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07090061
CITE'OF CUPERTINO BUILDmG QIVIS-0N PERMIT S Z PERMIT NO. BUiLf IYG�l�D�tESHOMESTEAD RD BLDG 20 PRO-CRItFT BUILDERS INC 07090061 UU U PERMIT LSSUE DATE OWN E: PROMETHEUS PROPERTIES INC 761 MA13URY RD STE 50 09/14/2007 SANITARY NO. CONTROL NO. )NE: BUILDING PERMIT INFO ARCHITECT/ENGINEER: DECK REPAIR BLDG ELECT PLUMB METH p p LICENSED CONTRACTOR'S DECLARATION Job Description U P I hereby affirm that I am licensed under provisions of Chapter 9(commencing ;Z m with Section 7000)of Division 3 of the Business and Professions Code,and my license is t<y in full force and effec v�Z License Is s Lic.# �;3 gig Z t-tp Date —�uT 427 Contractor Pf o Cf 14 !tl lQ 5 ARCHITECTS DECLARATION J d< 1 understand my plans shall be used as public records )aU ' U.y Licensed Professional y< OWNER-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the :00 following reason.(Section 7031.5,Business and Professions Code:Any city or county $ which requires a permit to construct,alter,improve,demolish,or repair any structure Z} prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation < that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter9 3q.Ft. Floor Area 2 F (commencing with Section 7000)of Division 3 of the Business and Professions Code)or 9 that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not more than five hundred dollars(5500). ❑1,as owner of the property.or my employees with wages as their sole compensation, will do the work,and the structure is not intended oroffered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business and Professions Code:)The Contractor's U- ccnae law does not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law. ❑1 am exempt under Sec. B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑i have and will maintain a Certificate of Consent to self-insure for Workers Compen- sation,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 required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Workers Compensation Insurance carrier and Policy number are: Carrier. EA t AMA Fit`L Policy No.:W 61 ERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must ,J O forthwith comply with such provisions or this permit shall be deemed revoked. Z " CONSTRUCTION LENDING AGENCY [~i C'n I hereby affirm that there is a construction lending agency for the performance of 04 > the work for which this permit is issued(Sec.3097,Civ.C.) VJ Q Lender's Name a,z Lender's Address U 0 1 certify that I have read this application and slate that the above information is iLcorreel.I agree to comply with all city and county ordinances and state laws relating to UUbuilding construction,and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. Date r—+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by �- iT7 SOURCE REGULATIONS. A,4*f X. -0 I-N-e7 Re-roofs Signature of Applicant/Contractor Date Type Of Roof HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupantstore or handle hazardous material as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Cole,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes Will the applicant or future building occupant use equipment or devices which If a roof i;installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new rr aterials for inspection. District? ❑Yes QNu I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Cade,Sections 25505,25533 and 25534.1 understand that if the building docs not currently have a tenant,that it is my responsibility to notify the occupant of Ute requirements which must be met prior to issuance of a Certificate of Occupancy. Signature of Applicant Date 6-z.i oZ �,� 1-114^h-) All roof coverings to be Class"B"or better Owner or authorized agent Datc CITY OF C'UPERTINO 0709 004o l WIFF PERMIT APPLI[CATION FORM CUPEkINO ON# o� (P O R O 51p 't l l Date: ' 7 Building Address: 4Z Mailing Address (if different from building address): Owner's Name: Phone#: Contractor: License #: F(-t, --G R A F4 C �- Contact, Phone: Cupertino Business License#: 13 N-L Fax: *1 - I - Icy 3 Iq Building Permit Info: Bldg Elect ❑ Plumb ❑ Mech ❑ Job Description: -Vie-;4 R EPR i R AP+1 Residential ❑ Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: 11 &C>0 Occupancy Group: > -L-� Type of Construction: Please checkthis box if the project is a second-story addition: ❑ Project Size: Standard ❑ Large ❑ Major ❑ Quantity Fee ID -Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boilor> 500K to 1M Btu MECHANICAL BBOILER4 Boile-> 1M to 1.75 M Btu MECHANICAL BBOILER5 B)iler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX In(VOff/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC 1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA -nvestigation fee BUILDING 1 of 3 CITY OF CUPERTINO CUPEI�F PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rm 11 Signs Add Branch ELECTRICAL BREMSIGNS Rerr.odel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL �,pecialInspection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Tem rary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC --lectrical sq foot ELECTRICAL EPERMITFEE Ekc Permit Issuance ELECTRICAL MPERMFEE Afechanical sq. foot MECHANICAL MPERMITFEE Meeh Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING ---PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING 3 :)f 3 CITY OF CUPERTINO 2 ITEMS OF 10 PERMIP RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . . 32609056.11 DATE ISSUED. . . . . . . : 09/14/2007 RECEIPT #. . . . . . . . . : BS000002647 REFERENCE ID # . . . : 07090061 SITE ADDRESS . . . . . : 20800 HOMESTEAD RD BLDG 20 #I& SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : PROMETHEUS PROPERTIES INC ADDRESS . . . . . . . . . . : 20800 HOMESTEAD RD # 20 CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : PRD-CRAFT BUILDERS CONTRACTOR . . . . . . . : BILL L. FEDOR-THURMAN LIC # 28938 COMPANY . . . . . . . . . . : PRO-CRAFT BUILDERS INC ADDRESS . . . . . . . . . . : 761 MABURY RD STE 50 CITY/STATE/ZIP . . . : SAN JOSE, CA 95133 TELEPHONE . . . . . . . . : (408) 441-1301 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 7, 600. 00 147 .96 0. 00 147 .96 0. 00 BSEISMICRE VALUATION 7, 600. 00 0 .80 0. 00 0.80 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT 148.76 0. 00 148.76 0. 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 101 FOUNDATION 102 PIERS 103 UFER 104 REBAR 105 ANCHOR BOLTS 106 SEWER & WATER 202 UNDERFLOOR PLUMBING 203 UNDERFLOOR MECHANICAL 204 UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION 301 ROUGH PLUMBING 302 TUB & OR SHOWER 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 305 FRAME 306 HOLDOWNS 307 INSULATION 308 SHEETROCK 309 EXTERIOR LATH 310 INTERIOR LATH 311 SCRATCH COAT 313 ROOF NAIL r Community Development 10300 Torre Avenue }' Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 `UPEkTIN0 Building Department JOB ADDRESS: PERMIT # .:20g00 �ko*tk5fg Al, Lb "Zo 6-70gCD& OWNER'S NAME: }lest PHONE # Alo,j- i-13© 1 GENERAL CONTRACTOR: -Fro —e-rR r-+ FAX# O _1141 q i -I5y I am not using any subcontractors: . _ -Q.�,oz-. -- -/�/-e7 Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical 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 Owner/Contractor Signature Date