs 0(tb
*Our municipal code requires all businesses working id 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.
1 am not using any subcontractors:
Signature Date
Please.check applicable subcontractors and complete the following information:
Owner / Contractor Signature
Date
SUBCONTRACTOR
BUSINESS NAVE
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
Owner / Contractor Signature
Date