12030041 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20900 HOMESTEAD RD CONTRACTOR:MONTEREY PERMIT NO: 12030041
CONSTRUCTION COMPANY
OWNER'S NAME: VS II LP Sri MONTEREY-SALINAS HWYSTE A DATE ISSUED:031098012
OWNER'S PHONE: 6509313400 SALINAS,CA 93903 PHONE NO:(831)601-2659
❑ LICENSED CONTRACTOR'S DECLARATION r_ r r.
� � BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class__ Lie.q
//11 M1IECH r RESIDENTIAL r COMMERCIAL r
Contractor CQ Date '-"
hereb) affirm Char I ardlicensed under the provisions of Chapter 9 JOB DESCRIPTION: BLDG 75-UNIT 1-INSTALL NEW WASHEWDRYER AND
(commencing with Section 70001 of Division 3 of the Business S Professions A7C.REMODEL EXISTING KITCHEN(50SQFT)
Code and chat my license is in full force and effect.
1 hereby affirm under penalty of perjury one of the following two declarations:
I have mid will maintain a cenifieme of consent in self-insure for Worker's
Compensation,as provided for by Section 3700 of rhe Lahr Code,for the
performance of the work for which this permit is issued.
(have and will maintain Worker's Congxnsation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$20000
Section 3700 of the Labor Code.for the performance of die work for which this
pemrit is issued.
APN Number.32(+09072.00 Occupancy Type:
APPLICAN'r CERTIFICATION
I cenify that I have read this application mid state(fiat the above infomtation is
correct. I agree to comply with all city and county ordinances mid state laws relating
to building construction,and hereby authorize representatives of(his city to enter PERMIT 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, WITHIN 18O DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION.
granting of this pemrit. Additionally,the applicant understands mid will comply
with all non-point source regulatims per the Cupertino Municipal Code.Section
9.13. Issued by: /f /1� /7�Gf7 Date: 3• `�-/�
SignatureDate 3-J��
❑ OWNER-BUILDER DECLARATION RE-ROOFS:
All roofs shall be ingxcled prior to my roofing material beimg installed.If a roof is
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of installed w4hour first obtaining an inspection,I agree to remove all new materials for
the following ono reasons: inspection.
1,as owner of the property,or my employees with wages as their sole compensation.
will do die work,mid the structure is not intended or offered for sale(Sec.7044, Signature of Applicant: Date:
Business R Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to
construct die project(Sec.7044,Business R Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
hereby affirm under penalty of pet-jury one of(lie following three
declarations: HAZARDOUS MATERIALS DISCLOSURE
I have mid will ntainmin aCenifi.ate of Consent to self-insure for Workers I have read(lie hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Heallf,C Safety Code.Sections 25505.25533.and 25534. 1 will maintain
perfonnance of the work for which(his permit is issued. compliance with the Cupertino Municipal Code.Chapter 9.12 and the Health d
I have mid will maintain Worker's Compensation Insurance,as provided for by Safety Cade.Section 25532(x)should I store or handle ha tardaus material.
Section 3 700 of the Labor Code,for Ilse perfommnce of the work for which(his Additionally,should I use equipment or devices which emit hazardous air
Permit is issued. comanduants as defined by(tie Bay Area Air Quality Management District 1 will
maintain compliance with the Cupertino Municipal Cude,Chapter 9.12 and the
I certify dim in the perfonnarce of(he work for which(his pernit is issued,I shall Health R Safety Code.Sections 25505,25533.and 25534.
not employ any person in my insurer so as to become subject to the Worker's
Compensation laws ofCalifomia. (f,after making this ceniricate of exemption,I Owner or guillpriY ger
become subject to the Worker's Compensation provisions of the Labor Code-I mus( Dale° _9
tordiwi(h comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I hereby affirm[fico there is a construction lending agency for the performance of work's
I certify(hat I have read(his application and state that the above information is for which this pemti(is issued(Sec.3097.Civ C.)
correct I agree to comply with all city and county ordinances and state Imus relating Lender's Name
to building concoction,mid hereby authorize representatives of this city(o enter
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address
indemnity and keep harmless the City of Cupertino against Iiabilities,judgnien(s,
costs,aid expenses which may acerae against said City in consequence of(he ARCHITECT'S DECLARATION
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.13.
