10120151I CITY OF CUPERTINO BUILDING PERMIT I
I BUILDING ADDRESS: 10207 ORANGE AVE I CONTRACTOR: ZV CONSTRUCTION INC I PERMIT NO: 10120151 1
OWNER'S NAME:
J� J LICENSED CONTRACTOR'S
DECLARATION
License Class Lic. Nam/ �Jy7
Contractor YJ eANW I wD 4ate
1 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.
1 hereby affirm under penalty of perjury one of the following two declarations:
1 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 h by.
Section 3700 of the Labor Code, for the performance of the work for whidl}tbj6�_
permit is issued. y
APPLICANT CERTIFICATION
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
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-
Signature Datel,
❑ OVER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
1, 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 (Sec.7044,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
1 hereby affirm under penalty of perjury one of the following three
declarations:
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
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 of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, 1 must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
1 certify that I have read this application and stale that the above information is
correct. 1 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. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
909 SAN RAFAEL AVE I DATE ISSUED: 05/13/2011
MOUNTAIN VIEW, CA 94043 PHONE NO: (650) 213-6512
JOB DESCRIPTION: RESIDENTIAL u COMMERCIALU
CONSTRUCT 1,716 SQ FT SFDWL, 1,128 BASEMENT W/ 413
SQ FT ATTACHED GARAGE, 142 SQ COVERED PATIO
Sq. Ft Floor Area: I Valuation: $398000
APN Number: 35715036.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by;_ l / ate: --S
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should 1 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 Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, S 25534.
Owner or authorized agent: Dale
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
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
Signature Date
CITY OF CUPERTINO BUILDING PERS1
BUILDING ADDRESS: 10207 ORANGE AVE
CONTRACTOR: ZV CONSTR
IT NO: 10120151
OWNER'S NAME:
MOUNTAIN VIEW, CA 94043
PHONE NO: (650) 213-6512
❑ LICENSED CONTRACTOR'S DECI.ARAT -
-T f -
'
p�/
License Class Lic. 0 �
BUILDING PERMIT INFO: BLDG ELECT PLUMB
F r r
'�/A7
ContractorZJ Wtl ;-[AUA �'" Date
MECH RESIDENTIAL COMMERCIAL
I hereby affirm, that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: CONSTRUCT 1,716 SQ FT SFDWL, 1,128 BASEMENT W/ 413
(commencing with Section 7000) of Division 3 of the Business & Professions
SQ FT ATTACHED GARAGE, 142 SQ COVERED PATIO
Code and that my license is in full force and effect.
6/13/2011 - REVNI- BASEMENT SEWER PUMP LOCATION CHANGE & SEWER
l hereby affirm under penalty of perjury one of the following two declarations:
LINE LAYOUT CHANGE-6/13/2011 REV# I APPRVD
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.
1 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: $398000
permit is issued.
APPLICANT CERTIFICATION
APN Number: 35715036.00
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
indemnify and keep harmless the City of Cupertino against liabilities, 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 180 DAYS OF PERMIT ISSUANCE OR
with all non-pouitpt7e regulations per the Cupertino Municipal Code, Section
180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature Date / /
Issued by: —bot> Date:
❑ DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for one of
RE -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, 1 agree to remove all new materials for
will do the work, and the structure is not intended or offered for sale (Sec.7044,
inspection.
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
Signature of Applicant: Date:
construct the project (Sec.7044, Business & Professions Code).
1 hereby affirm under penalty of perjury one of the following three
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
HAZARDOUS 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.
1 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 Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
Section 3700 of the Labor Code, for the performance of the work for which this
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(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 I 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
Health & Safety Code, Sections 25505, 25533, and 25534.
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such or this shall be deemed revoked.
provisions permit
Date:
APPLICANT CERTIFICATION
CONSTRUCTION LENDING AGENCY
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
I hereby affirm that there is a construction lending agency for the performance of w ork'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
ARCHITECT'S DECLARATION
9.18.
understand my plans shall be used as public records.
Signature Date
Licensed Professional
wmnele wl a
CITY OF CUPERTINO BUILDIN IT :-t <
BUILDING ADDRESS: 10207 ORANGE AVE
CONTRACTOR: ZV CONSTRUCTION INC
PERMIT NO: 10120151
OWNER'S NAME:
DECLARATION
-
T7 T F
BU LDING PERMIT INFO: BLDG. ELECT PLUMB
License ClassLic. q
r
j_IO'\ `
Contractor ( � ICJ Date
MECH RESIDENTIAL COMMERCIAL
1 hereby affirm that 1 am licensed under the provisions of Chapter 9
JOB DESCRIPTION: CONSTRUCT 1,716 SQ FT SFDWL, 1,128 BASEMENT W/ 413
(commencing with Section 7000) of Division 3 of the Business & Professions
SQ FT ATTACHED GARAGE, 142 SQ COVERED PATIO
Code and that my license is in full force and effect.
