10100113 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: DANUBE DR BLDG E CONTRACTOR:AXIS CONSTRUCTION,INC PERMIT NO: 10100113
OWNER'S NAME: CUPERTINO WATERFALL HOA 2566 BARRINGTON CT DATE ISSUED: 10/19/2010
JNER'S PHONE: 4084483080 HAYWARD,CA 94545 PHONE NO:(510)732-6111
❑ LICENSED CONTRACTOR'S DECLARATIONr r
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class 3 Lic.#
�n MECH r RESIDENTIAL I— COMMERCIALr
Contractor fi411 S z4)�1'IQ,U('�j�(Z! j Date /0 f
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:CUPERTINO WATERFALL-DANUBE DR BLDG E REPLACE
(commencing with Section 7000)of Division 3 of the Business&Professions DECAYED STAIR STRINGERS.
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,as provided for by Sq.Ft Floor Area: Valuation:$2633
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued.
APN Number:36949000.E Occupancy Type:
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 relat ng
to building construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION.
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regul tions per the Cupertino Municipal Code,Section
9.18. Issued byl- r- �- Date:
Signature Date l�
❑ _ OWNER-BUILDER DE LARATION RE-ROOFS:
All roofs shall be inspected prior to any roofing material being installed.If a roof is
I hereby affirm that I am exempt from the Contractor's License Law for on.!of installed without first obtaining an inspection,I agree to remove all new materials for
the following two reasons: inspection.
I,as owner of the property,or my employees with wages as their sole compensat on,
will do the work,and the structure is not intended or offered for sale(Sec.7044, Signature of Applicant: Date:
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to
ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued,I shz 11 Health&Safety Code,Sections 25505,25533,and 25534.
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 O r or author' agent:
become subject to the Worker's Compensation provisions of the Labor Code,I r lust Date:
A40
forthwith comply with such provisions or this permit shall be deemed revoked.
CONS RUCTION LENDING AGENCY
APPLICANT CERTIFICATION 1 hereby affirm that there is a construction lending agency for the performance of work's
I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.)
correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address
iify and keep harmless the City of Cupertino against liabilities,judgment,,
c. ,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Sectior I understand my plans shall be used as public records.
9.18.
Licensed Professional
Signature Date
Building Department
City Of Cupertino
[is 10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
CU PERTI NO Fax: 408-777-3333
CONTRACTOR / :iUBCONTRACTOR LIST
JOB ADDRESS: PERMIT#
OWNER'S NAME: PHONE# X00— 73 Z
GENERAL CONTRACTOR: BUSINESS LICENSE#
ADDRESS: CITY/ZIPCODE: 01
*Our municipal code requires all businesses orking in 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.
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
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
E
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
CITY OF CUPERTINO
3 ITEMS OF 24 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36949000 .E
DATE ISSUED. . . . . . . : 10/19/2010
RECEIPT #. . . . . . . . . : BS000011783
REFERENCE ID # . . . : 10100113
SITE ADDRESS . . . . . : DANUBE DR BLDG E
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . . CUPERTINO
IMPACT AREA . . . . . . :
OWNER . . . . . . . . . . . . : CUPERTINO WATERFALL HOA
ADDRESS . . . . . . . . . . : C/O CORNERSTONE COMMUNITY MGMT
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125-5635
RECEIVED FROM . . . . : AXIS CONSTRUCTION
CONTRACTOR . . . . . . . : CHRISTOPHER DURKIN LIC # 32093
COMPANY . . . . . . . . . . : AXIS CONSTRUCTION, INC
ADDRESS . . . . . . . . . . : 2566 BARRINGTON CT
CITY/STATE/ZIP . . . : HAYWARD, CA 94545
TELEPHONE . . . . . . . . : (510) 732-6111
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 2, 633 . 00 1 . 00 0. 00 1. 00 0 .00
1BSEISMICR VALUATION 2, 633 . 00 0 .50 0 .00 0.50 0 .00
1SUPINSFEE HOURS 1 . 00 126 . 00 0 .00 126. 00 0 .00
---------- ---------- ---------- ----------
TOTAL PERMIT 127 .50 0 . 00 127.50 0 .00
CUPERTINO WATERFALL HOMEOWNERS ,ASSOCIATION
c/o Cornerstone Community Management
1800 Hamilton Avenue,!'Suite 4210 San Jose, CA 95125-5635
(409)448-3080 x 218 Fax(408)448-3084
Roechelte Ayers,Association Manager
roc(corncratnncmet.hi7
October 14, 2010
City of Cupertino
Building Department
Fax: (403) 777-3333
Re: Stair Stringer Project/Axis Construction
To Wbom It Mav Concern;
This letter confirms that Cupertino Waterfall. i-iomeowners Association. has contracted and gives
permission to Axis Construction, .Inc to work c the stair stringer repair project.
