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11040145 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20900 HOMESTEAD RD BLDG 76 CONTRACTOR:MONTEREY PERMIT NO:11040145 CONSTRUCTION COMPANY OWNER'S NAME: PROMETHEUS 88 MONTEREY-SALINAS HWY STE A DATE ISSUED:04/20/2011 C :R'S PHONE: 6509313400 SALINAS,CA 93908 PHONE NO:(831)601-2659 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r— License Class Lic. /� MECH RESIDENTIAL COMMERCIAL Contractor Date _44 I hereby affirm that I am licensed under the provisions of Chap er 9 JOB DESCRIPTION:UNIT B-REMODEL KITCHEN(50SQFT),NON (commencing with Section 7000)of Division 3 of the Business&Professions STRUCTURAL,& Code and that m license is in full force and effect. LIGHTS;ADD NEW WASHER/DRYER IN EXISTING Y CLOSET(IOSQFT)&INSTALL NEW A/C UNIT I 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 will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$20000 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:32609065.76 Occupancy Type: 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-point source regulations per the Cupertino Municipal ode,Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. r7�� Ly Signature P Date ` Issued b Date: L OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS: the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date: construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS 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 Health&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 Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. permit is issued. Additionally,should I use equipment or devices which emit hazardous air I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534. become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Ow er o uthorizagent: Date: �—* �. 6 APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of wrk's to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.) upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name ir' -nnify and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the Lender's Address giu,,ting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 7 ITEMS OF 28 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32609065.76 DATE ISSUED. . . . . . . : 04/20/2011 RECEIPT #. . . . . . . . . BS000013244 REFERENCE ID # . . . : 11040145 SITE ADDRESS . . . . . : 20900 HOMESTEAD RD BLDG 76 SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : PROMETHEUS ADDRESS . . . . . . . . . . : 1900 SOUTH NORFOLK ST STE 150 CITY/STATE/ZIP . . . : SAN MATEO, CA 94403 RECEIVED FROM . . . . : RICHARD B REGA CONTRACTOR . . . . . . . : BEN REGA LIC # 32275 COMPANY . . . . . . . . . . : MONTEREY CONSTRUCTION COMPANY ADDRESS 88 MONTEREY-SALINAS HWY STE A CITY/STATE/ZIP . . . : SALINAS, CA 93908 TELEPHONE (831) 601-2659 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 20, 000 .00 1. 00 0.00 1.00 0. 00 1BREMAIRHA NO.UNITS 1.00 63 . 00 0. 00 63 . 00 0.00 1BSEISMICR VALUATION 20, 000.00 2 .00 0. 00 2 .00 0.00 1MPERMITFE FLAT RATE 1 . 00 42 . 00 0. 00 42 .00 0. 00 1REMRESKIT SQ FEET 50 .00 570. 00 0.00 570.00 0.00 1REMRESOTH SQ FEET 10 .OQ 380. 00 0. 00 380 .00 0.00 1TRAVDOC FLAT RATE 1.00 42 .00 0. 00 42 .00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 1100. 00 0. 00 1100 .00 0.00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 301 ROUGH PLUMBING 302 TUB & OR SHOWER 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 305 FRAME 307 INSULATION 308 SHEETROCK 309 EXTERIOR LATH 310 INTERIOR LATH 311 SCRATCH COAT 313 ROOF NAIL 317 MECHANICL ABOVE CEILING 318 ELECTRICAL ABOVE CEILING 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL 516 FINAL BUILDING CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 20900 homestead rd bldg 76 B DATE: 04/20/2011 REVIEWED BY: bobs. APN: BP# "VALUATION: 1$20,000 },PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Repair �2 PRIMARY Multi-Family g Dwellin Buildino is PENTAMATION 1 R EM USE: >3 Stories 0 Yes (E) No PERMIT TYPE:` WORK remodel kitchen non structural add new W/D at existing closet install new A/C unit. SCOPE Mech.Plan Check0.0 hrs $0.00 Mech.Permit Fee: IMPERMIT Other Mech.Insp. 0.0 hrs $42.00Li NOTE: Theseees are based on the preliminary information available and are only an estimate. Contact the De t or addn7 info. FEE ITEMS (Fee.Resolution 09-051 E ff. 1.