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07090070 CITY OF CUPERTINO BUiLDING DIVISION PERMIT G� Tk�� Q�I���?�2MAT�f�N. BUiL rrjj,,GU$4D ESS: PERMIT NO. 8� HOMESTEAD RD BLDG 7 #H PRO—CPJiFT BUILDERS INC 07090070 PERMrr nUE DATE OWNER'S NAME: PROMETHEUS 761 MABURY RD STE 50 09/14/2007 SANITARY NO. CONTROL NO. ONE: BUILDING PERMIT INFO ARCHITECT/ENGINEER: DECK REPAIR. BLDG ELECT PLUMB MECH C7 D D D p p LICENSED CONTRACTOR'S DECLARATION Job Description v I hereby affirm that I am licensed under provisions of Chapter 9(commencing Z with Section 7000)of Division 3 of the Business and Professions Code,and my license is H in full force and effect. 3 L Z License Class Lle•# M Date q— d Contractor D—C- ARCHITECTS DECLARATION i a< 1 understand my plans shall be used as public records )uiU 'n.y Licensed Professional y j OWNER-BUILDER DECLARATION > 1 hereby affirm that I am exempt from tate Contractor's License Law for the jp Or� 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 statementrc Valuation that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area t (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($500). 0 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 forsale(Sec.70",Business Required Inspections and Professions Code:The Contractor's License Law docs 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.). 0 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 Li- cense 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 Contractor's License Law. 0 I am exempt under Sec B&P C for this reason OwnerLADate WORKER'S COMPENSATION DECRATION I hereby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain a Certificate of Consent to self-insure for Worker's Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 0 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 Worker's Compensation insurance carrier and Policy number are: Carrier•.hFAi W'& ICYiZIF Policy No.:W(e 3S I�.,1� CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars(S 100) or less.) i certify that in the performance of the work for which this permit is issued.1 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" CONSTRUCTION LENDING AGENCY (~—t I hereby affirm that there is a construction lending agency for the performanceof C+ > the work for which this permit is issued(See.3097,Civ.C.) f3�Q Lender's Name az Lender's Address U 0 I certify that 1 have read this application and state that the above information is (y►+ correct.I agree to comply with all city and county ordinances and state laws relating to rJ- U building construction.and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. far (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 �. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by SOURCE REGULATIONS. 44m ze, ���it- _40t -- &I-hy-07 Re-roofs Signature of Applicam/Comractor DareT e of R oof HAZARDOUS MATERIALS DISCLOSURE Type 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 Code,Section 25532(a)7 All roofs shall be inspected prior to any roofing material being installed. 0 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 rr aterials for inspection. District? 0 Yes r;No 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 if the 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 A40 X. »- 1-im'07 All roof coverings to be Class"B"or better Owner or authorized agent Date 0709 OC) 70 CITY OF CvUPERTINO R_ PER CUPS TiNO MIT APPLICATION FORM APN# 3.9, �P �q 0�ZP e I Date: C? / I — 0 '7 Building Address: Mailing Address (if different from building address): :20F 5oo 1-1-0 P-G 5 CA Owner's Name: Phone #C t) Contractor: License #: L� f -KuiLPEAS i A/c- Contact: 3; L Phone: •voS-3``t•-Z z i z Cupertino Business License#: Fax: yWl- 1 n q Building Permit Info: Bldg K Elect ❑ Plumb ❑ Mech ❑ Job Description: R cepllA R p-�, Residential ❑ Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: �o o Occupancy Group: Type of Construction: Please check this 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 Bo ler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boil,-.r> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 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 Elm 600V <= 1 OOOA ELECTRICAL BELEC1001 El ec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD 1=nergy Add Multi BUILDING BINVESTIGA nvestigation fee BUILDING 1 of 3 f : 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 Inspection 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 Incl Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plai Check Repeat Fee BUILDING BPREPIPE R,! i e Of Fixtures PLUMBING BPSEWAGE c►ewa a Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lavin S rinkler/Backflo PLUMBING - - -BPSTORM torm/Rain-Water - PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT At 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 F:eater Installation MECHANICAL BREMINHOOD InAallation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Po.e/Platform Fixture ELECTRICAL BREMPOWER Powur Device/Apparatus ELECTRICAL BREMRECEPT Rc ia, Switch & Outlets ELECTRICAL BR.EMRELOCA R-,location of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2 of 3 CITY OF CrUPERTINO CU11 PEk ANO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rindl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Se:smic Commercial BUILDING BSEISMICRE Seismic 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 Electrical sq foot ELECTRICAL EPERMITFEE Elc c Permit Issuance ELECTRICAL MPERMFEE Mechanical sq. foot MECHANICAL MPERMITFEE Mech 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 A3 CITY OF CUPERTINO 2 ITEMS OF 10 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blc: Lot: APN . . . . . . . . . 32609056 .14 DATE ISSUED. . . . . . . : 09114/2007 RECEIPT #. . . . . . . . . . BS000002647 REFERENCE ID # . . . : 07090070 SITE ADDRESS . . . . . : 20300 HOMESTEAD RD BLDG 7 #H SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CU:?ERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : PROMETHEUS ADDRESS CITY/STATE/ZIP . . . : SAN MATEO CA, CA 94403 RECEIVED FROM . . . . : PRO)-CRAFT BUILDERS CONTRACTOR . . . . . . . : BI:�L L. FEDOR-THURMAN LIC # 28938 COMPANY . . . . . . . . . . : PRO)-CRAFT BUILDERS INC ADDRESS . . . . . . . . . . : 76L MABURY RD STE 50 CITY/STATE/ZIP . . . : SAN JOSE, CA 95133 TELEPHONE . . . . . . . . : (4 )8) 441-1301 FEE ID UNIT QUANTITY %MOUNT 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 01 71 10300 Torre Avenue 4a s Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 '�UPEkTIN0 Building Department JOB ADDRESS: PERMIT # 0 7o 9-no 7 o .;�n boa f R�, OWNER'S NAME: p t. H E U PHONE /- 3o t GENERAL CONTRACTOR: FAX # y'Y -f 3©y I am not using any subcontractors: A="I'd Signature Date Please check applicable subcontractors and con 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