10120119CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10508 S BLANEY AVE I CONTRACTOR:
MCCLELLAN I PERMIT NO: 10120119
OWNER'S NAME: BLANEY VENTURE LLC 11448 ENTRADA VERVE PL I DATE ISSUED: 03/10/2011 1
OWNER'S PHONE: 9259449108
❑ LICENS.ED WNTBACIOR'S DECLARATION
License Class . LiLic.k /
Contractor H��1��%6 JK/• Date -"& /d ^/�
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
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 this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18. 1
ALAMO, CA 94507 I PHONE NO: (925) 944-9108
BUILDING PERMIT INFO: BLDG r ELECT r PLUMB rr
MECH I RESIDENTIAL I COMMERCIAL
JOB DESCRIPTION: LOT I CONSTRUCT 1 STORY 2,171 SQ FT SFDWL W/
ATTACHED 421 SQ FT GARAGE-(ADDR CHANGED FROM 790 S
BLANEY)
Sq. Ft Floor Area: I Valuation: $259200
APN Number: 36911061.00 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:
Signature Date 3 0 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.
❑ OR -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)
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.
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
Compensation laws of California. If, after making this certificate of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, 1 must
forthwith comply with such provisions or this permit shall be deemed revoked.
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
to building constriction, 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 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, Sec ' ns 25505, 25533, and 25534. J
Owner or authorized agent:
LIV
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
ARIrHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
Signature Date
CITY OF CUPERTINO BUILDING PERMIT 7 7 t j
BUILDING ADDRESS: 10508 S BLANEY AVE CONTRACTOR: MCCLELLAN PERMIT NO: 10120119
DEVELOPMENT
OWNER'S NAME: BLANEY VENTURE LLC 1"8 ENTRADA VERDE PL DATE ISSUED: 03/10/2011
OWNER'S PHONE: 9259449108 I ALAMO, CA 94507 I PHONE NO: (925) 944-9108
U LICENSED CONTRACTOR'S DECLARATION
License Class D_`((Lic.#4_�66q,
Contractor LEI CC l eJa n Djn Date 7 L�
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
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 regu ti e e Cupertino Municipal Code, Section
9.18.
Signature Date 2 f
❑ 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).
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
l certify that l 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.
BUILDING PERMIT INFO: BLDG F ELECT F PLUMB I—
MECH F RESIDENTIAL F COMMERCIAL i—
JOB DESCRIPTION: LOT 1 CONSTRUCT 1 STORY 2,171 SQ FT SFDWL W/
ATTACHED 421 SQ FT GARAGE-(ADDR CHANGED FROM 790 S
BLANEY)
5/26/2011- REV#1 - REVISE INTERIOR WALL @HALLWAY ADDED 2 ARCH
OPENING -REV# 1 ISS'D 7/27/201 I
Sq. Ft Floor Area: I Valuation: $259200
APN Number: 3691I061.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued _ Date'z?��j
RE -ROOFS:
Al I roofs shal I 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 wit a Cupertino Municipal Code, Chapter 9.12 and the
Health & SaAhora
ns 25505, 25533, and 25534.
w a 711Z —7
Date•
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of %%ork's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
Signature Date,
I understand my plans shall be used as public records.
Licensed Professional
CITY OF CUPERTINO BUILDING PERND*TE
BUILDING ADDRESS: 10508 S BLANEY AVE
OWNER'S NAME: BLANEY VENTURE LLC
OWNER'S PHONE: 9259449108
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lic. # 4q go e (o
Contractor J(tI�, hm T)tyL Date v_ " it
1 hereby affirm that 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.
1 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.
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 this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18. t
Signature (LzDate
❑ R-BUILDER DECLARATION
I hereby affirm that 1 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).
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 Califomia. 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.
