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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 1 of. 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 2 of 3 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 3 of 3