Loading...
12030054CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10310 MORETTI DR CONTRACTOR: AVA CONSTRUCTION PERMIT NO: 12030054 OWNER'S NAME: CUPERTINO, CA 95014 PHONE NO: (408) 387-0999 ❑ LICENSED CONTRACTOR'S DECLARATION F F F BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic. # MECH RESIDENTIAL COMMERCIAL Contractor hereby affirm that I am licensed under the provisions of C apter 9 JOB DESCRIPTION: CONSTRUCT 2 STORY SFDWL 1,911 SQ FT LIVING, 464 SQ (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force FT ATTACHED GARAGE AND 297 SQ FT PORCH AREA - TOTAL 2,672 SQFT Sa4JfQP-y /s /I7 SU/1)7y 1w" SiIS/01� , and effect. 1 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. I have and will maintain Worker's Compensation insurance, as provided for by Sq. Ft Floor Area: Valuation: $300000 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION APN Number: 37515010.00 Occupancy Type: I certify that I have rcad 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 180 DAYS FROM LAST CALLED INSPECTION. with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature bAl�j) �� Issued by: Date: Date Cv ❑ 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. II'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: I 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. permit is issued. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will 1 certify that in the performance of the work for which this permit is issued, I shall maintain compliance 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 Health & fety Code, Sections 25505, 25533, and 25534. 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. Ow r / bate: APPLICANT CERTIFICATION CONSTRUCTION LF,NDING AGF,NCY 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 work's correct. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued (See. 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 with all non -point source regulations per the Cupertino Municipal Code, Section ARCHITECT'S DECLARATION 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO FM_' FEE ESTIMATOR — BUILDING DIVISION 19 ADDRESS: 10310 Moretti Dr DATE: 03/12/2012 REVIEWED BY: Sean APN: 375-15-010 BP#: 12030054 *VALUATION: $300,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY SFD or Duplex USE: 2nd Unit? Yes • No PENTAMATION 1 R3SFDW PERMIT TYPE: A WORK Construct a new 2 story residence (1,911 s ft with a porch 412 s ft and a attached garage 465 s ft . SCOPE Total sq footage 2,788 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 2,788 $2,758.37 IR3PLNCK $2,659.26 IR3INSP TOTALS: 2,788 $2,758.37 $2,659.26 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 preliminary information available and are only an estimate. Contact the Dept.for addn'l info. FEE ITEMS (Fee ResohNion 11-053 Eff 7/1111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,758.37 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (j) Reg. © OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $2,659.26 Suppl. Insp. Fee:Q Reg. 0 OT F0.O Trs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: iBCONSTAXR 1 N new units $583.80 O 0 Work Without Permit? O Yes (j) No $0.00 Advanced Planning Fee: PLLONGRNGR $362.44 Select a Non -Residential Building or Structure 0 0 Strong Motion Fee: IBSEISMICR $30.00 Select an Administrative Item Bldp Stds Commission Fee: IBCBSC $12.00 SUBTOTALS: $6,405.87 $0.00 TOTAL FEE: f $6,405.87 Revised: 1/19/2012