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07120150
CITY OF CUPERTINO BUILDING PERMIT • BUILDING ADDRESS: 20800 HOMESTEAD RD BLDG 8 A -H CONTRACTOR: WEST BUILDERS, INC. PERMIT NO: 09080040 OWNER'S NAME: VILLA SERRA APTS A CA LTD PARTN 1608 4TH ST STE 120 DATE ISSUED: 08/19/2009 OWNER'S PHONE: BERKELEY, CA 94710 PHONE NO: ( ❑ LICENSED CONTRACTOR'S DECLARATION T_ r r BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class 4f— Lic. 8 9_32S31�5 � MECH . RESIDENTIAL I-� COMMERCIAL ? % Contractor _AJ Date � Z%• l"' I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: REVISION: UTILITY CLOSET (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: 1 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: $2500 1 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. AFN Number: 32609056.8AH Occupancy Type: APPLICANT CERTIFICATION I certify that 1 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 PERMIT EXPIRES IF WORK IS NOT STARTED to building construction, and hereby authorize representatives of this city to enter Upon the above mentioned property for inspection purposes. (We) agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities, judgments, 180 DAYS FROM LAST CALLED INSPECTION. 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 Issued by: Date: 9.18. Signatu DateR%Z f- f RE -ROOFS: ❑ OWNER -BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being install'd. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: 1, as owner of the property, or my employees with wages as their sole compensation, Signature of Applicant: Date: will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self -insure for Worker's California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain Compensation, as provid A for by Section 3700 of the Labor Code, for the compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & performance of the work for which this permit is issued. Safety Code, Section 25532(a) should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance, as provided for by Additionally, should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code, for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the permit is issued. Health & Safety Code, Sections 25505, 25533, and 25534. 1 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 ONvrxor author' -- 9 Compensation laws of California. If, after making this certificate of exemption, I _ Date: become subject to the Worker's Compensation provisions of the Labor Code, 1 must 1 forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION f'or which this permit is issued (Sec. 3097, Civ C.) 1 certify that I have read this application and state that the above information is Lender's Name correct. 1 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 Lender's Address 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 granting of this permit. Additionally, the applicant understands and will comply 1 understand my plans shall be used as public records. with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Licensed Professional Signature Date BUILDING DIVISION PERMIT 9UILDINU ADDRESS: VbKM« NU. 20800 HOMESTEAD RD, BLDG 8 A -H TBD - TO BE DETERMINED 07120150 OWNER'S NAME: PERMIT ISSUE DATE VS II A CALIFORNIA LIMITED 07/08/2008 PHOMA R rl'TT SANITARY NO. CONTROL NO. ARCHrrWrADlGINEER BURRING PERMrriNFO REMODEL -NEW DECK RAILS, BLDG ELecr PLUMB MECH ±O 6 LICENSED CO 'S DECLARATION e1 hereby a(Btm that 1 am licensed under provisions of Chapter 9 (commencing t Z with So ctioo 7000) of Division 3 of the Business and Professions Cade, and my license is in full foto and ertect 1� 3 L Icanse Lie. I U � F Date ' Z 0 Contractor 9 ARCHI ECPS DECLARATION I understand my phw shall be used as public records CyU y Licensed Professional y OWNER-BITfLRPR DECLARATION t I hereby affirm that 1 am exempt from the Contractors License Law for the 00 following mason. (Section 7031.5. Business and Professions Cala. Any city or county $ Pi which requires a permit to construct, after, Improve, demolish, or repair any structure prior to its issuan= also requires the applicant for such permit to file a signed statcroau < that be is licensed pursuant to the provisions of the Conuactors License Law (Chapter 9 (commencing with Section 70DD) of Division 3 of the Business and Profession% Code) or y $ that be is c=ps thaeftose and the bads for the alleged exemption. Any violation