-10) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. Remodel,Kitchen(<=300 sf) Suppl.PC Fee: (F) Reg. 0 OT 0.0 hrs $0.00 $570.00 1REMRESKIT PME Plan Check: $0.00 = s.f Remodel,Other Permit Fee: $0.00 $380.00 IREMRESOTx Suppl. Insp. Fee-0 Reg. 0 OT 0.0 hrs $0.00 0 # Mechanical PME Unit Fee: $0.00 $63.00 IBREMAIR--] A/C Units(<=10K cfm) PME Permit Fee: $42.00 Acoustical Fee: 0 Yes (F) No $0.00 0 Work Without Permit? 0 Yes E) No $0.00 E) Planni Fee: $0.00 Select a Non-Residential G Travel Documentation Fee: ITRA VDOC $42.00 Building or Structure 0 i Strong Motion Fee: IBSEISMICR $2.00 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $87.00 $1,013.00 TOTAL FEE: $1,100.00 Revised: 01/15/2011 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: ZC)C�Z5d PERMIT# / d `/5- OWNER'S NAME: PHONE#r e i U(—2, GENERAL CONTRACTOR: BUSINESS LICENSE# Z Z`7 ADDRESS: ' c � CITY/ZIPCODE: 4,4,,l6 *Our municipal code requires all usi esses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical �'• . Excavation Fencing —7Flooring / Carpeting Linoleum / Wood lass /Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving astering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Own Contractor Signature Date 04/20/2011 11 : 41 (FAX) P. 007/021 CITY OF CITY OF CUPERTINO ADDITION/REMODEL CUPERTINO EEE SCHEDULE [A-PN# � Date: -�s a 2" unit being added? Yes ❑ No ® If yes, please fill out the permit application for 2" unit. s this a 2"�story Addition? Yes ❑ No s this house all Eichler? Yes ❑ No ❑ If yes, needs Planning approval. Building Address: 20900 Homestead Road Building Unit# Mailing Address (if different from building address): 88 Monterey-Salinas Hwy., Suite A, Salinas, CA 93908 Owner's Name: Phone# Prometheus Real Estate Group 650 931-3400 Contractor: Phone#:(831)455-7931 Monterey Construction Company Fax/e-mail; 831) 455-7986/thalia@mryconstructii)n.com Cupertino Business License: State Contractor License#: 32275 885297 Contact: Phone##:(831)455-7931 Thalia Tardivet/Ben Rega Fax/e-mai 1:(831)455-7986 Landscape Ordinance Compliance: Landscape area in sq. ft. (includes all irrigated!areas): �A If 2,500 sq. ft. or less, compliance with the Landscape Water-Efficiency Checklist is required. If more than 2,500 sq. ft.,a complete Landscape Project Submittal is required. Compliance Method: ❑ Plant Type i ❑ Water Budget Building Permit Info: Bldg. Elect. Plumbing ® Mechanical Hillside ❑ Project Size: Counter ❑ Express ❑ Standard ❑ Large [] Major ❑ Job Description: Addition-What is being added?(Be Specific):Install new washer/dryer at existing closet (10sq ft); install new air conditioning unit What is being remodeled (not including add ition)?Remodel existing kitchen (50 sq ft) cabinets, lights Remodel Includes Re-Roof: Yes ❑ No 0 If yes list number of sc}uar'es Remodel Includes Structural: Yes ❑ No Do you have the pre-application planning approval? Yes ❑ No ❑ If yes, please provide a copy of your plannigg approval letter. Planners name: Square Footage: Addition: Porch: Deck: Garage:Detached Attached Remodel: Kitchen 50 Bath Other 10 Type of Construction (Usage Class): Occupancy Type: i-A, 1-B ❑ II/III/V-A ❑ II/IIIB, IV-HT, V-B ❑� Valuation:$ � D Please complete relevant portion of the Green Building Checklist& attach it to the application or if applicable, Green Building Points Achieved: include in plan set& the sheet index.