13060018I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 20800 HOMESTEAD RD
OWNER'S NAME: VILLA SERRA APTS
OWNER'S PHONE: 4086881581
LICENSED CONTRACTORS DECLARATION
License Class Licc..,.# 8 15,�_7
Contractor �'I `- �/1 �/' ` Date
I hereby affirm that I am li ensed 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:
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.
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 -point source r lations per the Cupertino Municipal Code, Section
9.18.
Signature r ` Date
❑ OWNER - BUILDER DECLARATION
I 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 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).
I 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 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, 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 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.
Date
CONTRACTOR: MONTEREY PERMIT NO: 13060018
CONSTRUCTION COMPANY
88 MONTEREY - SALINAS HWY STE A DATE ISSUED: 06/04/2013
SALINAS, CA 93908 PHONE NO: (831) 601 -2659
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL0
MAINTENANCE ROOM ONLY NON - SEPERATED
OCCUPANCY, AS
PER SECTION 508.3 CBC, MODITY (E) 662 AREA TO
INCLUDE REPLACING ALL (E,M,P) ADD (N)UTILITY SINK
Sq. Ft Floor Area: I Valuation: $15000
APN Number: 32609073.20800 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAY F OM 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.6M 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 I 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 I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505 55 , and 25534.
Owner or authorized agent: ` Date.
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
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20800 HOMESTEAD RD
CONTRACTOR: MONTEREY
PERMIT NO: 13060018
CONSTRUCTION COMPANY
OWNER'S NAME: VILLA SERRA APTS
88 MONTEREY - SALINAS HWY STE A
DATE ISSUED: 06/04/2013
OWNER'S PHONE: 4086881581
SALINAS, CA 93908
PHONE NO: (831) 601 -2659
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIALII
License Class Lic. # 43.5-z —i
MAINTENANCE ROOM ONLY NON- SEPERATED
rn Lm� C t3
Contractor r Date
OCCUPANCY, AS
PER SECTION 508.3 CBC, MODITY (E) 662 AREA TO
I hereby affirm that I am licensed under the provisions of Chapter 9
INCLUDE REPLACING ALL (M,E,P) ADD (N)UTILITY SINK
(commencing with Section 7000) of Division 3 of the Business & Professions
REVISION # 1 - MINOR CHANGE TO INTERIOR WALL &
Code and that my license is in full force and effect.
HEADER. ACCESSIBLE PLAN FOR RESTROOM RECEIVED
I hereby affirm under penalty of perjury one of the following two declarations:
- ISSUED 9/4/2013
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
Sq. Ft Floor Area:
Valuation: $15000
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
APN Number: 32609073.20800
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
180 DAYS FROM LAS SPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
Issued by: Date:
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
RE- ROOFS:
9.18.
f� 1
Signature Date
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.
❑ OWNER - BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
I, 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
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 25532(a) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self - insure for Worker's
material. Additionally, should I use equipment or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sections 2550)5,2 3, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
g
Owner or authorized agent: Date: J
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
CONSTRUCTION LENDING AGENCY
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
I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked.
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
APPLICANT CERTIFICATION
Lender's Address
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
ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
I understand my plans shall be used as public records.
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
9.18.
Signature Date
CITY OF CUPERTINO
FF.F: F.CTTM A TOR - RI TIT .DING DIVISION
Mech. Plan Check 10.0 1 hrs $0.00 Plumb. Plan Check 10.0 1 hrs $0.00 Elec. Plan Check 10.0 1 hrs $0.00
Mech. Permit Fee: IMPERMIT Plumb. Permit Fee: IPPERMIT Elec. Permit Fee: 1EPERMIT
Other Mech. Insp. 0.0 hrs $45.00 Other Plumb Insp. M hrs L $45.00 Other Elea Insp. 0.0 hrs $45.00
.ttech. Insp. Fee: Plumb. Insp. Fee: Elec. Insp. Fee:
NUIE: This estimate does not include fees due to other Departments (Le. riammng, runic worKs, rare, aamrary newer "estrecy acnuut
ADDRESS: 20800 HOMESTEAD RD BLDG 5
DATE: 05/29/2013
REVIEWED BY: MELISSA
APN: 326 09073
BP #:
"VALUATION:
1$15,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration /Addition/ Repair
PRIMARY
Commercial Building
0 # Mechanical
PENTAMATION
1CMAP�
USE:
0.0
PERMIT TYPE:
WORK
*MAINTENANCE ROOM ONLY*NON- SEPARATED OCCUPANCY AS PER 508.3 REMODEL E 662
SCOPE
S.F. AREA TO INCLUDE REPLACING ALL ELECTRICAL, MECHANICAL & PLUBMING. ADD (N) p
Mech. Plan Check 10.0 1 hrs $0.00 Plumb. Plan Check 10.0 1 hrs $0.00 Elec. Plan Check 10.0 1 hrs $0.00
Mech. Permit Fee: IMPERMIT Plumb. Permit Fee: IPPERMIT Elec. Permit Fee: 1EPERMIT
Other Mech. Insp. 0.0 hrs $45.00 Other Plumb Insp. M hrs L $45.00 Other Elea Insp. 0.0 hrs $45.00
.ttech. Insp. Fee: Plumb. Insp. Fee: Elec. Insp. Fee:
NUIE: This estimate does not include fees due to other Departments (Le. riammng, runic worKs, rare, aamrary newer "estrecy acnuut
District, eta). These ees are based on the prelimina
information available and are only an estimate. Contact the De t or addn'1 info.
