12110047 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 208001IONIESTEAD RD MN'TRACTOR:MONTEREY PERMIT NO: 12110047
CONSTRUCTION COMPANY
OWNER'S NAME: VILLA SERRA APTS 88 MONTEREY-SAUNAS IIN Y SI'E A DA'Z'E ISSUED: 11/08/2012
O\YNERS PHONE: 6509313400 SALINAS.CA 93908 PRONE NO:(831)601 2659
❑ LICENSED COYFRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT❑ PLUMB r
License Class Lic.#aR SZnf 7 r r1 Cj
MECII RESIDENTIAL COMMERCIAL -J
Contractort N1ui„A , Date //-9—�Z
l herebyaffirm that l am4icensed under the provisions or Cha pier 9 3013 DESCRIPTION: BLDG 43,UNIT A-I1-REMODEL APT COMPLEX
(commencing with Section 7000)of Division 3 of the Rusiness A Professions Kll'GfIEN(G5
Code and that my license is in full force and effect. SQIT),BATIIR00x1(35 SQFr):NON-STRUCfURAL;INCLUDES
NEW SUBPANF.L,WASIlER/DRYER HOOK-UP,N17W HOTAND
hereby affirm under penally of perjury one orthe follmving two declornlions:
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 mill 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.' Sq.FI Floor Area: Valuation:$20000
,\rp1.1c\N•r cF:arrFlcrrloN
I certify that I have read this application and state that the above information is APN Number:3260907320800 Occupancy Type:
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 againstIiabiliiies,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN 1.80-DAYS- PERMIT ISSUANCE OR
with all non-point source regulatims per the Cupertino Municipal Code,Section 180 DAYS OM LAS CALLED INSPECTION.
9.18.
Signature � ¢ Date is I by Dale: '
❑ OWNER-RUILDER DECI-k RATION 1 '
I hereby affirm that I am exempt from the Contractor's License Law for one of RI:ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sce.7044, inspection,
Business d Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date:
construct the project(Sec.7044,Business d Professions Code).
I hereby affirm under penally of perjury one orthe following three ALI.ROO CO\'F"RINGS'I'O RE CLASS"A"OR 13F."1-I'ER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's IL\%ARDOIIS MATERIALS DISCLOSURE
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 read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California IIen11h S SafehCode.Sections 25505,25533,and 25531 1 will maintain
Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupe'lino Slunicipnl Code.Chapter 9.12 and the lic lth&
Safely Cade,Section 2553_(a)should I store or handle hazardous material.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality'Management District 1 will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code.Chapter 9.12 and the
Compensation laws of California. If,after making this certificate of exemption,I llealth S Safely Cade.Sections 25505,25533,and 25534.
become subject to die Worker's Compensation provisions of the Labor Code,I must
forthwith comply with such provisions or this permit shall be deemed revoked. O"��nr o�r�Ihoriz a eat:
b� �=Dale: "
API'1-ICAYI'CER'1'IFICAT'IOIN CONSTRUCTION LF,NDING AGENCY
I certify,that I have read this application and slate that the above information is
correct.I agree to comply with all city and county ordinances and state laws relating I hereby alTimm that there is a construction lending agency for the performance of work's
to building construction,and hereby authorize representatives of This city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCI I ITISCI"S DECLARATION9.18.
I understood my plans shall be used as public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 20800 homestead rd. bldg.43A-H DATE: 11/08/2012 REVIEWED BY: bobs.
APN: BP#: *1'ALUATION: 1$20,000
*PERIIIIT TYPE: Building Permit =
PLAN CIIECK TYPE: Alteration / Repair
PRIMARI' Buildina is PEN7AMATION
Multi-Family Dwelling 1R2REM
USE: ,3 Stories Yes 0 No PERMITTYPE:
WORK remodel apt complex kitchen and bath non structural includes new subpanel, W/D hook-up, new hot
SCOPE and cold water lines.
Mech.Plan Check o.0 hrs $0.00 Plumb. Plat Check Flec.Platt Check
Mech. Permit Fee: IMPER IT Phtmh. Permit Fee: Elec.Permit Fee:
Other Mech. Insp. FO
.0 hrs L$45.00 Other Plumb Insp, Ll Other Elec.btsp.
Hach.Imp.Fee: Plumb. Insp. Fee: Flee losp. Fee:
A'OTE: This estimate does not include jeer due to other Departments(i.e. Planning, Public Works. Fire,Sanitary Server District,School
District,etc.). These ees are based on Ute preliminan information available and are only an estimate. Contac(the De ( or addn'I info.
