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07120203FY OF CUPERTINO BUILDING DIVISION PERMIT BUILDING ADDRESS: retcmt t Ru. 20800 HOMESTEAD RD BLDG 14 A- WEST BUILDERS, INC. 07120203 OW 'S NAME: PERMIT ISSUE DATE VILLA SERRA APT A CA LTD 1608 4TH ST STE 120 09/26/2008 PHON&A 'D rrMT SANrfARY NO. CONTROL NO. ARCHTIEC IENGiNEEI LICENSED CONTRACLUR'S DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 (commenting With Section 7000) of Division 3 of the Business at�ess�ka Code, and�licenae is in full fm and dTcCL fC�/1 License LI.., Date Conuacmmr ARCHITECT'S DECLARATION I undersand my plans shall be used as public records Licensed Professional OWNER-BUMZER DECLAI A'110N I hereby &Mrm that 1 am exempt from the Contractors License Law for the following mason. (Section 70313, Business and Professions Code: Any city or county which requires a permit to construct. alter. hnprom demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the povisiona of the Contractors License 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 70313 by arty appUeart for a permit subjects the appllant to a civil penalty of not more than five hundred dollen (3500). ❑ i, as owner of the property, or my employees with wages as their sok compensation, will do the wok, and the structure is not intended or offered for sale (Sec. 7044, Business anti Professions Code. The Contactors I w"= Law does not apply to an caner of property who builds or improves thereon. and who does such work himself or through his sum employees, provided that such improvements ere not Intended or offered for sale, if. however. the building or improvement is sold within ane year of completion, the owner - bulkier will have the burden of proving that he did not build or improve for purpose of sale.). ❑ 1. as owner of the property, am exclusively contracting with licensed contractors to construct the Project (Sea 7044. Badness and Professions Code:) The Conaserars U cerae Law does not apply to an owner of property who builds or improves t emon. Lid who contracts for such projects with a eontnetor(s) licensed pursuam to the Contractors Lkemae Law. ❑ l am exempt under See. B k P C for this mason Dale WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a Canifiate of Consent to self-Insum for Workers Compen- sation, 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 malnuin Workers Compensation Insua ce, as required by Section 3700 of the Labor Codo, for the performance of toe work for which this permit is issued My World rlt Co penes m 1 carrier and Policy number am, —s ` Curr Policy No - CER'[ ICATE 0 EXEMPTION FROM WORKERS' COMPPNSAMONINSURANCE (This section need not be completed if the permit Is fa rte hundred dollen (3100) or leu) I certify that in the performance of the work for which this permit Is issued. I shall nes employ any person in any mauner so at to becomo subject to the Worked Compensation Laws of California. Due AppBan, NOTICE TO APPLICANT. if. after making this Certificate of Exemption, you should became subject to the Workers Compcnntiop provisions of the Labor Code, you mus forthwith comply with such provisions or this permit shall be deemed mrokrA CONSTRUCTION LENDING AGENCY I hereby affirm that tem is a construction lending agency for the prfermanca of the work for which this permit Is issued (Sec. 3097, Civ. C.) Lenders Name Lenders Address I citify that I have mad this application and stab that the above infomation is coned I agree to comply with all city and county ordinances and a= Ism relating to building coMmuction. and hereby authorize representatives of this city to enter upon the above- property for Inspection purpose. AICUNDERSTANDS me to