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11100028 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20900 HOMESTEAD RD CONTRACTOR:MONTEREY PERMIT NO: 11100028 CONSTRUCTION COMPANY OWNER'S NAME: VILLA SERRA APARTMENTS LP ET AL 88 MONTEREY-SALINAS HWY STE A DATE ISSUED: 10/05/2011 ( ER'S PHONE: 6509318400 SALINAS,CA 93908 PHONE NO:(831)601-2659 LICENSED CONTRACTOR'S DECLARATIONr BUILDING PERMIT INFO: BLDG ELECT PLUMB License Classy � Lic.# 3;2MECH RESIDENTIAL COMMERCIAL Contractor fit-�,/ Date ' �-' �� I hereby affirm that I am licensed under the provision of Chapter 9 JOB DESCRIPTION:BLDG 73,UNIT G,MULTI-FAMILY APT COMPLEX, (commencing with Section 7000)of Division 3 of the Business&Professions REMODEL Code and that my license is in full force and effect. KITCHEN 50 SF,ADD NEW W/D HOOK-UP 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,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$20000 permit is issued. APPLICANT CERTIFICATION APN Number:32609072.00 Occupancy Type: I 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 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 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 J§0 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 D ROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section ) 9.18. � Issued by: [ V l [ Date: Signature LZ Date IL OWNER-BUILDER DECLARATION RE-ROOFS: I 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 Applicant: Date: I,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 penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will 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(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must Owner on auth ized agent: forthwith comply with such provisions or this permit shall be deemed revoked. — 2—Zi ,o ,� Date: �U O �/ CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby affirm that there 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 -unify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address ,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 7 ITEMS OF 28 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32609072 . 00 DATE ISSUED. . . . . . . : 10/05/2011 RECEIPT #. . . . . . . . . : BS000014949 REFERENCE ID # . . . : 11100028 SITE ADDRESS . . . . . : 20900 HOMESTEAD RD SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : VILLA SERRA APARTMENTS LP ET A ADDRESS 20900 HOMESTEAD RD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : RICHARD REGA CONTRACTOR . . . . . . . : BEN REGA LIC # 32275 COMPANY MONTEREY CONSTRUCTION COMPANY ADDRESS . . . . . . . . . . : 88 MONTEREY-SALINAS HWY STE A CITY/STATE/ZIP . . . : SALINAS, CA 93908 TELEPHONE . . . . . . . . : (831) 601-2659 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- -ADMIN HOURS 1. 00 41. 00 0. 00 41. 00 0. 00 1BAPPLOTHE NO OF APPLIAN 2 . 00 130. 00 0. 00 130 . 00 0. 00 1BCBSC VALUATION 20, 000 .00 1. 00 0. 00 1 .00 0. 00 1BSEISMICR VALUATION 20, 000 .00 2 . 00 0. 00 2 .00 0 . 00 1MPERMITFE FLAT RATE 1. 00 44 . 00 0 . 00 44 .00 0 . 00 1REMRESKIT SQ FEET 50 .00 588. 00 0 . 00 588 . 00 0. 00 1TRAVDOC FLAT RATE 1 .00 44 . 00 0. 00 44 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 850. 00 0 . 00 850 .00 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 301 ROUGH PLUMBING 302 TUB & OR SHOWER 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 305 FRAME 307 INSULATION 308 SHEETROCK 309 EXTERIOR LATH 310 INTERIOR LATH 311 SCRATCH COAT 313 ROOF NAIL 317 MECHANICL ABOVE CEILING 318 ELECTRICAL ABOVE CEILING 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL 516 FINAL BUILDING CITY OF CUPERTINO " FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 20900 homestead rd bldg73#g DATE: 10/05/2011 REVIEWED BY: bobs. APN: IIP#: "VALUATION: 1$20,000 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY Multi-Family Dwelling Buildina is PENTAMATION 1 R2REM USE: 3 Stories 0 Yes (F) No PERMIT TYPE: WORK multi-family apt kitchen remodel add new W/D hook-up. SCOPE Mech.Plan Check 0.0 hrs $0.00 Mech.Permit Fee: IMPERMIT 7 - 7 Other Mech.Insp. 0.0 hrs $44.00 Lj Lj NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . Thesefees are based on the prelindina information available and are only an estimate. Contact the De t or addn 7 info, FEE ITEMS (Yee Resolution 11-053 L f. 7-1.