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07120136
CY OF CUPERTINO BUILDING DIVISION pEMM MITI RPIOMESTEAD RD BLDG 62 A— I WEST BUILDERS, INC. E32'S NAME: VILLA SERRA APTS A CA LTD 1608 4TH ST STE 120 ARCHITEC VENOINEER: u o p LICENSED CONTRACTOR'S DECLARATION ej I hereby affirm that I am licensed under provisions of Chapbr 9 (core ng with Section 7000) of Division 3 of the Business an III Code, and my license is 0 �Z fn in full farce and effecL ja 3 License a Lic. 9 F Data Contractor CH1TECi'S DECLARAT ON 1 understand my plans shall be used as public retards 7 n. Licenxd Professional S y OWNER -BUILDER DECLARATION I hereby &Mna that 1 am exempt from the Contractors License Law for the 00 following mason. (Section 70313, Business and Profession Code: Any city or county $ iri which require a permit to construct, alter. improve, demolish. or repair any stnuetwe xto prior b its issuance, also requires the applicant for such permit to file a signed statement = C that he is licensed pursuant to the provisions of to Contractors License Law (Chapter 9 F $ (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that be is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects to applicant to a civil penalty of oat mese than five hundred dollars (5300). ❑ L as owner of the property. or my employees with wages as their sok compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Profesdons Code The Contractors License Law does not apply to an owner of property who bulids or improves thereon, and who does such wort himself or Lhmgh his own employees, provided that such improvements are nes intended or offered for ale If, however. the building or improvement Is amid within one year of completion. the owner - builder win have the burden of proving that he did not build or improve for purpose of sale.). ❑ L u owner of the property. am esclaaively contracting with Iicemsed cormaerars to c ouuuct the project (Sec 7044, Business and Professions Code) The Contractors Lt. cease Law does mot appy to an owner of property who builds or Improves thereon. and who contracts for such projects with a contractor(s) licemd parmant to the Contractors License Law. ❑ I am meempt under Ser. B & P C for ibis mason Owner Dane — WORKERS COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a Certificate of Consent to self -Insure for Workers Compem- ation, as provided for by Section 3700 of the Labor Code. for the performance of the wort for which this permit is issued ❑ I her and anU maintain Wo&&s Compensation Insurance, at required by Section 3700 of the Labor Code. for the performance of the work for which this permit is Issa A My Worker Comp salon rnta`^nce carrier and Policy number are: Cartier. Policy No ro �>o CERTIFICATE OF OPTION FROM WORKERS* COMPENSATION INSURANCE (510) 525-9378 NEW APT BLDG, BLDG 62 8/25/08 SEE #07120212 PERMIT NO. 01120136 PERMIT ISSUE DATE 09/26/2008 SANITARY NO. CONTROL NO. BUILDING PERMIT INFO BLDG ELECT PLUMB Job Description A—D, 6218 SQ FOR SUBS. Sq. Ft. Floor Area $ 5 5 5 5 5 5 Valuation 32609056.. Required Inspections (Ibis section need not be completed if the permit Is forone hundred dollars ($100) or Ire) I certify that in the performance of the work for which this permit is issued I shall not employ anyperson in any nuttier sou tobecome subject to tie Workers' Compenuton Laws of Cslifonda. Date Applicant NOTICE TO APPLICANT: If, after malting this Certificate of Exemption. you should become subject to the Worker's Compensation provisions of the Labor Code, you must Oforthwith comply with such provhrlom or this permit shall be deemed revoked '--' CONSTRUCTION LENDING AGENCY eC4-e I hemby afllrm that them Is a construction lending agency for the performance of (Y.> the wort for which this permit is inued (Ser. 3097, Civ. C.) W Q Lender's Num: z Lenders Address U O 1 certify that I have read this application and sato that the above information is w E eonec I agra to campy with all city W county ordinances and sine lairs misdng a 0 SV bad! 'ot, and hereby authorize represenutiva of this city b enter upon the W abov .'I e d property for inspection purposes 04 (Wes a to ave, indamnify tad keep harmless the City of Cupertino against ►-e f/I I(aWH eta, j tis, cess and elpecam which may in any way accrue agdast said City U 7 in co dee granting of this permit ham- APPL CA �1 ERSTANDS AND WILL COMPLY WITY ALL NgN-POINT Issued by: signailmili t/Contractor Due p HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building oecupatt atom or handle hazardous material as deflned by the Cupertino Municipal Code. Chapter 9.12. and the Health tad Safety Code, Section 25532(1)7 ❑ Yes Will the applicant or fugue 'ng'aezvpant tax ageipmrnt or devices which emit haisrdous air conumirh.rhs recd by the Bay Area Air Quality Management District? ❑Yes o Ihave readaterialsmqufmn uunderCapter6.95oftheCaliGr- nia Health & S cry25505.25533 and 25534.1 u dmmnd emirthe buikding docs rot yhat It is my responsibility to Bali the t of the requirements IN prior to Ltsuarhce of a Certificf7mhpar _ . Re -roofs Type of Roof Date Type �Z L 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. All roof coverings to be Class 'W' or better CITY OF CUPERTINO BUILDING PERMIT F -"t" I '1�d an BUILDING ADDRESS: 20800 HOMESTEAD RD BLDG 62 A -D I CONTRACTOR: WEST BUILDERS, INC. PERMIT NO: 07120136 OWNER'S NAME: VILLA SERRA APTS A CA LTD PARTN 1608 4TH ST STE 120 1 DATE ISSUED: 09/26/2008 OWNER'S PHONE: 6509313457 1 BERKELEY, CA 94710 1 PHONE NO: (510) 525-9378 ❑ LICENSED CONTRACTOR'S DECLARcATION License Class_ Li`c. # �a53�S Contractor i �kcLV_5 Date Z • 6 L 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. 