Licensed Professional
Signature Date
03/08/2012 09 : 19 (FA%) czU3P.pO?/002
I
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO.CA 95014-3255
CUPERTIN0 (408)777-3228 • FAX(408) 777-3333 • buildingO.CUperlinoom
❑NEW CONSTRUCTION ❑ ADDITION _ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT If
rxaecrnuoRess Urv`_
APN• p �J
OWNERNAME
1�rom \-AWS �rzGJL 'cS}c.,le _ r»ONE
STB[LTAUDR[55 - CITY,STATE;LIP -
Ic�O S. C1—1 `'\�l`1�3 FAX
-PHONE + E-MAIL
.✓1
STREETADDRESS Gi`.\S'�-�UCi4�W.r-��•�
/Y CITI',STATE. ZIP rr
\"f-v-,NAC(' FAX
-- "3, VSS-1f-ieb1�.
❑OWNER ❑ OWNER-BUILDER }',D,OWNERAGIWF - (CONIRALTOR ❑CONTRACPORAGPNT ❑ nRCIHTECT: ❑ENONEER ❑ DEvUWPER ❑TENANT
CONPRACPOR NAME —
LICETlSE NUMBER'
2rz[Jcx... .. 4555?S1 I uccvsP,1;YPE Bus.uc r
� -22-2
COMPANY NAMEf: El.UIL -
mo,�\-¢}_I -1-k., can }1-�cJ.i�',-Iw.. I FAX lt3.)
STREET ......... ..•..,...:.... CITY STATE,ZIP .j• C.nrc,4-o�ckS.� i t'�'^ PfiO EC`f3'��C-•moi •+
55 6 T`r'1o, I er' ..�- ' n...s %Ak . Y, Y-A Sr-..sL:,r.c.S
nRCHITECMNOMEER NAME '
• � 1�� --- �����- � LICENSENUMDER
/J .. .. .. ._.I r. BUS.LIC M...
COFIPANYNAME ... . .. .. _ ..E-MAIL- - .. FAX
STREET ADDRESS' ..... :.,. :.. .... . _ .CITY,STATE.ZIP-
PHONE-
DESCRIPTION Of WORK �- � :•
\,'.c 6C er e,c•.Lxt�o r� Clvse>kI \G -;-
'.4. Sc�s1 .i(-i
' a3,'i, l"lPI\SI \( h-\-s \/GSZuG�Q-;Gv1.,-. J2C1p '1�.co
EXISTING U56 PROPOSID USE GDNSRL TYKE. •gSTORIES ��.1,NII1�1( s1(IGt11�'A�d1. ���l Mi 1YIlYI1P1 IIW 11 Na111!]ETaIYli"II"N
• ' 1 ! IfY•Y '1111I'11 r� llll l /ill 111'41111 K1 YJ;T1tIY 1I�•�{}' /(
EXISTG NALCPLOtlI UMLF'O -' TOTAL. IIJtC�I ' nl�Iljl7k�M,Cl IfN1��tl(III�I Y In'U 11� 11� �
naEw NEr.Yx,� p1'1LVI� a 44tT 1I,r
BATHROOM
RFMODELARF.A . IODELARFA � 0.ENODELARCA: NQ)IW.
tlI'r�SCr' sA!(
rORCI1 AREA DECKAREA. TOTALDECK/PORCIIAREA GARAGE AREA:1. .ODLTACII 1'114 ' 1 yIIP �p{�j�{Ifa III 3�y`tF I Ii�'�.
aWILLINO UNOS: - ATTACIL 11� ill �1��I�� A/I C'�IfA �Ir 541 � � IIrN E-0A91
INANICeN)UMT I]YFS FCIOMI 106Y YFS }'I I '1'. 11 1 1
'u. I I l6 i C ),r' � 11 '!° hp'��� 1r9f M1>I�t,I aif
Y
ouNenooenr r+_a wmnarir m ' IS5i JI I � krr4l dP 4tls I� 'InyJ kl
11 0. �A a1�4 11 I v 1 I/ A I L�jEIu�,.x`d9s
rRE.MILKwIgN ❑yg pYQI1IWm9 CDIY0r rUM1NE1lS M1AY£ 4YI IM VMy
Pfwnano Ara.. O OG co Y f 1Y Sir I er 1 r I-0>- ' r
NO IIANNLVO MIFOVALItTTFJt 1 IR �� • T fl {I I r r1>r b�gLlvA l'lo`i J+S
By my signature below,I ecnify.to each of dm fallowing:. I am the property owner or avithorizid agent to act on the properly owner's behalf. 1 have icad Ihis
application and the infomtation I have p vi
ordinances and statal is correct: I have read the Description of Work and verify it is accurst, I agree to comply with all applicable local
e laws relating I 'di g conslruction..1 authorize represcnmfivcs ofCupmino to enter the above(Ifi�cn-t/ifi 1property for inspection purposes.
