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14090175CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 14090175 10115 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 I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing _ T MECH RESIDENIAL COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: LOT 2 CONSTRUCT (N) DETACHED OFFICE/WORK SPACE I hereby affirm under penalty off perjury one of the following two declarations: 452SF r. I have and will maintain a certificate of consent to self -insure for Worker's REV # 1 -ALL BUILDINGS/OFFICES (14090172-14090182) - REVISE Compensation, as provided for by Section 3700 of the Labor Code, for the CEDAR SIDING TO FIBER CEMENT - ISSUED 8/11/16 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. APPLICANT CERTIFICATION Sq. Ft Floor Area: Valuation: $56500.00 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 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 comply with all non -point PERMIT EXPIRES IF WORK IS NOT STARTED source regulations per the Cupertino unicipal Code, Section 9.18. WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM INSPECTION. Signature Date OWNER-BLA DER DECLARATION Issued by: MELI Date: 01/04/2016 1 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 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 installed without first obtaining an inspection, I agree to remove all new materials for sale (Seo 7044, Business &Professions Code) inspection. 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). Signature of Applicant: I hereby affirm under penalty of perjury one of the following three declarations: Date: 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 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 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 maintain compliance with the Cupertino Municipal Code, Chapter 9,12 and the shall not employ any person in any manner so as to become subject to the Health & Safety Code, Section 25532(a) should I store or handle hazardous Worker's Compensation laws of California. If, after making this certificate of material. Additionally, should I use equipment or devices which emit hazardous exemption, I become subject to the Worker's Compensation provisions of the air contaminants as deSned by the Bay Area Air Quality Management District I Labor Code, I must forthwith comply with such provisions or this permit shall will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and be deemed revoked. the Health & Safety Code, Sections 25505, 25533, and 25534. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is Owner or authorized agent: correct. I agree to comply with all city and county ordinances and state laws Date: CON LENDING AGENCY relating to building construction, and hereby authorize representatives of this city I hereby affirm that there is a construction lending agency for the performance to enter upon the above mentioned property for inspection purposes. (We) agree of work's for which this permit is issued (Sec. 3097, Civ C.) to save indemnify and keep harmless the City of Cupertino against liabilities, 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 Lender's Address and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Signature Date Licensed CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10115 N FOOTHILL BLVD CONTRACTOR: SBI BUILDERS INC PERMIT NO: 14090175 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 Q. COMMERCIAL License Class Lia LOT LOT 2 CONSTRUCT (N) DETACHED OFFICE/WORK SPACE 452SF Contractor S 1U' 1 J1E,(4 4 (� 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: $56500 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: 34232070.10115 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 ITHIN 180 DAY PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save DAY L ALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, j180 costs, and expenses which may accrue against said City in consequence of the this IY: granting of permit. Additionally, the applicant understands and will comply Date: with all n on- o' t source regulations per the Cupertino MuCode, Section 9.18. RE-ROOFS: f ►/ LJ / Signature Date �Onicipal 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 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) 1, 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. I have and will maintain Worker's Compensation Insurance, as provided for by will maintain compliance with A Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sdo 5505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this L j j 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 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 CITY OF CUPERTINO WE FEE ESTIMATOR - BUILDING DIVISION F ADDRESS: 10121 N FOOTHILL BLVD LOT 2 DATE: 09/25/2014 REVIEWED BY: MELISSA PC FEE ID APN: 342 32 070 BP#: Q D *VALUATION: 1$56,500 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY USE: Commercial Building Civil / Religious activities in BQ zone? Yes � No PENTAMATION PERMIT TYPE: 1 BOFF WORK CONSTRUCT N OFFICE BLDGB / DETACHED WORK SPACE 452 S.F. SCOPE $1,824.00 OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA (s.f.) PC FEES PC FEE ID BP FEES BP FEE ID B (Offices) II-B,III-B,IV,V-B 452 $5,979.00 IBOPLNCK $1,824.00 1BOINSP Permit Fee: $1,824.00 Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: iBCONSTAxc $1,306.28 G Work Without Permit? Yes (2) No $0.00 TOTALS: 452 1 $5,979.00 f d 1 $1,824.00 Strong Motion Fee: IBSEISMICO 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 only an estimate. Contact the Dent for addn7 info. FEE ITEMS (Fee Resolution 11-053 E . 711113) FEE QTY/FEET MISC ITEMS Plan Check Fee: $5,979.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (F) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,824.00 Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: iBCONSTAxc $1,306.28 G Work Without Permit? Yes (2) No $0.00 Advanced Planning Fee: IPLLONGC $131.08 Select a Non -Residential Building or Structure � f d Strong Motion Fee: IBSEISMICO $15.82 Select an Administrative Item 1 Bldg Stds Commission Fee: IBCBSC 1 $3.001 SUBTOTALS:' 1 $9,259.18 $0.00 TOTAL FEE: 1 $9,259.18 Revised: 08/20/2014