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 me tioned property for inspection purposes. (We) agree to save m indenify and k harmless the City of Cupertino against liabilities, judgments, costs, and expenhich may accrue against said City in consequence of the granting of VsPK dditionally, the applicant understands and will comply with all non ofegulations per the Cupertino Municipal Code, Section 9.18. Signature. Date ( I Z, ❑ 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. 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. 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 BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r MECH r RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: 11/02/09 RVSN TO SHEET A9.1,FLR PLAN A10.8, FLR PLAN,A10.9 FLR PLN NEW APT BLDG, BLDG 62 A -D, 6218 SQ -DOES NOT i ✓t �-� rn/Q Sq. Ft Floor Area: I Valuation: $555555 APN Number: 32609056.62 A -D I Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 D YS FROM LrACLED INSPECTION. Issued by: 02e: 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 l will maintain co liance with the Cupertino Municipal Code, Chapter 9.12 and the Health &f Code, Sections 25505, 25533, and 25534. Owne r t ent: 11- 7,0_1Date: 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. Date I Licensed Professional aN CITY OF CUPEVINO CITY OF CUPERTINO 0-7 1 � ©1- 3,(,o NEW SINGLE/MULTI FAMILY DWELLING PERMIT APPLICATION FORM APN # 32 -to — 0 O 54 1 (P a _ Date: DcC-_-M G� lO 20o'j Building Address: .Poft�o N ovAeb�Ca a Mailing Address (if different from building address): tot 00 S 0VAV\ tN 0,r ;-a `kr-eA-, S ��►k-e. � ro S^v, � t o, Ck 9 4403 Owner's Name: Vs ,A A,. V i 1 w . A Phone Contractor:hone wGS4- &A\tt %Cta/5 Fax #: S%0 52,S-0666 Contractor License #: 82- 536% 15 Cupertino Business License #: Contact: Phone #: (Aso 0% 4,16inate-A DWAX. Fax #: 1060 41 Sk '- -2*C,3'1 Alternate Contact: Phone #: V160 A S I.. 1.5A 64:� TVA Hum Fax #: (O bO 013\ —36661 Single -Story ❑ Two -Story Three -Story F7 Basement 1:1 Hillside El Multi -family [,� Apartment [� Condo ❑ Townhouse ❑ Sq.Ft. Living Area (Including Basement & Attached Garage: Sq. Ft. Garage (Detached Only): 1012M4 Valuation: Job Description: �`SA� t�% *A& -% Its MA610� LL,W L%P f- 'V'ir., 4 I11* 00`^Q& vl t? • TA-0f0t, %'OR �'`O le a. vv{� %e4 s►� V kA 4a. I G\%AWWz\ ►s,c .- �r f0= -,AA V, err ems rio.�v��c 1 Type of Construction (Usage Class): Occupancy Type: 1 FR, 11FR ❑ 11, 111, V-1HR ❑ 11, 111, 1V V -N V-1 0 3l At Project Size: Standard ❑ Large E] Major 61 .Green Building: Must attach completed Green Building Checklist to the plans Green Building Points Achieved: For help, contact Build it Green at www.buiiditoreen.or6 ui • Of CITY OF CUPERTINO NEW SINGLEMULTI FAMILY DWELLING FEE SCHEDULE Quantity Fee ID Fee Description Fee.Grovp Permit Type 1RIINSP Apt. Bldg inspection fee B 1R1APT 0_( S_ 1RIPLNCK Apt Bldg plan check. fee . B 1RIREINSP Apt Bldg repeat unit B 1RIAPTR Inspection fee 1RIREPLNCK Apt Bldg repeat unit plan B check fee 1R3INSP Dwellings Inspection B 1R3SFDW 1R3PLNCK Dwellings Plan Check B 1R3REPINSP Dwellings Repeat B 1R3SFDR- Inspection 1R3REPPLNC Dwellings Repeat Plan B Check 1R3HINSP Dwellings Hillside B 1R3HILL Inspection IR31-IPLNCK Dwellings Hillside Plan B - ----. _Check--._. — 1R3HREINSP' Dwellings Hillside B Repeat Ins ection - WHREPLNC Dwelling Hillside Repeat B Plan Check 1R3ALTINSP- Dwellings Alternate B 1R3SFDALT Materials 1R3ALTPLNCK Dwellings Alternate B Materials 1 GARDTW<=1K Detached Garage Wood B 1GARDTM<=1K Detached Garage B Masonry �i 1BCONSTAXR Constax—Resi/Mobile B 1BMITIGATR Residential Housing PL Mitigation Fee-chrg only if lot is vacant or it is a subdivision -see lanning 2 of 3 CITY OF CUPERTlNO NEW SINGLE/MULTI FAMILY DWELLING FEE SCHEDULE Quantity Fee 1D Fee Description Fee Group Permit Type 1BSEISMICR Seismic Residential B / 2 1PLLONGRNGR Long Range PL C� Planning/Residential 1BPWSVCS Main Water Service P 1BSWIM Swimming Pool B 1PCESS For Ea.Ces*pool P 1PATMOBF For Atmospheric Type P Vacuum Breaker - backflow not included in item 1 (1-5).(5+) . 1PPRSEWG Ea: Private Sewage P Disposal System. 1PRSEWER For ea building sewer, P sanitary sewer, & ea trailer ark sewer 1BPSPRNK For ea. Lawn Sprinkler Sys.. P on any one mtr, incl. backflow protect device 1BUSLIC Business License B 3 of 3 .