FEE ITEMS (Fee Resolution 11-053 Eff 7/1/12) FEE QTY/FEE I MISC ITEMS
Plan Check Fee: $0.00 65
s.f. Remodel, Kitchen (<=300 sl)
Suppl. PC Fee: Q Reg. 0 OT 0.0 1 hrs $0.00 $600.00 IREURESKIT
PME Plan Check: $0.00 35 S.f. Remodel, Bath(<=300 so
Permit Fee: Hourly Only? 0' Yes 0 No $0.00 $600.00 IRE,IIRESBAT
Suppl. Insp. Fee-.0 Reg. 0 OT 0.0 1 hrs $0.00 = # Mechanical
PME Unit Fee: $0.00 $134.00 IBAPPLOT Other Appliance/Equip
PME Permit Fee: $45.001= # Mechanical
C'onsmtction Tax: $67.00 IBRF_h1AIR A/C Units(<=I OK efin)
Administrative Fee: IADMIN $42.00 0
Work Without Permit? 0 Yes (j) No $0.00 0
Advanced Planning Fee: $0.00 F__167 hours Inspections E)
Travel Documentation Fee: ITRAI DOC $45.00 $2,128.00 /SThvSP Inspection, Hourly 0
Strong Motion Fee: IBSEISMICR $2.00 Select an Administrative Item
Bldg Sids Commission Fee: IBCBSC $1.00
SUBTOTALS: $135.00 $3,529.001 TOTAL FEE: $3,664.00
Revised: 10101/2012
11/08/2012 11:57Htry Construction Co. (FAX)831 455 7986 P.003/003
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE ' CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•buildinoCacuoertlno.om
❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMrTa
P1$990omestead Road, Building#Ut2) , Units — N APN Y / ) (�
I o
EaArra Apartments lR AME "'*'1650)0N•g650)931-3400
Il
s R(T ogRMe}orfolk Street,# 150 cWW ateo, CA 94403 FAX
U8 VI0 Wfl Ilt PN NB MAIL
9 �50 931-3400 -MAIL
STREET ADDRESS CRY,STATE.LP FAX
1900 So. Norfolk Street # 1A,5AA0 Sen Mateo CA 94403
13 OWNER pfL❑ OWNP.R•BmLDER La OUTERACENT ❑ CONTRACTOR ❑CONTMCTORA05NT ❑ ARCHITECT ❑ENON'EER ❑ DEVELOPPA ❑ MNANr
I�?C std Reg E LICE8NU ynER LICENS19YPE eU6.L1 Y
MPANY NAME E•µ
onterey Constructlon Company benlmryconstrucllon.com (651)455-7986
T ADDRESS CITY.STATE,ZIP
onterey-Salinas Hwy., Suite A P3908 831 455.7931
ARCHITECT,ENGINEER NAME LICENSE NUMBER DUE.LIC Y
COMPANY NAME E-MAIL
PAX
STREET ADDRESS CITY,STATE,ZIP PHONE
emove&replace k1tchen & beth cabinets. Replace electrical subpanel & subfeed. Install new W/D & hookups.
Run new hot & cold water lines for all existing fixtures.' D( \.. ',
Se Co Q CAD
EXImNO USE PROPOSED USE II i4 %"
CON9TA TYPE Y67T)RlE9 �:i.:;::.'�::. ..._�:I (, ..: ...-.:>:.:: .:• •.. ..- ... . ...
EXISTO NEW MOOR DEMO TOTAL
AREA AREA AREA NETAREA
^^
DATHROOM KITCHEN ETHER 5: •(i'J: iC .::.{ P:(:_:;:F•e._y1,c>i ."rY=j"'f':f`�:•:,�:,.CCr ':. .-
REMOOELARBRENODEL AREA A RPMODEL AREA y : '.+
' .I' ?..• I�. ,
PORCHAREA DECK MEA TOTALDECKMORCH AREA OARAOEAREA:❑ DETACH ''�'' F;p;;:((/�,'+�+':j '777 -
ATTACH
POWQLaA1 VND1: uA LLCOMD L'IVR Y0 IICOK rtORr
❑
YPJ .:�, '.";r;"'':-.•:•.q::... -1::.i.:C..'I:_,{::
A[WOADETDI ❑MD AOeRI0a10 NO
rxe.MrLKwlron ❑ ns D n'.PROvDY COPY OP Pwa+pl'e NALO, :RECPMDBY 1 'r TOTAL
ATI��:(•A1'.
IIMNnsO Mtt, ❑ NO PIAMT'O APPRavAL LATR0. :li .',' �[ (Ir.\'�•
By.my signaturo below,I cantly,touch of the following: I am the property owner or authorized agent to act on the property owner's behalf. 1 have read this
application and the infommatlan I have provided Is comet. I have read the Description or Work and verify it is accurate. I agree to comply with all Applicable local
ordinances and state laws rel oting to building action. tau orize representatives of Cupertino to enter the abovo•ident�l0yed/property for inspection purposes,
Signature of Appllea t/Ageno Data:
SUPPLEMENFAL INFORMATION REQUIRED n•:_-r.'.:dpLANCHECK TYPE io.n:!;;;..::k:�4aj}[:�., '"
ROUTINO SLIP:
_New SFD or Multifamily dwellings: Apply for demolition permit for + " - I
CXI9IIn bulldi0 fi . Demolition OVLR-T I&Ca UNTER eU1LhIN0 PLAN AEVIEw
g gO permlit is required prior to issuance of building + I y l s s N :>
permit for new building. •❑ EXPRESS ' ' - •. ' ❑ pLA�T1INE PLAPi REVI[W
Commercial Bidgs: Provide a completed Hazardous Materials Disclosure /❑ STANDARD, ' ❑.PUBLIC IVORK9L ! ' I' +
forth irony Hazardous Materials we being used as part of this project. +.•�:'-'1,:;•' '" "!"-I'::--.' ""•is=�.y'.;J-'; `
❑ it.
❑ nfteacvr
•_Copy of Planning Approval Letter or Meeting with Planning prior to
submittal of Building Permit application. ❑•nlnsdq:.:.':�. ._:,.,. , „ .!sAr:ireaYsewYRulsrwer,,::.;,�;
:�. `'"�i•:y;'j'-" '.O:YKVIRONh1ENTwL HFALTII`�=,'�•''�
B1dgApp d011.doc revlscd 03/16/1/