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13020095-DCITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7802 BOLLINGER RD CONTRACTOR: MCCLELLAN PERMIT NO: 13020095 DEVELOPMENT OWNER'S NAME: BOLLINGER VENTURE LLC 1448 ENTRADA VERDE PL DATE ISSUED: 05/08/2013 OWNER'S PHONE: 9259449108 ALAMO, CA 94507 PHONE NO: (925) 944-9108 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL L1 COMMERCIAL License Class Lie. # r/. � � LOT 5- CONSTRUCT 2 STORY SFDWL 4,158 S FT, Q f f [� GARAGE _ ContractoMCQ J) c^ �� Date 7 « 704 SQ FT AND DECK 24 SQ FT I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions DEFERRED #1- TRUSS CALCS-ISSD 7/16/2013 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 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: $498960 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 APN Number: 35922077.7802 Occupancy Type: permit is issued. 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 WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAY F M LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the n Issued - granting of this permit. Additionally, the applicant understands and will comply by: Date: 4 with all non-point source regulations per the Cupertino Municipal ode, Section 9.18. - JL RE-ROOFS: Signatur�L f -[ Dat/ t% 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 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, wil I 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 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, Sections 2550 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: 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, 1 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 1 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 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • WILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 55014-3255 (408) 777-3228 • FAX (408) 777-3333 • building9cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ® REVISION/ DEFERRED ORIGINAL PERMIT # 110?0no � PROJECT ADDRESS 7802 Bollinger Road , Lc 5359-22-77 �7 APN # OWNERNAME Bollinger Venture LLC PHONE 925-452-927--7- 925-452-27 E-MAIL debbiem@mcdev.co STREET ADDRESS 501 Dublin Blvd, Suite 200 11 'TBUbfi1iE, �A 945608 FAX 925-452-8209 CONTACT NAME Debbie Ma allanez PHONE 925-452-8273 E-MAIL debbiem mcdev.co STREET ADDRESS 11501 Dublin Blvd, Suite 200 C1%9tiin, CSA 94568 FAX 925-452-8209 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTVCrJ�'egMan LICENSF�� 1 jn LICENSE T�E BUS. LIC # 32229 Development b7 COMPANY NAME E-MAIL FAX McClellan Development debbiem mcdev.co 925-452-8273 STREET 1 1 �V 1 Dublin Blvd, Suite 200 cbu9fiTE; VA 94568 PHONE 925-452-8273 ARCHITyTT/TEINrE R NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX 408-537-0535 VTBS i ee vtbs.com STREET 100 SW. San Fernado Street Suite 595 CITY, n Jose, CA 95113 PHONE408-537-0532 DESCRIPTION OF WORK Truss Calc Plan Check Review EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA. LJDETACH ❑ ATTACH #DWELLING UMTS: ISASECONDUNIT OYES SECONDSTORY OYES BEING ADDED? ONO ADDITION? ONO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED BY: TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO S7r, By my signature below, I certify to each of the following: 1 am the property owner or authorized agent to act on the property owner's behalf. 1 have read this application and the information I have provided is correct. I have read the De np ' n of Work and verify it is accurate. 1 agree to comply with all applicable local ordinances and state laws relating to build' r onstruction. I au orize repre, ntati sof Cupertino to enter the above -identified property for inspection purposes. C Signature of ApplicanUAgenk l� l C Date: l' ' SUPPLEMENTAL INFORMATION REQUIR PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW New SFD or Multifamily dwellings: Apply for demolition permit for 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 ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH B1dgApp 201 Ldoc revised 06121111 CITY OF CUPERTINO OM -7, FEE ESTIMATOR - BUIhDING DIVISION 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 addh 7 info. FEE ITEMS (Fee Resolution 11-053 Eff 7%11112) ADDRESS: 