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07120200log 7�3 3 gyygy � � "00 0< eg§ O O W v"" az U_O lit �a U4 BUILDING DIVISION PERMIT Bu1LfFERM1717 No. 2l�,lZgpJ�ESSliOMESTEAD RD BLDG 9 A—H WEST BUILDERS, INC. 07120200 OWNER'S N�jA�M(EJ: PERMIT ISSUR DATE VILLA SERRA APT A CA LTD 1608 4TH ST STE 120 09/26/2008 pHONn T D nrAt SANITARY NO. CONTROL NO. (510) 525-9378 ARCHrrECrIENGINEEK: LICENSED COKfRAC10R'S DECLARATION I hereby affirm that I we licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business an4_lolossions Code, and my He== is in full face and effect t$ eC t.leemso ass lJc. R hate Contractor ARCHITECTS DECLARATION I understand my plans shall be used as public records Licensed Professional OWNER-BUnMER DECLARATION I hereby afrinn that I sm exempt from the Contractor's License Law for the following reason. (Section 7031.5, Business and Professions Code: Any city or county which requires a permit to conswct, alter. Improve, demolish, or repair any stntemuo prior to its issuance, abso requires the Applicant for such permit to file a signed statement that be is licensed pursuant to the provisions of the Contractors Looe law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not mere than five hundred dollars (Ssoo). ❑ 1, as owner of the property. or my employees with wages as their sale compensation, win do the work ad the strttetme is not intended oroffered for sale (See. 7044, Business and Professions Code The Contractor's License taw does out apply to an owner of property who buildsor unprmves thereon, and who doessuch wort himself or through his owe onployees, provided that such Improvements am not intended or offered for sale n. however. the building or Improvement is sold within one year of completion, the owner - builder will have the burden of proving that he did not build or improve for purpose of ❑ L as owner of the popaty. am exclusively contracting with acensed cernractors to mnammct the pmj= (Ser. 7044. Business and Professions Code.) The Contractor's Lf- ccnse Law does mol apply to an owner of Property who builds or Improves thereon, mid. who contracts for such projects with a camracmr(f) licensed pursuant to the Contractor IJcense Law. ❑ I am exempt under See. , B h P C for this reason Owner Dae WORKERS COMPENSATION DECLARATION I hereby affirm under penalty of pajmy one of the following declarations ❑ t have and will maintain a Certificate of Consent to self -Insure for Worker's Compen- sation. as provided for by Section 3700 of the Labor Code, for the performance of the work for which tide permit is issued. ❑ I have and will maintain Worker's Compensation Insurance, as required by Scaian 3700 of the Labor Code, for the perform&= of the work for which this permit is isaued My Warkefa Coro rraation arta carrier and PolkXjr are: Carter !" G policy No.: 1' CERTIFICATE OF E7 PTTON FROM WORKELT COMPENSATION INSURANCE (1 his section need nor be completed if the permit is fa oro hundred dollars ($I00) or lest) 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 Worked Compensation Laws of California Dam Applicant NC TI iO APPLICANT: If, after making this Certificate of Fsempdm you should become Subject to the Worker's Compensation provisions of the Labor Code, you moa forthwith amply with such provisions or this peanit shall be deemed revoked CONSTRUCTION tFNDm AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097. Civ. C) Lender's Name LAndces Address I cxstify that I have read this application and stat that the shove information is conecL I agree to amply with all city and county ordinances and sate Laws relating to building construction, aced hereby authorize representatives of this city to eamr upon the above-memioned property for impeelion purposes. (We) agree lo save, indemnify and keep harmless the City of Cuperd m against