Signalumof Applicant/Agent:
Date a
\NCPCI T 11.
O6TI\1G-:L'IF.
SUPPLEMENTAL INFOIL�f 'REQUIRED 4,1
.,
Ncw SPDor Mullifaililydwell Ulgs: Apply;fordemohlion pem»t-for •F(Is IPI ill';mraYfi'rL'ItufJ
existing building(s)..Demolition pomlil is iepiredwpnor to Issuanie of bwklilig III / / ����'ty'tryirVl o,1GNirr11 �11; 1'1l]2+D it r I dnNlxEvrtw
41��' 1 \ I [ t ci rfiP• I l 111rw t 1>,'>t_ Ir
pennif for new building.,
gcompleted ...... . .._ .r�MI D1r11FY�IliVSIF hf'flrl � ryry..�I, _•' ` 't's�I L,11 tiR+d+.fs�.,w,� - , 'j
_Commercial Bldgs: PiovtdL'a 9Sd.ris'Haza Bos Materials-Disclosure-•; Lyda AOAKD p,111,1 fl'y71)DlkrUu,Lla DxKS iqt f'•
form if any FlazardousTVlatenals arc being used as pari df thus projeci +fin ,' 9N I SIL 11I�Nr 'rat �p `I r Ir� yllnr I r
1 ,xde lJlne ,p 1111 Nqqff , ''laf '' h
r.n/ Li.}'IRt D PTy1i T� !
_Copy of Planting Approval Lellcr or Mceung with Planning pnor to 1 41 I! rr�l I�IIII�! Ikr� II I �) I�h''I nr ' ,�t�`�,i1y�tt rri'I 7h�j4
submittal of Building PcrmiI application -• yo 1,tn' R1�+ , I; I IlO snNITnR�sew� �in�TlUcr r}
' .. '.nlllLl` Ir�I IJ �I� I� 111\1f� II IIJ� 51k�,' P H.I u IiT�lji
. : ••.• I '..• •. '• ` 4�I'+'1R'� �4m1� illy: p IiQnEh�VIRONMtIyNTA1:r11Rnunr. ..�-'c
.. Bld A
_ % PP`IOf/:doe.-e�lsed(13/lh///
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20900 HOMESTEAD RD CONTRACTOR:MONTEREY PERMIT NO: 12030041
CONSTRUCTION COMPANY
OWNER'S NAME: VS II LP Sri MONTEREY-SALINAS HWYSTE A DATE ISSUED:031098012
OWNER'S PHONE: 6509313400 SALINAS,CA 93903 PHONE NO:(831)601-2659
❑ LICENSED CONTRACTOR'S DECLARATION r_ r r.
� � BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class__ Lie.q
//11 M1IECH r RESIDENTIAL r COMMERCIAL r
Contractor CQ Date '-"
hereb) affirm Char I ardlicensed under the provisions of Chapter 9 JOB DESCRIPTION: BLDG 75-UNIT 1-INSTALL NEW WASHEWDRYER AND
(commencing with Section 70001 of Division 3 of the Business S Professions A7C.REMODEL EXISTING KITCHEN(50SQFT)
Code and chat my license is in full force and effect.
1 hereby affirm under penalty of perjury one of the following two declarations:
I have mid will maintain a cenifieme of consent in self-insure for Worker's
Compensation,as provided for by Section 3700 of rhe Lahr Code,for the
performance of the work for which this permit is issued.
(have and will maintain Worker's Congxnsation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$20000
Section 3700 of the Labor Code.for the performance of die work for which this
pemrit is issued.
APN Number.32(+09072.00 Occupancy Type:
APPLICAN'r CERTIFICATION
I cenify that I have read this application mid state(fiat the above infomtation is
correct. I agree to comply with all city and county ordinances mid state laws relating
to building construction,and hereby authorize representatives of(his city to enter PERMIT 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, WITHIN 18O DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION.
granting of this pemrit. Additionally,the applicant understands mid will comply
with all non-point source regulatims per the Cupertino Municipal Code.Section
9.13. Issued by: /f /1� /7�Gf7 Date: 3• `�-/�
SignatureDate 3-J��
❑ OWNER-BUILDER DECLARATION RE-ROOFS:
All roofs shall be ingxcled prior to my roofing material beimg installed.If a roof is
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of installed w4hour first obtaining an inspection,I agree to remove all new materials for
the following ono reasons: inspection.
