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15060088I CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10700 CLUB HOUSE LN CONTRACTOR: TBD - TO BE PERMIT NO: 15060088 DETERMINED OWNER'S NAME: AIKINS SONYA E TRUSTEE DATE ISSUED: 06/11/2015 OWN R'S PHONE: 4082535357 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL �.�-�, p' r — License Class �%�t%'�� -3: � 'c. # `�'' WMR AW DEEP CLIFF GOLF COURSE - INSTALL NEW 200 AMP PANEL _ Contractor' �= ' '� FOR AGRICULTURAL USE FOR NEW IRRIGATION �I�';i�i'k . Date PUMPING I hereby affirm that I am I ensed under the provisions of Chapter 9 SYSTEM, INSTALL 1065' FEET OF 2 1/2" ELECTRICAL (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 Sq. Ft Floor Area: Valuation: $20000 ]performance of the work for which this permit is issued. 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. APN Number: 35605003 10700 Occupancy Type: 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 to building construction, and hereby authorize representatives of this city to enter WITI�T 180 DAYS OF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save 180 D YS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the �`'r" granting of this permit. Additionall a plicant understands and will comply Issued by: T 1 �-Yr' �� "` Date: with all non -point sou regulatio s r e Cupertino Municipal Code, Section 9 18. X ,t• r ,� � � `N RE -ROOFS: 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 I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: 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 AYea Air-QuaTi .V- ana-eeme-n-I District I performance of the work for which this permit is issued. will maintain compliance with the Cuper n Municipal -Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sectio s 255 5, 5 3, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this 1 cs=_ - •rp ` permit is issued. Owner or authorized agent. - :" Dater 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 CONSTRUCTION LENDING AGENCY 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 Lender's Address 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, ARCHITECT'S DECLARATION 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 GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE ^ CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinaCa.cuoertino.org MECHANICAL MISCELLANEOUS PROJECT ADDRESS / ✓ v APN n /07007 ,L)0, S P ✓ OWNER NAME/'LPHONE /I�(�^L E-MAII _e. L.. �n .Jll �✓ L FJ .J STREET ADDRESSIfs e-'/ J �� '°'a✓ CITY, STATE, ZIP \ FAX /C� 1J CONTACT NAME % PHONE }� LA>1I3l E -MAI / O 4X' -",q STREET ADDRESS ij �1� ' +J ��Jn CITY, STATE, ZIP � d� ^ I FAX ❑ owNER ❑ OR'T`'ER-BUIIA_(ER ❑ OWNER AGENTT ,•"�A'MACTOR ❑ CONTRACTOR AGII.1T ❑ . ARCHITECT El ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR /� LICENSE NUT4BER l [� LICEN TYPE /3 BUS. LIC 9 COF P 44V NS - e-eo Aj- SCX;6 NE "l fD EMAIL FAX STREET AD Com. BNr CITY, STATE, ZIP PHOI2�00 ARCHITECT/ENGINEER NAME LICENSE NUMBER po BUS. LIC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or DUPLEX ❑ MULTI-F.AAffi.Y PROJECT IN WIIALAND EI YES PROTECT IN ElY'ES IS THE BLDG AN ❑ YES BL7 I\' G: ❑COMMERCLAL URBANATTERFACEAREA" . ❑ NO FLOOD ZONE NO EICHLERHOME? NO DESCRIPTION OF WORK n TOTAL VALUATION: ® �REC IVED 1 x x [ By my signature below,! certify to each of the following: I am the pe owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is c ct I have ea e escnption of'Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building con ion. I a o entatives of Cupertino to enter the a e -identified propel inspection purposes. Signature of ApplicanUAgent: Date: ' SU-PPLEA NTAL D\TFOFL ATION REQUIRED z or C1 r sEorBi' ��x ; N'��OVERsTI�t 0UTE u; 00. F. 0 Nank ir 01,�v AIEP1 riscApp_2011.doc I•evised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION 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 nreliminary information available and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 E(f. 7/1/13) ADDRESS: 10700 Clubhouse Dr DATE: 06/11/2015 REVIEWED BY: Paul 1191 APN: 356 05 003 BP#: "VALUATION: 1$20,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY USE: Commercial Building Civil / Religious activities in BQ zone? 0 Yes (E)No PENTAMATION PERMIT TYPE: 1 CEAP A WORKDee Cliff Golf Course - Install new 200 Am Panel for Agricultural Use for new irrigation pumping SCOPE system, Install 1065' feet of electrical conduit and water pipe in a 36" deep trench. 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 nreliminary information available and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 E(f. 7/1/13) Afech. Plan Check Plumb. Plan Check Elec. Plan Check 0.0 hrs $0.00 �Nech. Pepnit Fee: Plumb. Permit Fee: Elec. Permit Fee: IEPERMIT Other Rlech. Irrsp. C)ther Plumb Insp. ET—L— Other Elec. Insp. 0.0 hrs $48.00 P4ech Insp. Fee., Ptrtrnb. Insp. l"ee: Elec. 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 nreliminary information available and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 E(f. 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes Q No $0.00 $0.00 200 amps Electrical $48.00 IBELEC200 Services Suppl. PC Fee: (j) Reg. 0 OT0.0 hrs PME Plan Check: $0.00 $0.00 Permit Fee: Hourly Only? 0 Yes Q No Suppl. Insp. Feer Reg. OT 0.0 hrs $0.00 $0.00 PME Unit Fee: PME Permit Fee: $48.00 $0.00 Construction Tax: IBCONSTAXC Administrative Fee: ]ADMIN $45.00 $0.00 0 G Work Without Permit? 0 Yes (j) No Advanced Planning Le e: $0.00 $48.00./$143.00 hours Plan Check, Hourly ISTPLNCK 0 Travel Documentation Fee: ITRAVDOC Strong Motion Fee: IBSEISMICO $5.60 $1.00 5.0 hrs Inspections $715.00 ISTINSP Inspection Hourly Bldg Stds Commission Fee: IBCBSC SUBT0TAL'S $147.60 TOTAL $906.00 F Ire - 11V ��ez*y `! ( sC- f G 61,02-1 ef 7 6 t\Af� w -L,- *-Z-- �00 \ sal Ailwiv )cAlm `lox ` V � 60' �s " ,,.fir` �`> t � •,, �• ... �� cic of any ocs X0(3 cac �,3 cmc Lovk fop - C��, N-L.Yl I LAO C IW -41 ZO — - - t QD Oi VV N E m A W+ Santa Clara Valley Wale( District 5750AL ADEN EXPRESSWAY SAN JO DEEP CLWI.. F" SE, CA 95118-3686 s A, Zlox, !Az, 14 10, -N Aii� 'N 2�. 4 41, iyf 4, N, An WELLS.shp Water Supply - Active Water Supply -Standby cots AORExtraction m Water Supply - Inactive (Env) - Active REV�E�EU Extraction Inactive ed a (Env) - + Other - Active m Other - Inactive Abandoned Approximate Scale A Destroyed Status Undeten-nined 45 0 45 90 Feet PARCELS.SHP 0APost_GPS_Check\gpschkbc.apr February 2, 2015 —7 7