liabiRdea, judgments, costs and expenaa whfc4 may in any way aarne against said City in of the gnmimg of this PermiL 1C _ UND rP ERSTANDS AND WILL COMPLY Vi(1TH ALL NON -POINT I HAZARDOUS MATERIALS DISCLOSURE Will the appllant orfuurro buildfmg occu(ant store orhandle haandoa mamrial as dented by the Cupertino M Code, Chapter 9.12. and the Health and Safety Code. Section 25532(a)7 ❑ Yes t7N. Will the applicant or future ding occupant taro equipment a devices which emit hazardous air contandr uua recd by the Bay Area Air Quality Management District? ❑ Yes No I the hazardous materials requirements under Chapter 6.95 of the Califor- nia th Code, Saxfem 23505, 25533 and 25534. I understand thstif the building doest vn a irnartt. that It is my responsibility lo naffy the t of the req w met prior to isarance of a ccrtA-41c of 2e? BUILDING PERMrr1NFO BLDG ELECT PLUME MECH Job Description NEW APT BLDG 9 A—H 3,154 SF 8/25/08 SEE #07120212'FOR SUBS. Sq. Ft. Floor Area $555555 Valuation 32609056gNNumber Required Inspections Issued by: Re -roofs Type of Roof Type Date `f - 'L (_' s 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'r/i " or better CITY OF CUPEVINO CITY OF CUPERTINO NEW SINGLE/MULTI FAMILY DWELLING PERMIT APPLICATION FORM 1,0 ,7001,P APN #Date: 9 �eccr� c/ 10 2 00-1 Building Address: i oftO CT 7 Mailing Address (if different from building address): MOO Hole -6k1, 'S - S,„ k:c 160, <,,,, CA <94403 Owner's Name: V 11 w I Phone # D(v'So '13► -3+}5'1 Contractor: hone #: 5 16 Wz_-" ' �jv� G/'S Fax #: 511C Contractor License #: Cupertino Business License #: T� Phone #: (ASO ch31 Contact:__ 11 �IJNO.GI DWAX. Fax #: ipbo q 31 " 3 OBJ, Alternate Contact: Phone #: (*16b AS ` .. r, SVPA Hblao Of Fax #: & 6U 1013 36bot Single -Story ❑ Two -Story Y Three -Story ❑ Basement ❑ Hillside ❑ Multi -family [� Apartment [/ Condo ❑ Townhouse ❑ Sq.Ft. Living Area (Including Basement & Attached Garage: Sq. Ft. Garage (Detached Only): Valuation: Job Description: $Aa %z 1�`^ .� ; �, ��� ____iice 11-p^- +*ViO 1 4 11v y� %NA ��^� i • A-sf %,OR .0-AZ0 6,—P to- vvrr %p,.4 s%^& older. I C.X%AoWz%A%v6 I +VV6,p-*JVP 4 -00 -AA I V% 1 Type of Construction (Usage Class): Occupancy Type: 1 FR, l lFR ❑ 11, 111,V -IHR ❑ 11, 111, 1 V V -N POW Project Size: Standard ❑ Large❑ Major h[J Green Building: Must attach completed Green Building Checklist to the plans in Green Building Points Achieved: p For hel , contact Build it Green at www.builditareen.ora Ott FA CITY OF CUPERTINO NEW SINGLEMULTI FAMILY DWELLING FEE SCHEDULE Quantity Fee ID Fee Description Fee.Gronp Permit Type 1R1INSP Apt. Bldg inspection fee B 1R1APT 1RIPLNCK Apt Bldg plan check.fee . B 13 I r y 1RIREINSP Apt Bldg repeat unit . Inspection fee B 1RIAPTR 3 1RIREPLNCK Apt Bldg repeat unit plan check fee B 1R3INSP Dwellings Inspection B 1R3SFDW 1R3PLNCK Dwellings Plan Check B 1R3REPINSP .. Dwellings Repeat Inspection B 1R3SFDR. 1R3REPPLNC Dwellings Repeat Play. Check B 1R3H1NSP Dwellings Hillside Inspection B 1R3H]LL 1R3HPLNCK Dwellings Hillside Plan Check.---- B 1R3HREINSF Dwellings Hillside Repeat Inspection B 1R3HREPLNC Dwelling Hillside Repeat Plan Check B 1R3ALTINSP, Dwellings Alternate Materials B 1R3SFDALT 1R3ALTPLNCK Dwellings Alternate Materials B 1 GARDTW<=1K Detached Garage Wood B 1GARDTM<=1K Detached Garage Masonry B J 1BCONSTAXR Constax—Resi/Mobile B 1 BMITIGA.TR Residential Housing Mitigation Fee-chrg only if lot is vacant or it is a subdivision -see lanning PL 2of3 el CITY OF CUPERTINO NEW SINGLE/MULTI FAMILY DWELLING FEE SCHEDULE Quantity Fee.ID Fee Description Fee Group Permit Type 1BSEISMICR Seismic Residential B 1PLLONGRNGR Long Range PL Planning/Residential 1 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 1BPSPR1iVK For ea. Lawn Sprinkler Sys-','. P on any one mtr, incl. backflow protect device 1BUSLIC Business License B 3 of 3 .