12110048 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20800 f10MESTEAD RD CONTRACTOR:MONTEREY PERMITNO: 12110048
CONSTRUCTION COMPANY
OWNER'S NAME: VILLA SERRA APTS 88 NIONI'EREY-SALIVAS IPAW STE A DATE ISSUED: 11108r—)012
OWNER'S PDONF,: 6509313400 SALIVAS,CA 93908 PHONE NO:(831)601-2659
❑ LICI.NSED CON TRACTOR'S DECLARA'T'ION BUILDING PERMIT INFO: BLDG 1- ELECT r PLUMB r
License Class_ Lie.P 91?S 2-9
r C.N1ECH RESIDENTIAL r COMMERCIAL
Contractor . Date
hereby affirm that 1 am tic used under the provisions of Chapter 9 JOB DESCRIPTION: BLDG 6 UNIT A-11-REMODEL APT COMPLEX KITCliEN(65
(commencing with Section 7000)of Division 3 of the Business& Professions SQIR),BATHR0OM(35 SQEI');NON-STRUCTURAL;INCLUDES
Code and that my license is in full force and effect. NEIL'SUBPANEL,WASIIER/DRYER HOOK-UP,NEW HOT AND
hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,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 willmaintain Worker's Compensation Insurance,as provided for by
Section 3700 of the LaSor Code,for the performance of the work for which this Sq.Ft Floor Area: %'alumina:$20000
permit is issued..
APPLICAN'I'CER'1'11rICA'I'ION APN Number:32609073.20800 Occupancy Type:
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 building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against I iabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant underslands and will comply 180 DAYS F:OM LA T'CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
o Issue bv: Datr.
Signature�i� Date
❑ O\1'NER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Linc for one of All roofs shall be inspected prior m tiny rooting material beitg installed.If a roof is
the follmaing two reasons: installed without first obtaining an inspection,I agree to remove all new materials for
1,as owner of the property,or my employees with wages as their sole compensation. Inspection.
will do the work and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signature of Applicant: Date:
I,as owner of the property,am exclusively contracting with licensed contractors to
construct dee project(Sec.7044,Business&Professions Code). ALI,ROOF COVERINGS TO BF CLASS"A"OR RETTER
hereby affirm under penalty of perjure one of the follmying three
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's IL\%ARDOUS NIATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Ilcalth&Safety Code.Sections 25505,25533,and 25534. I will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Ileallh&
Section 3700 of the Labor Code,for the performance of die work for which this Safety Code,Section 25532(a)should I store or handle hazardous material.
Additionally,should I use equipment or devices which emit hazardous air
permit is issued:. contaminants as defined M•the Bay Area Air Quality Management District I mill
I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Nlunicipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Ilealth&Safety Code,Sections 25505,25533,and 2553E
Compensation Imus of Califoria. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Cade,I must. er or the ¢ed agent:
forthwith comply with such provisions or this permit shall be deemed revoked.
e � ���--Date:
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I cenify that 1 have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's
correct.I agree to comply with all city and county ordinances and slate laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of This city to enter Leader's Name
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accre against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply .\RCIII'1'F,CI"S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. 1 understand my plans shall be used as public records.
Signature Date Licensed Professional
11/08/2012 11:57t4try Construction Co. (FAx)831 455 7986 P.002/003
1 2 1 l vv L+c�'
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014.3265
CUPERTINO (408)777-3228-FAX (408)777-3333•bullcilnelMcupertinet.om
❑NEW CONSTRUCTIONADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT
P1891511'lomestead Road, 9 � Units
Building# APN0
:
W a ears Apartments PND. E•AIAIL
P 650) 931-3400
1t�A�oorfDlk Street,# 150 cS`t'en�aleo, CA 94403 FAX
16aV17\4AA��ll
PH
9 g50 931-3400 dPrtiwright@prometheusreg.com
STREETADDRESS CIY.STATE ZIP FAX
1900 So. Norfolk Street # 1550 San Malleo CA 94403
❑OWNER ❑ OWNER-BUILDER IO owNBRAOENr ❑ cONTRACTOR ❑CONDUCTOR AOBNr ❑ ARCHDeCT ❑ENGINEER ❑ DEVELOPER ❑TENANT
�2�Che L��{e"geE LICEw�P 17DER LICENSCTYPE BUS.LICe
MP.S.Y NAMB B-M li
onterey Construction Company benlmryconstruclion.com (611)455.7966
STREETADORCSS CITY,STATE.ZIP PHONE
86 Monterey-Salinas Hwy, Suite A 9 831 455-7931
ARCHRECrlENOWEER NAME LICENSE NUMBER BUS.LIC 0
COMPANY NAME EMAIL
FAX
STREET ADDRESS CITY.STATE,ZIP PHONE
SCRYPTION OF wo
elmove &rep race, kitchen & beth cabinets. Replace electrical sub anel &subfeed. Install new W/D &hookups.
