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13020154-PUB10097 S BLANEY AVE 13020154 F/P PREG BILTMORE SCANNED BOX #596 I CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS 2nnzn STFUF Tc n OWNER'S NAME: PREG BILTMORE OWNER'S PHONE: 65093I3457 P LICENSED CONTRACTOR'S DECLARATION License Class IE ` Lic. # Contractor Date I hereby affirk that I am licensed r der 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 ;formance of the work for which this permit is issued. ave and will maintain Worker's Compensation Insurance, as provided for by ection 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 ions per the Cupertino Municipal Code ctio 9.18. % Signature Date ❑ OViKER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1, 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. CONTRACTOR: JOHNSTONE MOYER, PERMIT NO: 13020154 INC. 1720 S AMPHLETT BLVD STE 250 DATE ISSUED: 08/02/20I3 SAN MATEO, CA 94402 PHONE NO: (650) 570-6161 JOB DESCRIPTION: RESIDENTIAL u COMMERCIAL BUILDING C- CONSTRUCT 2 FLOORS OF MFDWL UNITS (6) Sq. Ft Floor Area: I Valuation: $710000 APN Number: 36903004.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FR CALLED INSPECTION. 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 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 ' al Code, Chapter 9.12 and the Health & Safety Code, Seetions 505 31 d 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 Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Profess Date I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10097 S BLANEY AVE CONTRACTOR: JOHNSTONE MOYER, PERMIT NO: 13020154 INC. OWNER'S NAME: PREG BILTMORE 1720 S AMPHLETT BLVD STE 250 DATE ISSUED: 08/02/2013 OWNER'S PHONE: 6509313457 SAN MATEO, CA 94402 PHONE NO: (650) 570-6161 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL License Class 3 Lic. #� 1 I Contractor �'�(;i(aJj(Zs��tnouE� Date Z-1 3 I hereby affirm that I am licensed 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. have and will maintain Worker's Compensation Insurance, as provided for by ection 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. '-, --)A .,r Date !U -G 01� LNG 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 ofCalifomia. 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. BUILDING C- CONSTRUCT 2 FLOORS OF MFDWL UNITS (6) 9/25/13 DEFERRED #1 TRUSS CALCS - ISSUED 10/8/2013 rSq. Ft Floor Area: Valuation: $710000 PN Number: 36903007.10097 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAY ERMIT ISSUANCE OR 180 D CALLED INSPECTION. Issue y: � 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 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 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.I2 and the Health & Safety Code a ns 25505 25533, and 25534. Owner or authorized agent: Date: 0 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 Date CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10097 S BLANEY AVE CONTRACTOR: JOHNSTONE MOYER, PERMIT NO: 13020154 INC. OWNER'S NAME: PREG BILTMORE 1720 S AMPHLETT BLVD STE 250 DATE ISSUED: 08/02/2013 OWNER'S PHONE: 6509313457 SAN MATEO, CA 94402 PHONE NO: (650) 570-6161 fid LICENSED CONTRACTOR'S DECLARATION �� License Class Lic. # $ ( J 1 Contractor, 010 0 Z� 11/tJt; it Date / I hereby affirm that I am licensed coder 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. 1 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 erformance of the work for which this permit is issued. ve and will maintain Worker's Compensation Insurance, as provided for by ection 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION l 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,�e applicant understands and will comply with all n�ri�Qinttgo (^e regulations er the Cupertino Municipal Code, SectiQu_� 9.18. i t t\ t I Signature ❑■ I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1, 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) 1, 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 