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07090200 CITY OF CUPERTINO ` �R I `(}RM 'Tj(�1 • BUILDING DIY'ISION PERMIT PERMIT NO. BUILIf6�AOff{E�OMESTEAD RD BLDG 39 #F PRO CRA,T BUILDERS INC 07090200 G lJ L5 V V PERMIT ISSUE DATE OWNER'S NAME: PROMETHEUS 761 MAB)JRY RD STE 50 09/28/2007 SANITARY NO. CONTROL NO. BUILDING PERMIT INFO ARCHITECT/ENGINEER: BALCONY DECK REPAIRS BLDG ELECT PLUMB MECH 0 }p Q LICENSED CONTRACTOR'S DECLARATION Job Description VI hereby affirm that I am licensed under provisions of Chapter 9(commencing z m with Section 7000)of DiY�f�on 3 of the Business and fessions Code,and my license is y in full force and effect 1� ��� 'Z r ? License las 4 J Lic.B G pare Contractor m RCHITECTS DECLA TION i d< I understand my plans shall be used as public records >aU G H Licensed Professional OWNER-BUILDER DECLARATION j< I hereby affirm that 1 am exempt from the Contractors License Law for the p O following reason.(Section 7031.5,Business and Professions Code:Any city or county < 01 which requires a permit to construct,alter,improve,demolish,or repair any structure H prior to its issuance,also requires the applicant Cor such permit to file a signed statementArea Valuation ?a that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq,Ft.Floor e.IT O (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 Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number not more than five hundred dollars(5500). 0 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 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.). 0 I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractors 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 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 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 1 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 qsura carrier and Policy trtherdare- Carrier:"lfl2C7CE`) l 1►�Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is Cor 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 mus ,J Z forthwith comply with such provisions or this permit shall be deemed revoked. z CONSTRUCTION LENDING AGENCY (�rte) I hereby affirm that there is a construction lending agency for the performance of r7 the work for which this permit is issued(Sec.3097,Civ.C.) (�Q L.endcr s Name Z Lcndees Address I certify that I have read this application and state that the above information is IUL+ correct.I agree to comply with all city and county ordinances and state laws relating to O U building construction,and hereby authorise representatives of this city to enter upon the above-mentiuned property for inspection purposes. nWi (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 p U Z in consequence of the granting of this permit. Date -7/ ►-r APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NOON--POINT Issued by: SOUR — 6 V<"!! S. • /'t f ` ->V I � Ike-roofs Signature of Applicam/Contrac�tor Dare T e of R oof HAZARDOUS MATERIALS DISCLOSURE yP Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal ode,Chapter 9.12,and the Health and Safety Cole,Section 25532(a)? All roofs ;hall be inspected prior to any roofing material being installed. 0 Yes o Will the applicant or future building occupant use equipment or devices which If a roof i;installed without first obtaining an inspection, agree to remove emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? 13 Yes o I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&SafctyCode,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 Date reyuirehi must beet p' r issuance of a Certificate of Ocf upon Signature of Applicant < l©� All roof coverings to be Class"B"or better Owner or authorized agent Date CITY OF CUPERTINO 3 ITEMS OF 30 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 326J9056 .24 DATE ISSUED. . . . . . . . 09/28/2007 RECEIPT #. . . . . . . . . : BS000002810 REFERENCE ID # . . . : 07090200 SITE ADDRESS . . . . . : 20800 HOMESTEAD RD BLDG 39 #F SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER PROMETHEUS ADDRESS . . . . . . . . . . : 1900 S NORFOLK ST #150 CITY/STATE/ZIP . . . : SAN 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 . . . : SAY. JOSE, CA 95133 TELEPHONE (4C8) 441-1301 FEE ID UNIT QUANTITY FMOUNT 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 lr �= CITY OF C'UPERTINO -? CUPEKTIIVO PERMIT APPLICATION FORM APN# ` C 9r?r► R F-D u>o6,0 FSR •- GH5t.4L+ UJ�o/� Date: Z y'-o-7 Building Address: Mailing Address (if different from building address): Owner's Name: [Phone#: E - /A(/-/-?o1 Contractor: _ License#: _,-!te- 1 ff 6 2 Contact: Z 11L Phone: 1_i; -Z I Cupertino Business License#: Fax: 38_ Building Permit Info: Bldg Elect ❑ Plumb ❑ Mech ❑ Job D scription: Residential �rL Co ���� 12 pr`+ r.S Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: �, 1 Oo 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 AP liances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler 100K to 500K Btu MECHANICAL BBOILER3 Boiler > 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 Ind/Uff/ComnV uasi BUILDING BCONSTAXBQ Con. 'rax for BQ Zone �. BCONSTAXH Hotel and Motel BUIL BCONSTA.XR Const ix —Resi/Mobile BUILDIN BELEC1000 Elec ,500V<= IOOOA ELECTRICAL: BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V<= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investi ation fee BUILDING 1 of 3 allCITY OF C'UPERTINO cuPE�-rirvo PERMIT APPLICATION FORM E:�Uantity Fee ID Fee Descri tion Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BLJILDTNG BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP N:w Comm Plumb PLUMBING BOVERTIME Im ection Overtime BUILDING BPBACKFLOW Atriospheric 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 Play. Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinkler/Backflo PLUMBING -- BPSTORM Sorm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain &Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT R-,inspection 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 Lighting Fixtures ELECTRICAL BREMFURN Relc cation of Furnace MECHANICAL BREMFURNOV Relo Furnace> I OK btu MECHANICAL BREMHEAT He ater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC hfisc Apparatus ELECTRICAL BREMNR.APP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Rep air/Alter Heating MECHANICAL BREMRESAPP Remcdel Res Appliance ELECTRICAL 2of3 CITY OF C'UPERTINO CUPER,TINO PERMIT APPLICATION FORM uanti Fee ID Fee Descri tion Fee Group BREMSIGNAD Rmc I Si s Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Ven t Fan Single Duct MECHANICAL BREMVENSYS Veltilation Systems MECHANICAL BSCBLVD S�b S ecific Plan BUILDING BSEISMICOM_ Seismic Commercial _ _BUILDING BSEISMICRE Seismic Fee ResBUILDING BSPECIAL Special Inspection 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 Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Me;hanical sq. foot MECHANICAL MPERMITFEE Meet Permit Issuance MECHANICAL PPERMITFEE PIUM',Ding Permit Issue PLUMBING PPLBG Plunibin.g Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING PLLONGRNGR Planning ong Range Residential PLANNING 3 of 3