1,as owner of the property,or my employees with wages as their sole compensation.
will do die work,mid the structure is not intended or offered for sale(Sec.7044, Signature of Applicant: Date:
Business R Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to
construct die project(Sec.7044,Business R Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
hereby affirm under penalty of pet-jury one of(lie following three
declarations: HAZARDOUS MATERIALS DISCLOSURE
I have mid will ntainmin aCenifi.ate of Consent to self-insure for Workers I have read(lie hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Heallf,C Safety Code.Sections 25505.25533.and 25534. 1 will maintain
perfonnance of the work for which(his permit is issued. compliance with the Cupertino Municipal Code.Chapter 9.12 and the Health d
I have mid will maintain Worker's Compensation Insurance,as provided for by Safety Cade.Section 25532(x)should I store or handle ha tardaus material.
Section 3 700 of the Labor Code,for Ilse perfommnce of the work for which(his Additionally,should I use equipment or devices which emit hazardous air
Permit is issued. comanduants as defined by(tie Bay Area Air Quality Management District 1 will
maintain compliance with the Cupertino Municipal Cude,Chapter 9.12 and the
I certify dim in the perfonnarce of(he work for which(his pernit is issued,I shall Health R Safety Code.Sections 25505,25533.and 25534.
not employ any person in my insurer so as to become subject to the Worker's
Compensation laws ofCalifomia. (f,after making this ceniricate of exemption,I Owner or guillpriY ger
become subject to the Worker's Compensation provisions of the Labor Code-I mus( Dale° _9
tordiwi(h comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I hereby affirm[fico there is a construction lending agency for the performance of work's
I certify(hat I have read(his application and state that the above information is for which this pemti(is issued(Sec.3097.Civ C.)
correct I agree to comply with all city and county ordinances and state Imus relating Lender's Name
to building concoction,mid hereby authorize representatives of this city(o enter
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address
indemnity and keep harmless the City of Cupertino against Iiabilities,judgnien(s,
costs,aid expenses which may acerae against said City in consequence of(he ARCHITECT'S DECLARATION
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.13.
Licensed Professional
Signature Date
03/08/2012 09 : 19 (FA%) czU3P.pO?/002
I
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO.CA 95014-3255
CUPERTIN0 (408)777-3228 • FAX(408) 777-3333 • buildingO.CUperlinoom
❑NEW CONSTRUCTION ❑ ADDITION _ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT If
rxaecrnuoRess Urv`_
APN• p �J
OWNERNAME
1�rom \-AWS �rzGJL 'cS}c.,le _ r»ONE
STB[LTAUDR[55 - CITY,STATE;LIP -
Ic�O S. C1—1 `'\�l`1�3 FAX
-PHONE + E-MAIL
.✓1
STREETADDRESS Gi`.\S'�-�UCi4�W.r-��•�
/Y CITI',STATE. ZIP rr
\"f-v-,NAC(' FAX
-- "3, VSS-1f-ieb1�.
❑OWNER ❑ OWNER-BUILDER }',D,OWNERAGIWF - (CONIRALTOR ❑CONTRACPORAGPNT ❑ nRCIHTECT: ❑ENONEER ❑ DEvUWPER ❑TENANT
CONPRACPOR NAME —
LICETlSE NUMBER'
2rz[Jcx... .. 4555?S1 I uccvsP,1;YPE Bus.uc r
� -22-2
COMPANY NAMEf: El.UIL -
mo,�\-¢}_I -1-k., can }1-�cJ.i�',-Iw.. I FAX lt3.)
STREET ......... ..•..,...:.... CITY STATE,ZIP .j• C.nrc,4-o�ckS.� i t'�'^ PfiO EC`f3'��C-•moi •+
55 6 T`r'1o, I er' ..�- ' n...s %Ak . Y, Y-A Sr-..sL:,r.c.S
nRCHITECMNOMEER NAME '
• � 1�� --- �����- � LICENSENUMDER
/J .. .. .. ._.I r. BUS.LIC M...