Sincerely,
Roec elle Ayers
Association Manager
On behalf of the Board of Directors
C:(.:: Board of AirCCtorS/Contrnct Pifc
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CITY OF CUPERTINO
FEE ESTIMATOF: -BUILDING DIVISION
ADDRESS: DANUBE DR-BLDG E DATE: 10/14/2010 REVIEWED BY:
APN: BP#: `VALUATION: 1$2,633
*PERMIT TYPE: Building Permit _TP'AN CHECK TYPE: Addition
PRIMARY PENTAMATION 1GENRES
USE: SFD or Duplex ;. PERMIT TYPE:
WORK
SCOPE
_T7 i
1V
)r,.:, �F. r�.;=:
F-1 I
t' t
NOTE. Thesefees are based on the preliminary in ormation available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 09-051 E . 7ff /1/10) ViKE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 0 # Stairs
Suppl.PC Fee: 0 Reg. 0 OT 0.0 1 hrs $0.00 $0.00 (Specify#of Flights of Stairs)
PME Plan Check: $0.00
Permit Fee: 1SUPINSFEE $0.00
Suppl. Insp. Feer Reg. 0 OT 1-1.0 hrs $126.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Acoustical Fee: 0 Yes 0 No $0.00 0
Work Without Permit? 0 Yes E) No $0.00 E)
Planning Fee: $0.00 Select a Non-Residential 0
Building or Structure 0
Iran€'� f)Oc'trrt�'fTtErtt��f1 I'`:€'s:
Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
BldgStds Commission Fee: IBCBSC $1.00
SUBTOTALS: $127.50 $0.00 TOTAL FEE: $127.50
Revised: 9/29/2010
U
- CITY OF �CUPERTINO
CIT(of
CUPEkINO GENERAL BUMDL tG
PERMIT APPLICATION FORM
APN # Date:
ODO. it
Building Address: It -- )I
b i .
Mailing Address (if different from building address):
Are Hazardous Materials being used as part of this project? Yes No
HOA: (Exterior work only) Yes No ❑ Ii'yes, provide letter from HOA
Owner's Name- 6666.LC Phone#:40y-44 Y-3086
Contractor: Phone: 5-10-73 Z-Ip f(I
ANA Fax: 6-10-f3Z-ltzLL
Contractor License#: (P I (p
Cupertino Business License#: 13az d
Contact: Phone: 4f��-(o�
X544 9.4gvcY Fax: -)70.. 3.Z-&ZZ Z
_:.sidential KCommercial
Job Description:
Building Permit Info:
Bldg 1' Elect ❑ Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type: R ,z
1-A, 1-B ❑ II/=-A ❑ II/III B, IV-HT, V•B �=
Valuation: Square Footage:
Project Size: Expressard ❑ Large ❑ Major ❑
Green Building: Please complete relevant portion of the Green B' ' ding/LEED Checklist & attach it
to the application or if applicab]e, include in plan set & the sheet index .
'uts Achieved:
r ur help, contact Build it Green at www.buRditzx een.o
Revised 07/14/09