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07120146.7 C F04 W? a. G UC WF 0 C a U2 O� CITY OF CUPERTINisq ',' yONW. BUILDING DIVISION pERNIIT R q .' 1. :4.$ . Z ..M?'v4S y n x. •v".� „, WEST BUILDERS, INC. BUILDING ADDRESS: 20800 HOMESTEAD RD BLDG 31 A- PERMIT NO. 07120146 OW 'S NAME: PERMrr MM DATE VILLA SERRA APTS A CA LTD 1608 4TH ST STE 120 09/26/2008 PHONB:T o n'MT SANITARY NO. CONTROL NO. (510) 525-9378 ARCI.117EC'UENGiNEER: BUILDING PERMrrINFO BLDG ELECT PLUMB MECii UCENSED CONTRACTORS DECLARATION Job Description 1 bmcby affirm that 1 am licensed under provisions of Chapter 9 (commencing with section 7000) orDivislon 3 of the Business and Professions Code, and my license is NEW APT BLDG, BLDG 3 1 A— B 1 , 6 0 7 ' in full force and COWL license ClLic. + �^ ass SEE #07120212 FOR SUBS. Date Co=raetor. �` LA CMTEM DECRATION 1,,nderstand my plan shall be used as public meords Licensed Professional OWNER -BUILDER DECLARATION 1 hereby affirm that 1 am mtempt from the Contractor's License Law for the following mason. (Section 70713, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish. or repair any awcture prior to its issuance, also requires the applies= for such permit to file a signed statement Contractor's License law (Chapter 9 Sq. Ft. Floor Area Valuation that be is licensed pursuant to the provisions of the Division 7 Business Professions Code). $555555 (eornmencing with Section 7000) of of the and or that he to exempt thestdrom and the basis for the alleged emmption. Any violation of A,pN Number 32609056: Occupancy Type Section 7031.3 by ary applicant for a permit subjects the applicant to a civil penalty or not mom than five hundred dollars (SM 72' ❑ L as owner of the property. or my employees with wages as their sole compensation, Required Inspections nst will do the work. and the structure is not intended or offend for sale (Sex 7044, Business and Professions Cod= The Contractors License Law does roapply to an owner of q P property who builds or improves thereon, and who does such worst himself or through his own employees. provided that such improvements ore not intended or offered for sale. if. . however. the building or improvemens is sold within one year of cempledon. the owner - builder will have the burden of proving that he did not build or Improve for porpoae of sale.) ❑ L as owner of the property. am exclusively contracting with licensed contractors to construct the project (Sec. 7044. Business and Professions code;) The Coabacmra I.J. cense Law does mot apply to an owner or property who builds or hnproves thereon. and . who contracts for such projects with a contractor(s) licensed pursuant to the Contractors License Law. ❑ 1 am exempt under Sex B k P C for this mason Owner Date WORKERS COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following decluae one ❑ I have and win maintain a Cmtifiato of Conserv to self -insure for Workers compen- Won, as provided for by Suction 3700 or the Labor Code, for the performance of the work for which this permit is Issued. ❑ 1 have and will maintain Workers Compensation Insurance, as required by Section 7700 or the labor Code, for the performance of the work for which this permit 4laue& My We ompgpaatios 1 rarrce airier and Policy number am: Policy Ne.: CERTIFICATE OF P ION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit U for one hundred dollars (i 100) or less) 1 artily that in the performance of the work for which this permit is Luucd. l shail not employ any person in any mannerso as to become subject to the Workers' Compensation . Lava of California. Dare Appliamt NOTICE TO APPLICANT: If. tncr making this Certificate or Exemption, you should become subject to the Workers Compensation provisions of the Labor Code, you mug forthwith comply with Puck provisions or this permit shat be deemed mvoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that them is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097. Civ. C) Lenders Name Lenders Address . 