07090196 777777=777777777777 77777777
CITY OF CUPERTINO
BUILDING DIVISION PERMIT +C�l ' IZACTQI� IZM �'�� t�
PERMIT NO.
BUIL�r�c�.RD,gEsHOMESTEAD RD BLDG 38 #H PRO—CRAFT BUILDERS INC 07090196
�J UU�1J1 PERMIT ISSUE DATE
OWNER'S NAME:
PROMETHEUS 761 MABURY 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 5 1 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=y in full force and effect Z
: ? License Cie Lic•#
o DateContractor
F
UJ ARCHITECTS DECLAI N
i d< I understand my plans shall be used as public records
)yU
o.H Licensed Professional
o a OWNER-BUILDER DECLARATION
I hereby affirm that t am exempt from the Contractor's License Law for the
pO following reason.(Section 7031.5,Business and Professions Code:Any city or county
e m which requires a permit to construct,alter,improve,demolish,or repair any structure
prior to its issuance,also requires the applicant for such permit to rile a signed statement
t, Valuation
z a that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 ,rq.Ft.Floor Area
ts- (commencing with Section 7000)of Division 3 of the Business and Professions Code)ur
L 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 isnot 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 Contractoes Li-
cense Law docs 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.
❑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-insure for Workees 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 Worker's Co nsation In rw�w carrier and Policy number am:
Carrier: � Policy No.: 1 (o Al _ �
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 is issued,I shall not
employ any person in any manner so as to become subject to the Workers'Compensation
Laws
oC 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 mutt
Qforthwith comply with such provisions or this permit shall be deemed revoked.
z" CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of
tY+> the work for which this permit is issued(Sec.3097,Civ.C.)
[Ta Q Lender's Name
Z Lender's Address
U 0 I certify that I have read this application and state that the above information is
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
U above-mentioned property for inspection purposes.
A. (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
i. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by _
SOURCE I ULA NS.
LA_,L� Re-roofs
,• Date
Signature o(ApplicanUConRDO T of Roof
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
Cotte,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
0 Yes
If a roof is 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 contaminants as defined by the Bay Area Air Quality Management all new rr aterials for inspection.
District?
❑Yes Nu
I have read the hazardous materials requirements under Chapter 6.95 of the Califor-
nia Health&Safety Code,Sections 25505.25533 and 25534.I understand that if the building
docs not currently have a tenant,that it is my responsibility to notify the occupant of the
requiremc wh*h oat be metQ. tgi ince of a Certificate of I r- Signature of Applicant Date
7� w"`—'� V-iRM All roof coverings to be Class"B"or better
Owner or authorircd agent Date
CITY OF -_UPERTINO
3 ITEMS OF 30 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 32609056 .22
DATE ISSUED. . . . . . . : 09/28/2007
RECEIPT #. . . . . . . . . : BS000002810
REFERENCE ID # . . . : 07090196
SITE ADDRESS 20800 HOMESTEAD RD BLDG 38 #H
SUBDIVISION . . . . . .
CITY CUFERTINO
IMPACT AREA . . . . . . .
OWNER PRCMETHEUS
ADDRESS . . . . . . . . . . : 19CO S NORFOLK ST #150
CITY/STATE/ZIP . . . : SM MATEO CA, CA 94403
RECEIVED FROM . . . . : PRC-CRAFT BUILDERS
CONTRACTOR . . . . . . . : BILL L. FEDOR-THURMAN LIC # 28938
COMPANY . . . . . . . . . . : PRC-CRAFT BUILDERS INC
ADDRESS . . . . . . . . . . : 761 MABURY RD STE 50
CITY/STATE/ZIP . . . : SAD[ JOSE, CA 95133
TELEPHONE . . . . . . . . : (4C8) 441-1301
FEE ID UNIT QUANTITY 1,MOUNT 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
CITY OF (;UPERTINO
Cupp TINO PERMIT APPLICATION FORM
e
APN# �'� P' R F_fl W0910 F,,Cc: A
d- GASu,4�+ I,cJ(n35l(Qg
b O p a Date:
_6
Building Address: Mailing Address (if different from building address):
0 oWt S+t r'► \A&A
Owner's Name: J I Phone#:
E _ /-/3 o j
Contractor: License #:
o -- C (Z F-f- t L L R �e- 2
Contact: •L L Phone: .3,p q_ -Z 1 Cupertino Business License#:
Fax:
Building Permit Info:
Bldg Elect ❑ Plumb ❑ Mech ❑
Job D scription:
Residential �r�L G o N`� FG P ►rZ 5 Commercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: 3 10o Occupancy Group:
Type of Construction: Please check this box if the project is a
second-sto addition: ❑
Project Size: Standard ❑ Large ❑ Majo:•❑
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 Boiler> 500K to 1M Btu MECHANICAL
BBOILER4 Boiler'• 1 M to 1.75 M Btu MECHANICAL
BBOILER5 Boi]er> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/ComnV uasi JNG
BCONSTAXBQ Con. Tax for BQ Zone
BCONSTAXH Hotel and Motel BUIL
BCONSTAXR Constax—Resi/Mobile BurLDIN
BELEC1000 Elec 500V<= 1000A ELECTRICAL
BELEC1001 Elec 600V> 1000A ELECTRICAL
BELEC200 Elec Secs 600V<=200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA In esti ation fee BUILDING
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CITY OF C'UPERTINO
cuPE�Tiivo PERMIT APPL]:CATION FORM
E:_�Uantity Fee ID Tee Descri tion Fee Group
BMISCELL N/iscellaneous Fee BUILDING
BMITIGATC Comin. Housing Mit. Fee BUILDING
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP N(.w Comm Plumb PLUMBING
BOVERTIME Inspection Overtime BUILDING
BPBACKFLOW Atmospheric 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 Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plan Check Repeat Fee BUILDING
BPREPIPE Re )i a Of Fixtures PLUMBING
BPSEWAGE Smage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn S rinkler/Backflo PLUMBING
BPSTORM Stonn/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain &Vent PLUMBING
BPWATER Instal VAlter Water Pie PLUMBING
BPWHEATER Water Heater/Vent PLUMBING
BPWSVCS Ma:n 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 Li ,,hting Fixtures ELECTRICAL
BREMFURN Relo,-ation of Fumace MECHANICAL
BREMFURNOV Relo Furnace> l OK btu MECHANICAL
BREMHEAT He iter Installation MECHANICAL
BREMINHOOD Instillation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMRRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE PoleTlatform Fixture ELECTRICAL
BREMPOWER Power Device/Apparatus ELECTRICAL
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remo Jel Res Appliance ELECTRICAL
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CITY OF CUPERTINO
CUPS TINO PERMIT APPLICATION FORM
uanti Fee ID Fee Description Fee Group
BREMSIGNAD Rmd( Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Marquee ELECTRICAL
BREMTHEATR The<<trical Lighting Fix ELECTRICAL
BREMVENFAN Vent Fan Single Duct MECHANICAL
BREMVENSYS Ventilation Systems MECHANICAL
BSCBLVD Si;b Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL SrecialInspection BUILDING
BSWIM Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Temporary Bldg Permit BUILDING
BTEMPSVCS I emp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Ei ectrical sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicals . foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issue PLUMBING
PPLBG Plur.ibin Fee sq foot PLUMBING
PLLONGRNGC PlanningLR Comme/Multi-Fam PLANNING
PLLONGRNGR Planning ong Range Residential PLANNING
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