Loading...
11110023 CITY OF CUPERTINO BUILDING PERMI.1' BUILDING ADDRESS: 20900HOMESTEADRD CON"IItA Cr(IR:MONTEREY P ERINUTNO: 11110023 CONSTRUCTION COMPANY OWNER'SNAME: PROMETHEUS NN MION'I'Ii12E1'SA LINAS II\\'1'S'I'IiA DATE ISSUED: 11/04/2011 jR'S PI ZONE: 6509313400 SA LI N'AS,CA 93908 PHONE NO:(831)601-2659 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT IJ PLUMB(-'a License Class Lic,N AI DCII I— RESIDE TEr AL COMMERCIAL - ContractoriL Date hereby affirm that l mn ' ensed underlhe provisions of Cliopter9 JOB D FSCRIPTION: BLDG INIT -REMODEL KITCHEN(50SQFT)& (commencing with Section 7000)of Division 3 of Ibe Baxiae55&Professions WAS IERIDRYER I IOOKUP&ADD NEW A/C UNIT Code and that my license is in full force still]effect. hereby affirm under penalty ol'perjury one ul'the fallowing hvu declaralions: I have and will maintain a certificate of consent to self-insure lilr Worker's Compensation,as provided far 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. 1'1 19nar Area: \'situation:$20000 Section 3700 of the Labor Code,for the performance of die work for which this permit is issued. AI',,, Cu ether:32609065.00 Oecup;mey'I)pe: APPLICANT_CFR I'I 11CATION 1 certify that I have read(his ippliculina and state than 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 ofthis city to enter PFIZMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, NVITI IIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which miyaccruc against said City in consequence of(he 180 DAYS PROM LAST CALLED INSPECTION. granting of this permit. Additionally,Ihcapplirtnt Understands and will comply with all non-point source rcgulalims t the Cupertino Municipal Code,Section / 9.18. / Issued b '• Date: // y G Signature./ Dote[/ OWNER-BUILDIAt DECLARATION RL:ROOFS: Af I'oi15 Shull he inspected prior to any rooting material being installed.If a roof is I hereby affirm that 1 am exengrl from the Contractor's License Law for one of 'tuvalle,1 withom f irst obtaining an inspection,I agree to remove all now materials for the following two reasons: imp.cion. 1,as owner of the property,or my employees wi lh wages as their sole compensation, will do the work,and the structure is not intended sir offered for sale(9ec.7044, $ignalule of Appliamt: Datil: Business&Professions Cade) I,as owner of the property,;all exclusively contracting with licensed contractors to construct the project(Sec.7044,Rosiness&Professions Code). ALL ROOV COVERINGS TO BE CLASS"A"OR RFt-rER hereby affirm under penaly of perjury nuc of the follmring three declarations: HAZARDOUS NIATERIALS DISCLOSURE, I have and will maintain a Certif icate of Consent it,sclhinttuc fir Worker's I ha,v read the hazardous maleri;ds requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 if the Labor Code,lou the CalihO Ilia health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain performance of the work for which this permit is issued. eomphance with the Cupertino Municipal Code,Chapter 9.12 and the health& I have and will maintain Worker's Compensation Insurance,as provided for by Sutvly Code;Section 2553'_(x)should 1 store or handle hazardous material. Section 3700 of the Labor Cade,Ibe the perlornnunce ofthe work for which this Addlimwlly,should I use equipment or devices which emit hazardous air e onhamimutls ns deliurd by the Iixv Area Air Quality Manngemeal District I will permit is issued. maiuniin co tnpliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of flic work tlar which This pertnit is