save, indemnify and keep harmless the City of Cupertino against limemts, costa and expenses which may in any way accrue against said City inof the granting of this permit. A AND WILL COMPLY WITH AL4 NON -POINT SignZ0MATERIALS DISCLSUREw Palo Will the applicant or future building occupant sem or handle hazardous material as defined by the Cupertino Murdgpal Cada Chapter 9.17, and the Health and Safety Code, Section 25532(x)7 ®N/o ❑ Yes Will the applicant or fu7No Iding occupant use equipment or devices which emit hr/Ardous air comtanntnanllred by tie Bay Area Air Quality Management District? 4—d dmts materials requirements underChapter6.95 ofthe Caiifor- nixtions=W.25533and25534.1undosandthatifNebuilding do=ant. that it is my maponsibility to 'fy tie pant of Ane mqmet prior b i nce of a Crrtilj fart f Com, Owner or aInhorized agent Date (510) 525-9378 PERMIT INFO PLUMB MECH Job Description NEW APT BLDG 14 A -D 3,219 SF 8/25/08 SEE #07120212 FOR SUBS. Sq. Ft. Floor Area I $ 5 5 5 5 5 5 Valuation 32609056' Required Inspections Issued by: Re -roofs Type of Roof Type Date e'/— . 2e( -/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 '%>" or better Y ry�t�'j1J -,y CITY OF CUPEkT1NO CITY OF CUPERTINO NEW SINGLE/MULTI FAMILY DWELLING PERMIT APPLICATION FORM 1 /. W4 APN # Date: 32t* - d't - O 5(P• �cct-r� c/ 10 2 oc'7 Building Address: Mailing Address (if different from building address): Skrwk S "\kk -1601 S^v, LAoAco, Ck 94403 Owner's Name: V i 1 w �•.. v��n� 1 wh�}� � �ov+ Phone #: (vso '13t —345"1 Contractor: hone #: 516 j (K)C—,A- ave\ trl/5 Fax #: S%C' 525-066.6 Contractor License #: 82-530k C, Cupertino Business License #: Contact:II__ Phone #: to so x131 141CJAae-A DWAC, Fax #: 1050 41 #3 " '✓I0001 Alternate Contact: Phone #: Vgb g 31 .. I'VPn HbS& Fax #: 10 so 413 Single -Story ❑ Two -Story Three -Story ❑ Basement El Hillside ❑ Multi -family [ A artment [ Condo ❑ Townhouse ❑ Sq.Ft. Living Area (Including Basement & Attached Garage: Sq. Ft. Garage (Detached Only): 3 12. %tet sir Valuation: Job Description: Aa k\%fA rWAA:l ,fAAjCA, IAP --"�� 1 tiv v�� v1��s . -Tk•v�t .�` ..a to b� �.. ,�.r,,�, ��.� S,� o�� �. �1,�I,vbwN►�.c �.-�v �oawti �, �..s romn� i Type of Construction (Usage Class): Occupancy Type: 1 FR, 11FR ❑ 11, 111, V-1HR ❑ 11, 111, 1V V -N Project Size: Standard ❑ Large❑ Major V Green Building: Must attach completed Green Building Checklist to the plans Green Building Points Achieved: For help, contact Build it Green at www.buildit6reen.ora 1 kR CITY OF CUPERTINO NEW SINGLE/MULTI FAMILY DWELLING FEE SCHEDULE Quantity Fee ID Fee Description Fee.Group Permit Type 1RIINSP Apt. Bldg inspection fee B 1R1APT 1RIPLNCK Apt Bldg plan check. fee B 2 9 1RIREINSP Apt Bldg repeat unit Inspection fee B 1RIAPTR 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 Plan Check B 1R.3HINSP Dwellings Hillside Inspection B 1R3HILL IR3HPLNCK .... .._.._...... Dwellings Hillside Plan Check _ B - 1R3HREINSP Dwellirigs Hillside Repeat Inspection B 1R.3HREPLNC Dwelling Hillside Repeat Plan Check B 1R3ALTINSP Dwellings Alternate Materials B 1R3SFDALT 1R3ALTPLNCK Dwellings Alternate Materials B 1GARDTW<=1K Detached Garage Wood B 16ARDTM<=1K Detached Garage Masonry B 1BCONSTAXR Constax—Resi/Mobile B 1BMITIGATR Residential Housing Mitigation Fee-chrg only if lot is vacant or it is a subdivision -see lanning PL 2 of 3 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 2/ �( Planning/Residential 1BPWSVCS Main Water Service P 1BSWIM Swimming Pool B 1PCESS For Ea.Cesspool 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 1BPSPRI-NK For ea. Lawn Sprinkler Sys ' P on any one mtr, incl. - backflow protect device 1BUSLIC Business License B 3 of 3 .