-11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. Remodel,Kitchen(<=300 sf) Suppl.PC Fee: (F) Reg. 0 OT0.0 I hrs $0.00 $588.00 IREMRESKIT PME Plan Check: $0.00 2 # Mechanical Permit Fee: $0.00 $130.00 IBAPPLOT Other Appliance/Equip Suppl. Insp.Fee-0 Reg. OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $44.00 Administrative Fee: ]ADMIN $41.00 0 Work Without Permit? 0 Yes 0 No $0.00 Advanced Plannin Fee: $0.00 Select a Non-Residential or Structure Travel Documentation Fee: 1TRA VDOC $44.00 Building � Strong Motion Fee: IBSEISMICR $2.00 Select an Administrative Item Bld Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $132.00 $718.00 TOTAL FEE: $850.00 Revised: 10/01/2011 10/04/2011 13 : 08 (FAX) P. 004/005 ! CONSTRUCTION PERMIT APPLICATION <L COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 103001TORRE AVENUE •CUPERTINO, CA 95014-3255 CUPf~RTINO (408)177-3228• FAX((408))777-3333•buildinga-cupertino.org ❑NEW CONSTRUCTION ❑ (ADDITION LS41.TERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT DDRESSOO �-�C Y� �-eGl ` L7lU F�J ,<:-_ APN# `OWNER NAME PHONE • 7FAX —_ t'"I"�Sv1� �-lC•'.��:j �k'.C.SL.i ��'��c=�-�' �'�^.aP �aC� �t�1-:'S`It:�O E-MAI L STREET ADDRESS i CITY,STATE•,ZIP Sty CONTACT NAME PHONE -MAIL E _-- Q2 STREET ADDRESS c CITY,STATE, ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑gWNERAGENT CONTRACTOR ❑CONTRACIORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT f.ONTRACTOR NAME, LICENSE NUMBER LICENSE• YPE BUS.LIC# -- COMPANY NAME E-MAIL ' FAX L_$=5\) Ccs- 0--,cA%,.c._c=mr Cv c���-c �c�c�r.. w�. �_A S'g —1 STREET ADDRESS CITY,STATE,ZIP _ PHONE C 3' `d4S l"`r�os��-� ,-� i•�.S 1-� �i 'Sa `�C�-:�.r�.5, C�� c-1=��;G�'C __ �-1SS ' �r--�?� ARCHITECTIENGINEER NAME LICENSE NUMBER BUS.LIC q i COMPANY NAME E-MAIL FAX I STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK \rte-•�-c:,1� iYlS-�-G.\� T-lc�c� C,�n.r Gc74--.C�L��I�c��v—c Ltrr��- S�—���s^r-�oC.�PX E�•X���—'� :',- 1 .St:�::t�.�(-� -2_c). EXISTING USE f ,+ 4 i@ i j,E�t It j t Ir-t I� ( -.t.{+ rt-s•;' - PROPOS®USE CONSTR 7YPE #STORIES v�,taF,t,tt114 f�1 E1lJ�t'('1`�t'I �, „t �1,-'FFI 1 I t Ni, Y� —•— }t c.w si , t tRska} .;, t.r.�,. I5 tt �S t at r P t DES R1P fON '. VALUATION EXISTG NEW FLOOR DEMO - TOTALiJ igitst]'�aI AREA AREA AREA NET ARU (<�} Sa iltS;I}},!tIBATHROOM KICCHF]J _ OTHER ti RFMODELAREA REMODEL AREA ` REMODELAREA `O , ' ' -I E PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA; ❑DETACH - ❑ATTACH K DWELLING UNITS: IS A SECOND UNIT EJ YES SECOND STORY ❑YE9 F+f i 15'�fjt�11�ii 4� ;,�c it !+3 a� r: t r � 4 - BEINGADDED? NO ADDITIONt - afn.S PRE-APPLICATION ❑ YES IF YES,PROVIDa COPYOF PLANNER'S NAME: TioJµy PLANNING ADPL K ❑ NO PlANND70 APPRO�AL LETTER }'111k 9#+ tYyl I�}k fl f}fi ,•4y+t�!19 �S sk"t! �- By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provi ed is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating i g construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: i Date; SUPPLEMENTAL INFORMATION REQUIRED ''-tt' Dy Ar7,{yHE(IKTI:XPE, ROUTINE$LIP _New SFD or Multifamily dwellings: Apply for demolition permit for411 existing building(s). Demolition permit is 1 equired poor to issuance of buildin t,t tlgsv,D xT E�COUNTBIt­11' L7 BUILD INe PLAN;REVrEW g s,j�n 7P,(tt(f to+8+'} }I iWi-m­ h E4 permit for new buildin u i g' ,Ib Y1� E Si}Eiy.tf��i ;�Y,tit t i, i i'�❑ PLANNING PLAN,REVIEW.- rxtl i it �j.,Plt _Commercial Bldgs: Provide a cote leted Hazardous Materials Disclosure I' ' "` ft 1 r,1 I E1' ttr} P i i}5 A1�1DAy 14, i ❑ PU$JAC WORICS' form if any Hazardous Materials are b ing used as part of this project. }filIJr Ii4 ptil R�} ,}t} �t}� s sk 1` of s❑"FIRE D _ &1Stcltt jt,}a Er t ftrt j t +} {li}fi II v Copy of Planning Approval Letter;or Meeting with Planning prior to 1 , z r S( ! t �4 !Ey C i t submittal ofBuildili Permit a lication. l�= l},4 ,+t ztdt } i s tl } SAMTARYSEWER'DISTRICT_ s� �t EN.VIR9N111ENTA LMrA LTH'. BldgApp_1011.doc revised 03116/11 Building Department City Of Cupertino 10300 Torre Avenue (� Cupertino, CA 95014-3255 C U P E RT I N O �%!- � � � Telephone: 408-777-3228 Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: b 60 el PERMIT# // OWNER'S NAME: PHONE# _ 7/` �-0 GENERAL CONTRACTOR: 6�/�T, Z� , BUSINESS LICENSE # ADDRESS: CITY/ZIPCODE: c� *Our municipal code requires all businesses working in the ity 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. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME 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