14090176CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:.
PERMIT NO: 14090176
10113 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 Lie. #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
MECH _ RESIDENTIAL — 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 3 - CONSTRUCT (N 2 STORY SFD (2220 S.F.) WITH
I hereby affirm under penalty of perjury one of the following two declarations:
ATTACHED GARAGE (448 S.F.)
1. I have andwill 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.
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: $277500.00
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 WORD IS NOT STARTED
source regulation the Cupertino Municipal Code, Section 9.18.
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FR NSPECTION.
signature d Date
OWNER -BUILDER DECLARATION
Issued by: MELISSA S
Date: 01/04/2016
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
RE -ROOFS:
1. I, as owner of the property, or my employees with wages as their sole
All roofs shall be inspected prior to any roofing material being installed. If a roof is
compensation, will do the work, and the structure is not intended or offered for
installed without first obtaining an inspection, I agree to remove all new materials for
sale Sec,7044, Business &Professions Code
( )
inspection.
2. I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (See.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. 1 have and will maintain Worker's Compensation Insurance, as provided for by
DISCLOSURE
Section 3700 of the Labor Code, for the performance of the work for which this
I have read the hazardous materials requirements under Chapter 6.95 of the
hazardous rialsMATrequire
permit is issued.
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
3. I certify that in the performance of the work for which this permit is issued, I
MunicipalCode, Chapter 9.12 and the
maintain compliance with the Cupertino)should
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 r use equipment or devices which emit hazardous
exemption, I become subject to the Worker's Compensation provisions of the
air contaminants as defined 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, Chapte .12 and
be deemed revoked.
the Health & Safety Code, SS:ctons 25505, 25533, and 255334.
APPLICANT CERTIFICATION
information is
Droner or authorized agent:
I certify that I have read this application and state that the above
Date: /
correct. I agree to comply with all city and county ordinances and state laws
CONSTRUCTION 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: 10113 N FOOTHILL BLVD
CONTRACTOR: SBI BUILDERS INC
PERMIT NO: 14090176
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 r-1 COMMERCIAL
�p��
License Class Lic. #i' l�l�
LOT 3 - CONSTRUCT (N) 2 STORY SFD (2220 S.F.) WITH
ATTACHED GARAGE (448 S.F.)
Contractor!��bl %3t1.1 l g 5 fjl Date 1 I{ 16
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: 34232070.10113
Occupancy Type:
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXPIRES IF WOR_ K 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
WI ISSUANCE OR
upon the above mentioned property for inspection purposes. (We) agree to save
O DAYS LLED INSPE TIO
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
.
costs, and expenses which may accrue against said City in consequence of the
this
granting of permit. Additionally, the applicant understands and will comply
e -- Date:
with all non-"t' source regulations per the Cupertino Municipal Code, Section
9.18. t
i /
SignatureL�L_ Date tD
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 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
the Health & Safety Code, Sdo 25505, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
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
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
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
tM_1 FEE ESTIMATOR — BUILDING DIVISION
ig,ADDRESS:
10121 N FOOTHILL BLVD LOT 3
DATE: 09/25/2014
REVIEWED BY: MELISSA
PC FEE ID
APN: 342 32 070
BP#: V (___r
*VALUATION: 1$277,500
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY SFD or Duplex
USE:
2nd Unit? 0 Yes 0 No
PENTAMATION 1 R3SFDW
PERMIT TYPE.
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
IR3INSP
U (Private Gar/Ag Bldg)
II-B,III-B,IV,V-B
448
$0.00
IUIPLNCK
$1,290.00
1U11NSP
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: IBCONSTAXR
# new
units
$667.63
ltfrnin .' ?rabic• Fisc'.:
G
Work Without Permit? 0 Yes 0 No
$0.00
TOTALS:
2,668
$2,922.19
Tr'avel1.)ricionentiation F , ti
1 $3,916.83
Strong Motion Fee: IBSEISMICR
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 Prelinjinar information available and are only an estimate. Contact the Dept for addit 7 info,
FEE ITEMS (Fee Resolution 11-053 E .. 7�
FEE
P4an C.i7",k
`.;t8£.'. 1,;,"n
F, (x>cr
f'lydnrl�. Pcr Writ I'c:
Irler.. t'.
01ter Much. Insp.
i::er Plumb InSr.
diner Elec. htsp.
$0.00
PME Plan Check:
_..,..la 41 Fi,
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 Prelinjinar information available and are only an estimate. Contact the Dept for addit 7 info,
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. OT
0.0
lirs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$3,916.83
Suppl. Insp. Feer Reg. Q OTT_00
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: IBCONSTAXR
# new
units
$667.63
ltfrnin .' ?rabic• Fisc'.:
G
Work Without Permit? 0 Yes 0 No
$0.00
Advanced Planning Fee: 1PLLONGR
$373.52
Select a Non -Residential G
Building or Structure
Tr'avel1.)ricionentiation F , ti
Strong Motion Fee: IBSEISMICR
$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