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08040181 BUILDmc DlvfsbN PERMIT CO1�IT CT.ORgINFORMAT QN -- BUILDING ADDRESS: PERMIT NO. 20800 HOMESTEAD RD NATIONAL CONSTRUCTION 08040181 OWNER'S NAME: PERMIT ISSUE DATE VSII,A CALIFORNIA LMTD 15319 CHATSWORTH ST 04/25/2008 Nen mown Cvrn (818) 221-6057 SANTTARY NO. CONTROL NO. ARCHITECTIENGINBER: BUILDING PERMfr INFO BLDG ELECT PLUMB MECH 306 LICENSED CONTRACTOR'S DECLARATION O O O O 1 areby affirm dust 1 un 11¢necd undo provisions of Chapter 9(mmmencinp Job Description NN Section TOM)of Division J ofthe Sud.W 4 Prefessimu Code,send my license ^� Infullforaandcrtat 'fr/A>� TEMP POWER 1-200 AMP DOUBLE, 1-200 AMP NAIL ?gi n.mma.m -lf...=ma.m - 014.1.0 m 6s.911 SUB, 3-100 AMP SUBS, 15 STINGER POLES. ARCHTIECI-S DECLARATION I underatur d my plans Nail be used an public records D U y0 Licensed Professional OWNER-BUILDER DECLARATION i 1 hereby AM.that I am exempt from the Canuaclm/s License law far to 00 following moron.(Section RD I.S.Bwtnu and Pmfessiam Cade:Any city or county which mor m,a Permit to cunmact.slmr,improve.demolish,or repair soy aaactum ZSn prior an its issuance.also nation;the Applicant far such permit m files signed uamocom < that he is licensed Pursuant rode provisionsof de Conunrune.Lt..Low(Chapter 9 Sq.Ft.Floor Area Valuation $ (.comseing with Section 7000)ofDivision Jaffa Bu.Mmand ProRutons Code)or $20000 that a is asempt Ibcmfmm and the hands for to Alleged gumption.My violation of Section 7071.5 by Any,Applicant for a permit subjects the Applicant o a civil penalty of Number Occupancy e, antmom than five hundred dollars(IISW). 32609056 A'P& p yTyp 0 I,As owner of the property.or my employes with"Bad as tab mid eampenNmn, will do the wort and to mamma to Act intended or offered for Ass(See.7044.Busixu and Prefesdmu Cade The CmntrmmYs Liter.law dos rot apply m an Owner of Required Inspections pr ope ty w a builds orimproves thsmn,and who dos ouch work hivuelf or Cuoegb his awn employes,provided tat such Impmwmanu are trot Intended oro@rod for sale It, however,the building orimproverrom Is said within ane year o(completion.the Owner. builder will haw to herders of proving that he did not Wild or Improve for purpose of sale.). ❑1.as weer a to property.w exclusively conuanint with licensed canuaemrs to cmutnct the pro)m(See.7044.Bovines and Poofesdons Cade:)The Caumtor's U. cava law dean not apply on an owner of Property who WHO or Improves thamem,and who contracts forouch projects with a commands)licensed Pursuant to to Communes Liave Law. 0 lunsemphundm5ee ,Bk PCfCAt1dA n Owner Data WORKER'S COMPENSATION DECLARATION I areby&firm under penally of perjury mm of the following declandon: have and will broadcast.a CeNOam of Consent to scar--insure fan Worals Compere aatlmn,u provided for by Sec an 5700 of to labor Code,far the Performance of the work for which ads Permit is issued. Cow and will maintain Worker's Compcm an hap rsnco,as required by Section 3700 of Chu labor Cade,for the performance of the work for which this permit is issued. ' MY Warkeh£ompensatian In nota artier sa and policy number e: ��y Cartler�/h JiI2N i-0j Policy NmafCZSUay7 3 Oc A CEA7TFlC'A7E OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (thissceden need rota comp mord HIM permit Is for o m hundred dollars(SIM) or less.) 1 amity that in to puffmnnanee of to work fon which this permit is Wood.l salt wt employ any N.in my mannerm as At become subject in Ne Womerf Cwnpceuden laws of CalifoMa.Dam Applicant NOTICE TO APPLICANT.If,boar making this certificate of Exemption,you should acome subject to the Worm's Compensation prevision of Ne Lada Codc,you must wJ O forthwith comply with such provisions or this permit shall he damcd asked. 5`-' CONSTRUCTION LENDING AGENCY �w [-+ I arwhicby hmtdwtaa maansSec.i097,lending .) y(er thcpMmmuax of IX to wark for which Mho permit ts imMM' (Ss..7097,Cl,Cr.C.) 6Wi Q Lente.Nemo Q,Z LendeM1 Address V Q 1 enmity Cut I Cow teed this application and atom that Me abow informadon is {L^ conmt.I airme to comply with all city and cowry marmoset and sure laws awing to Q LSJ' Wilding Construction.and amby mthariu representatives of this city to ams upon Cc tg1 ahow-memlaned property for Impecom purposes. gL (We)agree to saw,indemnify and keep hatmlou the City of Cupertino against ww Cn Iiabiliulujudgmcnu,cammd Carman,which may In any way accrue4ainl said City V Z in consequence of the stenting of this permit .. APPLICANT U14DERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE RE TIONg, 1JTfj , o.,.i `Y Re-roofs Signature mf Ap Ii.VC.p=tor Data HAZARDOUS MATERIALS DISCLOSURE - Type Of Roof Will Cc applicant or future Wilding m eapam more ora ak haaaaus materiai u deflad by tic Cupeaa MuacipA Cade.Caper 9.1;and ac Healthand Safety Code.Section n53z(a)± All roofs shall be inspected prior to any roofing material being installed. YO Will the applicant at future Wilding Occupant um equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove t huudmu air conteminna As defined by the Bay Am,Air Quality Management all new materials for inspection. w cMT ❑Ya law rom the AftyCduaamrs 25 .2553ls imine 5534.1under CMPmndMan of done WiCaldni; Y �� Clues nlNaS ray .edc,Sec.. U505,ZSSl7 and 25344.1 andcwand Man done dtilding C aee a sy have•mnsnL than It r mat mapomlhility m notify Cc occupant of Ccavo� - - require hich mtw be and pd r in I..of a Ccniricase of Occupanry. V- 5_v Signature of Applicant Date Owner or mthntn= .gem Data- All roof coverings to be Class'W'or better CITY OF CUPERTINO • 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: suew COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32609056 .ALL DATE ISSUED. . . . . . . : 04/25/2008 RECEIPT #. . . . . . . . . : BS000004579 REFERENCE ID # . . . : 08040181 SITE ADDRESS . . . . . : 20800 HOMESTEAD RD SUBDIVISION . . . . . . : CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : VSII,A CALIFORNIA LMTD PRTNERS ADDRESS . . . . . . . . . . : 1900 SOUTH NORTOLK STREET CITY/STATE/ZIP . . . : SAN MATEO, CA 94403 RECEIVED FROM . . . . : EDWARD GREGORY CONTRACTOR . . . . . . . : NATIONAL CONSTRUCTION RENTALS LIC # 22537 COMPANY . . . . . . . . . . : NATIONAL CONSTRUCTION RENTALS ADDRESS . . . . . . . . . . : 15319 CHATSWORTH ST CITY/STATE/ZIP . . . : MISSION HILLS, CA 91345 TELEPHONE . . . . . . . . : (818) 221-6057 ® FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- lERT<200 UNITS 5 . 00 203 . 95 0. 00 203 .95 0. 00 BSEISMICRE VALUATION 20, 000. 00 2 .00 0. 00 2 . 00 0. 00 EPERMITFEE FLAT RATE 1. 00 40.79 0. 00 40 .79 0. 00 TRAVDOC FLAT RATE 1 . 00 40.79 0. 00 40.79 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 287 .53 0. 00 287 .53 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 287 . 53 MC --------------- TOTAL RECEIPT - 287 . 53 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 402 TEMPORARY POWER aTyo CITY OF CUPERTINO TEMPPOWER CUPVINO PERMIT APPLICATION FORM APN# Date: 3aG O9U.5�, ALL 5/- zs- zoo� Building Address: -zo Owner's Name: T Phone#: Contractor: / � Phone#: C/pd=Lc�v— 27C� Fax #: Contact,�� Phone#: Contractor License#: Cupertino Business License #: Z Z S 37 Job Description: /9 .41 P �DJ6/� 3 — jJ� '¢"��S✓bs D UJ el Residential [ Commercial Valuation: Z v U06 Qty. if Applicable Fee ID Fee Description Fee Group Permit Type ERT>1K Res. Temp Power>IK Amps ELECTRIC REAP14 S ERT<200 Res. Temp Power<200 ELECTRIC Amps ERT2001K Res. Temp Power 200-1K ELECTRIC Amps / EPERMITFEE Electric Permit Issuance ELECTRIC ELCPLNCK Electric Plan Check ELECTRIC BSEISMICRE Seismic Residential BUILDING BSEISMICOM Seismic Commercial BUILDING CEAP14 • • q CITY OF CUPERTINO ao TEMP POWER CUPERTINO PERMIT APPLICATION FORM BPWSVCS Water Service PLUMBING CPWS or RPWS PPRSEWG Private Sewage Disposal PLUMBING System PCESS Cesspool PLUMBING BPWATER Install/alter Water Pipe PLUMBING BPFIXTURE Plumbing Fixture PLUMBING PGASRES Residential Gas Piping PLUMBING System 1-4 Outlets BPGAS Gas Piping System 5+ PLUMBING Outlets PPERMITFEE Plumbing Permit Fee PLUMBING Issuance PLMBLNCK Plumbing Plan Check PLUMBING PLMBINSP Other Plumbing/gas Insp. PLUMBING TRAVDOC Travel & Documentation Fee BUILDING S BUSLIC Business License BUILDING CITY OF CUPERTINO TEMP POWER k4CUPERTINO PERMIT APPLICATION FORM ECT<200 Commercial Temp Power ELECTRIC <200 Amps ECT>1K Commercial Temp Power ELECTRIC >1K Amps ECT2001K Commercial Temp Power ELECTRIC 100-1K Amps TRAVDOC Travel &Documentation Fee BUILDING BUSLIC Business License BUILDING Community Development 10300 Torre Avenue irL 4' Cupertino CA 95014 x Telephone(408) 777-3228 CITY OF Fax(408)777-3333 4JUPERTINO Building De artment JOB ADDRESS: Po l`D�e S j�� PERMIT # b b OWNER'S NAME: Ike ds er �s ¢ ` PHONE #6-SV- 93 1-3 srw GENERAL CONTRACTOR: .�• e r ,, „ FAX # ,od'- leo— 770Y Z e,c I am not using any subcontractors: d Signature V Date Please check applicable subcontractors and complete the following information: 60 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical �'o K sl Ks v ;rti Z 2 S'3 7 Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile CA 0 Owner/Contractor i Date