11100140CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19920 OLIVEWOOD ST
CONTRACTOR: EDEN LANDSCAPE
PERMIT NO: 11100140
MANAGEMENT
OWNER'S NAME:
12550 PASEO CERRO
DATE ISSUED: 11/08/2011
OWNER'S PHONE: 4088589085
SARATOGA, CA 95070
PHONE NO: (408)858-9085
❑ LICENSED CONTRACTOR'S DECLARATION
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License Class c21 Lic. N
BUILDING PERMIT INFO: BLDG PLUMB
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MECH RESIDENTIAL COMMERCIAL
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Contractor ate
I hereby affirm that I am licensed under the provisions of apf 9
JOB DESCRIPTION: APARTMENT COMPLEX- INSTALL NEW ARBOR/TRELLIS
(commencing with Section 7000) of Division 3 of the Business & Professions
ACEESSIBLE PARKING AND RAMP RECONFIGURATION
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
Sq. Ft Floor Area:
Valuation: $20000
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APN Number: 31643004.19920
Occupancy Type:
APPLICANT CERTIFICATION
1 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
PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally, the applicant understands and will comply
with all non -point so gulations per the e ' o MunV;Code,tion
180 DAYS FROM LAST CALLED INSPECTION.
9.18.Issued
�'
by: Date:Signature
❑ OWNER -BUILDER DECLARATION
RE -ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of
All roofs shall be inspected prior to any roofing material being installed. If a roof is
the following two reasons:
installed without first obtaining an inspection, I agree to remove all new materials for
I, as owner of the property, or my employees with wages as their sole compensation,
inspection.
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
Signature of Applicant: Date:
1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
I 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
HAZARDOUS MATERIALS DISCLOSURE
Compensation, as provided for by Section 3700 of the Labor Code, for the
I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued.
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
I have and will maintain Worker's Compensation Insurance, as provided for by
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Section 3700 of the Labor Code, for the performance of the work for which this
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
permit is issued.
contaminants as defined by the Bay Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is issued, I shall
maintain com 'ance with the Cupertino Municipal Code, Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's
forthwith comply with such provisions or this permit shall be deemed revoked.
Date:
APPLICANT CERTIFICATION
CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is
I hereby affirm that there is a construction lending agency for the performance of wrk's
correct. I agree to comply with all city and county ordinances and state laws relating
for which this permit is issued (Sec. 3097, Civ C.)
to building construction, and hereby authorize representatives of this city to enter
Lender's Name
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
Lender's Address
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
ARCHITECT'S DECLARATION
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
I understand my plans shall be used as public records.
Signature Dale
Licensed Professional
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CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 19920 olivewood st.
DATE: 10/18/2011
REVIEWED BY: bobs.
APN:
BP#:
`VALUATION:
,00t)
rPERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY Multi-FamilyDwellingBuildina
USE:
is
>3 Stories 0 Yes (F) No
PENTAMATION 1GENRES
PERMIT TYPE:
WORK
complex install new arbor/trellis accessible parking and ramp reconfig uration.
SCOPE
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NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
Dictriet_ ote L Thoce feoc aro hacod on tho nreiimnary infnrmallnn ovailahie and are nniv an octimale_ Canlaey the Deny far adds 11 info.
FEE ITEMS (Tee Resolution 11-053 Eff 7/1i11)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee: Hourly
Only? Q Yes
® No
$0.00
4 1 hours
$520.00
Plan Check, Hourly
ISTPLNCK
Suppl. PC Fee: Q Reg. OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee: Hourly
Suppl. Insp. Fee-0 Reg.
Only? Q Yes
Q OT 0.0
0 No
1 hrs
$0.00
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
0
E)
Work Without Permit? O Yes (E) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential E)
Building or Structure 0
Strong Motion Fee:
IBSEISMICR
$2.00
2.0 hrs
$260.00
Inspections
ISTINSP Inspection, Hourly
Bldg Stds Commission Fee: IBCBSC
1 $1.00
SUBTOTALS:
$3.00
$780.00
TOTAL FEE:
$783.00
Revised: 10101/2011