issued,I shall Icnlhh,C Sal'rty Cade.SV, lolls 2551I)_255.13,and 25534. not employ any person in any manner so as ti become subject to the Worker's Compensation laws ofClilbrnia. lf,nliernakiug Ibis cenilicalc ul'cxcmplion,l 0", become subject o the Worker's Compensilion provisions oft lie Labor Code,I n11tst forthwith comply with such provisions or this pennil shall be deenhed revoked. CONSTRUCTION LENDING AcrSCY APPLICANT CERTI FICIA'1'ION I hctrhv 11111111 that there is a construction lending agency for the performance of work's I certify Dat I have read this apphcait on and sante than the above information is tlhr sclueh this peanut is issued(Sec.3097,Civ C.) correct.1 agree to comply with all city and count' ordinances and shale laws relating Lrndcr's,N'ume to building construction,and herchv authorize representatives of this city to enter upon the above mentioned property Ibe inspect nil purposes.(We)agrae to save Leaders Address nify,and keep harmless the City of Cipert'mi ugninsl l iuhllin",judgments, and expenses which may accrue against said Cin'in COIaSegacnee of the -,\RCI l l'r P:C"f:S Ill?CL,Ut.CI'ION ling of this permit.Additionally,the applicant understands and will comply with all non-point source regulaliahs per the Cupertino Municipal Code,Section I wtdetsumd sip'plans shall he used as public records. 9.18. Lirrn:rd I'rofr"iunal Signature Date 11/03/2011 15: 32 (FAR) 111 p�32-3 P. 003/005 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPM ENT.DEPARTM ENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPEf10 (408)777-3228' FAX(408)777.3333' bLIlldlnQACUpertlno,OrCl ' ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DFPERRED ORIGINALPERMITN PROJECT AID^DKESs onty APNq OWNGR NAML PHDNE E-MAIL Atom-+ C> > '22cJL IcS-E�'� C ` 50 Gi\-B�1uG STREET ADORFSs CITY,STATE,ZIP FAX aoo , r�u, CO ACT NAME PHONE __-- R-M IL STRCET ADDRESS CITY,STATF, ZIP FAX YY,cry-F Cr _ScQ.:.n�-, Nw '31 yr�c' U� S3gG 3R �1SS'�lr=r`E4+ ❑OwNBR ❑ OwNEN-BUILURR ❑ OWNLRAOENT ❑CONTRACIORAGENr ❑ ARCIIFTFCT 1:1 ENGINEER ❑ DEVEWPL'R ❑TENANT OONTTRRAACTOR NAME,/Ze LICENSE NUMBER LICIT I�TYPE BUS.LICA COMPANY NAME L•J E-MAIL FAX(_-&. N) TYICJptipr' �.t:t1S�-'r� G• Lan }1-icLy.�4 c mr STREEI'ADDRESS � CITY,STATB,ZIP PHONE�-�'3'� �6SS T�rlFar�1-er ems..`�r.Q.irv:`.> \-4t,x�, ti 'f `.mac 1L.L nc:s. Gf•� G<Sc'.u�! \.-155' 1F'?> ARCHITECT/ENOrNEER NAME LICENSE NUMBER BUS.LIC x COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE.ZIP PHONE DESCRIPTION O WORX —� \ f` ccp.�c9:L \ � oc.AeQ_ PX._�-; ':k � mss. .(-•t' n r.� EXISTwGUSEto CONsrn.TWE #STORIPs ExrsTO DEMO TorAI,AREA ARRA NE1'ARLADATNROOMOTHBIIREMODELAMA REMODCLAREA A� tIPORCHAREADK/1'OROi AREA GARAGE MLA;❑pLTACFI P }II 1711 a B11��r.l �� 1. rt yF I, ❑ATrACH II lllu I,1,lIt I� rift III Tal .owLwNG UNns: IN SECOND ❑YEN NECOROLTORY ❑YPs I /, �'I I r l r {{��rF a1110T'f hi t!l � I ( NEI _L -No AaaNTrroB Not l ��l�j N t� PRE-APPLtCAT10N ❑ YFS IP YHS,IROV0.COPY OP PIANNWS NAME: I a�1r'NEI III�p��yy�1a LI� II'rlgfy�IA)]�1l� t1I1�U� ITA VA ATIO,Na. F R PUNNEOArPLY ❑ NO RwNNWO APPRpIALIbTfWt {•yI �( 'I )1' Iln'(P" X'I'i�1J 'FAME �R l4.` By my signalurc below,T certify to each of fins following: I am the property owner or authorized agent to Oct on the proper) owner's behalf. I have read this application and the intervention I haveled is correct. I have read the Description of Work and verify it is accurate. I a Fee to comply with all applicable local ordinances and Stale laws relating t i g conshuction. 