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12030068 REV CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20800 HOMESTEAD RD CONTRACTOR:MONTEREY PERMIT O:12030068 CONSTRUCTION COMPANY DATE - OWNER'S NAME: VILLA SERRA APARTMENTS LLC 88 MONTEREY-SALINAS HWY STE A DATE ISSUED:06/12/2012 OWNER'S PHONE: 4086881581 SALINAS,CA 93908 PHONE NO:(831)601-2659 ❑ LICENSED CONTRACTOR'S DECLARATION S7 BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class_ Lic.4 EE2z7 i I Z MECH RESIDENTIALCOMMERCIAL Contractor 19n Date I hereby affirm that I n licensed under the provisions of Chapter 9 JOB DESCRIPTION:20800,20900 HOMESTEAD&10870 N STELLING(MASTER (commencing with Section 7000 of Division 3 of the Business&Professions STRUCTURAL REMODEL IN LATI 012-REV#1- ( g ) STRUCTURAL PLAN AND CALCULATIONS FOR BATHROOM 7/27/12-REV#I-STRUCTURAL Code and that my license is in full force and effect. PLAN AND CALCULATIONS FOR BATHROOM ALTERNATE#1 FOR UNIT TYPE B-8/12/2012 REV #1 ISS'D 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 permit is issued. Sq.Ft Floor Area: Valuation:$15000 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:32609073.20800 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 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 regulation p e Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. SignatureDate V 114/' 2 ..R­ Issued by: Date: ❑ OWNER-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 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 Compensation,as provided for by Section 3700 of the Labor Code,for the HAZARDOUS MATERIALS DISCLOSURE 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& permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. I certify that in the performance of the work for which this permit is issued,I shall Additionally,should I use equipment or devices which emit hazardous air not employ any person in any manner so as to become subject to the Worker's 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 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. O er or uthorized ag I Dater 2 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY 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 wrk'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 9.18. ARCHITECT'S DECLARATION Signature Date I understand my plans shall be used as public records. Licensed Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 ��S1®� * 1B (408)777-3228- FAX(408)777-3333- building(cDcupertino.ora CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI REVISION/DEFERRED ORIGINAL PERMIT O L O SO'3�A� PROJECT ADDRESS 2®b bloAPN# r OWNERNAME "'`\iPHONE ^fJ / MAIL STREET ADDRESS 1� . �br �` NC ' CISTATE -9 $AX� 31 - 357 CONTACT NAMED;1' r` PHONE �' f E- IL 10 vl �/ MW6 / ,cb STREET ADDRESS i C MITA I� ^Gfj'_[�� FAX 656���,' �/ OWNER ❑ OWNER-BUILDERWNER AGENT 11 CONTRACTOR El CONTRACTOR AGENT 1:1 /ARCHITECT C3 ENGINEER 171 DEVELOPER ❑ TENANT .OPCONT CETO NAM /1 LIC E LICENS E 27 BUS.LIC# Z7 6� COMPANY NAME K MAIL FAX M—�n �v Cb . jE u. onsur��oo�.cnr. 3 I— '(5.5—— STREET ADDRESS 'n� ^ CITY S ,,� Q� py PHO - r lsa; ARCHITECT/E ER NAME ( LICENSE NUMBEL f BUS.LIC# P a-Jl COMPANY NAMEE-MAIL Faux SSS •' � f SSa�d,ik C-4-L& ,C-C 0-\, (�S-a—,?6--L—(/o STREET ADDRESCITY_. ATE,Z PHONE /aln ark C� 9ya7b DESCRIPTION OF WORK 1(e,4,�;0 �Q oLt EXISTING USEPROPOS NS TYPE #STORIES r2 A! 2 USE TYPE OCC. SQ.FT. VALUATION($) AREAEXISTNEW FLOOR DEMO TOTAL e!N f� -2- BATHROOM 2 AREA AREA AREA NET AREA t/� /�c- BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKMORCH AREA GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? []NO ADDITION? []NO PRE-APPLICATION [I YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES CFI t �f TOTAL. DATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO _ 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 provided 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 rel ing buildin constru authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent, Date: SUPPLEMENTAL INFORMAITON REQUIREDK _New SFD or Multifamily dwellings: Apply for demolition permit forBIN �n� w existing building(s). Demolition permit is required prior to issuance of building permit for new building. 