Run new hot& cold water lines for all existing fixtures. , —
t^A - C"i.\l
Pxtsn.a use eaoroseD use consTR nve I rroalEs
AFLaOA DEMO TOTAL
AREMAA AMA ARBA NET ARBA
BATHROOM XTTCIIEN OTHER ,�:.:'...'>.:::.f •. :::?i •`•1...'q:'li: -'
REMODELARBA noOEC ARBA M%IOOBL A �!I'!r �"
FOR CH AREA DECK AREA TOTALDECX!PORCII AREA GARAGSAmA:❑ OHTACH .;.I:(' {: �, '' ::r:,'.i .I,:.,.:;•;:q ;: 'i! •a1
TTAaH •.r.=i:v:::.4
r DAULINO Mttft UA I[cVvV LLVR 1T] um"M Ity 13 Y6! _ "-'l� .' _.'� -:'::•1:: •••'=i:i.
eIL OADCfDI NO A001TIeX1 NO :f:!i�?•��• .,�:�I"'=.•. ;.I t},'�; :.� .�. u',""G
PIIE-VNICATIW ❑ Yas 61Y1./bvme mPY rs PLSM.tka NAW.:
V6 Y. .J�:. ' •,TOTAL VAA'LLllAT3oN: "::-:; .��r.':�
IYANNNa.VM1r ❑ ND ILNT'INO APYROYW.L6rTER :,': ; _;_:.:,A� .;
By my signature below,I ecniry to each orthe following: I am the property owner or authaind agent to act on the property owner's behalf. I have read this
application and the Information I have provided is correct. I have read the Description of Work and verify It is accurate. I agree 10 comply wltn all applicable local
ordinances End state laws minting to buliding clion, I Eu adze representatives orcupertlna to enter the above-Identln prepeny for Inspection purposes.
Signature of Appilaens/Agent: 11 - Date:_ I�(�t
SUPPLEMENTAL INFORMATION REQUIREDpiaivcilEt._t i': ': :'`.:: ,'(=ROUTING silv:a
_New SFD or Multlramlt7 dwellings: Apply for demolition permit for - •" T!.5r. :'r:=is':.";�E;
existing building(s). Demolition permit is required prior to issuance of building .oyEliinF.,coONTER^fE t
i7++oUILOING PLAN REV]E1V I ..
permh for new building. ;❑•.ExpRsss f ' ❑ ja'TR1.O PLAN ItCVIEW r
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑•-srenDApo- S ' - 'PuoucSvoRHE-
form If any Hazardous Materials aro being used as pan of this project.
"LAROEI Ic ❑1.FIRE
—Copy or Planning Approval Letter or Meeting with Planning prior 10
submittal of Building Permit application. OR.":� � O SAN[7ARY SEWEI�DISTRICT.1�
- �I❑:ENVNONAIENTAI;HBALTII'':'.:•.;'1
BrdgApp 201].doe revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 20800 homestead rd. bldg. 6 A-H DATE: 11/08/2012 REVIEWED BY: bobs.
APN: BP#: 'VALUATION: $20,000
*PERIbiIT TYPE: Building Permit PLAN CIIECK TYPE: Alteration / Repair
PRINIARI' Multi-Family Dwelling Buildina is PENTAMATION
USE: 3 Stories Q Yes Q No PERM1TT1'PE: 1R2REMAt
WORK remodel apt complex kitchen and bath non structural includes new subpanel, W/D hook-up, new hot
SCOPE and cold water lines.
Mech. Plan Check 0.0 firs $0.00 Plumb.Plan Check Elea Plan Check
• Mech. Perini t Fee: IMPERMIT Plan'. Permit Fee: Flee. Permit Fee:
Other Mech. Insp. 0.0 his $45.00 Other Phcmh Insp. Other Elcc. Grasp.
'Ilech./lisp.Fee: Plumb. Lisp. Fee: F.Ice. Insp.Fee: ,
NOTE: This estinmte does not include fees due to other Departments(i.e. Planning, Puh/ie Works, Fire,Sanita!r Server District,School
District,etc. . These feiu are based on the prelindnai3 information mailable and are onh,air estimate. Contact the Dept for addh'I info.
FEE ITEMS (Fee Resolution 11-053 1,-"ff.- 7/1/11) FEE QTY/FEE MISC ITEMS
Plan Check Fee: , $0.00 F65 s.f. Remodel, Kitchen (<=300 sf)
Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $600.00 IREURESKIT
PME Plan Check: $0.00 35 s.f. Remodel, Bath (<=300 so
Permit Fee: Hourly Only? p Yes Q No $0.00 $600.00 1 IREURES8AT
Suppl. Insp. FeeQ Reg. Q OT 0.0 hrs $0.00 = # Mechanical
PME Unit Fee: $0.00 $134.00 1BAPPGOT Other Appliance/Equip
PME Permit Fee: $45.00 = # Mechanical
Convruction Tax: $67.00 IBREMAIR A/C Units(<=10K cfm)
Administrative Fee: 1ADMIN $42.00
Work Without Permit? O Yes C!) No $0.00 E)
Advanced Planning Fee: $0.00 F 16 hours Inspections E)
Travel Documentation Fee: ITRA FDOC $45.00 $2,128.00IST/,vSP Inspection, Hourly
Strong Motion Tee: IBSEISMICR $2.00 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $135.001$3,529.001 TOTAL FEE: $3,664.00
Revised: 10/01/2012