CONTRACTOR: MCCLELLAN PERMIT NO: 10120119
DEVELOPMENT
1448 ENTRADA VERDE PL DATE ISSUED: 03/10/201 1
ALAMO, CA 94507 PHONE NO: (925) 944-9108
BUILDING PERMIT INFO: BLDG r ELECT F PLUMB r
MECH F RESIDENTIAL r COMMERCIAL r—
JOB DESCRIPTION: LOT I CONSTRUCT 1 STORY 2,171 SQ FT SFDWL W/
ATTACHED 421 SQ FT GARAGE-(ADDR CHANGED FROM 790 S
BLANEY)
4/7/1 I- DEFERRED # I- TRUSS CALCS- 5/24/2011 DEFR'D# I ISS'D
Sq. Ft Floor Area: I Valuation: $259200
APN Number: 36911061.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS ROM LAST CALLED INSPECTION.
Issued �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. 1 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 o u rized agent: _
Date: 1.4
vi
CONSTRUCTION LENDING AGENCY
I hereby affir at there is a construction lending agency for the performance of Hork'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.
Date I Licensed Professional
Fm__�
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
19
ADDRESS: 10508 s. blaney
DATE: 05/26/2011
REVIEWED BY: bobs.
APN:
BP#:
"VALUATION: $400
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
PENTAMATION
PERMIT TYPE:
WORK
revise interior wall and hallway add 2 new arch opening
SCOPE
tiir,;n. F'crirti� f•'e'[.'
..
>'r,t+s Fi'ct
Li
NOTE. These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'1 info.
FEE ITEMS (Fee Resolution 09-051 F. '. 711110)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: G 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
�r�rt�'lritt.:(I(1rt T��.t
Acoustical Fee: 0 Yes 0 No
$0.00
0
Work Without Permit? 0 Yes O No
$0.00
Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
0
0
T't,wef lac , wrier:r: j1ion 1 `c
Strong Motion Fee: 1BSEISMICR
$0.50
1 #
$760.00
Revision
IREVSFDWL SFDWL
Bldg Stds Commission Fee: 1BCBSC
$1.00
SUBTOTALS: 1
$1.50
$760.00
TOTAL FEE:
$761.50
Revised: 04/29/2011
� CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
1AADDRESS:
790 S BLANEY AVE LOT 1
DATE: 12/17/2010
REVIEWED BY:
APN:
BP#:
`VALUATION:
1$259,200
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY SFD or Duplex
USE:
TOT.1 L
FLOOR ARF 4.
PENTAMATION 1 R3SFDW
PERMIT TYPE:
WORK
SCOPE
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
SA.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
R-3 (Custom)
II-B,III-B,IV,V-B
2,591
$2,641.24
IR3PLNCK
$2,497.16
IR3INSP
TOTALS:
2,591
$2,641.24
$2,497.16
.._
Wech. Plan Check
l'hwih. Plan Ch«,:k
E'lec. Plan Check
:11ech. 1'(; war F-,r
PhImb. pefvrit >'C'::
lilac. Pc/ Mir Fecr:
(.)lher tdech. h�:�p.
Ld
Utl I'%�r�rrh lr;sc�.17-
othcei- � ;i>.. I sp.ET
AA"'ch. I12sp. Fee:
Phonh. rii p. 1` c:
Elec. htsp. l''c.
NOTE: These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'1 info.
FEE ITEMS (Fee Resolution 09-051 E . 711110)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,641.24
1 amps
$42.00
Electrical
IERT<200 Services
Suppl. PC Fee: 0 Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
0 #
$21.00
Plumbing
IPRSEWER Sewer, Sanitary
Permit Fee:
$2,497.16
Suppl. Insp. Feed Reg. 0 OT
f 0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
L—j-1 #
$21.00
Plumbing
IBPWSVCS Water Service
Constr. Tax: IBCONSTAXR
F1 Tbld
# Ss
$558.42
Acoustical Fee:
0 Yes (F) No
$0.00
0
E)
Work Without Permit? 0 Yes 0 No
$0.00
Planning Fee.
PLLONGRNGR
$336.83
0
0
Travel Documentation Fee: ITRAVDOC
$42.00
Strong Motion Fee:
IBSEISMICR
$25.92
Select an Administrative Item
Blde Stds Commission Fee: IBCBSC
$11.00
SUBTOTALS:
$6,112.57
$84.00
TOTAL FEE: $6,196.57
Revised: 12/07/2010