08040070 CITY OF CUPERTINO +%s 7A
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BUDUbINGDIVISION PERAU
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PERMIT NO.
BG`115p.Ap"FkEVENS CREEK BLVD APT ORION FINANCIAL SERVICES 08040070
u N is U PERT ISSUB DATE
OW AME: MI
PROMETHEUS REAL ESTATE GROUP PO BOX 693 04/09/2008
NE: SANITARY NO. CONTROL NO.
(916) 789-8484
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
300 LICENSED CONTRACTOR'S DECLARATION IObD SCrI non
4 ff 1 tachy ar bas that 1 am licensed under pmvi dare of Chapter 9(commencing p
with Southern 7003)o(Division Jargon Business and Pmfcaiom Code,and my license is WSHR&DRYR RTROFTS,KTCH&BTH CBNT&CNTRTP
^ in full fano and cRat
unnheclasa ata.. UPGRD,DUCTLS SPLT SYS,'HVAC RTRFT
Dem Conuacmr
3
ARCHITECTS OECIwRKrION
1 I und¢raand my pilots Shall he used as public roads .
yQ�n Licensed Pmfeacional -
3 OWNER-BUILDE0.m Ce Contractors
ON
COs I hereby affirm bol 1 1. esempt from the Cssrom;Co License law for the
COD wicfallowing won.(Salton 7W 1.5.Business;and
pr Pmhda odi Cade:Any city or county
3$ which its cent•centered.
re u irenct alter,ho Prow,demur W,ri gams any wmmum
prior bitslensedprhnal to rees thcappnahef for such permit mfileasigned Chap=9
2y�< that he is licensed witputhemt to the of Division
of the Connector'.Veuve Law(Chadtm9 SG.F[.Floor Area 3900 Valuation
9
(commencing e is wag with Sccoon 7.4 the
basis f r of the Business and Profession Cade)Or
B 8 bathe 7 31.5 b any applicant,
and Ne hula fm gm alleged ewnptlon Any violnall,of
.1me7413T,snartybed dhetrs(apeamhhebjav the.ppliahetmadv1l pensuy of Number - Occupancy Type
detmermthhenwbmdeadalWa(ssom 36901026
❑I.a owuer of the property.Or my emplayees with wages as their sale compenadon,
will do the.4.send w rmeture b Out intended or offered turmer(Sec.704th,emw
inRequired Inspections
and Proresaterns Cada:The conuacter's Licrnsa Law does nut apply m e an Owner err 9 p
property who bulWa orienpraten thrown.and whodoman ch wok hit"fm Wough his --
awnanploym s,provided that each improwmnLL sm Out intended moBmrb Is,axle If.
haaeser,the building Or impromm ent is held within ore yew of mmpledon.the Owmr-
builder wilt haw the Ouadcn of proving that M did not Wild or Impmw for purpose of
"to.).
1,u order of the Property ern m elurinly contracting with Ilcenseel cenaactna in
catmmm the projacs(Sec TDee,Bueinm am Profession Code)Toe Couw.note U.
access Law Occur mat apply as an Owder Of property was,builds Of hnpmws dmw.and.
who aontracLL for such son m.,with a nntrumr(s)licensed punnnt b the Conuamor's
License Law.
❑Tom neapt under Sac .B d P C for this maven
Owuer Due—
WORKERS COMPENSATION DECLARArION
aeWORKER9COMPENSATIONDECLARATION
1 hemby affnm under penalty of peQury arm of the following hcW Wmu:
maintain and will mainn a CeriBom m ofCOnsent self-Inure for Workaea Compmt-
n,u provided for by Salton 3700 Of dm Labor Code,far the performance Of the
for which this permit is Issued.
❑I have and will maintain Worker's Compensation Insurance,as nyuied by Second
3700 of the lather Code.for the Performance of thea woda for which this permit is seemed.
My WarkeM1 Compensation Inuahece carrier ad Policy number art:
Cwafer: Policy NO.:
CERTIFICATE OF EKEhIPTON FROM WORKERS'
COMPENSATION INSURANCE
Crisis second reed not beconpleted If nm permit is(mune hundmddo fare($1410)
or Ims)
I unify that In the performance of be work for which this permit LL issued.I Nall wt
cmplay any Person In any mMlmfm a ad Wmernua subject to dCWaakafe'GmnpCltLdon
Laws Of California.Dae
Applicant
NOTICE TO APPLICANT:If,mese,making this Cartifinm of Eaeapnan,you should
become subject in the Woho's Composition provision,of me tabor Code,you atm
ZfOdhwith comply with such premiaton or bat permit Nall M domed mooted.
O
Z C CONSTRUCTION LENDING AGENCY
[-. I hereby of iron draw them is a construction lending agency for the Performance of
Nrthe work for which this permit LL issued(Sec,3197,Civ.C.)
W� Lender's Name
OZ lender's Adder
V O 1 ceNfy bon 1 law:read this appliamm and team that the show infmmadon is
Iy correct.lag=in comply with all city and county ardinamea and sme laws elating b
building construction,and hemby wbmim epewnetives of this city to cams upon IN
W aroma-mentioned property fur inpecdon purposes
Ly,,gy (We)agree to an.indemnify and keep hannkw the City of Cupertino against
I..,VI Isabslige;JWgmenu,cOW and expenes which may In anywaysconm againt a id City
t, in consequadee of the aaanling Of this Permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
Re-roofs
Si{datum of ApplinHAZAR O Data
HAZARDOUsMATERIALS DIS
arx,ar URE Type of Roof
Will dm a C�pon or mfotum opal Ca e.Chapter
nand m hisaadou material
u donned by the CupeNno Municipal Code.Qapmr 9.11,hen the Health and Safety
Cade,Section 153320)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yes ❑NO
Will be a"Ilm,or future building oceupmo rte equipment Or devices which If a roof is installed without firs[obtaining an inspection,I agree to remove
t hwasom.air mmmbads ss derided by the Bay Amo Air Quality Mwagcmcnt all new materials for inspection.
