13030029 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20800 HOMESTEAD RD CONTRACTOR:MONTEREY PERMIT NO:13030029
CONSTRUCTION COMPANY
OWNER'S NAME: VILLA SERRA APTS 88 MONTEREY-SALINAS HWY STE A DATE ISSUED:03/13/2013
OWNER'S PHONE: 6509313400 SALINAS,CA 93908 PHONE NO:(831)601-2659
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIALS
License Class Lic.# ��Jr 2 f[ 1 BLDG 59 REMODEL UNITS A-H-750 SQ FT EACH(6000
SQ FT TOTAL)REPLACE KITCHEN&BATHROOM
Contractor �40l•d'"mq� K--w ✓t4 • Date 26i 51 CABINETS&
I heretfy affirm that I am licensed under the provisions of Chapter 9 ELECTRICAL SUBPANELS.INSTALL(N)W/D&HOOKUPS,
(commencing with Section 7000)of Division 3 of the Business&Professions
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. Sq.Ft Floor Area: Valuation:$160000
1 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 APN Number:32609073.20800 Occupancy Type:
permit is issued.
APPLICANT.CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DA ROM LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Issued by Date 13
/1-3
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.
� "[cry.- 3 I r any
Signature Date ! 6 3 All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I,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,
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. I will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authorized agent: -� - �- Date:. J?
permit is issued.
I,certify that in the performance of the work for which this permit is issued,I shall
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 CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
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 ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
03/05/2013 09:10Mtry Construction Co, (FAX)831 455 7986 Ag P,003l003
CONSTRUCTION PERMIT APPLICATION Q 9
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION C7v
10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 -;D
CUPERTINO (408)777-3228•FAX(408)777.3333-bulldlno(Mcunertino.ora l `��
❑NEW CONSTRUCTION ❑ ADDITION DALTERATION/Tl ❑ REVISION/DEFERRED ORIGINAL PERMIT N
PAT69606'Pomestead Road,Building--SQ ,Units — NA ANN 3Z-Z (gyp 0 3j Z-09-0 d
°VI a Werra Apartments PHONE (650)931-3400 g M^tL/
9W So l�orfoik Street,9150 cganaao PCA 94403 FAX
s 1
c01 01dNlll�ght 19$ 1931-3400 cpmw 'ght@prometheusreg.colm
STREET ADDRESSCITY,STATE,ZIP FAX
1900 So.Norfolk Street At 150San Mateo CA 94403
C3OWNER
Q�❑ RWU
OWNEILDER ff 13 ❑ 1313OWNERAGENr CO=Acroa CONiRACrORAGENr ARC111TECr ENGWCI ❑
ME
BER DBLOPER TENANT
fiMc rgrR as LI9ENSAMUM IlR LECENSBTYPE BUS.UCN
6tl5Z87 B 32275
COMPANYNAME
Montero Construction Company MAILben m constructlon.com 831 455.7888
s eon°D�eyS Sallnes Hwy.,Suite A cm'b0 1%1� CA 93908 f931455-7931
ARCHITECTIENGINSER NAME LICBNSE NUMBER BUS.LIC Y
COI"ANY NAME EMAIL FAX
STREET ADDRESS Cr[Y,STATE,ZIP PHONE
DESCWPnO OF RK
Remove 8. 1V replace kitchen&bath cabinets,Replace electrical subpanel&subfeed, Install new W/D&hookups.Run new hot&cold
water Imes For all existing Bxtures. X
Valuation$
BXISTINO USB FROP059D Use CONSIX TYPE
:USE TYPE OCC, SQ,Pr. VALUATION(S)
E)asTG NEW FLOOR DLMO TOTAL
AREA ARLA AREA NUT AREA
BATIM335i RUCION
REMODEL AREA REMODEL ARBA RRMODSL AREA
PORCHAREA I DECKARBA TALDHCKRO A I OARA A; DBl'ACH
ISA
ATTACEr ,
Y DWELLING UMTS; ECOND UNrr YES sECOND sT RY 13YPS
BBMGADDED? NO ADDMONt ❑NO
PRE APPLICATION ❑YES IP YES.PROVIDE COPY OF ISTIIE BLOC AN ❑YESt,: •;;'j!i:;r•
PLANNING APPL N a NO PLANNINO APPROVAL Lffr= E1CItL6R HOME? ❑NO •; ,. ;, ;;':.p::,:.� i .;,. ..'...; TOTAL VALUATION:
8y my slgnaturc below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf, 1 have read this
application and the infbrmation I have provided la correct, 1 have read the Description of Work and verify it is accurate, 1 agree to comply with all applicable local
ordinances and state laws relating to buconstruct1 authorize representatives of Cuponlno to enter the above-identifi d property for Inspcction purposes,
Signature of Applicant/Agcnt: Date: 3
SUPPLEMENTAL[NFORMATIONREQUIRED 1::,PLA:' ci:TYes!