of Section 7031.5 by any appkanrfor a permit subjects the applicant to a civil penally of not more than five hundred dollars (5500). ❑ L as owrrr of the property, or my employes with wages as their sole camptut"do t. will do One wok and the structure is not imended or of[aed for lair (Sec 7044, Badness and Professions Code The Contractors I I=- Law does not apply to an owner of property who bunds or improves Wacon, and who doessuch work hireself or though his own employees, provided dm such improvernetu ore not intended or oQemd for sale, If however, the building or improvement is sold within one year of completion. We owner - builder will have the bardep of proving West he did not Guild or improve for purpose of ❑ L as owner of the property. am exclusively contracting with nnxnaed comraaers to construct the projal (Sec. 7044. Business and Profession Codc) The Contractors Li. c am Law does not apply to an owner of property who bunds or improves thensao. and who wntnaeu for projects with a contractor(s) licensed purtoanl to the Contractors Llesmse Iiw 01. W . B h P']C for this reaara Ownw Data I �- OMPENSA7T0N DECLARATION 1 hereby affirm under penalty of perjury one of the following dsciarations ❑ I have and will mainudo a Certificate of Consent to self-iasum for Workers Cernpen- sation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issua ❑ I have and will malmain Workers Compensation Iunurarm a required by Section 3700 of We Labor Code, for the performance of the work for which this permit is isswd. My Worke's goo enatkoe Insurance carrier and Policy number arc: CuriesPolicy Nz ZS case 0CD1 '0 CERTIFICATE OF 07.rFrION FROM WORKERS' COMPENSATION INSURANCE (This section need nes be completed If the permit is foroae hundred donan (SIM) or less) I ratify that in the performance of the work for which this permit is issued l shall rot employ any person in any manner a as to become abject to the Workers' Compensation Laws of Califomis. Dale AppOcart NonCE TO APPLICANT: If, alter mddng this Certificate of Exemption. you should become subject to the Workers Compensation provisions of the Labor Code, you mum 0 forthwith comply with such provisions or this petmil that be deemed revoker. CONSTRUCTION LENDING AOE NCY F -n ►+ I hereby affirm that Wens is a construction lending agency for the performance of C4 > the work for which this permit is issued (Sec. 3097. Civ. C) WIL 0 Ledges Nana .7 L.eders Address C) O 1 certify that 1 have rad this application and mate Wal the above information is ' correct. I agree to comply with all city and county ordinances and sure laws mining to C) building construction. and hereby sudtor ze rep sentatira of [itis city to enter upon the above-mentioned prom y for inspection purposes autave, indemnify and keep harmless Wes City of Cupertino against .H fna Costs and expenses which may in any way accrue against said City U 7 in c the granting of this permit. i� A PRSTANf3,S AND wN.L COMPLY WITH ALL NON -POINT SO TIONS. SI tactor Dam S MAIEFLIALS DISCLOSURE WW We applicant or future building occupant store or handle haandoos material as defined by the Cupertino Municipal Code, Chapter 9.12. and the Ha1W and Safety Code. Section 25532(a)7 ❑ Yea 054 Will the applicant or future building occupant use equipment or devices which emit hazardous air eomami,tunu as defined by the Bay Ama Air Quality Management District? � ❑ Yes NO gmad the haardaa materials nsqulenuertls render Chapaa 6.9s of Wes f}Iifor• y be carer prior m ismsncC Of a Calif of Ompra7: Dam Ft. Issued by: Re -roofs Type of Roof Area Required Inspections Date /— crl..06" 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 'W, or better j' CITY Of CUPEkTINO CITY OF CUPERTINO REVISION/DEFERRED PERMIT APPLICATION FORM APN # 3 2 LP D 9 p 5-Z0 (?A)4 Date. Original Permit #: O-7 12 C> 1 r=> C> Building Address: # 2,D8 0 ia� M CS��►� a-(3 `b Mailing Address (if different from building address): Owner's Name: Phone #: &50-931-34,57 ?N-0 zrµ(✓ N -s Mt V -C DLI,-C-C)T Contractor: Phone: 51 p _ 77S, p77a Fax: Yoe) - 7q & — 5033 Contractor License #: 132--1539r-,;, Cupertino Business License #: 2q 9 (D l Contact: Phone: Sia --773 -0 770 Fax:. 