14090180CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: 14090180
10105 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
LICENSEDCONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class CONTRACTOR - GENERAL Lic. #a60997
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 5 - 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 and will maintain a certificate of consent to self-insure for Worker's
REV # i - 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 for by
provided
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
Sq. Ft Floor Area:
Valuation: $277500.00
APPLICANT CERTIFICATION
certify that I have read this application and state that the above
APN Number:
Occupancy Type:
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize
342 32 070
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
PERMIT EXPIRES IF WORD IS NOT STARTED
may accrue against said City in consequence of the granting of this permit.
Additionally, the applicant understands and will comply with all non-point
WITHIN 180 DAYS ®% PERMIT ISSUANCE OR
source regulations pijj the Cupertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signature DateIssued
byME
-
Date:01/04/2016
OWNER-BUILD R DECLARATION
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
Signature of Applicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date:
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A'° OR BETTER
t. 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.
HAZARDOUS MATERIALS DISCLOSURE
2. I have and will maintain Worker's Compensation Insurance, as provided for by
I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code, for the performance of the work for which this
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
permit is issued.
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
3. I certify that in the performance of the work for which this permit is issued, I
Health & Safety Code, Section 25532(a) should I store or handle hazardous
shall not employ any person in any manner so as to become subject to 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
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code, Sections 25505 5533, a d 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agent: It
APPLICANT CERTIFICATION
Date:.
I certify that I have read this application and state that the above information is
CONSTRUCTION LENDING AGENCY
correct. I agree to comply with all city and county ordinances and state laws
I hereby affirm that there is a construction lending agency for the performance
relating to building construction, and hereby authorize representatives of this city
of work's for which this permit is issued (Sec. 3097, Civ C.)
to enter upon the above mentioned property for inspection purposes. (We) agree
Lender's Name
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 Address
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal
ARCHITECT'S DECLARATION
Code, Section 9.18.
1 understand my plans shall be used as public records.
Signature Date
Licensed
Professional
I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 10105 N FOOTHILL BLVD I CONTRACTOR: SBI BUILDERS INC PERMIT NO: 14090180
OWNER'S NAME: FOOTHILL AUTO SERV & DETAIL INC 11515 THE ALAMEDA STE 300 1 DATE ISSUED: 01/04/2016 1
OWNER'S PHONE: 4083994950 I SAN JOSE, CA 95132 I PHONE NO: (408) 549-1305
IN LICENSED CONTRACTOR'S DECLARATION
License Class Lie. # 1 (®_/ 7
O
Contractor�� k.Jl7Lil KiC� , J.a► G Date l "� 1(0
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.
JOB DESCRIPTION:: RESIDENTIAL [] COMMERCIAL
LOT 5 - CONSTRUCT (N) 2 STORY SFD (2220 S.F.) WITH
ATTACHED GARAGE (448 S.F.)
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:
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
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 comp+
with all no pint source regulations per the Cupertino Munici al ode, Section.
9.18.
Signature Date ,
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
I, as owner of the property, or my employees with wages as their sole compensation,
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
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
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.
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
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
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
Valuation: $277500
APN Number: 34232070.10105 1 Occupancy Type:
PERMIT EXPIRE
WITHIN 1
KOT STARTED
ISSUANCE OR
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.
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(a) 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/+e Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, SotoA Sot25505, 25533, and 25534. I
Owner or authorized agent:k J t A 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
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
CITY OF CUPERTINO
V -1 -ft FEE ESTIMATOR — BUILDING DIVISION
OCCUPANCY TYPE:
ADDRESS: 10121 N FOOTHILL BLVD LOT 5
DATE: 09/25/2014
REVIEWED BY: MELISSA
PC FEE ID
APN: 342 32 070
BP#: 17
*VALUATION: 1$277,500
*'PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY SFD or Duplex
USE:
2nd Unit? 0 Yes ) 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
1R3INSP
U (Private Gar/Ag Bldg)
II-B,III-B,IV,V-B
448
$0.00
I UIPLNCK
$1,290.00
1 UIINSP
Pen -nit Fee:
$3,916.83
Suppl. Insp. Feer Reg. 0 OT0.p
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
TOTALS:
2,668
$2,922.19
Construction Tax: IBCONSTAXR1
$3,916.83
#new
„nits
NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
Dktriet vtr_ 1_ Thoce feec are hnced mt the nrelintinary infnrntatinn availahle and are ank an evintate_ Contact the Dent for addn'I info_
FEE ITEMS (Fee Resolution 11-053 Elf. 7/1/13)
FEE
___7-
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,922.19
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: (j) Reg. 0 OTT0,0
l�rs
$0.00
PME Plan Check:
$0.00
Pen -nit Fee:
$3,916.83
Suppl. Insp. Feer Reg. 0 OT0.p
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: IBCONSTAXR1
#new
„nits
$667.63
G
Work Without Permit? 0 Yes (2) No
$0.00
Advanced Planning Fee: 1PLLONGR
$373.52
Select a Non -Residential
Building or Structure
G
r
Strong Motion Fee: 1BSEISMICR
$36.08
Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC
$12.00
SUBTOTALS:'
$7,928.25
$0.00
TOTAL FEE:
$7,928.25
Revised: 08/20/2014