FEE ITEMS (Fee Resolution 11 -053 E . 711112)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee: Hourly Only? ® Yes Q No
$0.00
0 # Mechanical
Suppl. PC Fee: Q Reg. ® OT
0.0
hrs
$0.00
$100.00
1BREMVENS
Ventilation System
PME Plan Check:
$0.00
20
Electrical
Permit Fee: Hourly Only? ® Yes (D No
$0.00
$45.00
IBREAMECEP
Recep /Switch/Outlets
Suppl. Insp. Fee-.0 Reg. Q OT
0 0
hrs
$0.00
0 Electrical
PME Unit Fee:
$0.00
$67.00
IBREW=
Fixtures, Lighting
PME Permit Fee:
$135.00
®
# Plumbing
Constr- cction :Ta :
$40.00
1BPF=RE
Fixture or Trap
Administrative Fee: IADMIN
$42.00
1
## Mechanical
Work Without Permit? ® Yes C) No
$0.00
$133.00
IBCAIRHA
Heat Pump ( < =10K cfiri)
Advanced Planning Fee.
$0.00
0 hours Plan Check, Hourly
0
Travel Documentation Fee: ITRAVDOC
$45.00
$133.00
ISTPLNCK
®�
Strong Motion Fee: IBSEISMICO
$3.15
= hrs Inspections
Bldg Stds Commission Fee: IBCBSC
1 $1.00
$266.00 ISTINSP
Inspection, Hourly
"� • i 1 1
Noun=
9- -• 04/29/2013
CITY OF CUPERTINO
Off - /J131 FF.F. F.CTTMATnR — RTT111.11IN DIV14RION
im,
ADDRESS: 20800 HOMESTEAD RD
DATE: 09/04/2013
REVIEWED BY: MELISSA
$0.00
APN: 326 09 073
BP #:
`'VALUATION:
Iso
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY Multi- Family Dwelling
USE:
Building is
1 >3 Stories ® Yes ® No
PENTAMATION 1GENRES
PERMIT TYPE:
WORK
REVISION # 1 - MINOR CHANGES TO INTERIOR WALL & HEADER. ACCESSIBLE PLAN FOR
SCOPE I
RESTROOM RECEIVED - ISSUED 9/4/2013
Xfe <,h. Plan ('heck
Meclr. Permit Fee:
Chlrer Akch. Insp.
rtlech. Insp. Fee:
Plumb. Plan Check
Plumb. Permit Fee:
Other Plumb lnsp.
Plumb. hap. Fee:
Flee. Plan (:'heck
faec. Permit Fee:
(slier face. Imp.
Elec. Insp. Fee:
NOTE. This estimate does not includefees due to other Departments (i.e. Planning, Public Worxs, rire, samrary newer uisrricy acnoot
District, etc). These-fees are based on the prelimina information available and are only an estimate- Contact the Dept-for addn'1 info.
FEE ITEMS 6Fee Resolution 11 -053 E . 711112) FEE QTY/FEE MISC ITEMS
Plan Check Fee: Hourly Only? ® Yes (E) No $0.00 = hours Plan Check, Hourly
Suppl. PC Fee: Q Reg. ® OT 0.0 hrs $0.00 $139.00 ISTPLNCK
PME Plan Check: $0.00
Permit Fee: Hourly Only? ® Yes Q No $0.00
Suppl. Insp. Fee-.0 Reg. ® OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Construction :Tax:
r1dininistrative Fee:
0
Work Without Permit? ® Yes No
$0.00
Advanced Planning Fee:
$0.00
Select a Non - Residential E)
Building or Structure
I �
TrUvel Documentation Fees:
Strong; Motion. Fee:
$0.00
= hrs Inspections
$139.00 ISTINSP Inspection, Hourly
Bldg Stds Commission Fee:
$0.00
a 11 R§P
�Tp $0.00 $278.00 ���_ $278.00
�' Revised: 07/01/2013