1 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. JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ BUILDING C- CONSTRUCT 2 FLOORS OF MFDWL UNITS (6) DEFERRED #2- STAIRCASES - ISSUED 2/14/14 Sq. Ft Floor Area: Valuation: $710000 APN Number: 36903007.10097 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAY,ISSUANCE OR 180 DAYLAS LED INSPECTION. Date: Z l RE -ROOFS - All roofs shall be inspected prior to any roofing material being installed. if a roof is installed without first obtaining an inspection, 1 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 1 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 wi Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 55 , 25 ,and 25534. Owner or authorized agent: Date: CONSTRUCTION LENDING AG ,�) 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 Date CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10097 S BLANEY AVE CONTRACTOR: JOHNSTONE MOYER, PERMIT NO: 13020154 INC. OWNER'S NAME: PREG BILTMORE 555 OLD COUNTY RD DATE ISSUED: 08/02/2013 OWNER'S PHONE: 6509313457 SAN C:ARLOS, CA 94070 PHONE NO: (650) 570-6161 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL p Q BUILDING C- CONSTRUCT 2 FLOORS OF MFDWL UNITS License Class Lic.# L ` (6) Contractor pyb\ / Date ( c,. 5/23/14 - REV # 1 - DIVIDE (E) CARPORT IN TO 2 1 hereby affirm that I am licensed 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. 1 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: $710000 erformance ofthe 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 APN Number: 36903007,10097 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERM EXPIRES IF K IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WIT 180 DAYS OF PE IT 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 DA rAffl` 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 granting of this permit. Additionally, the applicant understands and will comply issued by: Date: IfH with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signat 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 1 am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1, 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. 1 will 1 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 1 have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this 9-9 Owner or authorized a e: l�( 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, l 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 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 ° FAX (408) 777-3333 • buildiinnq(d�cupetno.org 3 q 03 0 AT)T)TTIC)N I I-7A1.TF.RATInN/TT 1 I RAV1S10N/T7)RFFRRRr) ORTGTNAT.PFRMTTfi PROJECT ADDRESS l` OWNERNAME E-MAIL STREETADDRESS©������ /1 . CITY, STATE,ZIP(1{,� _ t^ t /+ f1, f''C� Cl� t FAX + ,1j�• CONTACT NAME cIl `' >, ^ '-,iQQ Q �i}"X1 ^ E_a 1TVq ® OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHTJTCr ❑ ENGINEER ❑ DEVELOPER ❑ TENANT L E N rb4l I ¢t` LICENSE TYPE BUS. LIC 4 REISS CI STATE, 7Jy_ P( �'�i✓) f � _ C�Ti 4�� �A\ J 14^ L'7` �` A�iCPSjT GIjJEER hF�L�/L.`�CS yt 131 R� ` — 'SAVI 131"m 'p'�a,vt,� ` � • "� `^��"`� y iY�aa `rr`1 r+'�Ci1%:�C6ii+Cr��Ga►7('G'Y�s . W� �� ���'e'� CA,- 14tt)-J DESCRIPTION OF WORK y� � �� �j � � � � I._ � � t ✓` �� ��Y\ TI G U RO OSED US '•"� TR 7"1'PESTORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA ` BATHROOM REMODEL AREA \ �� eVDECK KITCHEN REMODEL AREA �JA _ OTHER REMODEL AREA PORCH AREA 11`+1'-I�1\ A TOTAL. DE&1 PORRCCH AREA .Nl fA"� GARAGE :��' ATTACH N ATTACH ADWIL S: IS A SECOND UNIT [:]YES BEING ADDED? 0 SECONDSTORY ❑1�fES ADDrr10N? O PRE -APPLICATION ❑ YES W YES, PROVIDE COPY OF PLANNING APPL k ❑ NO PLANNING AP tROVAL LETTER t IS THE BLDG AN ❑ YES EICHLER HOME? ffNO RECEIVED BY.. :,:.: " '''�:: `,:.: ".