7802 BOLLINGER RD DATE: 06/10/2013 REVIEWED BY: MENDEZ APN: BP#: S— `VALUATION: Iso xPERMIT TYPE: Building Permit 2 hours Plan Check, Hourly $266.00 1STPLNCK PLAN CHECK TYPE: New Construction PRIMARY SFD or DuplexT USE: hrs PENTAMATION 1GENRES PERMIT TYPE: WORK DEFERRED #1- TRUSS CALCS $0.00 SCOPE 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 addh 7 info. FEE ITEMS (Fee Resolution 11-053 Eff 7%11112) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? () Yes 0 No $0.00 2 hours Plan Check, Hourly $266.00 1STPLNCK Suppl. PC Fee: 0 Reg. () OTT -0.07 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee.0 Reg. C) OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 ConstructionTax: 1BCONSTAXR 07Vn_e- units $0.00 0 0 Work Without Permit? Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 A Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $266.00 TOTAL FEE: $266.00 Revised: 04/29/2013 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7802 BOLLINGER RD CONTRACTOR: MCCLELLAN PERMIT NO: 13020095 DEVELOPMENT OWNER'S NAME: BOLLINGER VENTURE LLC 1448 ENTRADA VERDE PL DATE ISSUED: 05/08/2013 OWNER'S PHONE: 9259449108 ALAMO, CA 94507 PHONE NO: (925) 944-9108 n LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL LJ COMMERCIAL License Class Lic. # L -q R V e( LOT 5- CONSTRUCT 2 STORY SFDWL 4,158 SQ FT, Contractor �V' Date GARAGE 704 SQ FT AND DECK 24 SQ FT 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: $498960 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. APN Number: 35922077.7802 Occupancy Type: APPLICANT CERTIFICATION I certify that 1 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 WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 D Al INSPECTION. 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 co m sued b Date: /� with all non -point source regulations per the Cupertino Municipal Code, Section 0Z RE -ROOFS: Signature Date 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 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) 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 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(x) 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. 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 _ 25533, and 24. Section 3700 of the Labor Code, for the performance of the work for which this Owner C Date: permit is issued. or authorized agent: 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 1 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 10300 TORRE AVENUE • CUPERTINO, CA 95014-32552 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • building@cupertino.org 1 ® NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS Bollinger Road Lot 5, Cupertino, CA APN # 359-22-077 OWNER NAME Bollinger Venture LLC PHONE (925) 944-9108 E-MAIL mikem.mcdev@sbcglobal.net STREET ADDRESS 1448 Entrada Verde CITY, STATE, ZIP Alamo, CA 94507 FAX (925) 944-9108 CONTACT NAME Debbie Magallanez PHONE (925) 944-9108 E-MAIL debbiem.mcdev@sbcglobal.net STREET ADDRESS 1448 Entrada Verde Place CITY, STATE, ZIP Alamo, CA 94507 FAX (925) 944-9108 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER N DEVELOPER ❑ TENANT CONTRACTOR NAME McClellan Development LICENSE NUMBER 478869 LICENSE TYPE Class B BUS. LIC# 33-0176209 COMPANY NAME McClellan Development E-MAIL mikem.mcdev@sbcglobal.net FAX (925) 944-9108 STREET ADDRESS 1448 Entrada Verde Place CITY, STATE, ZIP Alamo, CA 94507 PHONE (925) 944-9108 (City O ) ARCHITECTIENGMEER NAME Navy Banvard LICENSE NUMBER C-18051 BUS. LIC 3053582210 COMPANY NAMF"an Tilburg, Banvard & Soderbergh AIA E-MAIL jyee@vtbs.com FAX (408) 537-0535 STREETADDRESSV 100 W- San Fernando St., Suite 595 CITY, STATE, ZIP San Jose, CA 95113 PHONE (408) 537-0532 DESCRIPTION OF WORK Construction of a new 4,862 Single Family House including landscaping, fencing & off-site improvements EXISTING USE PROPOSED USE CONSTR TYPE # STORIES Vacant Land R1-6000 VB 2 USE TYPE OCC. SQ.FT. VALUATION($) EXISTG AREA N/A NEW FLOOR AREA 4,862 DEMO AREA N/A I TOTAL NET AREA 4862 R1-6000 VB R3 4,862 BATHROOM REMODEL AREA N/A KITCHEN REMODELAREA N/A OTHER REMODEL AREA N/A PORCH AREA I DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH N/A 24 Sq. Ft. 24 Sq. Ft. 704 Sq. Ft. ATrncB #DWELLINGUNITS: IS A SECOND UNIT YES SECOND STORY OYES 1 BEINGADDED! WNO ADDITION' DQNO PRE -APPLICATION MYES IF YES, PROVIDE COPY OF PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER IS THE BLDG AN[] YES EICHLER HOME' NO RECEIV B A _ T IOI: V�/1' U By my signature below, I certify to each of the following: I am the property owner 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. 