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11050064CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22085 REGNART RD I CONTRACTOR: VIA BUILDERS INC. I PERMIT NO: 11050064 OWNER'S NAME: LICENSED CONTRACTOR'S DE/C^�LARATION License Class Lic. # l rZ y!0� U Contractor Date — I I hereby affW 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 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 �~ ' ! "` Date ` N ❑ 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 up-- the above mentioned property for inspection purposes. (We) agree to save -iify and keep harmless the City of Cupertino against liabilities, judgments, c _ 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 Date 4600 EL CAMINO REAL STE 209 ] DATE ISSUED: 07/18/2011 LOS ALTOS, CA 94022 PHONE NO: (650)948-1077 BUILDING PERMIT INFO: BLDG F ELECT f— PLUMB F MECH r— RESIDENTIAL r— COMMERCIAL f— JOB DESCRIPTION: SFDW ADDITION(289SQFT)-FAMILY ROOM INTO EXISTING PORCH AREA, NEW PORCH AT WEST SIDE OF BUILDING, NEW FIREPLACE Sq. Ft Floor Area: I Valuation: $45000 APN Number: 36602047.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Date: 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 I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner - Date: 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 Add ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO BUILDING BUILDING ADDRESS: 22085 REGNART RD I CONTRACTOR: VIA BUILDERS INC. I PERMIT NO: 1105006/ I OWNER'S NAME: LICENSED CONTRACT'OR'S DECLARATION License Cl Itic.N Contract . Date I heretiyf"elTh',' "thlatilupNilirtcensed'undeer the provisions of Chapter 9 (commencing with Section 7600) of Division 3 or the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penally of perjury one of the following Iwo 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 forwhich 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, mid 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 p lit. Additionally, the applicant understands and will comply with all non-po t s Ince regulayyrsn�s per the Cupertino Municipal Code, Section 9.18. /) / /; . 'Date,'')[-21,.-�//-,/t-' 1, OWNER-RUILDER DECLARATION ereby 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 (Sce.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 die 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 Califomia. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions ofthe Labor Code, I most forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTI FI CATION I certify that I have read this application mid state that the above information is 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 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 acerae against said City in consequence of the ,Iftmg of this permit. Additionally, the applicant understands slid will comply Ill non -point source ingulatinis per the Cupertino Municipnl Code, Section e.,d. Date 4600 EL CAMIN'O REAL NE 209 I DA'Z'E ISSUED: 07/18/2011 LOS ALTOS, CA 94022 I I PHONE NO: (650)948-1077 BUILDING PERMIT• INFO: BLDG r ELECT r PLUMB r MECII r RESIDENTIAL r COMMERCIAL JOB DESCRIPTION: SFDW ADDI I'ION(2a9SQF I}FAMILY ROOM IN R) EXISTING PORCH AREA, NEW PORCH AT WEST SIDE OF RUILDING, NEW FIREPLACE REVISION 92- REVISE ISR ,WALL, BEAM CHANGE TO EXTERIOR WALL & LEDGER DETAIL-REVN2 ISS'D 11/2112011 Sq. Ft Floor Area: I Valuation: $45000 APN Number: 36602047.00 I Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by ���� Dat��1 / —c: RF. -ROOFS: All roofs shall be inspected prior to any roofing material being installed 11's roof is Installed without Ii6i 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 1 have read the hazardous inalerials requirements under Chapter 6.95 of the California Health & SafetyjCode, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Ilealth & Safety Code, Section 25532(a) should 1 store or handle hazardous material. Additionally, should 1 use equipment or devices which emit hazardous air contaminants as defined by the Ray Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Date:= CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for One performance of work's for which this permit is issued (.Sec. 3097, Civ C.) Lender's Name Lender's ARCIIITECT'S DECLARATION I understand my plans shall be used as public records. Licensed REVISION # CITY OF CUPERTINO BUILDING PERNME BUILDING ADDRESS: 22085 REGNART RD CONTRACTOR: VIA BUILDERS INC. PERMIT NO: 11050064 OWNER'S NAME: LOS ALTOS, CA 94022 PHONE NO: (650)948-1077 ❑ LICENSED CONTRACTOR'S DECLARATION License Cl ic. tl -7 1 _? g10-5 Contracto Date t_/6 4 / I hereby affirm IZ t 1 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: 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. 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. 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 th' rmit. Additionally, the applicant understands and will comply with all non o' source r aliens per the Cupertino Municipal Code, Section 9.18. Signatur Date ?'D ff ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1, 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) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 1 hereby affirm under penalty of perjury one of the following three 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. 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, Date BUILDING PERMIT INFO: BLDG F ELECT F PLUMB r MECH ±— RESIDENTIAL f— COMMERCIAL I— JOB DESCRIPTION: SFDW ADDITION(289SQFT}FAMILY ROOM INTO EXISTING PORCH AREA, NEW PORCH AT WEST SIDE OF BUILDING, NEW FIREPLACE 8/10/2011 -REV41 REVISE FAMILY ROOM AREA, ADD NEW BENCH SEAT-ISS'D 8/10/2011 Sq. Ft Floor Area: I Valuation: $45000 APN Number: 36602047.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by7 Date: 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(x) should I store or handle hazardous material. Additionally, should 1 use equipment or devices which emit hazardous air 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 Hem& Safety Code, Sections 25505, 25533, and 25534. Date CIa �l CONSTRUCTION LENDING AGENCY 1 hereby aff inn 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. Licensed Professional CITY OF CUPERTINO FM_ l FEE ESTIMATOR - BUILDING DIVISION NOTE. This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the Drelininary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 EN 711111) ADDRESS: 22085 regnart rd. DATE: 10/28/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: Suppl. PC Fee: Q Reg. 0 OT PENTAMATION 1GENRES PERMIT TYPE: WORK 12nd revision= ISB wall beam change to exterior wall an ledger detail. SCOPE NOTE. This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the Drelininary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 EN 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: 77 $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. 0 OT 0.0 NOTE. This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the Drelininary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 EN 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee,0 Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? 0 Yes (E) No $0.00 Advanced Planninp, Fee: $0.00 Select a Non -Residential Building or Structure 0 0 A Strong Motion Fee: $0.00 1 # $652.00IREVRESADD Revision Addition Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $652.00 TOTAL FEE F $652.00 Revised: 10/01/2011 FM_7 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION balADDRESS: 22085 regnart rd DATE: 08/10/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: 1$2,500 *"PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: 0.0 PENTAMATION 1GENRES PERMIT TYPE: wORK revise family room area add new bench seat. SCOPE $0.00 NOTE: These tees are based on the nreliminary information avallahle and are only an estimate. Contact the Dent for addn'l info_ FEE ITEMS (1,ee Resolution 11-053 I:. 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Q Yes O No $0.00 0 hours $130.00 Plan Check, Hourly ISTPI,NCK Suppl. PC Fee: G Reg. 0 OT 0.0 firs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee.e Reg. 0 OT 0.0 1 firs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 CoflstructioF; lav Acoustical Fee: 0 Yes (D No $0.00 Q 0 Work Without Permit? 0 Yes G No $0.00 Planning Fee: $0.00 Select a Non -Residential 0 Building or Structure 0 F; al . Strong, Motion Fee: IBSEISMICR $0.50 �0 # $0.00 Revision IREvSFDWt, SFDWL Bldg Stds Commission Fee: IBCBSC $1.00 SL BTFOTALS: $1.50 $130.00 TOTAL FEE: $131.50 Revised: 07/04/2011