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07090189 CITY OF CUPERTINO BUILDING DIVISION PERMIT PERMIT NO. BU"'I 1j,'iQQj3�ESS�:_OMESTEAD RD BLDG 30 #E PRO-CR,-.FT BUILDERS INC 07090189 G(J�j(J �j PERMIT ISSUE DATE OWNER'S NAME: PROMETHEUS 761 MADURY RD STE 50 09/28/2007 SANITARY NO. CONTROL NO. )NE: BUILDING PERMIT INFO ARCHITECT/ENGINEER: BALCONY' DECK REPAIRS BLDG ELECT PLUMB MECH p p LICENSED CONTRACTOR'S DECLARATION Job Description i v C 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 r -,Q,, in full force and effect t r ? Licteense CI Lam• E- DaContractor ARCHITECT'S DECLA N i a< 1 understand my plans shall be used as public records )yU U,f•' Licensed Professional a OWNER-BUILDER DECLARATION j< I hereby affirm that 1 am exempt from the Contractor's License Law for the -n opr following reason.(Section 7031.5,Business and Professions Code:Any city or county �Ic, 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 t ,Ft.Floor Area Valuation < that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 1q e F (commencing with Section 7000)of Division 3 of the Business and Professions Code)or i 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 Conuactoes 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 sa1.7 ❑I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractors U- ccnse 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. ❑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: ❑1 have and will maintain a Certificate of Consent to self-insurc 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 Worke,Xs-co-m1 pensadon {pn 'carrier and Polity num r : Carrier:fti� L-5t"C"),rt 2-E Policy No.. rP ( NC CERTIFICATE 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's issued.I shall not employ any person in any manner so as to become subject to the Workcrs'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 O forthwith comply with such provisions or this permit shall be deemed revoked. z, CONSTRUCTION LENDING AGENCY rA 1 hereby affirm that there is a construction lending agency for the performance of (Y,7 the work for which this permit is issued(Sec.3097,Civ.C.) aA Lender's Name z Lender's Address U 0 1 certify that I have read this application and state that the above information is L►� 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. Ia. (We)agree to save,indemnify and keep harmless the City of Cupertino against t) liabilities,judgments,toss 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 T✓ SOUR GU ONS.ul�_l 9V 7 Wal L� Re-roofs Signature of Applicant/Contractor °"` HAZARDOUS e of Roof HAZARDODOType MATERIALS DISCLOSURE 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)? All roofs Shall be inspected prior to any roofing material being installed. ❑Yes If a roof i3 installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminans as do ned by the Bay Arca Air Quality Management all new n'aterials for inspection. District? ❑Yes 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 docs not currently have a tenant that it is my responsibility to notify the occupant of the rc uirc >s which ren t be met 'or to iss cc of a Certificate ofCyt ©� Signature of Applicant Date ��� `^- p y'/ Date All roof coverings to be Class"B or better Owner or authorized agent CITY OF CUPERTINO 3 ITEMS OF 30 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk : Lot: APN 32E09056 .20 DATE ISSUED. . . . . . . : 09/28/2007 RECEIPT #. . . . . . . . . . BSC00002810 REFERENCE ID # 07C90189 SITE ADDRESS . . . . . : 20E00 HOMESTEAD RD BLDG 30 #E SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER PROMETHEUS ADDRESS 1900 S NORFOLK ST #150 CITY/STATE/ZIP . . . : SAN MATEO CA, CA 94403 RECEIVED FROM PRO-CRAFT BUILDERS CONTRACTOR BILL L. FEDOR-THURMAN LIC # 28938 COMPANY PRC -CRAFT BUILDERS INC ADDRESS 76'. MABURY RD STE 50 CITY/STATE/ZIP . . . : SAN JOSE, CA 95133 TELEPHONE (408) 441-1301 FEE ID UNIT QUANTITY EiMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----------- ---------- ---------- ---------- BPERMFEE VALUATION 3, 100. 00 104 .76 0. 00 104 .76 0. 00 BPLANCHK PERMIT FEE 104 .76 139 .80 0. 00 139 . 80 0. 00 BSEISMICRE VALUATION 3, 100. 00 0.50 0. 00 0.50 0. 00 ----------- ---------- ---------- ---------- TOTAL PERMIT 245 .06 0. 00 245. 06 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 1110A 1 CITY OF (.UPERTINO U `�c� CUPEI�TINO PERMIT APPLICATION FORM APN# C ort, P, R rfl Wv-&O Fik ,I- CASsaAL+ LJ&A oJ�P 07 Date: Z y-o-7 Building Address: Mailing Address (if different from building address): 20 Wo DWI _S ,E A b t Owner's Name: Phone M E - l-l3 o j Contractor: License M Contact: I'LL Phone: 3,9 q--Z Z I Cupertino Business License#: Fax: Building Permit Info: Bldg Elect ❑ P.'umb ❑ Mech ❑ Job D ription: . Residential ��4LGo►�/ ��Ck �P����s Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: 100 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 OtherAp liances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler 1M to 1.75 M Btu MECHANICAL BBOILER5 Boi:er> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi 7 1NG BCONSTAXBQ Con. Tax for BQ Zone BCONSTAXH Hotel and Motel BUIL BCONSTAXR Constax —Resi/Mobile BUILD1 BELEC 1000 Elec 500V<= l OOOA ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Secs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Ener Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3 CITY OF CUPERTINO -CUPE�Tirvo PERMIT APPLICATION FORM Quantity Fee ID lee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Com n. Housing Mit. Fee BUILDING BNUCOMME Ne:w Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP N.w Comm Plumb PLUMBING BOVERTIME Im- ection Overtime BUILDING BPBACKFLOW Atr.ios heric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pb1g Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK flan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Dis osal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawgi S rinkler/Backflo PLUMBING --BPSTORM- - Sl orm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT All of Drain &Vent PLUMBING BPWATER Insta /Alter Water Pie PLUMBING BPWHEATER Writer Heater/Vent PLUMBING BPWSVCS Win Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C IJnits<= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT L i tin Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> I OK btu MECHANICAL BREMHEAT Hi.ater Installation MECHANICAL BREMINHOOD Ins.allation of Hood MECHANICAL BR.EMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem von-Res Appliance ELECTRICAL BREMPOLE Polc/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rcpt , Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2of3 0CITY OF C'UPERTINO •CUPEkTINO PERMIT APPLICATION FORM Qwantity Fee ID :Fee Description Fee Group BREMSIGNAD Rm 11 Si s Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD c cb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE E;eismic Fee Res BUILDING BSPECIAL S 3ecial Inspection BUILDING BSWIM 'Swiniming 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 Elei; Permit Issuance ELECTRICAL MPERMFEE Mechanical sq. foot MECHANICAL MPERMITFEE Mecb Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING -- -PPLBG - - Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning:LR Comme/Multi-Fam PLANNING PLLONGRNGR Planning]mon Range Residential PLANNING 3 o:'3