Loading...
07090067 CITY OF C-UPERTINO BUILDING DIVISION PERMIT PERMIT NO. 2S BU1L1ydAlfl - ES$YOMESTEAD RD BLDG 21 #E PROCRI�FT BUILDERS INC 07090067 L U (J�J t1 PERMIT L5SUEDATE OWNER'S NAME: PROMETHEUS 761 MA13URY RD STE 50 09/14/2007 SANITARY NO. CONTROL NO. NE: BUILDING PERMIT INFO ARCHITECT/ENGINEER: DECK REPAIR BLDG ELECT PLUMB MECH 0 p p LICENSED CONTRACTOR'S DECLARATION Job Description u K I hereby affirm that I am licensed under provisions of Chapter 9(commencing Z w with Section 7000)of Division 3 of the Business and Professions Code,and my license is 110- in full force and effect. g v�Z License Class Lie.l►_ t—w DateIa_ARCHITECT'S DECLARATION AFS .t jw< l understand my plans shall be used as public records )yU U.i— Licensed Professional < OWNER-BUILDER DECLARATION J� a 1 hereby affirm that I am exempt from the Contractors License Law for the jp o following reason.(Section 7031.5,Business and Professions Code:Any city or county m which requires a permit to construct,alter,improve,demolieh,or repair any structure priorto its issuance,also requires thc applicant for such permit to file a signed statement Valuation P .Ft.Floor Area a that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 yq e F (commencing with Section 7000)of Division 3 of the Business and Professions Code)or 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). ❑I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law dots 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(wild 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 Contractors Li- ecnse Law does not apply to an owner of property who builds or improves thereon,and. who contracts for such projects with a contractors)licensed pursuant to the Contractor's License Law. ❑I 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. 9 hV f46161ft k ll'E Policy No.:WCe 5?3S;JL CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is far 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 Oforthwith comply with such provisions or this permit shall be deemed revoked. Z 2CONSTRUC7ION LENDING AGENCY (~i►.—i i hereby affirm that there is a construction(ending agency for the performance of > the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name aLender's Address U 0 1 certify that I have read this application and state that the above information is 4>, ►" correct.I agree to comply with all city and county ordinances and state laws relating to Ubuilding construction.and hereby authorize representatives of this city to enter upon the Uabove-mentioned property for inspection purposes. a (We)agree to save,indemnify and keep harmless the City of Cupertino against fn liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. �—+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATION . .�7,;,4.�, �/,,��irr ?—Irl—o Re-roofs Signature of Applicant/Contractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Cotte,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes �No Will the applicant or future building occupant use equipment or devices which If a roof is 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 materials for inspection. District? ❑YesNo I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that.ifthe building does not currently have a tenant.that it is my responsibility to notify the occupant of the requirements which must be met prior to issuance of a certificate of Occupancy. Signature of Applicant Date All roof coverings to be Class "B"or better Owne or authorized agent ate 0-7 Oct v u (o-7 CITY OF C.UPERTINO CITYOr PERMIT APPLICATION FORM CUPEkTINO CPN# / 3 Date: Building Address: \ Mailing Address (if different from building address): `` Z08vo i O^E,4EA� i�vu -L� U-V� E- Ownner's Name: Phone#:(qoP,) yy - 13 0 C Pico Aq J1h EU S Contractor: License #: Contact: PhonAQc?,t 3 U -ZZ I Z_ Cupertino Business License#: Fax:(go,,) qq1 - �3� �.� Z ai S Building Permit Info: Bldg L9 Elect ❑ Plumb ❑ Mech ❑ Job Description: D E c V� 2E(ac�;� -T � • Residential ❑ Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: 3,goo Occupancy Group: -2- Type Type of Construction: Please check this box if the project is a second-story addition: El �-Iroject Size: Standard ❑ Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Bo:ler<= 100,000 Btu MECHANICAL BBOILER2 Boile--> I OOK to 500K Btu MECHANICAL BBOILER3 Boil,;r> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> IM to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX IncVOff/Comm/Quasi BUILDING BCONSTAXBQ Coa. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax-Resi/Mobile BUILDING BELEC 1000 Eli,c 600V <= l OOOA ELECTRICAL BELEC1001 E-Re600V> 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 C'UPERTINO CITY Of PERMIT APPL=ICATION FORM CUPEkTINO —Quantity Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME N,,w Comm Electric ELECTRICAL BNUCOMMM Nev, Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTIME In3pection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Uldg Permit Fees BUILDING BPFIXTURE Pb1g Fixture PLUMBING BPGAS Ga,, Piping System Fee PLUMBING BPINTERCEP Inc[Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Ri, i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK La A n SprinklerBackflo PLUMBING - - -- -- BPSTORibI-- 5 torm/Rain Water PLUMB-ING BPTRAP Kitchen Trap PLUMBING BPVENT A t of Drain &Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER W ater Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units<= 10,000 cfm MECHANICAL BREMAPPLI .appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT bighting Fixtures ELECTRICAL BREMFURN Re ocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> l OK btu MECHANICAL BREMHEAT I­[eater Installation MECHANICAL BREMINHOOD InAallation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Po le/Platform Fixture ELECTRICAL BREMPOWER Powfr Device/Apparatus ELECTRICAL BREMRECEPT Rc rl, Switch & Outlets ELECTRICAL BREMRELOCA R-location of Hood MECHANICAL BREMREPALT Re pair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2 of 3 CITY OF C'UPERTINO CUPEI�F PERMIT APPL=ICATION FORM Quantity Fee ID _Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR The atrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Vf ntilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE 35eismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC I'llectrical sq foot ELECTRICAL EPERMITFEE Elc c Permit Issuance ELECTRICAL MPERMFEE Mechanical sq. foot MECHANICAL MPERMITFEE Meeh Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPL-BG --- --- Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING 3 of 3 CITY OF CUPERTINO 2 ITEMS OF 10 PERMI`[' RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Bl_c: Lot: APN . . . . . . . . . 32509056.13 DATE ISSUED. . . . . . . : 09 /14/2007 RECEIPT #. . . . . . . . . . BS)00002647 REFERENCE ID # . . . : 07 )90067 SITE ADDRESS . . . . . : 20300 HOMESTEAD RD BLDG 21 #E SUBDIVISION . . . . . . CITY CU?ERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . . PROMETHEUS ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : SAN MATEO CA, CA 94403 RECEIVED FROM . . . . : PR)-CRAFT BUILDERS CONTRACTOR . . . . . . . : BILL L. FEDOR-THURMAN LIC # 28938 COMPANY PR)-CRAFT BUILDERS INC ADDRESS . . . . . . . . . . : 761 MABURY RD STE 50 CITY/STATE/ZIP . . . : SAJ JOSE, CA 95133 TELEPHONE . . . . . . . . : (4)8) 441-1301 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 3, 800. 00 104 .76 0. 00 104 .76 0. 00 BSEISMICRE VALUATION 3, 800. 00 0.50 0. 00 0.50 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 105.26 0. 00 105 .26 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 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CJTY OF "UPE�TINO Fax(408)777-3333 Building Department JOB ADDRESS: PERMIT # 67© gaol T1.6 2 OWNER'S NAME: o vK(54 E c 4 S PHONE # — o GENERAL CONTRACTOR: —G .3 L DR 5. FAX# ( -- I am not using any subcontractors: Si;nature Date Please check applicable subcontractors and co m Mete 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