COFIPANYNAME ... . .. .. _ ..E-MAIL- - .. FAX
STREET ADDRESS' ..... :.,. :.. .... . _ .CITY,STATE.ZIP-
PHONE-
DESCRIPTION Of WORK �- � :•
\,'.c 6C er e,c•.Lxt�o r� Clvse>kI \G -;-
'.4. Sc�s1 .i(-i
' a3,'i, l"lPI\SI \( h-\-s \/GSZuG�Q-;Gv1.,-. J2C1p '1�.co
EXISTING U56 PROPOSID USE GDNSRL TYKE. •gSTORIES ��.1,NII1�1( s1(IGt11�'A�d1. ���l Mi 1YIlYI1P1 IIW 11 Na111!]ETaIYli"II"N
• ' 1 ! IfY•Y '1111I'11 r� llll l /ill 111'41111 K1 YJ;T1tIY 1I�•�{}' /(
EXISTG NALCPLOtlI UMLF'O -' TOTAL. IIJtC�I ' nl�Iljl7k�M,Cl IfN1��tl(III�I Y In'U 11� 11� �
naEw NEr.Yx,� p1'1LVI� a 44tT 1I,r
BATHROOM
RFMODELARF.A . IODELARFA � 0.ENODELARCA: NQ)IW.
tlI'r�SCr' sA!(
rORCI1 AREA DECKAREA. TOTALDECK/PORCIIAREA GARAGE AREA:1. .ODLTACII 1'114 ' 1 yIIP �p{�j�{Ifa III 3�y`tF I Ii�'�.
aWILLINO UNOS: - ATTACIL 11� ill �1��I�� A/I C'�IfA �Ir 541 � � IIrN E-0A91
INANICeN)UMT I]YFS FCIOMI 106Y YFS }'I I '1'. 11 1 1
'u. I I l6 i C ),r' � 11 '!° hp'��� 1r9f M1>I�t,I aif
Y
ouNenooenr r+_a wmnarir m ' IS5i JI I � krr4l dP 4tls I� 'InyJ kl
11 0. �A a1�4 11 I v 1 I/ A I L�jEIu�,.x`d9s
rRE.MILKwIgN ❑yg pYQI1IWm9 CDIY0r rUM1NE1lS M1AY£ 4YI IM VMy
Pfwnano Ara.. O OG co Y f 1Y Sir I er 1 r I-0>- ' r
NO IIANNLVO MIFOVALItTTFJt 1 IR �� • T fl {I I r r1>r b�gLlvA l'lo`i J+S
By my signature below,I ecnify.to each of dm fallowing:. I am the property owner or avithorizid agent to act on the properly owner's behalf. 1 have icad Ihis
application and the infomtation I have p vi
ordinances and statal is correct: I have read the Description of Work and verify it is accurst, I agree to comply with all applicable local
e laws relating I 'di g conslruction..1 authorize represcnmfivcs ofCupmino to enter the above(Ifi�cn-t/ifi 1property for inspection purposes.
Signalumof Applicant/Agent:
Date a
\NCPCI T 11.
O6TI\1G-:L'IF.
SUPPLEMENTAL INFOIL�f 'REQUIRED 4,1
.,
Ncw SPDor Mullifaililydwell Ulgs: Apply;fordemohlion pem»t-for •F(Is IPI ill';mraYfi'rL'ItufJ
existing building(s)..Demolition pomlil is iepiredwpnor to Issuanie of bwklilig III / / ����'ty'tryirVl o,1GNirr11 �11; 1'1l]2+D it r I dnNlxEvrtw
41��' 1 \ I [ t ci rfiP• I l 111rw t 1>,'>t_ Ir
pennif for new building.,
gcompleted ...... . .._ .r�MI D1r11FY�IliVSIF hf'flrl � ryry..�I, _•' ` 't's�I L,11 tiR+d+.fs�.,w,� - , 'j
_Commercial Bldgs: PiovtdL'a 9Sd.ris'Haza Bos Materials-Disclosure-•; Lyda AOAKD p,111,1 fl'y71)DlkrUu,Lla DxKS iqt f'•
form if any FlazardousTVlatenals arc being used as pari df thus projeci +fin ,' 9N I SIL 11I�Nr 'rat �p `I r Ir� yllnr I r
1 ,xde lJlne ,p 1111 Nqqff , ''laf '' h
r.n/ Li.}'IRt D PTy1i T� !
_Copy of Planting Approval Lellcr or Mceung with Planning pnor to 1 41 I! rr�l I�IIII�! Ikr� II I �) I�h''I nr ' ,�t�`�,i1y�tt rri'I 7h�j4
submittal of Building PcrmiI application -• yo 1,tn' R1�+ , I; I IlO snNITnR�sew� �in�TlUcr r}
' .. '.nlllLl` Ir�I IJ �I� I� 111\1f� II IIJ� 51k�,' P H.I u IiT�lji
. : ••.• I '..• •. '• ` 4�I'+'1R'� �4m1� illy: p IiQnEh�VIRONMtIyNTA1:r11Rnunr. ..�-'c
.. Bld A
_ % PP`IOf/:doe.-e�lsed(13/lh///