14090172CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
10121 N FOOTHILL BLVD (342 32 070)
OWNER'S NAME: FOOTHILL AUTO SERV & DETAIL INC
OWNER'S PHONE:
LICENSED CONTRACTOR'S DECLARATION
License Class CONTRACTOR - GENERAL Lie. #860997
Contractor SBI BUILDERS Date 02/29/2016
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:
1. 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.
(12. 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 thiscityto 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 r the Cupertino Municipal Code, Section 9.18.
Signature 7 Date
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
r. I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the stricture is not intended or offered for
sale (See. 7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (See.7044, Business & Professions Code).
SBI BUILDERS
1064 ALMARIDA DR
SAN JOSE, CA 95128
PERMIT NO: 14090172
ISSUED: 01/04/2016
PHONE NO: 408-2034397
BUILDING PERMIT INFO:
BLDG —ELECT —PLUMB
MECH _ RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
LOT 1 - CONSTRUCT (N) 2 STORY SFD (2220 S.F.) WITH
ATTACHED GARAGE (448 S.F.)
REV # I - ALL BUILDINGS/OFFICES (14090172-1409-0182) - REVISE
CEDAR SIDING TO FIBER CEMENT - ISSUED 8/11/16
Sq. Ft Floor Area: I Valuation: $277500.00
APN Number: Occupancy Type:
342 32 070
PERMIT EXPIRES IF WORD IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM L D INSPECTION.
Issued
Date: 01/04/2016
s
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without fust obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant:
I hereby affirm under penalty of perjury one of the following three declarations:
L I have and will maintain a Certificate of Consent to self -insure for Worker's ALL
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
2. 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.
s. 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
BE CLASS "A" OR
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(x) 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, Cha ter 9.12 and
the Health & Safety Code, a ions 25505, 25533, an 24.
Owner or authorized agent: va4 4v
Date:
CONSTRUC ION 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. 3,097, Civ C.)
Lender's Name
Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
Professional
� CITY OF CUPERTINO
IF 1 FEE ESTIMATOR - BUILDING DIVISION
OCCUPANCY TYPE:
ADDRESS: 10121 N FOOTHILL BLVD LOT 1
DATE: 09/25/2014
REVIEWED BY: MELISSA
PC FEE ID
APN: 342 32 070
BP#: I qoq Q t ?-2,-
*VALUATION: 1$277,500
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY
USE: SFD or Duplex
2nd Unit? Yes ' No
PENTAMATION
PERMIT TYPE: 1 R3SFD i
wORK
CONSTRUCT N STORY SFD 2220 S.F. WITH ATTACHED GARAGE 448 S.F.
SCOPE
448
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
R-3 (Custom)
II-B,III-B,IV,V-B
2,220
$2,922.19
IR3PLNCK
$2,626.83
IRMNSP
U (Private Gar/Ag Bldg)
II-6,111-B,IV,V-B
448
$0.00
IU1PLNCK
$1,290.00
1UIINSP
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: IBCONSTAXR
1
#new
units
$667.63
O
Work Without Permit? 0 Yes No
$0.00
TOTALS:
2,668
$2,922.19
p,;<.' �:�?r>cttr�tenturion I'E�€�•
$3,916.83
Strong Motion Fee: IBSEISMICR
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 Dept -for addn'l info.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/132
'0'ec,i1. Pio, C, hf,("4
it it77ib.-1`1a;f C h", K
MISC ITEMS
Meech. Permit Fee:
PI?deli. Pcrn:ir Fee:
Isier.. I'rrrJit 1.'
01her tt ,A Insp.
Ot/:>er P/tImb Insp.ELI
Oihsr Elec. Irrsp,
k,,.1r. /t_sP. RV:
P1umh. Insp. Fee;
:. b sp, Fce:
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 Dept -for addn'l info.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/132
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,922.19
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: (D Reg. 0 OT
p.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$3,916.83
Suppl. Insp. Feer Reg. Q OT
0 0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: IBCONSTAXR
1
#new
units
$667.63
O
Work Without Permit? 0 Yes No
$0.00
Advanced Planning Fee: IPLLONGR
$373.52
Select a Non -Residential Q
Building or Structure 0
�
p,;<.' �:�?r>cttr�tenturion I'E�€�•
Strong Motion Fee: IBSEISMICR
$36.08
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
1 $12.00
SUBTOTALS:
1 $7,928.25
$0.00 TOTAL FEE:
1 $7,928.25
Revised: 08/20/2014
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10121 N FOOTHILL BLVD CONTRACTOR: SBI BUILDERS INC PERMIT NO: 14090172
OWNER'S NAME: FOOTHILL AUTO SERV & DETAIL INC 1515 THE ALAMEDA STE 300 DATE ISSUED: 01/04/2016
OWNER'S PHONE: SAN JOSE, CA 95132 PHONE NO: (408) 549-1305
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL
LOT I CONSTRUCT (N) 2 STORY SFD (2220 S.F.) WITH
License Class Lic. ATTACHED GARAGE (448 S.F.)
Contractor L -1i Bu eWml_?_s G Date 't 1
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. Sq. Ft Floor Area: Valuation: $277500
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: 34232070,00 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 WIT A 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 1 AYS FR LAST CALLED INSPECTIO
N.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the Paie�� - V
granting of this permit. Additionally, the applicant understands and will comply Issued b
with all non- ' t source regulations per the Cupertino Municipal ode, Section
RE -ROOFS:
9.18.
Signature Date i' 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. 1 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 25505, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date:
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