11040146 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20900 HOMESTEAD RD BLDG 76 CONTRACTOR:MONTEREY PERMIT NO: 11040146
CONSTRUCTION COMPANY
OWNER'S NAME: PROMETHEUS 88 MONTEREY-SALINAS HWY STE A DATE ISSUED:04/20/2011
"ER'S PHONE: 6509313400 SALINAS,CA 93908 PHONE NO:(831)601-2659
❑ LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.#
/- MECH RESIDENTIAL COMMERCIAL
Contractor�A,��"G!r-le t--�/`oI' "'Date 2� �I
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:UNIT A-REMODEL KITCHEN(50SQFT),NON
(commencing with Section 7000)of Division 3 of the Business&Professions STRUCTURAL,&
LIGHTS;ADD NEW WASHER/
Code and that my license is in full force and effect.
CLOSET(1 OSQFT)&INSTALL NEW NEW IN EXISTING
AA/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 MuW
tion 180 DAYS FROM LAST CALLED INSPECTION.
9.18. �
Signature �`- Date � Issued b ��''�� Date: ('Z�—L1
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
1,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)
1,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.
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
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 r or thorized��ent:
Date. Gt/
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 vork'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
indemnify 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
_mg 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 # . . . : 11040146
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 .00 380. 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
MAPN:
DDRESS: 20900 homestead rd bldg 76 A __TDATE: 04/20/2011 REVIEWED BY: bobs.
BP#: "VALUATION: $20,000
'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Repair
PRIMARY Multi-FamilyDwellin Building is PENTAMATION 1 REM
USE: g >3 Stories 0 Yes 0 No PERMIT TYPE:
WORK remodel kitchen non structural add new W/D at existing closet install new A/C unit.
SCOPE
Mech.Plan Check To.oThrs $0.00
Mech.Permit Fee: IMPERMIT
Other Mech.Insp. 0.0 hrs $42.00
NOTE: These ees are based on the preliminary information available and are only an estimate. Contact the Det or addn'l info.
FEE ITEMS (Pe Resolution 09-051 1st'. 7-1.,"10) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 = s.f Remodel,Kitchen(<=300 sf)
Suppl.PC Fee: G Reg. 0 OT 1 0.0 1 hrs $0.00 $570.00 1REMRESKIT
PME Plan Check: $0.00 = s.f. Remodel,Other
Permit Fee: $0.00 $380.00 1REMRESOTH
Suppl.Insp.Fee.e Reg. 0 OTT0.-01 hrs $0.00 = # Mechanical
PME Unit Fee: $0.00 $63.00 IBREMAIR A/C Units(<=10K cfm)
PME Permit Fee: $42.00
Acoustical Fee: 0 Yes 0 No $0.00 0
Work Without Permit? 0 Yes 0 No $0.00
Planning Fee: $0.00 Select a Non-Residential 0
Travel Documentation Fee: ITRA VDOC $42.00 Building or Structure 0
i
Strom Motion Fee: 1BSEIS1vffCR $2.00 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: 1 $87.001$1,013.001 TOTALFEE: $1,100.00
Revised: 01/15/2011
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: 408-777-3228
;UPERTINO Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: 2-0<tpc> PERMIT# 0
OWNER'S NAME: PHONE# —26
GENERAL CONTRACTOR: yl BUSINESS LICENSE# 2
ADDRESS: c,✓ CITY/ZIPCODE:
*Our municipal code requires all usinesses working int 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
ement Finishing
Electrical
Excavation
Fencing
Flooring/ Carpeting
Linoleum /Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
/Z--cv
ner/Contractor Signature l Date
04/20/2011 11 : 40 (FAX) //vt_( C1IVP. 002/021
CITY OF
CITY CSF CUPERTINO
ADDITION/REMODEL
CUPERTINO FEE :SCHEDULE
FA-PN# �)/G off'-` � Date: 4,Z�J ,tit being added'? Yes No If yes, please fill out the permit application for" story Addition? Yes ❑ No
Is this house an Eichler? Yes ❑ No ® If yes, needs Planning approval.
Building Address:
20900 Homestead Road Building Unit#
Mailing Address (if different from building address):
88 Montere -Sallnas 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-rail:(831) 455-7986/thalia@mryconstructii)n.com
Cupertino Business License: State Contractor License#:
32275 885297
Contact: 831
Phone#;( ) 455-7931
Thalia Tardivet/Ben Rega Fax/e-mai1:(831)455-7986
Landscape Ordinance Compliance:
Landscape area in sq. ft. (includes all irrigated!areas):
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 TYPC [] Water Budget
Building Permit Info; Bldg. Elect. I X1 Plumbing ® Mechanical Hillside
Project Size: Counter Express ElStandard ❑ Large E] Major E]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 addition)?Remodel existing kitchen (50 sq ft) cabinets, lights
Remodel Includes Re-Roof. Yes ❑ No ® If yes list number of squares
Remodel Includes Structural: Yes ❑ No
Do you have the pre-application planning approval? Yes ❑ No ❑
If yes, please provide a copy of ourlannirt a royal letter. Planners name:
Square Footage:
Addition: Porch: Deck: Garage:Detached Attacfted
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:$ pw
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.