1 agree to comply with all applicable local ordinances and state laws relating to building c struction. hauthorizeitWesentatives of Cupertino to enter the above -identified pro erty for inspection purposes. G U t Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REWIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER PLAN REVIEW New SFD or Multifamilv dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building -1:3-�DING permit for new building. ❑ EXPRESSPL ING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD C WORKS form if any Hazardous Materials are being used as part Of this project. El LARGE FI Copy of Planning Approval Letter or Meeting with Planning prior to ❑ submittal of Building Permit application. MAJOR SANITARY SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH B1dgApp 2011.doc revised 06/21/11 CITY OF CUPERTINO FM_7 FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: Lot 5 DATE: 02/08/2013 REVIEWED BY: Mendez PC FEE ID APN: BP#: `�� *VALUATION: 1$498,960 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY SFD or Duplex USE: I 2nd Unit? 0 Yes • No PENTAMATION 1 R3SFDW I PERMIT TYPE: WORK construct 2 story sfdwl 4,158 sq ft garage 704 sq ft deck 24 s ft 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 4,886 $3,108.71 IR3PLNCK $3,754.94 IR3INSP $0.00 PME Plan Check: $0.00 Permit Fee: $3,754.94 Suppl. Insp. Fee -.(j) Reg. Q OT F0.07 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: TOTALS: 4,886 $3,108.71 $3,754.94 1 NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School 1)ictrict etr_)_ These fees are based on the nreliminary information available and are nnlv an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Ef. 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,108.71 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (E)Reg. ® OT FO.OThrs $0.00 PME Plan Check: $0.00 Permit Fee: $3,754.94 Suppl. Insp. Fee -.(j) Reg. Q OT F0.07 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: I BCONSTAXR 1 # new units $62a. 9 Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: IPLLONGR $635.18 Select a Non -Residential Building or Structure G 0 Strong Motion Fee: 1BSEISMICR $49.90 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $20.00 SUBTOTALS: $8,198.02 $0.00 TOTAL FEE: F $8,198.02 Revised: 01/01/2013 CUPERTINO Building Department CITY OF CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 TELEPHONE: (408) 777-3228 • FAX: (408) 777-7606 OFFICIAL NOTIFICATION OF NEW/ADDRESS CHANGE TO: All Agencies FROM: City of Cupertino DATE: April 08, 2013 RE: New/Change of Address APN #359-22-077 Please note the following new addresses: The vacant lot on Bollinger Rd is being subdivided into 5 lots. The new addresses are as follows: Lot 1 7801 Bollinger Rd Lo 2 7803 Bollinger Rd Lot 3 7805 Bollinger Rd Lot 4 7806 Bollinger Rd Lot 5 7802 Bollinger Rd The new address will take effect in 30 days. See the attached map. Please update your records accordingly. If you have any questions, please call me at (408) 777-3246. Sincerely, usan Winslow Administrative Clerk Cupertino Building Dept 408-777-3246 or suew@cupertino.org O Llj ic O LLI cr 111 Wcr 00 0 Ln LD " mlyCi.� d lIzIc IDILL Z w 0 .d oo Ln 40 P-4 c Z w 1� T cc 0 Lu Z .99-4c L (U 40 c co cc cc (U oo oo w co A- cLo ss oo co cr cc �D Lf) o (U cl co on co 3 -v S'd D i 'Zoi 9�E-L iquioS :y zst Al zi Cr ca � T ai Q -`a •m o d s E g o p rL C p N C - d IL d ++ d d m Q. N cn d ii Q 0 m � U U Q! d r U C U � 7 d ` y 0 a m m U x CL LL a co E 0 E 0 L C c 0 C Sl. a s CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: ac""aG L_ PERMIT # 1302 0-C)"<> OWNER'S NAME: O(i ere_n4Qre_ L -L PHONE# Q26— 462 - -C, GENERAL CONTRACTOR: WC -le -1 larl e.Ve_t fne f BUSINESS LICENSE # 33- 61-7 & SLC ADDRESS: I ( Ut" iI}i, ).i CITY/ZIPCODE:'1 04 z , bL_�f4 *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date o/ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork o9 -7a 4-d Cement Finishing' ' `t SC' r , N `'C? f Electrical I :� i St; r EC:� t' ► ° x ( '53 CG L Excavation /U Fencing t"� Gmbt'.r + net, L `' 7 -1 Flooring / Carpeting ," &" ' .7 _ . z7'3i�' Linoleum / Wood - : '^;� �` ,�- f L4 Glass / Glazing S} (I vl-� 5 . Heating �e�-�'t{ZC Q'ti i? X0_1 Insulation MvAkA - J Landscaping ' �,' �, • , } y C) l Lathing Masonry 34-7 Oe Painting / Wallpaper "SDO � n -k rvci C5 Paving G �.