Loading...
13080028MY OF CUP E][ 71NO BUM DEN G PER ff7 BUILDING ADDRESS: 10011 N FOOTHILL BLVD STE 101 CONTRACTOR: EARTHPRO PERMIT NO: 13080028 OWNER'S NAME: KIMIAVO LLC SERIES D 100 GREAT OAKS BLVD STE 140 DATE ISSUED: 08/05/2013 OWNER'S PHONE: 4082699040 SAN JOSE, CA 95119 PHONE NO: (408) 294-1920 LICENSED CONTRACTOR'S DECLARATION 30B DESCRIPTION: RESIDENTIAL 0 COMMERCIAL[] License Class C Z-1 Lic. # 9 5 -7,9q?_ SUITE 101 FOR IPEJl81i/[]IT PURPOSES DRILY)**OOMlI''IIORI I --� nn 1'� �—� 2©� 3 A1REA**1ROMOVE (E) WOOD DECK, INSTALL (N) PAVER Contractor o ✓ n Date PATIO (2000 S.F.) 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 Sq. Ft Floor Area: Valuation: $35000 ; performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by ection 3700 of the Labor Code, for the performance of the work for which this APN Number: 34249024.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is E][D PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating ����� 180 ���� ®� PERMIT ISSUANCE ®� to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 1 ED INSPIECT)ION. 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 4; ed by: Date,:with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. �7 I RE -ROOFS: Signature Date (J All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, l agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1, 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) 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 California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three 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 Managgment 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, Sections , 25 3, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner agent: Date permit. is issued. or authorized 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 CONSTRUCTION PERMIT APPLICATION ®® COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 4 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 /i_0 CCUPERTINO (408) 777-3228 • FAX (408) 777-3333 e buildingOcupertino.org \ I U 8) I NEW CONSTR CTION I I ADDITION ltAl NrFRATION / TI I inI RFVIRION / DEFF.RRED ORIGINAL PERMIT # PROJECT ADDRESS j>/ -S I fl©D 1 1 APN # 1 V3 ( O { OWNER NAME t^O'O��.II CvIMrn �,la Cd�cla 'aIPL PHON Zn I �1� V EMA'IL,ia�-B/I% �+ STREET ADDRESS , �V I ] "�� 1.1� V (� CITY, STATE,,_ZY� f� C/ ' C /Sia q OE-MMUAIILI FAX `Y03� P �t/ l4' �O - CONTACT NAME PHONE de- STREET ADDRESS ��� r� S I� A� CIIjY, STZaoAT ZIP `� �� F 1g ZI ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT :ONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONIRACTQRNAME LICENSENUM R LICENSE TYPE BUS. LIC# O �•� P �p(J CO PANY N E rc) Ea -MAIL _-u%isbq/-7 FAX STREET ADDRESS ve t q A % r� r y `LIICENSENUMBER 5q KAT se A 9 S -B fl �L `b Y d PION 4 �^ `� �L ARCHITECT/ENGINEER NAME BUS. LIC # COMPANY NAME E-MAIL FAX - STREET ADDRESS CITY, STATE, ZIP PHONE D SCRIPTION OF WORK I l tT EXISTINGUSE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECKT.S.ICE TOTAL DECK/PORCH AREA GARAGE AREA: DETACH []ATTACH 4 DWELLING UNITS:C-ND UNIT VES SECONDSTORV ❑YES NADDED? 0 ADDITION? 0 PRE -APPLICATION []YES IF YES, PROVIDE COPY OF IS THE BLDG AN YES RECEIVED B)` TOTAL VALUATION: PLANNING ADPL # NO. PLANNING APPROVAL LETTER EICHLER NOME? 20 By my signature below, I certify to each of the following: I am the property Amer or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building c. traction. 1 uthorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: c� I SUPPLEMENTAL INFORMATU REQUIRED PLAN CHECK TYPE ROUTING SLIP BUILDING PLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit forVER-THE-COUNTER existing building(s). Demolition permit is required prior to issuance of building permit for new building. EXPRESS PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure L7 STANDARD PUBLIC WOKKS form if any Hazardous Materials are being used as part of this project. El LARGE ❑ ,.FIRE DEPT. _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ sANIrnRYSEWF.eDtsTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_201 1. doe revised 06/21/11 (M �xn 91 CITY OF cCNFERTRN® FEE ESTIMATOR — BUILDING DMSIGN 19 ADDRESS: 10011 N Foothill DATE: 08/01/2013 REVIEWED BY: Se f'Ilech. Permit Fee: APN: BP#: a G G "'YAILUJATIO $35,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition PRIMARY USE: Building Plumb. Insp. Fee: PENTAMATION PERMIT TYPE: 1GERICOM PERMIT WORD existinq wood deck and replace with paver patio 2000 sq ft SCOPE tove NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. eta). These fees are based on the oreliminary information available and are onlv an estimate Contact the Dept for addn'l info. EEE ITEMS (Fee Resolution 11-053 Eff 7/1/12) Xlech. Plan Check Plvnrb. Plan Check Elec..Plan Check f'Ilech. Permit Fee: r'lumb. Po -mil Fee: l-lec•. Permit Fee: Other• Alech. Other Phwnh Asp. Other Elec. Insp, ALech. Insp. Fee: Plumb. Insp. Fee: Eley. Imp, Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. eta). These fees are based on the oreliminary information available and are onlv an estimate Contact the Dept for addn'l info. EEE ITEMS (Fee Resolution 11-053 Eff 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: hourly Only? 0 Yes (E) No $0.00 = hours Plan Check, Hourly $139.00 ISTPLNCK Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PN/1E Plan Check: $0.00 Permit Fee: Hourly Only? 0 Yes Q No $0.00 Suppl. Insp. Fee -0 Reg. 0 OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Conswuction Tax: Administrative Fee: Work Without Pen -nit? Yes E) No $0.00 Advanced Planning Fee: $0.00 0 hours Inspections Q $417.00 ISTINSP Inspection, Hourly 0 Travel Documentarion Fees: Strong Motion Fee: IBSEISMICO $7.35 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: $9.35 $556.00 TOTAL FEE: $565.35 Revised: 07/01/2013 7 rx cr -.4 -4. D"" Ld I vZ, .......... V -,! N ;? "—j V, 4 WN M. Mid LU CJ 11 4a- -Al 11 CD E) LO C) NO VII 'IX . . . . . . . . . . . . . . . . ... 77, WM H0,56 V� 6ON1,LH2tdfl;j o M VAIH IJIHIOOJ W 11001 or ----- — Z, - --------- . . . . . . . . . . . . . . . . ... 77, WM o M z 1, or ----- — WM o M z 1, tl O 0-80-