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13020093 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7805 BOLLINGER RD CONTRACTOR:MCCLELLAN PERMIT NO:13020093 DEVELOPMENT OWNER'S NAME: BOLLINGER VENTURE LLC 1448 ENTRADA VERDE PL DATE ISSUED:05/02/2013 OWNER'S PHONE: 9259449108 ALAMO,CA 94507 PHONE NO:(925)944-9108 ❑ LICENSED CONTRACTOR'S DECLr�ARAATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL License Class Lic.# ( LOT 3-CONSTRUCT 2 STORY SFDWL 3,541 SQ FT, GARAGE Contractor + Ic ���r �. Date 7 470 SQ FT PORCH 43 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: 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:$424920 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:35922077.7805 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 1 0 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 DT7M 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 granting of this permit. Additionally,the applicant understands and will comply Issued by: Date.'/y/& /7 with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. lRE-ROOFS: Signature Date 7 1ZII 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: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 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 25505 2 3 and 25534. /46 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Owner or authorized agent: Datey 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 ADDRESS: 7805 BOLLINGER RD DATE: 06/10/2013 REVIEWED BY: MENDEZ APN: BP#: `VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY SFD or Duplex PENTAMATION 1GENRES USE: PERMIT TYPE: WORK DEFERRED#1-TRUSS CALCS SCOPE t N'- .i ( :.. NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1,12) FEE QTY/FEE I MISC ITEMS Plan Check Fee: Hourly Only? ®Yes (F)No $0.002 hours Plan Check,Hourly Suppl. PC Fee: Q Reg. 0 OT p,p hrs $0.00 $266.00 ISTPLNCK PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. Q OT Q Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: 1BCONST4XR #new 0 units $0.00 Work Without Permit? Q Yes (F) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential 1i Building or Structure r'/lJt%C'1'If]E'fiiid fd f)77 t`t,'�4.' 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: 7805 BOLLINGER RD CONTRACTOR:MCCLELLAN PERMIT NO: 13020093 DEVELOPMENT OWNER'S NAME: BOLLINGER VENTURE LLC 1448 ENTRADA VERDE PL DATE ISSUED:05/02/2013 OWNER'S PHONE: 9259449108 ALAMO,CA 94507 PHONE NO:(925)944-9108 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class Lic.# LOT 3-CONSTRUCT 2 STORY SFDWL 3,541 SQ FT, r✓//� GARAGE Contractor (/�/�i� I/o Date 470 SQ FT PORCH 43 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 performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$424920 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:35922077.7805 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 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 save180 DAYS F 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 _ a 3 granting of this permit. Additionally,the applicant understands and will comply Y with all non-point source regulations per the Cupertino Municipal Code,SSeectio 9.18. RE-ROOFS: Signature Date 2 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: 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.I2 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.I2 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agegjtl� lfY� te: 6/.3- 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 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 FEE ESTIMATOR—BUILDING DIVISION ADDRESS: Lot 3 DATE: 02/08/2013 REVIEWED BY: Mendez APN: BP#: VALUATION: 1$424,920 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY SFD or Duplex 2nd Unit? Yes No PTYPE:ENTAMATION 1 R3SFDW USE: PERMIT WORK construct 2 story sfdwl 3,541 sq ft garage 470 sq ft porch 43 sq ft SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. (s.f. R-3(Custom) II-B,111-B,IV,V-B 4,054 $3,051.19 IR3PLNCK $3,301.66 IR3INSP TOTALS: 4,054 1 $3,051.19 1 $3,301.66 L1 Ll NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Puhlic Works,Fire,Sanitary Sewer District,School District,etc.). These fiees are based on the preliminar in ormation availahle and are only an estimate. Contact the De t or addn'l info. FEE ITEMS(Fee Resolution 11-053 E f. 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,051.19 Select a Misc Bldg/Structure Suppl. PC Fee: (D Reg. 0 OT 1 0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $3,301.66 Suppl. Insp. Fee-.Q) Reg. 00:T 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXR 1 units $629 O Work Without Permit? 0 Yes r'• No $0.00 G Advanced Planning Fee: IPLLONGR $527.02 Select a Non-Residential 0 Building or Structure ®� Strong Motion Fee: IBSEISMICR $42.49 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $17.00 SUBTOTALS: $7,568.65 $0.00 TOTAL FEE: $7,568.65 Revised: 01/01/2013