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11090199CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10260 S DE ANZA BLVD OWNER'S NAIN7E: AT C BUILDING COMPANY OWNER'S PIIONE: LICENSED CONTRACTOR'S DECLARATION License Class_ Lic. 4 5ncscesc)� Contractor_ I hereby affirm that I am tcensed 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 sell' -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 inlormation 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 It 11 c-X ❑ OWNER -BUILDER DECLARATION��C�� 1 hereby affirm that 1 am exempt from the Contractor's License Law for one of the following hvo 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 & Prolcssions Code). 1 hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certilicate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, Ior 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 ofCalil'ornia. If, after making this certificate ofexemption. 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. APPLICANTCERTIFICATION I certify that I have read this application and 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 accrue against said City in consequence ofthe granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section ').18. CONTRACTOR: CAL -BAY PERiMI T NO: 11090199 CONSTRUCTION 22025 CENTER ST DATE ISSUED: 01/26/2012 CASTRO VALLEY, CA 94546 PHONE NO: (510) 581-0719 BI ILDING PERMIT INFO: BLDG ELECT PLUMB 1 %lECll RF:SIDF:NTIA1, COMMERCIAL. JOB 1)ESCR IPTION: NFW CI IA IN LINK TRASH ENCLOSURE AT EXISTING COMMERCIAL PARKING LOT 90 SQ lq f Sq. Ft Floor Area: I Valuation: $12000 APN Number: 36940004.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued b Date: z� .r' RE -ROOFS: All rools shall he inspected prior to any roofing material being installed. If a rool' is installed without irst obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: AL1, ROOF COVERINGS TO BE CLASS "A" OR BE'rrER IIAZARDOUS MATERIALS DISCLOSURE 1 have read the hazardous materials requirements under Chapter 6.95 of the California Ilealth & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & 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 Bay Area Air Quality .Management District 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Ilealth & Safety Code, Sections 25505, 255553(31,/a�ndd 125�5e34,.' , � ,�, _ � Owner or authorized atite: 1 ►9A 11 1 ent:1 111 1 1`I.LJ� DaI c CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which [his permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Add ARCIIITF,CT'S DECLARATION I understand in), plans shall be used as public records. Licensed Profess Date CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10260 s. de anza blvd K DATE: 09/28/2011 REVIEWED BY: bobs. APN: BP#: d "VALUATION: $12,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Commercial Building USE- PENTAMATION 1 U1 PERMIT TYPE: WORK new chain link trach enclosure at existing commercial parkinq lot. SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID U (Private Gar/Ag Bldg) II-B,III-B,IV,V-B 0 $0.00 $0.00 TOTALS: 0 $0.00 $0.00 MECH, HOURLY 0 Yes (E) No PLUMB, HOURLY 0 Yes Q No ELEC, HOURLY 0 Yes Q No -------- El NOTE. This estimate does not include fees due to other Depts (Le- Public Works, Sanitary Sewer District, School District, etc). These fees are based on the preliminary information available and are only an estimate. Contact the Dept -for addn'l info. FEE ITEMS (Fee Resohition 11-053 E(f. 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Q Yes 0 No $0.00 4 hours Plan Check, Hourly $520.00 ISTPLNCK Suppl. PC Fee: � Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? 0 Yes 0 No $0.00 Suppl. Insp. Fee-0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 t�lntdnasrratiix� ! �z�. 0 0 Work Without Permit? 0 Yes Q No $0.00 Advanced Planning Fee: $0.00 ® hours Inspections $520.00 ISTINSP Inspection, Hourly E) 0 1 rc{i J Iir,�c rr�M�r►rl�rtir3rr Fc ir:," Strong Motion Fee: IBSEISNfICO $2.52 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $3.52 $1,040.00 TOTAL FEE: 1 $1,043.52 Revised: 09/02/2011