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14090174CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 14090174 10117 N FOOTHILL BLVD (342 32 070) SBI BUILDERS 1064ALMARIDA DR SAN JOSE, CA 95128 OWNER'S NAME: FOOTHILL AUTO SERV & DETAIL INC OWNER'S PHONE: LICENSED CONTRACTOR'S DECLARATION License Class CONTRACTOR - GENERAL Lic. #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 fall 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. z. 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 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 Muni ipaI Code, Section 9.18. Signature Date OWNER-BUI ER DECLARATION DATE ISSUED: 01/04/2016 NO: 408-203-4397 BUILDING PERMIT INFO: —BLDG — ELECT — PLUMB _ MECH _ RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: LOT 2 - CONSTRUCT (N) 2 STORY SFD (2220 S.F.) WITH ATTACHED GARAGE (448 S.F.) REV # 1 - ALL BUILDINGS/OFFICES (14090172-14090182) - 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 LAST CALLED INSPECTION. I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is 1. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sec.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). I hereby affirm under penalty of perjury one of the following three 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. 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. 3. 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 Signature ofApplieant: Date: BE CLASS "A" HAZARDOUS MATEMALS 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 CodeAliapter 9.12 and the Health & Safety Code, §ections 25505, 25533,sand 25534. Owner or authorized agent, -_Pd IS" 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 Professional CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10117 N FOOTHILL BLVD CONTRACTOR: SBI BUILDERS INC PERMIT NO: 14090174 OWNER'S NAME: FOOTHILL AUTO SERV & DETAIL INC 1515 THE ALAMEDA STE 300 DATE ISSUED: 01/04/2016 OWNER'S PHONE: 4083994950 SAN JOSE, CA 95132 PHONE NO: (408) 549-1305 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class Lic. # 0j� LOT 2 - CONSTRUCT (N) 2 STORY SFD (2220 S.F.) WITH ATTACHED GARAGE (448 S.F.) Contractor �� Date , 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 permit is issued. APN Number: 34232070.10117 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 WITHIN 180 DAYS IT ISSUANCE OR .upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS LA D 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 iAe Iss granting of this permit. Additionally, the applicant understands and will comply with all non- pint source regulations per the Cupertino Municipal Code, Section ROOFS: 9.18. l rra� Signature()3—k Date j lJ roofs shall be inspected prior to y roofing material being installed. If a roof is All an y 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: 1, 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 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 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 Section 3700 of the Labor Code, for the performance of the work for which this the Health & Safety Code, Se i 25505, 25533, and 25534. !% Owner or authorized agent: J 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 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 APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct. l 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 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION im,ADDRESS: 10121 N FOOTHILL BLVD LOT 2 DATE: 09/25/2014 REVIEWED BY: MELISSA PC FEE ID APN: 342 32 070 BP#: *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 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 1R3PLNCK $2,626.83 IR3INSP U (Private Gar/Ag Bldg) II-B,III-B,IV,V-B 448 $0.00 IU1PLNCK $1,290.00 1WINSP PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: 1BCONSTX R # new units $667.63 rtinistrativ e T`ec , G Work Without Permit? 0 Yes (F) No $0.00 TOTALS: 2,668 $2,922.19 > °l l)t��ume:t�tra ion T'ea s $3,916.83 Strong Motion Fee: 1BSEISMICR 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 nreliminary information available and are onlv an estimate. Contact the Dept for addn I into. FEE ITEMS (Fee Resolution 11-053 E . 7� %iech. Plan Check QTY/FEE MISC ITEMS Plan Check Fee: ?67it r7..:� '.'t F. F Select a Misc Bldg/Structure or Element of a Building 'Iher 1E1e,-h, histr, i:; f'7° Pt' "Mbg Insp. 07Yii'Y Elec, Iris/?, Li $0.00 PME Plan Check: F e, - 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 nreliminary information available and are onlv an estimate. Contact the Dept for addn I into. FEE ITEMS (Fee Resolution 11-053 E . 7� FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,922.19 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (F) Reg. 0 OT 0.0 1 hr's $0.00 PME Plan Check: $0.00 Permit Fee: $3,916.83 Suppl. Insp. Feer Reg. 0 OT 0,0hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: 1BCONSTX R # new units $667.63 rtinistrativ e T`ec , G Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: 1PLLONGR $373.52 Select a Non -Residential Building or Structure 0 i > °l l)t��ume:t�tra ion T'ea s Strong Motion Fee: 1BSEISMICR $36.08 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $12.00 SUBTOTALS: $7,928.25 $0.00 TOTAL FEE: $7,928.25 Revised: 08/20/2014