� nor '= Plastering m;-� 7 Plumbing Roofing '3 4L4 q Septic Tank Sheet Metal r&Ii 1 oo rvl Sheet Rock Tile ` jr Owner / Contractor Signature IL..!-I'R Date CUPERTINO PROJECT DATA - RESIDENTIAL COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - building@cupertino.org PROJECT ADDRESS Bollinger Road Lot 5, Cupertino, CA Existing APN # 359-22-077 Proposed OWNER NAME Bollinger Venture LLC PHONE (925) 944-9108 7MAIL mikem.mcdev@sbcglobal.net STREET ADDRESS 1448 Entrada Verde Place CITY, STATE, ZIP Alamo, CA 94507 s.f. FAX (925) 944-9108 APPLICANT NAME Debbie Magallanez PHONE (925) 944-9108 E-MAILdebbiem.mcdev@sbcglobal.ne STREET ADDRESS 1448 Entrada Verde Place CITY, STATE, ZIP Alamo, CA 94507 N/A FAX (925) 944-9108 ❑ OWNER 11OWNER-BUILDER 11 OWNER AGENT 11 CONTRACTOR �y{ 11 CONTRACTOR AGENT 11ARCHITECT 11ENGINEER Q§ DEVELOPER ❑ TENANT DESCRIPTION OF WORK N/A S. f. 4,862 S. f. EXISTING USE(S): Vacant Land PROPOSED USE(S): R1-6000 OCCUPANCY(S): R3 TYPE OF VB PARCEL 11,101 Sq. Ft. CONSTRUCTION: AREA: FIRE y N WUI AREA: Y N FLOOD AREA Y N SIESMIC AREA: Y N SPRINKLERS: Are there at least two 10 feet by 20 feet clear spaces inside the garage? Y N Is privacy protection planting required for the project? Y N Governing Codes: 2010 California Building Code (based on the 2009 International Building Code) 2010 California Residential Code (based on the 2009 International Residential Code) 2010 California Plumbing Code (based on the 2009 Uniform Plumbing Code) 2010 California Mechanical Code (based on the 2009 Uniform Mechanical Code) 2010 California Electrical Code (based on the 2009 International Electrical Code) 2010 California Energy Code 2010 California Green Building Standards Code Cupertino Municipal Code ProjectData-ResidentiaLdoc revised 03/09/11 Existing Proposed Floor Area: First Floor: N/A s.f. 2,555 s.f. Second Floor: N/A s.f. 1,603 s.f. Garage N/A s.f. 704 s.f TOTAL: N/A S. f. 4,862 S. f. Are there at least two 10 feet by 20 feet clear spaces inside the garage? Y N Is privacy protection planting required for the project? Y N Governing Codes: 2010 California Building Code (based on the 2009 International Building Code) 2010 California Residential Code (based on the 2009 International Residential Code) 2010 California Plumbing Code (based on the 2009 Uniform Plumbing Code) 2010 California Mechanical Code (based on the 2009 Uniform Mechanical Code) 2010 California Electrical Code (based on the 2009 International Electrical Code) 2010 California Energy Code 2010 California Green Building Standards Code Cupertino Municipal Code ProjectData-ResidentiaLdoc revised 03/09/11 Oct 31 13 09:00a CUPERTINO PURPOSE McClellan Development 925-4528209 p.5 UTILITY RELEASE REQUEST FORM COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - buildinq_C'cupertino.org For residential single family or duplex construction, there are cases where gas and electric utilities are requested to be released prior to the issuance of the certificate of occupancy. Upon approval from the building inspector, the City of Cupertino is allowing both utilities to be released prior to the final sign -off of the building. INSTRUCTIONS 1. Download this form at: http:l/w`,,Nv.cupert ino.orG;index. aspx?gage=297. 2. Complete the form and obtain signatures from both the owner of the property and the primary contractor. 