7/20/11 - REVg2 - BASEMENT FOUNDATION REDESIGN, RELOCATE REBAR-
1 hereby affirm under penalty of perjury one of the following two declarations:
8/10/201 1-REVH2 ISS'D
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 (his
Sq. Ft Floor Area:
Valuation: $398000
permit is issued.
APPLICANT CERTIFICATION
APN Number: 35715036.00
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
indemnify and keep harmless the City of Cupertino against liabilities, 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 180 DAYS OF PERMIT ISSUANCE OR
with all non -point source
by: Date:
OWNER -BUILDER DECLARATION
hereby affirm that I am exempt from the Contractor's License Law for one of
RE -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 (Sec.7044,
inspection.
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
Signature of Applicant: Date:
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
HAZARDOUS 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 Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
Section 3700 of the Labor Code, for the performance of the work for which this
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should 1 store or handle hazardous material.
permit is issued.
Additionally, should 1 use equipment or devices which emit hazardous air
1 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 I 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
Health & Safety Code, Sections 25505, 25533, and 25534.
become subject to the Worker's Compensation provisions of the Labor Code, I must
\
forthwith comply with such provisions or this permit shall be deemed revoked.
Owner ore
CERTIFICATION
CONSTRUCTION LENDING AGENCY
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
I hereby affirm 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 sour a regulatims per the upertino Municipal Code, Section
ARCHITECT'S DECLARATION
9. 18.
/
Signature Date l rl
I understand my plans shall be used as public records.
Licensed Professional
CITY OF CUPERTINO BUILDING S§MIT -
BUILDING ADDRESS: 10292 ORANGE AVE CONTRACTOR: T J CONSTRUCTION INC PERMIT NO: 11010085
OWNER'S NAME:
MILLBRAE, CA 94030 PHONE NO: (415) 816-5828
❑ LICENSED CONTRACTOR'S'DECLARATION -F F
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic. N
Contractor
Date
1 hereby affirm that 1 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:
1 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
permit is issued.
APPLICANT CERTIFICATION
certify that I have read (his 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
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 regulations per the Cupertino Municipal Code, Section
9.18.
Signature,
Date
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
I, as owner of the property, or my employees with wages as their sole compensation,
will do (he work, and the structure is not intended or offered for sale (Sec.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).
1 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 work 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 (he Worker's
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
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
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 stale 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. Additionally, the applicant understands and will comply
with all non -point Municipal Code, Section
9.18.
Signature Date I I
MECH F RESIDENTIAL r COMMERCIAL r
JOB DESCRIPTION: NEW (2)STORY SFDWL-2819SQFT(2361SQ-LIVING)
&(458SQ-ATTACHED GARAGE); PLANNING RESIDENTIAL
PERMIT
8/11/2011-REV 1- REMOVE ONE STRONG WALL ALONG LINE(5) ADD COLLECTOR
ALONG LTNFO THAT SEISMIC FORCE WILL BE RE -DIRECTED TO SHEAR
WALLS ALO G LTNi# REVISISS'D 8/11/2011
Sq. Ft Floor Area: I Valuation: $480000
APN Number: 35719030.00 1 Occupancy Type:
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 roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should 1 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 1 will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Dale:
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of uork's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
CITY OF CUPERTINO BUILDING PE
BUILDING ADDRESS: 10207 ORANGE AVE
CONTRACTOR: ZV CONSTR ION
PERMIT NO: I0120151
OWNER'S NAME:
MOUNTAIN VIEW, CA 94043
PHONE NO: (650) 213-6512
❑ LICENSED CONTRACTOR'SDFCLneatTlDNL — -
S
BUILDING PERMIT INFO: BLDG� ELECT PLUMB
License Class Lic.11
r
r ��S �r/�(D
Contractor L/ 4at -_ r q
MECH RESIDENTIAL COMMERCIAL
i hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: CONSTRUCT 1,716 SQ FT SFDWL, 1,128 BASEMENT W/ 413
(commencing with Section 7000) of Division 3 of the Business & Professions
SQ FT ATTACHED GARAGE, 142 SQ COVERED PATIO
Code and that my license is in full force and effect.
10/182011- REVISION k 4-REVISE GARAGE PiER LOCATION-STRUCTURAL-
i hereby affirm under penalty of perjury one of the following two declarations:
10202011 REWI4 iSS'D
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.
l 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: $398000
permit is issued.
APPLICANT CERTIFICATION
APN Number: 35715036.00
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
indemnify and keep harmless the City of Cupertino against liabilities, 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 180 DAYS OF PERMIT ISSUANCE OR
with all non -point source regulations per the C rtino Municipal Code, Section
180 DAYS FROM LAST CALLED INSPECTION.
9.18. '^
Signature Date t!� �(/
Issued by: Date:
❑ O NER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
RE -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 al I new materials for
will do the work, and the structure is not intended or offered for sale (Sec.7044,
inspection.