ronbol
❑Yes ONO
I sow read the hanrdau material,requirements under hipter6.95oftheC.Ifar-
nuHcal"SafetyCode.Section 25505,25533 am125534.1 undersand that if use building
dm Out currently haw a u nwn,bat it W my responsibility m notify the occupant of arm
requirements which mntbe=Ipoor to issuance erfaCanlrmateofOccupancy. Signature of Applicant Date
Owner or womized agent Dam' All roof coverings to be Class'W'or better
CITY OF CUPERTINO
® 8 ITEMS OF 8 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36901026 .315
DATE ISSUED. . . . . . . : 04/09/2008
RECEIPT # . . . . . . . . . : BS000004432
REFERENCE ID # . . . : 08040070
SITE ADDRESS . . . . . : 20380 STEVENS CREEK BLVD APT 3
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : PROMETHEUS REAL ESTATE GROUP
ADDRESS . . . . . . . . . . : 1900 S NORFOLK ST STE 150
CITY/STATE/ZIP . . . : SAN MATEO, CA 94403
RECEIVED FROM . . . . : ORION FINANCIAL SER
CONTRACTOR . . . . . . . : STEVE WHITESIDES LIC # 29564
COMPANY . . . . . . . . . . : ORION FINANCIAL SERVICES
ADDRESS . . . . . . . . . . : PO BOX 693
CITY/STATE/ZIP . . . : ROSEVILLE, CA 95678
TELEPHONE . . . . . . . . : (916) 789-8484
OFEE ID UNIT----- QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 3, 900. 00 0 .50 0. 00 0. 50 0. 00
IELECINSP HOUR 1. 00 122 .38 0. 00 122 .38 0. 00
1EPERMITFE FLAT RATE 1. 00 40.79 0. 00 40.79 0. 00
1MECHINSP HOUR 1 . 00 122 .38 0. 00 122 .38 0. 00
IMPERMITFE FLAT RATE 1 . 00 40.79 0. 00 40 .79 0. 00
1PLMBINSP HOURS 1 . 00 122 .38 0. 00 122 .38 0. 00 ,
1PPERMITFE FLAT RATE 1. 00 40.79 0. 00 40.79 0. 00
1TRAVDOC FLAT RATE 1. 00 40.79 0. 00 40.79 0. 00
------ ---------- ---------- ----------
TOTAL PERMIT 530.80 0. 00 530. 80 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 530 . 80 AMEX
---------------
TOTAL RECEIPT 530 . 80
CITY OF CUPERTINO BUILDING PERMIT APPLICATION
• E-Mail ORIONOSUREWEST.NET
Jobsite Address: 20380 STEVENS CREEK BLVD Date:314/08
APT 315
Owners Name:PROMETHEUS REAL ESTATE GROUP
Phone No.:(408)253-7100
APN#: 389-01-028 .?/5 Project Valuation: $3900.00
Big. Permit Information: Bldg. ■ Elec.■ Plumb.■ Mech.•
JOB DESCRIPTION
Washer and Dryer Retrofits; Kitchen and Bath cabinet and counter-
top upgrade. Ductless split system;HVAC Retrofit.
CONTRACTOR INFORMATION
Company;ORION DEVELOPMENT Phone:(9181 789-8484
• Contact Name:STEVE WHITESIDE$ Fax:(918)789-1051
Address: P.O. BOX 893
City, State, and Zip:Rosevllle. CA 95878
State Contractors License: 747992 Exp. Date:9-30-2009
Workers Comp.*: 238-0002445-07 Carrier:STATE FUND Exp. Date: 4-1-2009
Cupertino Business License#:
CREDIT CARD INFORMATION
Credit Card#.
Name on Card: Orion Financial Services Inc.
Expiration Date: pt Ito
Visa 0 MasterCard 13 Discover 0 American Express■
Eile' �dit'',gcbons,Petailsj Viinks jelp
• , ,
P 'i"(P�{G Ln .. i` Nrl pl � .. ::jt �'1 1� It � • °
Permit Information
I Permit Number 08040070 Status. Open
� . 369010263 L_7 uv ._•�7,J
I Adiiress f j,fi�',• 20380-STEVENS CREEK BLVD'APT'315
Own'ei Name PROMETHEUS REAL ESTATE GROLI
Fee ID, •1 Contractor IQt ,•i ;i Units IQuantity, • , Fee Amount To,
Fee
1ELECINSP HOUR 1.00 122.38 CIO
a 1EPERMITFE FLAT RATE 1.00 40.79
n
1MECHINSP HOUR 1.00 122.38 ' Tot
y
1MPE44ITFE FLAT RATE 1.00 40.79
•1 ..............._.._.............. .._._..._.._...__....__._.... - — �.
1PLMBINSP __ HOURS 1.00 122.38
1PPERMITFE FLAT RATE 1.00 40.79
1TRAVDOC FLAT RATE 1.00 40.79 „,f
M
After Fact—
Feelnformationx , ICreddlnformation —
` AftetFactG
Yeelnformation
it { M,7711-77 T 7 Multiplier, 1 OOj
i 1 eelDWN 4
� 1BSEISMICf1 SEISMIO'RESIDENT'IAL r '"
Units VALUATION' j Cont.,
ani
< Quantity 3900100
1,
I, r r :
FeeA oun .5011
11. Contractor ID
•
Pt•rmil rites
es
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