3. Fax, E -Mail, Mail or hand deliver the original signed form to: City of Cupertino Building Division Attn: Utility Release Request Form 408-777-3228 office 10300 Torre Ave. 408-777-3333 fax Cupertino, CA 95014 buildine(a�.cupertino org 4. Schedule a Gas Meter Release inspection (4403) and/or Electric Meter Release inspection (9404). Please note, a Gas Test inspection (9506) is required prior to or at the same time of the Gas Meter Release inspection. BUILDING INFORMATION (Please complete the following information): APN 359-22-77 BLDG PERMIT#: 13020095 DATE: 10-31-13 SITE ADDRESS: 7802 Bollinger Road, Cupertino, CA 95014 OWNER'S NAME: Bollinger Venture LLC PHONE #= 925-452-8273 /925-452-8209 MAILING ADDRESS (if different from site address): CONTRACTOR: McClellan Develpment FA°#E# 925-452-8273/925-452-8209 CONTACT: PHONE #: Debbie Magallanez FAX #: 925-452-8273/925-452-8209 I request the City to release my utilities prior to obtaining a final inspection approval for the building. I fully understand the occupants of the building cannot move into the residence until they "eceive all of the required final sign -offs and the City has issued a certificate of occupancy for the build in . owner:4�F..1► .. � Ij! lu.. (.0.0.Q.,........_..... Phnt:....Michael..W..McClellan.................. Date:.. 1.0:31-43 ........ Contractor: 4 f _,r.. ..., 1- -1.4 G.II...........C✓a,.,,.........Print:......M.jChae1 W...MC( .lellan................ Date: .... 1.1.1-3.1.-.1-i...... UNJi1yReleaseForm_2(711.docrevised 08109111 1 understand this may not be a complete list of required items due to the variations for each project and additional code related information may be required. 1 understand that an incomplete plan check submittal may result in delays in the plan review process. Applicant Name (Print): � � �, l f-pgv(C Applicant Signature: Applicant's Phone: Cp�� e1 Li LP -41-1, c6 Applicant's Email: oLG�C) tet.1(4-in k41to , Date: IT ` A PlanCheckSubmittalChecklist 2011.doc revised 03/31/11 Window alignment and privacy protection requirements for second stories or ❑ ❑ Z new second story windows or letter of waiver. One 8 1/2 x 11 copy of the site plan, with privacy protection planting shown (tree location, tree canopy, tree species, dimensioned planting distance) ❑ ❑ O Affidavit from a certified arborist/landscape architect. (Affidavit should have a UL z copy of the privacy plantingIan attached). w Landscape Water -Efficiency Checklist (click for entire landscape ordinance) Q ❑ HFence Approval Form (click for entire fence ordinance) ❑X ❑ O Incorporate the City of Cupertino Best Management Practices (BMP) sheet into 0 ❑ all Ian sets. Completed and. Signed Plan Review Submittal Checklist © Elz Completed and Signed Construction Permit Application Form ❑x El W Structural Calculations stamped and signed by licensed professional ❑x ❑ v Geotechnical Soils Investigation report stamped and signed by licensed ❑ ❑ O professional (2 copies) o Title 24 Energy Certificate of Compliance forms incorporated into all plan sets. 0 z Depending on the scope of the project, Installation Certificates may be ❑ prior the final sign off for project. O -required Manufacturer's Specifications 11 El a � Owner -Builder Disclosure Form (for property owners applying for their own El building11 Cn Hazardous Materials Questionnaire Form El El o Building Department 408-777-3228 ❑x ❑ X Planning Department 408-777-3308 ❑x ❑ E5 Public Works Department — New SFD, addition/remodel with 25% increase in w floor area, hillside construction, grading and drainage permits, retaining wallx❑ ❑ err -nits, swimming pools (new/demo) 408-777-3354 LU Santa Clara County Fire Department 408-378-4010 ® ❑ z County Health Department 408-918-3400 ❑ ❑ QCupertino Sanitary Sewer District 408-253-7071 © ❑ LU Other: ❑ ❑ v Other: ❑ ❑ If an existing residence is proposed to be demolished as part of the 0 construction of a new residence, a DEMOLITION PERMIT APPLICATION Cn shall be applied for at the same time the construction permit application for the ❑ new residence is applied for. 1 understand this may not be a complete list of required items due to the variations for each project and additional code related information may be required. 1 understand that an incomplete plan check submittal may result in delays in the plan review process. Applicant Name (Print): � � �, l f-pgv(C Applicant Signature: Applicant's Phone: Cp�� e1 Li LP -41-1, c6 Applicant's Email: oLG�C) tet.1(4-in k41to , Date: IT ` A PlanCheckSubmittalChecklist 2011.doc revised 03/31/11