1 certify that 1 have mad this application and gate that the above information is correct. 1 agree to comply with all city and county ordinances and state lana relating to building construction. and bereby authorize representatives of this city to enter upon the doped property for inspection purposes c) agree to save. indemnify and keep harmless the City of Cupertino against j liabilid and expenses which in City gmcn%cats may any way accrue against said in co of the granting of this Permit. A I NT ERSTANDS AND WILL COMPLY AL ON All / by; Date ZU' �� -POINT sued ONS. Re -roofs Type of Roof Si g n alp q Vf-Abj H NUS MATERIALS DISCLOSURE Date Will the applicant or future building occupant atom or handle hasadous material as defined by the Cupenion M pal Code. Chapter 9.12, and the Health and Safety cum, en 2ss3z(a)7 All roofs shall be inspected nor to an roofing material beim Installed. P P� Y g g ❑Yes Nm 0 If a roof 'is installed without first obtaining an inspection, I agree to remove Will the appllesnt ser fun ilding occupant use equipment or devices whim emh hrrardous air cortWninan mfmcd by the Bay Area Air Quality Management all new materials for inspection. Diattict7 ❑Yes No Iban barardousmaterials mquirementsunder Chapter Q95oflheCaiir«- iia FNalth y seeriurts 25305.25333 and 25534.1 erne stand datirtbe building sicca not a tensrn. that It b my responsibility to notify t of site requ prior to issuance ora Ceruf Signature of Applicant Date All roof coverings to be Class''' or better Owner erau t Date. r I lu: CITY OF CUPEkT1NO CITY OF CUPERTINO 0'J1 Zo W o NEW SINGLE/MULTI FAMILY DWELLING PERMIT APPLICATION FORM APN # �Z� r �• O s�o Date: Dece ev lO 20o'1 Building Address: A-6 Q -;I osbo "O"e-ACw ck v*51 1 2 Mailing Address (if different from building address): M00 5�,..�Nn Nor.�o11,�. ` -e 5�..`�-e� 16b S.►,\ �Aeo- o, CA 94403 Owner's Name: o. \; K Phone # : ( Contractor: hone #: WZ—Jr ����5 Fax #: 51f, gZ {J .�pCJSJ' Contractor License #: 853 \ 5 Cupertino Business License #: Contact:11 Phone #: - 14%,c nOl�l DwdM Fax #: 1060 q �34061 Alternate Contact: Phone #: •• TTS Husv Fax #: (O bU 013 \ — 361601 Single -Story ❑ Two -Story W Three -Story ❑ Basement ❑ Hillside ❑ Multi -family [Z Apartment [/ Condo ❑ Townhouse ❑ Sq.Ft. Living Area (Including Basement & Attached Garage: Sq. Ft. Garage (Detached Only): 1)4 Valuation: Job Description:` ,W ,C�% • V.&�..P. MA%kavk� \A 44ml.. "'S1w•raf, .,`R .0-A So 1dG to- A r� lea s cots a. a1„ A0Wz\*u I +�w.,.Iv too -AA JV\ r oy%* PWA Type of Construction (Usage Class): Occupancy Type: 1 FR, 11FR ❑ 11, 111, V-1HR ❑ 11, 111, 1V V -N �3 p� Project Size: Standard ❑ Large E] Major i Green Building: Must attach completed Green Building Checklist to the plans Green Building Points Achieved: hnin rn_+o +,n. ;iii ;t 1--w . ot, CITY OF CUPERTINO NEW SINGLEMULTI FAMILY DWELLING FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit 'Type 1RIINSP Apt. Bldg inspection fee B 1RIAPT lRIPLNCK Apt Bldg plan check. fee . B / G IRIREINSP Apt Bldg repeat unit Ins ection fee B 1RIAPTR b� 1RIREPLNCK Apt Bldg repeat unit plan check fee B 1R3INSP Dwellings Inspection B 1R3SFDW IR3PLNCK Dwellings Plan Check B IR3REPINSP Dwellings Repeat Inspection B 1R3SFDR" 1R3REPPLNC Dwellings Repeat Plan Check B IR3HINSP Dwellings Hillside Inspection B 1R3HILL 1R3HPLNCK Dwellings Hillside Plan B 1R3HREINSP' Dwellings Hillside Repeat Inspection B IR3HREPLNC Dwelling Hillside Repeat Plan Check B IR3ALTINSP Dwellings Alternate Materials 13 1R3SFDALT 1R3ALTPLNCK Dwellings Alternate Materials B IGARDTW<=1K Detached Garage Wood B IGARDTM<=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'planning 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 6 0 7 Planniug/Residential 1BPWSVCS Main Water Service P l / 1BSWIM Swimming Pool B 1PCESS For Ea.Ceswpool 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 ca building sewer, P / sanitary sewer, & ea trailer park sewer 1BPSPRINK For ea. Lawn Sprinkler Sys-''. P on any one mtr, incl. - backflow protect device - 1BUSLIC Business License B 3 of 3 .