1 authorize E present Elives of Cup,Hino to enter the nbovejdent fredfproperty for inspection purposes. Signature of Applicant/Agent; Date: SUPPLEMENTAL INFORMATIiION REQUIRED i New SFD or Multifamily dwellings: Apply for demolition permit for t: 1 (d - existingbuilding(s), Demolition ermit is re u red prior to issuance of building GUILD NC PLAN RRVIRIV P r 4 I a I � Y � ®t 1 permit for new building. I v F s! 1 �'�, �W � � Nit ItEVIgtY 917tH I+Lp filo I Is 1 �. 1 Colnmm'cial Bldgs: Provide a�cmnpleted Hazardous Materials Disclosure � � �1 I i�td P� , i�, h nunL'IC wpRKs form if any Hazardous Materials M being usedlas part of this project, Y I pp0i AllwWU _ E , iV' yf1l p SISI u n lde�P�� Copy of Planning Approval Letter or Meeting with Planning prior to �1 Submittal ofBuilding PermitsPPlidation. Ezr!_ '- ;av IAII�IIJi ,lla.� .�HIIUa�t���r has�fJh,`fI I�'EN�IRONMF PNTADIH'EAUTHI ' I Bldgdpp_201Ldoc reviser!03/16/1l i CITY OF CUPERTINO 8 ITEMS OF 32 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 32609065 . 00 DATE ISSUED. . . . . . . : 11/04/2011 RECEIPT 4. . . . . . . . . ; BS000015241 REFERENCE ID # . . . : 11110023 SITE ADDRESS . . . . . : 20900 HOMESTEAD RD ` SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . . PROMETHEUS ADDRESS . . . . . . . . . . : 1900 S NORFOLK ST STE 150 CITY/STATE/ZIP . . . : SAN MATEO, CA 94403 RECEIVED FROM . . . . : RICH' D REGA CONTRACTOR . . . . . . . : BEN REGA LIC # 32275 COMPANY . . . . . . . . . . : MONTEREY CONSTRUCTION COMPANY ADDRESS . . . . . . . . . . : 88 MONTEREY-SALINAS HWY STE A CITY/STATE/ZIP . . . : SALI-FAS, CA 93908 TELEPHONE . . . . . . . . : (831) 601-2659 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- -ADMIN HOURS 1. 00 41 . 00 0.00 41 .00 0. 00 1BAPPLOTHE NO OF APPLIAN 2. 00 130 . 00 0.00 130 .00 0. 00 1BCBSC VALUATION 20, 000 . 00 1 . 00 0.00 1.00 0. 00 1BREMAIRHA NO.UNITS 1. 00 65 . 00 0. 00 65. 00 0. 00 1BSEISMICR VALUATION 20, 000 . 00 2 . 00 0.00 2 .00 0 . 00 1MPERMITFE FLAT RATE 1. 00 44 . 00 0. 00 44 . 00 0 . 00 1REMRESKIT SQ FEET 50 . 00 588 . 00 0. 00 588 .00 0 . 00 1TRAVDOC FLAT RATE 1. 00 44 . 00 0. 00 44 . 00 0 .00 ------ ---- ---------- ---------- ---------- TOTAL PERMIT 91.5 . 00 0. 00 915. 00 0 . 00 • CITY OF CUPERTINO ITEM 1 OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32609065 .00 DATE ISSUED. . . . . . . : 11/07/2011 RECEIPT #. . . . . . . . . : BS000015248 REFERENCE ID # . . . : 11110023 SITE ADDRESS . . . . . : 20900 HOMESTEAD RD SUBDIVISION . . . . . . : CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : PROMETHEUS ADDRESS . . . . . . . . . . : 1900 S NORFOLK ST STE 150 CITY/STATE/ZIP . . . : SAN MATEO, CA 94403 RECEIVED FROM . . . . : MICHAEL FURTADO CONTRACTOR . . . . . . . : BEN REGA LIC # 32275 COMPANY . . . . . . . . . . : MONTEREY CONSTRUCTION COMPANY ADDRESS . . . . . . . . . . : 88 MONTEREY-SALINAS HWY STE A CITY/STATE/ZIP . . . : SALINAS, CA 93908 TELEPHONE . . . . . . . . : (831) 601-2659 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- -ADMIN HOURS 2 .00 82 . 00 41. 00 41 .00 0. 00 1BAPPLOTHE NO OF APPLIAN 2 .00 130. 00 130.00 0 .00 0. 00 1BCBSC VALUATION 20, 000.00 1.00 1.00 0 .00 0. 00 1BREMAIRHA NO.UNITS 1. 00 65.00 65. 00 0.00 0. 00 1BSEISMICR VALUATION 20, 000. 00 2.00 2. 00 0.00 0 . 00 1MPERMITFE FLAT RATE 1. 00 44. 00 44 . 00 0.00 0 . 00 1REMRESKIT SQ FEET 50 . 00 588. 00 588. 00 0. 00 0 . 00 1TRAVDOC FLAT RATE 1. 00 44 . 00 44 . 00 0. 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 956. 00 915. 00 41. 00 0 . 00 •