1REs pyvP�RT� tEOV _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure Lstatzu uB ©RKS y form if any Hazardous Materials are being used as part of this project k ( LARG7 � TRE DEE> ' _Copy of Planning Approval Letter or Meeting with Planning prior to ntA�o>t Se4NFCt�SEWERDISTRIc. submittal of Building Permit application. BldgApp_2011.doc revised 06/21/11 _ CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 1030Q TORRE AVENUE•CUPERTINO, CA 95014-3255 REVISION (408)777-3228• FAX (408)777- 333 • buildingaa.cupertino.org CUPERTI.NO ry ❑NEW CONSTRUCTION ADDITION —] ALTERATION/TI REVISION/DEFERRED ORIGINAL PERMIT# 30n�o PROJECT ADDRESS t� ®P � (� r APN% OWNER NAME �i' + � y PHONE STREET ADDRESS - yaZ ' CI STATE I Q�4� CIAc 1(Z(Q �6-931 CONTACT NAM i _A r C; 17 /�G I E IL �\l\ O NfUJ6� 2 CFs STREET ADDRESS �KT� ��TA ZIP ^gj�,lO� �47C�_V/- 7/ 120 r c�-C-� `r Y l9 OWNER ❑ OWNER-BUILDER WNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT Q ENGINEER ❑ DEVELOPER ❑ TENANT CONTP, NA LIC E NUNf�F� q LICENS E BUS.LIC# 27 5— COMPANY NAME MAILG FAX co 79 STREET ADDRESS I^ c ^ CITYS �TI ���o g PHONE ARCHITECT ER NAME ��` ( R! LICENSE NUMBEL, q3 BUS.LIC# K1 COMPANY NAME (r/� k9sd 1EMAIL 0 rS.S6l fd_IkC�c . STREET ADDRES �1nu� CITY . ATE,Z �� n n Gp1U-7b PH �,rO ��� Z�$` DESCRIPTION OF WORK er�\Q ^l 09 �k 40 EXISTING USEPROPOSED ONS TYPE #STORIES �2 �"Z USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO [TOTAL AREA AREA AREA NET AREA AaL U AJ 6 Z V BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: LIDETACH []ATTACH #DWELLING UMTS: IS A SECOND UNIT Q YES SECOND STORY ❑YES BEING ADDED? []NO ADDITION? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES EOWN 'rte & TOTAL UATION. PLANNINGAPPL# ❑NO PLANNING APPROVAL LETTER EICBLERHOME? ❑NO ' 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 provided 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 rel 'ng 0 buildin constru t authorize representatives of Cupertino to enter the above-identified roperty for inspection purposes. Signature of Applicant/Agent: Date: !f 27//_Z_ SUPPLEMENTAL INFORMA ON REQUIRED � �eir cltiP„ �. o>Ju�asa New SFD or Multifamily dwellings: Apply for demolition permit for 07 P ;P acgEl� existing building(s). Demolition permit is required prior to issuance of building OO,` permit for new building. _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. � 15AIFG~E x F,IREbER , _ Copy of Planning Approval Letter or Meeting with Planning Prior � to submittal of Building Permit application. �oRf � BldgApp_2011.doc revised 06121/11 _ CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 20800 Homestead Road DATE: 07/27/2012 REVIEWED BY: Sean APN: BP#: *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY Buildina is PENTAMATION USE: Multi-Family Dwelling >3 Stories ® Yes Q No PERMIT TYPE: 1GENRE A WORK Revision#1: Structural plan and calculations for bathroom alternate#1 for unit type B. SCOPE MOM g = - = s Il a: a ... Y3. m e mn M9, IA . Xfe h, Plan CheckPlumb,flan Check Ilea. Flan("neck F1i>c111.Penni[Fee: Plumb.Permit Fire: Elec.Permit Fee: Other"llech.Insp. Other Plumb Insp. E]F__1_ Other Elec.Insp, 14er,'6r.Insp.I tze: Plumb. hap.Fee: Islee.Insp,Fee 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 prelhiniina information available and are only an estimate. Contact the De t or addn'l info, FEE ITEMS(Fee Resolution 11-053 E . 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes 0 No $0.00 hours Plan Check,Hourly Suppl.PC Fee: (F) Reg. 0 OT0.0 hrs $0.00 $133.00 ISTPLNCK PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee:(E) Reg. OOT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 ("'onstivetion Tax: �.rlrn itaistr�rtive.FC'e': Work Without Permit? ® Yes E) No $0.00 E) Advanced Planning Fee. $0.00 Select a Non-Residential Travel Docutnenlati€}n Fees: Building or Structure i Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 { 3 3 __ IB $0.00 $133.00 �� $133.00 Revised: 07/01/2012 o?o$oo IsAcklift d 3 ® A U U D E ID U A B e-A A UA ® A � A D A H E D C B A H E C BF H G' F E G EEfv FA CBF .L GH CE EK BH B_ CG Af C ] OH BD"AC B D A B F D D E I C I E I AE H E D C CJ D' ® C A H C G H F3 DH G D A H B F A E B I 'j,• EJ A B A G BF AE 0 A 6 C 0 C C H K A B F G H B A F H G F E. E M aF G L E 'F D - AE - _ t G H AE A .:. - J CH F F A .. D C B D G = AE I..aF BF A 8 -❑: ' E CG A 8 C D E F B E I C AE F G DH ®' B Spa- G H I J K LD .. C. ., B AE.. G H D DH A A HIrE F A B C D 6 AE `_ C 8 C LE Ll tCG�j AE 1� rL AC E C r ..:. E G B F CG A B C D B D H E F G H J D C B H ' C I G F AE B �q H s G H c a H The Markham G F BF A OH AE � DH AE G s E F B E F G A artm" ' ents D C D C D H p - A - A B A B E E D C B A B rL K J I H G f K L K l Community Map C F E q t 1 C D C D - I J I J DH G H H B D C GH 0 G H - A B C D A 6 C O F a 9'D A C D C D E - " . N Homestead Road 0