11090185CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10165 BONNY DR
CONTRACTOR: MANA GENERAL
PERMIT NO: 11090185
CONTRACTOR
OWNER'S
SAN JOSE, CA 95122
PHONE NO: (408)375-4288
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIALS
21 LICENSED CONTRACTOR'S DECLARATION
License Class tt k Lie. # L t ® I
SFD ADDITION, 447 SF, ADDING TWO BEDROOMS,
Contractorimm i ne y-a J w Date 11 1 116111SF,
KITCHEN, AND DINING ROOM. SFD REMODEL, ALSO 447
KITCHEN, BATHROOMS, AND LAUNDRY
I hereby affirm 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
Sq. Ft Floor Area:
Valuation: $130000
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
APN Number: 35912029.00
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
180 DAYS FROM LAST CALLED INSPECTION.
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
,.
Issuedb ,
with all non- Municipal Code, Section
9.18.
RE -ROOFS:
Signature Dat
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.
❑ OWNER -BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law forone of
the following two reasons:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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 (See.7044,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 25532(a) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self -insure for Worker's
material. Additionally, should I use equipment or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for whichthis permit is issued.
Cupertino Municipal Code, Chapter 9.12 and
will maintain
authorized ageDate:Il o
is issued.Owner
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
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I must
I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked.
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
APPLICANT CERTIFICATION
Lender's Address
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,
ARCHITECT'S DECLARATION
costs, and expenses which may accrue against said City in consequence of the
I understand my plans shall be used as public records.
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
9.18.
Signature Date
BUILDING ADDRESS: 10165 BONNY DR CONTRACTOR: MANA GENEPhAV .' PER IT N0:, tt090185_
CONTRACTOR
OWNER'S NAME:
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lie. #-,
Contraetorir�/�r� 4,e v�-t� Date % z_
`7
I hereby aftirru that I am licensed tinder the provisions of Chapter 9
(commencittg with Section 7000) of Division 3 of the Business & Professions
Code and that toy license is in full force and effect.
I hereby afCr•m tinder 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 (lie
performance of the work for whiehhthis 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 put -poses. (We) agree to save
indemnit}, 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 no
v
❑ ONVNER-BUILDER DECLARATION
I hereby affirtu that I am exempt from the Contractor's License Law for one of
the following two reasons:
I, as owtner of (lie 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, aril 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 whiehthis 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 die 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 California. If, after making this certificate of exemption, I
become subject to tlhe 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 thus 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 whidn may accrue against said City in consequence of the
granting of this pernnit. Additionally, the applicant understands and will comply
with all non -point source regulatirns per the Cupertino Municipal Code, Section
9,18.
1839 TAMPA WAY DATE ISSUED: I1/10/2011
SAN JOSE, CA 95122 PHONE NO: (408)375-4288
JOB DESCRIPTION: RESIDENTIAL El CONIMERCIAL11
1 ADDITION,1i1 TWO BEDROOMS,
KITCHEN, AND DINING ROOM. SFD RE MODEL, ALSO 447
KITCHEN, BATHROOMS, 1 LAUNDRY
1120/2012- REVISION fit- SHEAR WALL- COLLECTOR,
','; SHEAR
GARAGE,'WALL AT tt BEDROOM 1 t 1/20/12
Sq. Ft Floor Area: I Valuation: $130000
I APN Number: 35912029.00 I Occupancy Type: I
Issued by: '' "s — 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 deflued by the Bay Area Air Quality Management District I
will maintain compliance with tide Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, .
Owner or authorized age n Date:�t.. I G
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 Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
Signature
Date
wvA- CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 10165 bonny dr. DATE: 01/2012012 RE%4EWED BY: bob s.
APN: 71P#: 17ALUATION: Iso J F
'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex 'ENTAMATION IGENRES
USE: PERMIT TYPE:
woRu- revise shear wall -collector, revise shear -wall at garage, add bedroom windows.
SCOPE
NOTE: This estintafe does not include fees due to other Departments (i.e. Planning, Public f Vorks, Fire, Sanitary Sewer District, School
Dhtrh-i oir. ) Thavo foot firo hacad aft the lippli"ififirp himp"I"linn ov"Hahlo, and are nniv an estimate. Contact the Dent for addal info.
FEE ITEMS LFe.e Re,yohftion 11-053Eff, 711M)
FEE
QTY/FEET
MISC ITEMS
Plan Check Fee: Hourly Only? 0 Yes (D No
$0.00
1 hours Plan Check, Hourly
$130.001 ISTPLNCK
A
Suppt. PC Fee: G) Reg. 0 OT
L-0
his
$0.00
PME Plan Check:
$0.00
1
Permit Fee:
$0.00
Suppt, Insp. Fee.G Reg. 0
OTFo--ol
lirs
$0.00
1
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
0
(D
Work Without Permit? 0 Yes No
$0.00
Advanced Plannim-, Fe�,:
$0.00
Select a Non -Residential
Building or Structure
(D
0
Strong D/fo I ion Fee:
$0.00
Select an Administrative Item
Bfclg Stds Commission Fee:
1 $0.001
SUBTOTALS:
$0.00
$130. 0
TOTAL FEE:
F $130.001
Revised: 1/19/2012
CITY OF CUPERTINO
RRAWN FEE ESTIMATOR - BUILDING DIVISION
im,
ADDRESS: 10165 bonny dr.
DATE: 09/26/2011
REVIEWED BY: bobs.
APN:
BP#:` (
"VALUATION: 1$130,000
'`PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Addition
PRIMARY SFD or Duplex
I
2nd Unit? 0Yes No
PENTAMATION 1 R3SFDADD
USE:
OTC. 0 Yes ONo
PERMIT TYPE:
WORK I
sfd add bedrooms kitchen dining 447s.f., remodel bathrooms kitchen laundry 447 s.f.
SCOPE
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
R-3 (Custom)
II-B,III-B,IV,V-B
447
$1,482.00
IADDPLCK
$1,205.00
IADDINSP
TOTALS:
447
$1,482.00
$1,205.00
MECH, HOURLY 0 Yes G No
PLUMB, HOURLY Q Yes Q No
ELEC, HOURLY 0 Yes Q No
I t c' 1 <Cm _,.
1.. '�}. 7 str •, f°e ..,
r'r7. ,<. , . .. �.. � ..f„
1. 7c ';t r3<i1 i i. ...
Ll
E3
f-
'o'
NOTE. This estimate does not include fees due to other Depts (I.e. Public Works, Sanitary Sewer District, School District, etc.).
These fees are bared on the oreliminary information available and are only an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resohrtion 11-053 E'. 71LI11
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$1,482.00
180 s.£
$588.00
Remodel, Kitchen (<=300 si)
1REMRESIUT
Suppl. PC Fee: (F) Reg. 0 OT
0.0
1 hrs
$0.00
PME Plan Check:
$0.00
=s.f. Remodel, Bath (<=300 sf)
$588.00 IREMRESBAT
Permit Fee:
$1,205.00
Suppl. Insp. Fee:G Reg. 0 OT
0.0
1 hrs
$0.00
= s.f. Remodel, Other
$392.00 IREMRESOTH
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
0
Work Without Permit? Q Yes (D No
$0.00
Advanced Planning Fee:
PLLONGRNGR
$58.11
Select a Non -Residential
Building or Structure
G)
0
7 f
f r,.,.f :'1<. F7Y7 F"i;. i..£>si £'''f.'
Strom Motion Fee:
IBSEISMICR
$13.00
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$6.00
SUBTOTALS:
$2,764.11
$1,568.00
TOTAL FEE:
$4,332.11
Revised: 09/02/2011