14090173CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: 14090173
10119 N FOOTHILL BLVD (342 32 070) SBI
BUILDERS
1064
ALMARIDA DR
SAN JOSE, CA 95128
OWNER'S NAME: FOOTHILL AUTO SERV & DETAIL INC
DATE ISSUED: 01/04/2016
OWNER'S PHONE:
PHONE NO: 408-203-4397
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class CONTRACTOR - GENERAL Lic. #860997
Contractor SBI BUILDERS Date 02/29/2016
—BLDG —ELECT _PLUMB
MECH RESIDENTIAL COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
— _ v
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
LOT 1 - CONSTRUCT (N) OFFICE BLDG / DETACHED WORK
I hereby affirm under penalty of perjury one of the following two declarations:
SPACE (452 S.F.)
1. T 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
REV # 1 - ALL BUILDINGS/OFFICES (14090172-14090182) - REVISE
performance of the work for which this permit is issued.
CEDAR SIDING TO FIBER CEMENT - ISSUED 8/11/16
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
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
Sq. Ft Floor Area:
Valuation: $56500.00
and state laws relating to building construction, and hereby authorize
representatives of this city to enter upon the above mentioned property for
APN Number:
Occupancy Type:
inspection purposes. (We) agree to save indemnify and keep harmless the
342 32 070
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 cojnply with all non -point
source regulations r the Cupertino MunicipWCode, Section 9.18.,
PERMIT EXPIRES IF WORD IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Signature 1w 1 Date 08/11/2016
180 DAYS FROM LAST CALLED INSPECTION.
OWNER -BUILDER DECLARATION
Issued byME
I hereby affirm that I am exempt from the Contractor's License Law for one of the
Date: 01 /0 2016
following two reasons:
1. 1,, as owner of the property, or my employees with wages as their sole
RE -ROOFS:
compensation, will do the work, and the structure is not intended or offered for
All roofs shall be inspected prior to any roofing material being installed. If a roof is
Pr
sale (Sec.7044, Business &Professions"Code)
4
le
installed without fust obtaining an inspection, I agree to remove all new materials for
owner the roe exclusive) contracting with licensed
2. I, property, rt} Y g
inspection.
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
Signature of Applicant:
1. 1 have and will maintain a Certificate of Consent to self -insure for Worker's
Date: 08/11/2016
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
2. 1 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
HAZARDOUS MATERIALS DISCLOSURE
permit is issued.I
have read the hazardous materials requirements under Chapter 6:95 of the
s. I certify that in the performance of the; work for which this permit is issued, I
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
shall not employ any person in any manner so as to become subject to the
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Worker's Compensation laws of California. If, after making this certificate of
of the
Health & Safety Code, Section 25532(x) should I store or handle hazardous
I use equipment or devices which emit hazardous
exemption, I become subject to the Worker's Compensation provisions
material. Additionally; should
I
Labor Code, I must forthwith comply with such provisions or this permit shall
air contaminants as defined by the Bay Area Air Quality Management District
be deemed revoked.
will maintain compliance with the Cupertino Municipal Code, Cha -c 9.12 and
the Health & Safety Code, ections 25505, 25533,andx5534.
APPLICANT CERTIFICATION
e
I certify that I have read this application and state that the above information is
Owner or authorized agent:
r or
correct. I agree to comply with all city and county ordinances and state laws
Date: 2016
relating to building construction, and hereby authorize representatives of this city
CONSTRUC ION LENDING AGENCY
to enter upon the above mentioned property for inspection purposes. (We) agree
I hereby affirm that there is a construction lending agency for the performance
to save indemnify and keep harmless the City of Cupertino against liabilities,
of work's for which this permit is issued (Sec. 3097, Civ C.)
judgments, costs, and expenses which may accrue against said City in
Lender's Name
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.
Lender's Address
ARCHITECT'S DECLARATION
Signature Date 08/11/2016
1 understand my plans shall be used as public records.
