14090178CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
10109 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.
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
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 tobuildingconstruction, 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 c mply with all non -point
source regulations ppr the Cupertino Municip2ode, Section 9.18. -
Signature l/,/M 1/ //r✓.� Date
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
CONTRACTOR: I PERMIT NO: 14090178
SBI BUILDERS
1064 ALNIARIDA DR
SAN JOSE, CA 95128
DATE ISSUED: 01/04/2016
PHONE NO: 408-203-4397
BUILDING PERMIT INFO:
BLDG —ELECT —PLUMB
MECH _ RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
LOT 4 - 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: { 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 LASTLY - -- - SPECTION.
Issued by: MELISSA NAMES
Date: 01/04/2016
I, as owner of the property, or my employees with wages as their sole �r-xcvvrn:
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 obtainine an inspection, I agree to remove all new materials 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).
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
inspection.
Signature of Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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, Chapter 9.12 and
the Health & Safety Code,c dons 25505, 25533, and 2
Owner or authorized agent:
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
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10109 N FOOTHILL BLVD
CONTRACTOR: SBI BUILDERS INC PERMIT NO: 14090178
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. # 0
LOT 4 - CONSTRUCT (N) 2 STORY SFD (2220 S.F.) WITH
ATTACHED GARAGE (448 S.F.)
Contractor�bl f{vt.- i
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: 34232070.10109
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 180DERMIT ISSUANCE OR
upon the above mentioned property for inspection purposes. (We) agree to save
180 D RO CALLED INSPEC7 ON.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
g
granting of this permit. Additionally, the applicant understands and will co P1
sued ; - rr Date: d
with all no oint source regulations per the Cupertino Municipal Code, S on
9.18. (�
\�
='
j
Signature ) Date I LI /
}�
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 GLASS "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:
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.
I have and will maintain Worker's Compensation Insurance, as provided for by
will maintain compliance withA Cupertino Municipal Code, Chapter 9.1 and
the Health & Safety Code, S do s 5505, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
/)
Owner or authoriagent: Date , 't
zed
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. 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
FEE ESTIMATOR - BUILDING DIVISION
OCCUPANCY TYPE:
ADDRESS:1 N FOOTHILL BLVD LOT 4
1 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
SFD or Duplex
USE: -7
2nd Unit? Yes •' No
PENTAMATION
1 PERMIT TYPE: 1R3SFD
WORK
CONSTRUCT N STORY SFD 2220 S.F. WITH ATTACHED GARAGE 448 S.F.
SCOPE
$0.00
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
1R3INSP
U (Private Gar/Ag Bldg)
II-B,III-B,IV,V-B
448
$0.00
JU1PLNCK
$1,290.00
1UHNSP
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: 1BCONSTAXR1
# new
units
$667.63
L/inlnf.St7t:i�il%<? 1'<'':
O
0
Work Without Permit? 0 Yes (!) No
$0.00
TOTALS:
2,668
$2,922.19
71-av l I)ocuntenrurion Tees:
$3,916.83
Strong Motion Fee: 1BSEISMICR
NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District. etc.1. These fees are based on the Dreliminary information available and are onlv an estimates Contact the Dept for addn 7 info.
FEE ITEMS lFee Resolution 11-053 E . 7�
Alec"/. 1 Pin ChtacriN
QTY/FEE
1l eG'h. Prr?3tfi F(ee:
�:?ditA Permit �'L'E':
Eiiec. Pc!rl7nIt 1`e,
t:)thc'r' :Lig t?, Inst?.
;,,er Plumb lrsP.
Other Elec. litsf?. Ll
$0.00
PME Plan Check:
$0.00
NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District. etc.1. These fees are based on the Dreliminary information available and are onlv an estimates Contact the Dept for addn 7 info.
FEE ITEMS lFee 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: 0 Reg. 0 OT
0.0
1 lirs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$3,916.83
Suppl. Insp. Fee.e Reg. 0 OT 1
0,0
7hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: 1BCONSTAXR1
# new
units
$667.63
L/inlnf.St7t:i�il%<? 1'<'':
O
0
Work Without Permit? 0 Yes (!) No
$0.00
Advanced Planning_Fee. 1PLLONGR
$373.52
Select a Non -Residential O
Building or Structure 0
i
71-av l I)ocuntenrurion Tees:
Strong Motion Fee: 1BSEISMICR
$36.08
Select an Administrative Item
1
Bldg Stds Commission Fee: 1BCBSC
1 $12.001
SUBTOTALS:
1 $7,928.25
$0.00 TOTAL FEE:
1 $7,928.25
Revised: 08/20/2014