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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