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11060159 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20900 HOMESTEAD RD BLDG 75 A-L CONTRACTOR:MONTEREY PERMIT NO: 11060159 CONSTRUCTION COMPANY OWNER'S NAME: PROMETHEUS 88 MONTEREY-SALINAS HWY STE A DATE ISSUED:06/20/2011 C :R'S PHONE: 6509313400 SALINAS,CA 93908 PHONE NO:(831)601-2659 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# 29!�y 7 MECH f— RESIDENTIAL r COMMERCIAL Contractor Date I hereby affirm that I am li sed under the provisions of Chapter 9 JOB DESCRIPTION:BLDG 75,UNIT L,REMODEL KITCHEN,50SF,ADD (commencing with Section 7000)of Division 3 of the Business&Professions WASHER/DRYER HOOK-UP AND A/C UNIT. Code and that my license is in full force and effect. 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 Sq.Ft Floor Area: Valuation:$20000 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Im r APN Number:32609029.75 Occupancy Type: APPLICANT CERTIFICATION 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18• Issued by: Date: Signature i �� Date L OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. 1,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, Signature of Applicant: Date: Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: 1 have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& 1 have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I Owner gr�aautbq zed a become subject to the Worker's Compensation provisions of the Labor Code,I must --'L Date:–�y�/� 2� forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address it' -nnify and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION glwamg of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date CITY OF CUPERTINO 7 ITEMS OF 21 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32609029. 75 DATE ISSUED. . . . . . . : 06/20/2011 RECEIPT #. . . . . . . . . : BS000013832 REFERENCE ID ## . . . : 11060159 SITE ADDRESS . . . . . : 20900 HOMESTEAD RD BLDG 75 A-L SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : PROMETHEUS ADDRESS . . . . . . . . . . : 1900 SOUTH NORFOLK ST STE 150 CITY/STATE/ZIP . . . : SAN MATEO, CA 94403 RECEIVED FROM . . . . : RICHARD 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 ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BAPPLOTHE NO OF APPLIAN 2 . 00 126 . 00 0 . 00 126 . 00 0. 00 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 1. 00 570. 00 0 . 00 570 .00 0. 00 1TRAVDOC FLAT RATE 1. 00 42 . 00 0. 00 42 .00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 846 . 00 0 . 00 846 .00 0. 00 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 20900 homestead rd. Bldg L DATE: 06/16/2011 REVIEWED BY: bobs. APN: BP#: `VALUATION: $20,000 "PERMIT TYPE: Building Permit I PLAN CHECK TYPE: Alteration / Repair PRIMARY Multi-FamilyDwelling Building is PENTAMATION 1 R3SFDREM USE: g >3 Stories 0 Yes (F) No PERMIT TYPE: WORK remodel kitchen add W/D hook-up, A/C unit. SCOPE Mech.Plan Check0.0 hrs $0.00 [Mech.Permit Fee: IMPERMIT Other Mech.Insp. L0.0 hrs $42.00 Li NOTE: Thesefees are based on the prelindnary information available and are only an estimate. Contact the De t or addn'l info, FEE ITEMS (Fee Resolution 09-051 F, . T1'10) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.f. Remodel,Kitchen(<=300 sf) Suppl. PC Fee: E) Reg. 0 OT F0.0 hrs $0.00 $570.00 IREMRESKIT PME Plan Check: $0.00 0 # Mechanical Permit Fee: $0.00 $63.00 1BREMAIR A/C Units(<=I OK cfm) Suppl. Insp. Fee-0 Reg. 0 OT0.0 hrs $0.00 = # Mechanical PME Unit Fee: $0.00 $126.00 1BAPPLOT Other Appliance/Equip PME Permit Fee: _T7 $42.00 Acoustical Fee: 0 Yes (F) No $0.00 Work Without Permit? 