_New SFD or Muldramily dwellings: Apply for demolition permit for
existing building(s). DemolitionP ermit is required prior building
to issuance of
permit for now building. 9 P B ti: .:i;f�;!:' •:��;�::;i,°:;:i'• ,,i,> i:: ,:.;;,�..::;.;, ::i.:.;:,.: . , •
it '.''ExPR¢99; ,•'...;:;I .'i` :iii!, '❑;,'P1:AW1N0�PLAN REVir;W°
_Commercial Bldgs: Provide a completed Hazardous Materials
;O!;§TaNCAtiD, ;'I? '.: ?°' !i❑r•;etrBiic;woxics:l,
form if any Hazardous Materials are being used as part of this project. i.r,. ::!� :��: .i,,� :•t:
' ..ROE',
_
I�, ; r
Copy of Planning Approval Letter or Meeting with Planning ;i:.:� `�°I�i;'.i �'❑;I FIRE::D::.E.::p:.::t:.;:�,:;:':'�.,
prior to
submittal of Building
g Permit application. .'.SAN sEK'EADCCARY, `i. •0'!
19rRI
'.,: r; . O;:eivvrRONMsriraL usiLrri `'';'
SldgMpp 2011,doc revised 06/21111
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 20800 HOMESTEAD RD BLDG 59 DATE: 03/06/2013 REVIEWED BY: MELISSA
APN: 32609073.20800 BP#: *VALUATION: 1$160,000
^•PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY Multi-Family Dwelling Buildina is PENTAMATION 1 R2REM
USE: 3 Stories Yes Q No PERMIT TYPE:
WORK REMODEL UNITS A- H -750 SQ FT EACH 6000 SQ FT TOTAL REPLACE KITCHEN &
SCOPE BATHROOM CABINETS & ELECTRICAL SUBPANELS. INSTALL (N)W/D & HOOKUPS, RUN NEW
l",
Afec.,,.1110,,(,heck Plait=h.I'lat?Che":4 E111<:. blear,
§ £:£: . 1'<c,e ig Fee: F'?rrrnr•..I'£:r;it,'t I'ee
—1 1
insp. C.)fhe'
' k'r`aa=nrj.As).l'ee;
NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc.). These ees are based on the preliminar information available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS(Fee Resolution 11-053 E . 711112) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 6,000 s.f. Remodel,Other
Suppl. PC Fee: (F) Reg. ® OT 0.0 hrs $0.00 $7,629.00 1REMRES3
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Fee:Q Reg. ® OT 0,0 1 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
(;onsrrrr<tion Tax:
Work Without Permit? 0 Yes ( No $0.00 G
Advanced Planning Fee: $0.00 Select a Non-Residential G
Building or Structure 0
�
Strong Motion Fee: IBSEISMICR $16.00 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $7.00
MORE` $23.00 $7,629.00 ,,,,TOTAL FEES 7,6
., ter, TO $ 52.00
Revised: 01101/2013
03/19/2013 11 :09 FAX 4085579463 Q 003/003
f
Commuuity Development
10300 Torre Aver
Cuperaaa CA 95014 `
Telepkzte(408)777-3228
CUPGe ��N� Fax(408)777-3333
(�rvT)
BuildftnLr Department
JOB AD•DIRESS: zQ n �J PERMIT,#
KOC
1.303
y
OWNER'S NA M: roPHONE# Yo
GENEIW,CONTRACTOR/hon��e e��on FAX# 57)- -3S
l am not using any subcontractors:
Signature Date
Please checl�;a licable subcontractors and c2a: tete the following information:
SUBCONTRACTOR EUSMESS NAME =13USDTESS LICENSE #
Cabinets&Millwork
Cement Fmislvng -
Electrical
Excavation - -
Fencing ~_
Flooring: Carpetbag
Linoleum/ Woc3
Glass/ Glazing
Heating
InsWation
Landscaping
Lat7aing .
