13060058I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 20800 HOMESTEAD RD
OWNER'S NAME: VILLA SERRA APTS
OWNER'S PHONE: 6509313400
�a LICENSED CONTRACTOR'S DECLARATION]
License Class Lic. #
Contractor( Date_
I hereby affirm that I a" censed 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 regulations per the Cupertino Municipal Code, Section
9.18.
Signature , Date 1p
❑ 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.
Signature Date
CONTRACTOR: MONTEREY PERMIT NO: 13060058
CONSTRUCTION COMPANY
88 MONTEREY - SALINAS HWY STE A DATE ISSUED: 06/13/2013
SALINAS, CA 93908 PHONE NO: (831) 601 -2659
JOB DESCRIPTION: RESIDENTIAL COMMERCIALS
BUILDING 10 UNITS A - H REMODEL KITCHEN, BATH,
ELECTRICAL SUBFEED, W/D HOOKUPS HOT & COLD
WATER
LINES FOR ALL (E) FIXTURES. 1,025 SQ FT PER UNIT
Sq. Ft Floor Area: Valuation: $160000
APN Number: 32609073.20800 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS F ST CALLED INSPECTION.
Date: 6 l3 /3
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 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, 2533, and 25
Owner or authorized agent: ate:
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
06/06/2013 11:02Mtry Construction Co. (FAX)831 455 7986 P.004 /004
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014 -3255 O�
CUPERTINO (408) 777 -3228 - FAX (408) 777 -3333 - bulldingi2oupertino,ora
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P1818 M'esteed Road, Bullding # 1 , Units JA - kA (z =Q -0 :� 3. ZOgod
V111ra She ra Apartments "'01650 931.3400 E-Maa
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WKWorfolk Street, # 150
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FAX
PHONE (650 931 -3400
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STREET ADDRESS
CITY, STATE. ZIP
FAX
1900 So. Norfolk Street # 150
San Mateo CA 94403
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ARCHMC IENOINEER NAME
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FAX
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g emoveN & O replace kitchen & bath cabinets. Replace electrical sub anal & subfeed; Install new W/D & hookups.
Run new hot & cold water lines for all existing fixtures. �. \ Y
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By my signature below, i certify to each of the following: I am the property owner or au nz sent to on porly owner's behalf. I have read this
application and the inibrmation I have provided is correct. I have read the Description of Work and ver ccurato. I agree to comply with all applicable local
ordinances and state laws relating to building ction. I au prize representatives of Cupertino to enter the above- identifod property for Inspection purposes,
Signature of ApplicanttAgent: Dato:
SUPPLEMENTAL INFORMATION REQUIRED
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W). ROUT LNG BLIP.. ;^' ='.,.,... �:. ,i'..,
_ New SFD or Multifamily dwellings: Apply for demolition permit for
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a BUILDING ELAN R6YIEW
existing building(s). Demolition permit is required prior to issuance of building
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permit for new building.
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_ CommercialBldgs: Provide a completed Hazardous Materials Disclosure
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form i f any H azardous Materials Bre being used as part of this project.
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Co of Planning A Approval Letter or Meeting wi
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B1dgApp 2011.doe revised 03116111
WN CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
f,),.'t'N.'a" .f�!1t; ieL %.177.1']7.
Phia r•i7.1t ?ST3. 1'ee:
NOTE: This estimate does not include fees due to other Departments (ie. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.). 7hese.fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info.
FEE ITEMS (Fee Resolution 11 -053 Eff. 711112) FEE QTY/FEE I MISC ITEMS
Plan Check Fee: $0.00 6,000 s.f. Remodel, Other
Suppl. PC Fee: (D Reg. ® OT 0.0 1 hrs $0.00 $7,629.00 IREMRES3
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Fee-i@ Reg. 0 OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Pen-nit Fee: $0.00
20800 HOMESTEAD RD 10 A -H
DATE: 06/1012013
REVIEWED BY: MELISSA
JimADDRESS:
APN: 32609073.20800
BP #:
*VALUATION: 1$160,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
$16.00
PENTAMATION 1 R3SFDREM
PERMIT TYPE:
WORK
BUILDING 10 UNITS A THRU H REMODEL KITCHEN BATH, ELECTRICAL SUBFEED, W/D
SCOPE
HOOKUP, 750 SQ FT PER UNIT
f,),.'t'N.'a" .f�!1t; ieL %.177.1']7.
Phia r•i7.1t ?ST3. 1'ee:
NOTE: This estimate does not include fees due to other Departments (ie. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.). 7hese.fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info.
FEE ITEMS (Fee Resolution 11 -053 Eff. 711112) FEE QTY/FEE I MISC ITEMS
Plan Check Fee: $0.00 6,000 s.f. Remodel, Other
Suppl. PC Fee: (D Reg. ® OT 0.0 1 hrs $0.00 $7,629.00 IREMRES3
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Fee-i@ Reg. 0 OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Pen-nit Fee: $0.00
Revised: 04/29/2013
E)
Work Without Permit? 0 Yes Q) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non - Residential G
Building or Structure 0
�
/ 7 "C f � %�' -1.� i' {3C's'f7r3?[;I s'. X�IIt t�p7 .�` £'g;'.4 ;
Strong Motion Fee: IBSEISMICR
$16.00
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$7.00
,a�. ...... ate, ..:.
$ 23 .00,$7629.00
TOTAL FEE:
r.
$7,652.00
Revised: 04/29/2013
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014 -3255
C O P E RT I N O Telephone: 408 - 777 -3228
Fax: 408- 777 -3333
CONTRACTOR/ SUBCONTRACTOR LIST '
JOB ADDRESS: 13 L p b — H 20700 meX
ERMIT #
OWNER'S NAME:\
PHONE #.
GENERAL CONTRACTOR:
BUSINESS' LICEN. SE
ADDRESS:
CITY /ZIPCODE:::, jj
*Our municipal code requires "Al businesses working 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.
T am not using any subcontractors:
Signature Date
Please eherk nnnlirnhle enhenntrnetnrc and emmnlete the fnllnwinv.infnrmatinn
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
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owners ontractor Signature
Date
07/18/2013 13:27 FAX 4085579463
Z 002/002
r
to ,a= H V
- Communiry Development
�LD� - 10300 Torre Avenue
CuPartiao CA 95014
?c) Thone (408) 777 -3228
CUPERTINO Fax (409) 777 -3333
---Building De ent
JOB ADDRESS;
•�O£�od i'�r►res- i�cad� . ,�aa� 77yci OWN ER'S NAME: tb - -�
GENERAL CONTRACx'OR: on� c�'i =.�6 FAX #
T am not using any subcontractors:
Signature
Please check a livable subcontractors and ccam -.ete the follow
SUBCONTRACTOR BUSINESS N�
Cabinets & Millwork
Cement Finishuig
—. –
Electrical
Excavation
_Per►.cing
Linoleum / Woca
Glass / Glazing
hwalation
Masonry
Oauamental Sheet Metal
VA
�Y Date
iun;
BUSINESS LICENSE #
'1' :3
Roofing V �(o 13
C) M12 DL Septic Tank -
Sheer Metal
Mrfn7-
a Iqio•nafi•„re . ' -