0 Yes G No $0.00 E) PlanningFee: $0.00 Select a Non-Residential E) Travel Documentation Fee: ITRA VDOC $42.00 Building or Structure i Strong Motion Fee: IBSEISMICR $2.00 Select an Administrative Item Bldy-Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: 1 $87.00 $759.00 TOTAL FEE: $846.00 Revised: 03/01/2011 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RTI N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: 6 « PERMIT# //P OWNER'S NAME: PHONE # — — GENERAL CONTRACTOR: -A'\&YLBUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses 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 Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile OwsfWl Contractor Signature Date 06/16/2011 15 : 15 (FAX) P. 004/004 CONSTRUCTION PERMIT APPLICATION! l �` C COMMUNITY DEVELOP ENT DEPARTMENT•BUILDING DIVISION `O { 10300 TORRE AVENUE CUPERTINO,CA 95014-3255 \ GIJPERTlAIrU (408)777-3228•FAX(40 )777-3333 • bt61dln4Ca)cur2er1ino.oro NFW CONSTRUCTION ❑ ADDI[TloN ❑ ALTERATION/TI ❑ RL'VISION/DEFERRED ORIGINAL PERMIT PROJECT ADDRESS �:s;"1��'� APNN •�/9- 15, .�•�') �,eo.e.k Qzk O\VNBA NAA1E + _ PHONE E-MAIL ��;\�:-�•• >tll•<•tit?r.• �'���?.c�� .. h:.`a;. ,;{y G,4,,,,-k? �,`t.�..».::� c;::>'i••:j..�,:::•t:3 s'ritEi3,r ADDRESS J CITY,STATE,ZIP FAX At ;;'fit,; :1C: {-Y•..,ti. ?t'C,^ C ;j. ij '1`+ t: .. CONTACT NAME ..) PHONE F•-MAII. ���F`; �� SL %Y•„�\[: l f•' -.y'i 1�i`.” :'�� �..i: ,f;s v-v _ . .�- 1�_:w::•-, sTREr_T AnDl�ss i CITY,wrier:, _ FAX v ❑OwNER ❑OWNER-DUILDPIt ❑ UWNEKAGF.NT CO''ITtACrolt- ❑CONTRAC1Olt AGENT ❑ ARCHITLCT Cl ENGINEER ❑ DEVELOPER ❑TENANT 1'ONTRACToR NAME LICENSE NUMBER LICE\SI TYPE I BUS.LICK _ '�yp..� \a�,f,CL^}M.,.., r,5•:r;r.. �.� ,,,3 t..1� I ::i.C:-..) �'1,''�:� CON-1PA1Y NAME ... ... E-MAIL. PAX f•;:,�••:j :••• •�• ,s ^:�-4.> �-..G.+••1`.;}-§-�' s.':•st••,Gs.••1 �.i..:- ..t.�..��..\, :� .-tom.-.-1 C ,•r-. a'4, ,•,?r:h•: .•-, t_�,^:; ,..l��r��� S7'KELft ADDRESS .r V CITY,STA'CE,ZIP PHONE Y^i"1-::,^.vy-t' .3 '<f:, 1._i.."1w': :•',:,..i.a '<i: �i =;)CuL. :•,;�; <•�i'A: C':` -✓`•i'.::�� ....;�,. ARCr1ITECTtENOLNEERNAME LICENSF NLIMMIR . .I Rus.I.IC 0 C O.'ArAN Y NAME - E-NiAIL FAX. STREET ADDRESS CITY,STATE.ZIP PHONE UESCRIPTIL)N OF;WORK ',{•-�: ,.�•�':.Y 't^Sf](�w..� r:.A.'C:< :iv' ! `�>,�-�:v.�- _ •?,. f•%.;%..'�`:�.�:�.:,y`,>.a t' .S"(:••:y:1:a1�•,.. � ;I" _-t:; `,..1.�•1 -.7..,' -:•Y t-"�1 ••>r�w,.� :5�,.�� •,:`,^>: -'":^iC..`i:-,i e`.��x j sem_><••1`.�,- {';,.� ..` �V t:<.,. .. I .! � '�o- A..{ EXISTING USE PROPOSFD USE CONSTR.'rl P i 'P STORIEStFiflf L'xISTG NEW FLOOR DEMO TOTAL ,jk,y AREA - +LRE.4 AREA NET AREA .:,...... DATHROO\1 01TER RE RFTdODf?f.AREA ,l'•;;: - RL•RtODIF.3.:VtEA PORCH AREA DECK ARFA TOTAL DECKIPORCH AREA GARAGE ARCA:❑DL'TACE1 s ATTACTI u:vtLUNcur+n's. rsA..£eow uNrr []:resseco'vSTORY ©vcs BCL�c.tnoeot No AnornNo PRF:APPLICAMN ❑yF.S IF YES.MOVIDYCOPYOF PLAN14BICSN l£: ` £-� - , - Rr�p46D t3Y �y1jt5'Y<: PLANNLMAPPLe ❑>i0 PLANNINOAPMOVALLUITF.R 6, By ary signature below,I certify to each of the following: .l am the property owner or-authorized agent to act or)the propL�ty owner's behalf.1 bwl�read this appticution and the information 1 have provided is correct. I havelread the Description of Work and verify it in accurate. I jsgree to comply'with all applicable local ordinnttees and slate Jaws relating Kt,4,k construction: 1 aulL}crize representative's of Cupertino to enter the above-iderytitied property`,'ar inspection purposes. r , I _ Iry 1 l Sign Lturt of ApplicantrAgenc',-.!�.._'a Date: SUPPLEMENTAL INFORMATION REQUIRED ` t iIr ATFCTICCkY1'Pt 7iUC"iINGJLIP. New SFD or Nfultifatllily dwellings: Apply for demolition pennit for �r x + ` I ❑ QVj tt T ]t(Y11171lI 13� i d )I11II DIA<.I LAN RE\'tLN existing building(s). Demolition permit is required prior t Issuance of building permit for new huildin.g. tGxpREt t h� ❑ Xl 1AI�INGY1 4r`11U,vltt►t Commercial Bldgs: Provide a completed Ha2ardous Materials Disclosure [1 rraNhnlih FilnLtt 5r4ixlFs loan_ if any Iiazardous.rVlaierials are being used as Bartof(his project. " ' Cfi,1�aF,Y `O F1Iurr —Copy of'Pl.anning ApprovaLLetter or,Meeting with Pl uung prior to ' submittal of Building Permit application. ANIIAnk �yTr4plrTgrCT . ,. yl#tfllM,tfEtE4Al1>ltlisfti 4' BldgApp_201 Ldoc revised 03/16/11 I '