Ma:ionry 1
Ornamental Sheet.Metal
Painting/ Wallpaper -
Paving
Plastering
Plumbing 5
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
3 ..
QWnt'rlCtT8P1-1'1r�loTtafilro - �-
03/19/2013 11 :08 FAX 4085579463 001/003
r ,
45
Community Development
10300 Torre Avenue
Cuperdao CA 95014 '
Te!cplaone(403)777-3228
CUP417YOF
I Fax(408)777-3333
R. C�ng� 7177000,
Building lie axttment
JOB ADEMESS: PERMrr#�
/.30�C�o y3
OWNER'►NAIL; cbr_,��►SS ems- &acre. PHONE# yci
GENERA-i.CONTRACTOR c /...(,e TFAM 40-M -3Y71
I am,not using any subcontractors:
Signature Date
Please check a licable subcontractors and cv_rrm,lete the following-nformation:
SUBCONTRACTOR BUSINESS NAME 1 BUS1_r1FSS LICENSE #
Cabinets &Mi work
CEatent Finishing -
Eleclrical •& '3Z Z
Excavation
Fencing
Flooring: Carpeting
Linoleum/ woe d.
Glass/ Glazing
Heating _;w
Insulation i
Landscaping
Lathing
Masonry
Omamental Sheet Meta].
Pautting/ Wallpaper -
Paving
Plastering
Plumbing 2. 5
Rooffing
Septic Tank
Sheet Metal 35
Sheet Rock
Tile 1
I
f 4, --
03/19/2013 11 : 08 FAX 4085579463 002/003
t
community Development
10300 Torte Avenue
CuPerfmo CA 95014
Telephone(408)777-3228
CUPS TINO Fax(408)777-3333
�, (yug) 7�7s7G0(,
Buildin De �m.it
JOB ADDRESS: PERMIT#
2a oo Acs- a� . 4 X31
OWNER'S NAME: roux P a &+f- PHONE# '10
ZZ
GENERAL,CONTRACTOR:/rlonrkn c�-l..►6 FAX# _ '33
I ana not using any subcontractors:
Signature Date
Please check applicable subcontractors and ccs .Mete the following?nformati')n
SUBCONTRACTOR BUSINESS NAME 13USDTESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical ,
3Z.�
Excavation
Fetucing r`-
Flooring. Carpeting
L inoIeum/Woo--I
Glass/ Glazing
Heating
Insulation
Landscaping
Lathing.
Ma,-aonry
Ornamental Sheet Metal 1
Painting/ Wallpaper
Pavir�g '
Plastering
Plumbing 165
Roofing
Septic Tank
Sheet Metal --
Sheet Rock
ti •
Tile
's
Building Department
City Of Cupertino
10300 Torre Avenue
4Cupertino,CA 95014-3255
Telephone:408-777-3228
C U P E RT I N O Fax:408-777-3333
CONTRACTOR/SUBCONTRACTOR LIST' -
JOB ADDRESS: jpl" bi, A y PERMIT#.. , jtW.-` / 3
OWNER'S NAME: nG PHONEf#.
GENERAL CONTRACTOR: BUSINESS LICENSE#.�*1-
_ ADDRESS: 2,0Ij A4,j�aa14 • CITY/ZIPCODE:
*Our municipal code requires all businesses working in the cityao have a City of Cupe tin business license.
NO BUILDING FINAL-OR FINAL OCCUPANCY INSPECTION(S) �V.ILL�SB ' S DULED UNTIL THE
GENERAL CONTRACTOR AND: ALL. SUBCONTRACTORS-HAVE, D=ACITY OF CUPERTINO
BUSINESS LICENSE.
-. I am not using any subcontractors: "
Signature. '
" r Date
Please check applicable subcontractors and complete the>following mforination
SUBCONTRACTOR. BUSINESS NAME K dBUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing .,
s
Flooring/Carpeting ,y
Linoleum/Wood '
Glass/Glazing `
-_ Heating
_ Insulation s h
Landscaping
Lathing
Masonry
Painting/Wallpaper
Paving
Plastering k< �
Plumbing
3
Roofing xa
Septic Tank
Sheet Metal
Sheet Rock
Tile _
Owner/Contractor Signature - <
'`" Date _