CITY OF CUPERTINO
BUILDING PERMIT
BUILDING ADDRESS: 10119 N FOOTHILL BLVD
CONTRACTOR: SBI BUILDERS INC PERMIT NO: 14090173
OWNER'S NAME: FOOTHILL AUTO SERV & DETAIL INC
1515 THE ALAMEDA STE 300 DATE ISSUED: 01/04/2016
SAN JOSE, CA 95132 PHONE NO: (408) 549-1305
OWNER'S PHONE: 4083994950
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
License Class Lic.
LOT I - CONSTRUCT (N) OFFICE BLDG / DETACHED
_
WORK
Contractor`�)mot�Sr0l Date f q (
SPACE (452 S.F.)
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.
I have and
Sq. Ft Floor Area:
Valuation: $56500
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: 34232070.10119
Occupancy Type:
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
PERMIT EXPIRES IF WORK IS NOT STARTED
to building construction, and hereby authorize representatives of this city to enter
WITHIN 180 D IIT ISSUANCE OR
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities; judgments,
180 DA OMED INSPECT ON.
costs, and expenses which may accrue against said City in consequence of the
of this
s ® g
granting permit. Additionally, the applicant understands and will comply
de, Section
9.18.
with all no int source regulations per the Cupertino MuW�J�
'"
Signature Date
N
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.
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:
I, as owner of the property, or my employees with wages as their sole compensation,
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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
I hereby affirm under penalty of perjury one of the following three
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations: I
I have and will maintain a Certificate of Consent to self -insure for Worker's
Health & Safety Code, Section 25532(a) should I store or handle hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
material. Additionally, should I use equipment or devices which emit hazardous
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 he Cupertino Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, S ti 25505, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this(7A
i
permit is issued.
Owner or authorized agent: Date: !
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
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ialADDRESS:
10121 N FOOTHILL BLVD LOT 1
DATE: 09/25/2014
REVIEWED BY: MELISSA
PC FEE ID
APN: 342 32 070
BP#: 1 qa 1012-3
*VALUATION: 1$56,500
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY
USE: Commercial Building
Civil / Religious activities
in BQ zone? 0 Yes (F) No
PENTAMATION
1 BOF
PERMIT TYPE:
WORK
CONSTRUCT N OFFICE BLDG / DETACHED WORK SPACE 452 S.F.
SCOPE
Suppl. Insp. Fee -0 Reg. Q OT
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
B (Offices)
II-B,11]-B,IV,V-B
452
$5,979.00
IBOPLNCK
$1,824.00
IBOINSP
Permit Fee:
$1, 824.00
Suppl. Insp. Fee -0 Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: 1BCONSTAXC
$1,306.28
qac rninisiralive Fee:
G)
Work Without Permit? 0 Yes E) No
$0.00
TOTALS:
452
$5,979.00
t.R���ell7oc°ct�rrE�ntr�tir�n Fees:�
$1,824.00
Strong Motion Fee: IBSEISMICO
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 addh I info.
FEE ITEMS (Fee Resolution 11-053 E . 7{ jd j
Itiec/t. f tank Cfii'%ri.
QTY/FEE
MISC ITEMS
:1lIec.h. Permit Fee:
Plumb. Permit l=ee:
�'/(.'c. Aernrit
;LIE•t'Ir. Inst?.
:.='er Plef th Insp.Ll
Oiher Elec. 11;.t -.
Li
$0.00
1'tr?mb, Insl>, Fee;
Elea 111sp, 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 Dept for addh I info.
FEE ITEMS (Fee Resolution 11-053 E . 7{ jd j
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$5,979.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: (E) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$1, 824.00
Suppl. Insp. Fee -0 Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: 1BCONSTAXC
$1,306.28
qac rninisiralive Fee:
G)
Work Without Permit? 0 Yes E) No
$0.00
Advanced Planning Fee 1PLLONGC
$131.08
Select a Non -Residential
Building or Structure O
t.R���ell7oc°ct�rrE�ntr�tir�n Fees:�
Strong Motion Fee: IBSEISMICO
$15.82
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$3.00
SUBTOTALS: 1
$9,259.18
$0.00 TOTAL FEL:
1 $9,259.18
Revised: 08/20/2014