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
Signature of Applicant: Date:
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
HAZARDOUS 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 Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
Section 3700 of the Labor Code, for the performance of the work for which this
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(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 I 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
Health & Safety Code, Sections 25505, 25533, and 25534.
become subject to the Worker's Compensation provisions of the Labor Code, i must
forthwith comply with such provisions or this permit shall be deemed revoked.
ner or
Date:��
APPLICANT
LENDING AGENCY
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
I hereby affirm 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
ARCHITECT'S DECLARATION
9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO
ID/fJl FEE ESTIMATOR - BUILDING DIVISION
jj
RESS: 10207 orange ave.
DATE: 10/18/2011
REVIEWED BY: bobs.
E7APN:
BP#:
"VALUATION: $1,000
PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE: p
PENTAMATION
PERMIT TYPE: 1GENRE ;
WORK
revise garage pier location
SCOPE
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District. etc.). These fees are based on the nrellminary information available and are only an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff 711/11)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: Q Reg. Q OT
FO.OThrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee-.0 Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
l "0"O
0
Work Without Permit? 0 Yes (E) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
0
0
Strone Motion Fee: IBSEISMICR
$0.50
1 #
$783.00
Revision
IRE�SFDWL SFDWL
Bide Stds Commission Fee: 1BCBSC
$1.00
SUBTOTALS:
$1.50
$783.00
TOTAL FEE:
$784,50
Revised: 10/01 /2011
CITY OF CUPERTINO
FM_7FEE ESTIMATOR - BUILDING DIVISION
ADDRESS:
DATE:
REVIEWED BY:
B-P#-
sa
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Addition
PRIMARY SFD or Duplex
USE:
PENTAMATION 1GENRES
PERMIT TYPE:
WORK
Remove one strong wall alonq Line 5.
SCOPE
NOTE: These fees are based on the Dreliminary information available and are onlv an estimate. Contact the Dew for addn'l info.
FEE ITEMS (Fee Resolution 11-053 F_ff 7,1'11)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: (F) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee-0 Reg. 0 OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Acoustical Fee: 0 Yes 0 No
$0.00
0
0
Work Without Permit? 0 Yes 0 No
$0.00
Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
0
0
Strong Motion Fee:
$0.00
1� #
$783.00
Revision
IPEVSFDWL SFDWL
Bldg Stds Commission Fee:
$0.00
SUBTOTALS:
$0.00
$783.00
TOTAL FEE:
$783.00
Revised: 07/04/2011
WW
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 10207 ORANGE AVE.
DATE: 06/13/2011
REVIEWED BY: LARRYS
AT�I:
B-P#: -
ACLITA $0
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY SFD or Duplex
USE:
PENTAMATION
PERMIT TYPE:
WORK
REVISION REROUTE SEWER EJECTOR SYSTEM. REVISION TO PERMIT #10120151
SCOPE
Li
NOTE: These fees are based an the nreliminary infnrmatinn availahle and are nnly an estimate. Contact the Dent far addn'l info.
FEE ITEMS (Fee Resolution 09-051 Eff 711110)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: 0 Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee Reg. 0 OT
1 0.0
1 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Constr. Tax: IBCONST,4VR
1
units
$569.36
Acoustical Fee: 0 Yes 0 No
$0.00
0
0
Work Without Permit? 0 Yes 0 No
$0.00
Planning Fee
$0.00
Select a Non -Residential
Building or Structure
0
0
i
StronC Motion Fee:
$0.00
0 #
$0.00
Revision
IREvSFDWL SFDWL
Bldg Stds Commission Fee:
$0.00
SUBTOTALS:
$569.36
$0.00
TOTAL FEE:
$569.36
Revised: 04/29/2011
ww
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 10207 Orange Dr.
DATE: 07/20/2011
REVIEWED BY:
APN:
BP#:
"VALUATION:
1$5,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
PENTAMATION
PERMIT TYPE:
WORK
Basement / Foundation Revision. Re -locate rebar.
SCOPE
NOTE: These fees are based on the nreliminary information availahle and are only an estimate. Contact the Dent tar addn'l into.
FEE ITEMS (fee Resolution 11-053 EIT 711111
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: E) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Feed Reg.
0 OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Acoustical Fee:
0 Yes (F) No
$0.00
Q
Work Without Permit? 0 Yes 0 No
$0.00
Planning Fee
$0.00
Select a Non -Residential
Building or Structure
0
i
Strong Motion Fee:
IBSEISMCR
$0.50
1� #
$783.00
Revision
IREVSFDWL SFDWL
Bldg, Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$1.50
$783.00
TOTAL FEE:
$784.50
Revised: 07/04/2011