-.77TOTAL VALUATION: —% 1 U 000 i - f le following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this d is have Description Work it is I to local By my signature below, I certify ttbui information I application and the h vi correct. I read the of and verify accurate. agree comply with all applicable for ordinances and state laws relating in c s . I authorize representatives of Cupertino to enter the above -identified property inspection purposes. Applicant/Agent: Date: day////ems Signature of SUPPLEMENT �Ii�Ij'ORM ION REQUIRED PLAN CHECK TYPE`. ROUTING SLIP ❑ OVERTHF-COUNTTR'; .. �.,BUILDINGPLANRCVIL9Y1 — New SFD or Multifamily wellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to Issuance of building permit for new building. Elixrtirss:':r:::..'' '';..: °. 1T rlkrtivri5cpiariiicviEw': Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ `STANDARD. ❑ PLBLIC V11 form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ rM, DEPT.:: _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MA.TOR ❑ SANITARY SCWER DISTRICT submittal of Building Permit application. -.. ..:: .. ❑ ENVIRONMI;NTALit]:ALT73":` BldgApp_2011.doc revised 06/21111 IQ C PERTiNO NEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION 0\5A COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING D[VISION � 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a cuDertino.org ❑ ADDITION ❑ ALTERATION / TI O REVISI / DEFERRED ORIGINAL PERMIT 4 PROJECT ADDRESS ' O OG 7 S, . $ N E , O , OWNER NAME ?1 C. I t _ w � I E-MAIL �[ STREET ADDRESS .� /N .1 _' - CITY, STATE. ZIPIs FAX �,- �J✓G�r CONTACT NAME p ✓'✓t L�i� aoQ �� �� CF��J�ESa �S sTtlyqel'Us"j.�' o� �-�C L�(� cIT ST ��pCOO,- c�o-i; MC>:111---3/,5-7 a RI OWNER ❑ OIANER-BUILDER ❑ OWNER AGENT CONT,RAACCT'OR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT LICENSE TYPE BUS, L[C R ` %-I -" iOP$TGI�EERh�1', _ �v� ♦ VeffNSE R�� �"vpl�gk'V�i �-A+G��"�r "'� .^�lo+ �•�•••4�.c�.��.r���0+0(-�'Y�J .�i>IR.%E. � �FC�" i tti�i D�`�GX �i STAT ck- C'AL'�l DESCRIPTION OF WORK �� � �✓� �} e , (1 T_ � tv 1 �� �/ � I C�,���a1 9�� /�CJ!'�� ��� �..%�d\�� t�'CiV'�'�-� �� � • \ FfL(' ��✓' i VtF'p%�c-°� ' �FiC� � '- y1— �ie'p—� eE^ � � ��i • �RO OSE�u�SL COS l�al, STAR APE �• V O� USE TYPE OCC. SQ.FT. VALUATION (S) AREA AREA NEW FLOOR AREA DEMO AREA NET AREA NET U BATHROOM REMODEL AREA KITCHEN REMODEL AREA V OTHER REMODEL AREA VAN �; PORCH AREA i��F DECK AREA IF�Fi�_ TOTAL DL-CIC/PORCH AREA aQ�l �R'q GAATTACK rC"I [ATTACH 9 DR'ELw: IS A SECOND UNIT ❑)'ES BEING ADDED?� O SECOND STORY �S ADDrrION? O PRE :Ar'PLICATION ❑YES IF YES, PROVIDE COPY OF PLANTING APPL k ❑ NO PLANNING APPROVAL LETTER IS THE 6LDG AN ❑YES EICHLER HOME? P`NO 'RECEIVED BY:_'.;;.:.":.:.;:'::,;,..::::;jy(:.;:2::::: TOTAL VALUATION: 0 By my signature below, I certify to Each cif e following: I am the property o%Aroer or authorized agent to act on the property owner's behalf I have read this application and the information I have p vi d is correct. I have read the Description of Work and verify it is accurate. I ao ee to comply with all applicable local ordinances and state laws relating buI it c Shu n. utho ze r resentatives of Cupertino to enter the above-identifie property for inspection purposes. Signature of Applicant/Agent: Date: sv e SUPPLEMENT MO ION REQUIRED : rLtx ci crcT <Trt RoilTrrrc sLlr _ . ❑6 ) R TIITiCOUN'T�R ❑ BUILDING PLAIT REVIEW' ••.. New SFD or Multifamily wellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance ofbuilding permit for new building. ❑;ixRrss.'a,`_. `.;".'::` `:::`.< :❑;.riAi.IVlivcpiANRENMw.:;„,.,::.;:: _ Bldgs: Provide a completed Hazardous Materials Disclosure ❑ :;S::<TA..'