11040147 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20900 HOMESTEAD RD BLDG 78 CONTRACTOR:MONTEREY PERMIT NO: 11040147
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
❑ CENSED CONTRACTOR'S DECLARATION r r-
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class t�:) Lic.# rr r
MECH RESIDENTIAL COMMERCIAL
Contractor )sate
I hereby affirm that I am licensed under the provisions 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(IOSQFT)&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:32609065.78 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 lation per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
L y2 -�!
SignatureP Date t Issued by:�"r""^`�i�"�-- 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
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
performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the
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,l 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. Owner or auth Sze e /
Date-
1
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 work'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
irl--unify 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
gi—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.
1 understand my plans shall be used as public records.
Signature Date
Licensed Professional
//(_�)L/ 7
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 20900 homestead rd bldg 78 A DATE: 04/20/2011 REVIEWED BY: bobs.
APN: BP#: "VALUATION: $20,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Repair ?j
PRIMARY Multi-Family Dwelling Buildina is PENTAMATION 1R3 REM
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 Check 0.0 hrs $0.00
Mech.Permit Fee: IMPERMIT
Other Mech.Insp. 0.0 hrs $42.00
NOTE. These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info.
FEE ITEMS (Fee Resolution 09-051 l;tf. ' U"101 FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 = s.£ Remodel,Kitchen(<=300 sf)
Suppl.PC Fee: G Reg. 0 OT 0.0 hrs $0.00 $570.00 1REMRESKIT
PME Plan Check: $0.00 10 s.f. Remodel,Other
Permit Fee: $0.00 $380.00 1REMRESOTH
Suppl. Insp.Fee-0 Reg. 0 OT 0.0 hrs $0.00 I I # Mechanical
PME Unit Fee: $0.00 $63.00 1BREMAIR A/C Units(<=10K cfm)
PME Permit Fee: $42.00
Acoustical Fee: 0 Yes (E) No $0.00
Work Without Permit? 0 Yes (D No $0.00
Planning Fee: $0.00 Select a Non-Residential G
Travel Documentation Fee: ITRA VDOC $42.00 Building or Structure Q
i
Strom Motion Fee: 1BSEISMICR $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
CITY OF CUPERTINO
7 ITEMS OF 28 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32609065.78
DATE ISSUED. . . . . . . : 04/20/2011
RECEIPT #. . . . . . . . . BS000013244
REFERENCE ID # . . . : 11040147
SITE ADDRESS . . . . . : 20900 HOMESTEAD RD BLDG 78
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
Building Department
ILM 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: o PERMIT# ' 0
OWNER'S NAME: PHONE# / /-
GENERAL CONTRACTOR: ,,� �� C . Gd . BUSINESS LICENSE# 2Z7
ADDRESS: CITY/ZIPCODE: t
*Our municipal code requires all 6usinesses 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:
V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing
Heating ,
Insulation
Landscaping
Lathing
Masonry
Painting/ Wallpaper
Paving
Plastering
17 Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
'7Tile
� ! 1
Ow /Contractor Signature Date
04/20/2011 11 : 42 (FAX) ioq
P. 012/021
CITY OF
CITY OF CUPERTINO
ADDITION/REMODEL
C U P E RT f N O FEL'K 'SCHEDULE
APN#
Is a 2'd unit being added? Yes M No 0 Ityes, please fill out the permit application for 2" lllllt.
Is this a 2°d story Addition? Yes ❑ No
Is this house an Eichler? Yes ❑ No_M 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-mail:(831) 455-7986
Landscape Ordinance Compliance:
Landscape area in sq. ft. (includes all irrigated,areas): (t'//4--
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 ❑ Water Budget
Building Permit Info: Bldg. 1XI Elect. LN Plumbing ® Mechanical Hillside ❑
Project Size: Counter ❑ Express ❑ Standard ❑ Large ❑ Major ❑
Job Description:
Addition-What is being added?(Be Specific):III stall new washer/dryer at existing closet(10sq ft); install
new air conditioning unit
What is being remodeled (not including addition)7Remodel existing kitchen (50 sq ft)cabinets, lights
Remodel Licludes Re-Roof: Yes ❑ No ® If yes list number of squares
Remodel Includes Structural: Yes ❑ No 0
Do you have the pre-application planning approval? Yes ❑ No ❑
If yes, lease provide a co of our zlannir approval letter. Planners name:
Square Footage:
Addition: Porch: Deck: Garage:Detached Attached
Remodel: Kitchen 50 Bath Other 10
Type of Construction (Usage Class): Qccupancy Type:
1-A, 1-13 II/III/V-A 11/111 13, IV-HT, V-B Valuation:$ I_C., 0 o a
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.