14D t) 7y lu - 5 33 Building Permit Info: Bldg,® Elect ❑ Plumb ❑ Mech ❑ Residential © Commercial ❑ Job Description: U,-F1L1Ty CL -os -1 S Is the project in the Wildland- Urban Interface Fire Area? Yes ❑ No ❑ Type of Construction (Usage Class):. * Occupancy Type: 1 n 1 _R n TT/THOU nF7( TT/til R 1',/_T4T V_R —1 Valuation (cost of project) - Project 5Jze, Express ❑ Standard ❑ Large ❑ Ulajor Green Building: Please complete relevant portion of the Green Building/LEED Checklist & attach it to the application or if applicable, include in plan set & the sheet index. Points Achieved: For help, contact Build it Green at www.builditgreen.org Revised 01/07/09 aTYv CUPEkT1NO CITY OF CUPERTINO REVISION/DEFERRED PERMIT APPLICATION FORM FEE SCHEDULE Quantity Sq Ft Fee ID Fee Description Fee Group Permit Type 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1REVCOMNEW Revision Commercial New B 1* 1 REVCOMTI Revision Tenant Improvement B 1* TI 1REVSFDWL Revision SFDWL B 1R3SFDW 1REVRESADD Revision Addition B 1R3SFDADD 1REVRESREM Revision Remodel B 1R3SFDREM 1 DEFINSP Deferred Submittal not R-3 Inspection B IDS 1DEFPLNCK Deferred Submittal not R-3 Plan Check B IDS 1DEFR31NSP Deferred Submittal Inspection B 1DSR3 1DEFR3PLNCK Deferred Submittal R-3 Plan Chk B 1DSR3 CITY OF CUPERTINO CITY OF CUPERTINO ADDITION/REMODEL PERMIT APPLICATION FORM I/0?d /_ 6 APN# t,_ ?ZG _ 0n — O �P Date: C��Mbr�✓ Z��i Building Address: .20s00 Mailing Address (if different from building address): 19oo Spin t` r 1`c .ed,r Svc iso 5,o%v\ &Aat�d43 Owner's Name: rw C;kV% Nj%%%X,k ' Phone # : ` tW+.,. .e 4 Contractor: Phone #: ! w4p-bk- iC Fax #: SIO 5ZS-C>S65 Contractor License #: `r3Z Cupertino Business License #: TSD Contact: Phone #: ( R'v%414,1 ��Ct Fax #: (0 50 Building Permit Info: Bldg. / Elect. V Plumb. [� Mech. Hillside ❑ Job Description: 1 r What is being added? AAAwN4j %A4 What is being remodeled? ae" JreG\r._ rCA."I 5}G11� 1id•1�S a11��– P00, VN+. Remodel Includes Re -Roof. Yes No If yes list number of squares i Remodel Includes Structural: Yes No ❑ Square Footage: Addition: ;L5 4 Remodel: Garage: Porch: 1W Deck: Other: s Type of Construction (Usage Class): Occupancy Type - ki 1 FR; 1,1FR ❑ 111111, V-lHR 11, 1.11, 1V V -N [ Valuation: 61 Please check this box if the project is a second -story addition ❑ Green Building Check list must be completed and attached to the plans. Green Building Points Achieved: ***For Office Use Only*** Over -the -Counter 0 CITY OF CUPEIZTINO CITY OF CUPERTINO ADDITION/REMODEL FEE SCHEDULE Quantity Sq Ft Fee ID Fee Description Fee Group Permit Type ADDITIONS 1R3SFDADD PLLONGRNGR Long Range Planning/Residential PL 1R3INSP Dwellings Inspections B 1R3PLNCK Dwellings plan check B 1R3REPINSP Dwellings Repeat Inspection B 1R3REPPLNC Dwellings Repeat Plan Check B 1R3H]NSP Dwellings Hillside inspection B 1R311PLNCK Dwellings Hillside plan check B 1R3HREINSP Dwellings Hillside Repeat Inspection B 1R3HREPLNC Dwellings Hillside Repeat Plan Check B 1R3ALTINSP Dwellings Alternate Materials Inspection B 1R3ALTPLNC Dwellings Alternate Materials -Plan Check B 1PCESS Cesspool P 1PPR.SEWG Ea. Private Sewage Disposal System P 1PRSEWER Sewers P 1 BP SPRINK Lawn Sprinkler/Backflow P 1BPWSVCS Main Water Service P / ( 1BSEISMICRE SeismicResidential B DECKS IR3SFDADDQR WSFDRE 1DECrK/� Deck (Wood) B 1DE Deck Railing B I LINIJIMIMIKIN-OPINVI 10111 ADDITON/REMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft GARAGES 1R3SFDADD OR 1R3SFDREM 1 GARDTW<=1K Wood Frame up to B 1,000 SF 1GARDTM<=1K Masonry up to 1,000 B SF PATIO'S OPEN 1R3SFDADD OR 1R3SFOREM iPATIOWOOD Wood Frame up to 300 B SF 1PATIOMETAL Metal Frame up to 300 B SF 1PATIOOTHER Other Frame up to 300 B SF PATIO'S CLOSED 1R3SFDADD OR 1R3SFDREM 1PATIOENCLW Enclosed Wood up to B 300 SF 1PATIOENCLM Enclosed Metal up to B 300 SF 1PATIOENCLO -- - - --- - Other Enclosed Patio- _. _ . .. _. B____ up to 300 SF 1 COVPORCH Porch Covered B 1REROOFRES Residential Re -roof B Each 100 SF REMODELS 1R3SFDREM 1REMRESKIT Kitchen Remodel up to B 300 SF 1REMRESBAT Bath Remodel up to B 300 SF 1R _MREOTH Other Remodel up to B 300 SF REMODEL PLNCK 1 STPLNCK Standard Plan Check B NOT FOR OVER THE COUNTER PLAN CKS. 3 of 3 CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE ( @ CZ � H 2 4 of 3 Quantity Sq Ft Fee ID Fee Description Fee Group Permit Type WINDOW/SLIDING 1R3SFDREM GLASS DOOR 1 WINREP Replacement windows (ea 8 windows B 1 VJINNEWNSTR New Window (non- structural) B 1WII�TNMWSTR New Window (Structural Shear Wall/Masonry) B IW NBAYSTR Bay Window (Structural) B IBUSLIC Business License B ( @ CZ � H 2 4 of 3