«N:: Dr:A:R:`!D',. ,:`:;;.::.::„:';. i>.;" . ;' , ❑:;;:UBLI;C,::. T4'O; R1C: S;;'Commercial an Hazardous Materials are being used art of this ro'ect. form if y Haz s g as s p � — Copy of Planning Approval Letter r Meeting Planning prior submittal of Building Permit application. .TO'' R:... SAA'ITARY SEP✓E R DI$T RICT ❑ ENVIRONMENTAL IIEALTII CUPWrINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 O ��� (408) 777-3228 • FAX (408) 777-3333 • building(c5cupertino.org 130 ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS �) `�v APN # 1^�� �v J OWNER NAME PHONE G UI STREET ADDRESS ��/ 1�Y�T E IP / /� �I j11� FAX 6\ �/ CONTACT NAME PHONE jl -0 % �( E—MAIL' I' CG� STREET ADDRE,S6 CITY, STAN(A It (❑ FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNE.RAGENT ❑ CONTACTOR ❑CONTRACTORAGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICEN LICF.TiSE TYPfc BUS. LIC S COMPANY NAME 1 E-MiL,C 1 1 1_ FAX �/J `� (/1 STREET ADDRESS I 20 A 2 S IAE ZIP (J / ARC CT GWEEK // �, /� Zo LICENSE NUMBER BUS. LIICC # T \ i'1 G r5 d 1 COMPAN-e n- E-MAIL i `G w ^/� j/ FAX (I[ f 2 j 1 — q "(�J S.g.1 ST ADDRESS �.. �tia stAIWT ��� ,j ��, � PHONE %///S ' I/ C . � h (i((% CJ I DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA G �-RG PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑YES BEING ADDED? ❑NO ADDITION? []NO PRE -APPLICATION [-]YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES PLANNING APPL # []NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO „ t'>s,�+�` By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating too uil� nstru thoorri_zef epresentatives of Cupertino to enter the abov i nti�fi^eddppro �r inspection purposes. :,v S ignature of Applicant/Agent: �/;" 7� Date: SUPPLEMENTAL INFO ION REQUIREDrriNc:SL- Q 39 WgS ❑ OVER 7;H)r��C�OIINTER ' ��� � BiJIiDI13G PLAN SFD or Multifamily dwellings: Apply for demolition permit for _New existing building(s). Demolition permit is required prior to issuance of building permit for new building. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure : DExPREss iatvD �� rI�II+InvcrJ >zEVIEwI s r P,UBLI wORKS� xd form if any Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to`� submittal of Building Permit application. �' MAJOR ' ANITAR ER'ERDIST C1`� *` i�ENVHtONMENT HEI G TH.! R. <GW� B1dgApp_2011.doc revised 06121/11 CUPERTIN© CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISI 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building a cupertino.orq ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION 1 TI © REVISION / DEFERRED ORIGINAL PERMIT #__ 3o Zoi s"y outh Blaney Avenue APN a+-r d 3.6 - p O °EW11PPfore Apartments a California limited partnership PHnO 931-3457 maucote rometheusre .com S s asabove C' STATE, IF CA F�`50 931-3657ame 'WiNae` bucote P 931-3457 E-M IL m�ucote@prometheusreg.com S A RES 146b `�oulh Norfolk Street, Suite 150 C Y, ST T ZIP gan Mateo, CA 94403 FAX 650 931-3657 El OWNER ❑ OWNER -BUILDER IQ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CJSON ACTOR NAME ohnstone Mo er Inc. LI NSE NUMBER n record CENSE TYPE n record B LIC k n record COMPANY NAME E- AIL n record F bn record ST tJh record CITIr�S�ATk ord "M record Atfi%i Tffa 'EJ6hffion Architects LICEdh�Ny�, ffid "OHceecord COMPANY NAME E ,vh record F �n record j� A fe��tt 66 �$$S STOR d Y 71e 9 rfT�bVId PI OM record ` DESCRIPTION OF WORK ,4eQ 1 \ C. � 6.rIke— EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES 1 USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA I GARAGE AREA: U DETACH []ATTACH k DWELLING UNITS. []YES SECOND STORV YES 71SASECONDUNIT BEING ADDED? []NO ADDITION? []NO PRE -APPLICATION ❑ VES IF YES. PROVIDE COPY OF IS THE BLDG AN ❑ YES 1:ATk1_V-A+i!�ATION: PLANNING APPL # []NO PLANNING A ROVAL LETTER EICHLER HOME? ❑ NO By my signature below, I certify to eac I am the property owner or aut agen I t e property owner's behalf. 1 have read this fLiscorrect. application and the information 1 h e v1 have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating t b 1 in. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent..• Date: 05/22/14 SUPPLEMENTAL RM TI0N REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW _ New SFD or Multifamily dwel I pply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH B1dgApp_2011.doc revised 06121111 � CITY OF CUPERTINO ICI FEE ESTIMATOR -BUILDING DIVISION ADDRESS: 20030 SCB- BUILDING C DATE: 02/27/2013 REVIEWED BY: MENDEZ APN: BP#: *VALUATION: 1$710,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY Multi -Family Dwelling USE: 7>3 Building is Stories 0 Yes � No PENTAMATION 1 R2 PERMIT TYPE: WORK BUILDING C- CONSTRUCT 6 MFDWL UNITS SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-2 (Apartment) II-B,III-B,IV,V-B 6,421 $5,777.00 IR2PLNCK $3,667.00 IR2INSP TOTALS: 6,421 $5,777.00 '' $3,667.00 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School nictrirt otr L Thoco fooc are haled nn the nreliminafv information availahle and are nnlv an estimate_ Cnntaet the Dent for addn'l info_ FEE ITEMS (Fee Resolution 11-053 E .. 7� FEE QTY/FEE MISC ITEMS Plan Check Fee: $5,777.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (2) Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $3,667.00 Suppl. Insp. Fee:Q Reg. Q OT Fo.ol hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: 1BCONSTAXR 1 # new units $629.29 G Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: 1PLLONGC $1,733.67 Select a Non -Residential Building or Structure Strong Motion Fee: 1BSEISMICR $71.00 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $29.00 SUBTOTALS: 11,906.96 $0.00 TOTAL FEE: 1 $11,906.96 Revised: 01 /01 /2013 %SG�) (_� CITY OF CUPERTINO FM_7 FEE ESTIMATOR - BUILDING DIVISION imADDRESS: O (3 97S . 13 W'Ff ,6 DATE: 09/25/2013 REVIEWED BY: larrys APN: BP#: I3 Q z. O J 5+3� fr 'VALUATION: $0 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY Multi -Family Dwelling USE: Buildina is 3 Stories Q Yes Q No PENTAMATION 1 R2 PERMIT TYPE: WORK submittal of truss calculations 1 �defered SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-2 (Apartment) II-B,III-B,IV,V-B 0 $0.00 $0.00 i TOTALS: 0 $0.00 $0.00 ' �... �..._ 1", f. NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. eta). These fees are based on the areliminary information available and are only an estimate Contact the Dent for addn 7 info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1113) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? () Yes Q) No $0.00 # $0.00 Deferred Submittal Suppl. PC Fee: Q Reg, 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? ()Yes Q No $0.00 Suppl. Insp. Fee-0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXR 0 # new units $0.00 ditr,tri> : ti uti. Fci E) Work Without Permit? Yes No $0.00 Advanced Planning Fee: $0.00 hours $417.00 Plan Check, Hourly ISTPLNCK 0 © A 7�r t'1 1)��GtUr7z'r?tutiuti €'c'E'ti: Strom Motion Fee: $0.00 =hrs $417.00 Inspections 1sTINSP Inspection, Hourly Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $834.00 TOTAL FEE: $834.00 Revised: 08/01/2013 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION 10097 S BLANEY AVE DATE: 05/23/2014 REVIEWED BV: MEUSSA k4ADDRESS: APN: 369 03 004 BP#: 13020154 'VALUATION: Iso PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Commercial Building USE: PENTAMATION PERMIT TYPE: WORK - REV # 1 - DIVIDE E CARPORT IN TO 2 SEPARATE 4 SPACE CARPORTS �5/23/14 SCOPE NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These 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 T'Mj FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (2) Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? 0 Yes (2) No $0.00% Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure d Strom Motion Fee: $0.00 1 # $834.00 Revisions IREVCOMTI Tenant Improvement Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $834.00 TOTAL. FEE: 1 $834.00 Revised: 04/01 /2014 looq7 '51 6ZAT CONTRACTOR /SUBCONTRACTOR LIST xftildi�g,Dfepa appt"t City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: �.: .d�> t PERMI <, _ ? ,0 1 5; QWIIVE'S 1lAIE: ..: <<- x,{ PHONE # (j - GE AAL CONTRACTOR: 3� „, .� � .i.. BUSINESS LICENSE # ' ADDRESS: 17?U f,;�4 -� M��v °';i CITY/ZIPCODE: *Our municipal code requires all businesses working in the city t�i-hsve 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 CUPERTIN:Q.,,. 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 Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile / Contractor Signature