13030028 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20800 HOMESTEAD RD CONTRACTOR:MONTEREY PERMIT NO:13030028
CONSTRUCTION COMPANY
OWNER'S NAME: VILLA SERRA APTS 88 MONTEREY-SALINAS HWY STE A DATE ISSUED:03/13/2013
OWNER'S PHONE: 13030028 SALINAS,CA 93908 16.PHONE NO:(831)601-2659
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIALU .
License Class - Lic.# C, BLDG 58 REMODEL UNITS A-L-1,025 SQ FT EACH
(12300 SQ FT TOTAL)REPLACE KITCHEN&BATHROOM
Contractor M(7htiEes4 cOH-312 Date b 3 L 1 S CABINETS&ELECTRICAL SUBPANELS.INSTALL(N)W/D
I hereby affirm that I amlicensed under the provisions of Chapter 9 &
(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:$240000
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 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 andcounty ordinances and state laws relating WITHIN 10 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 DAYM LAST CALLED INSP CTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the /3
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date
With all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature per- —r Date 2GI'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,,22555333,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: �,, Kr�4�IG Date: 013
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 P.002/003
CONSTRUCTION PERMIT APPLICATION DO
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
10300 TORRE AVENUE-CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228-FAX(408)777.3333•bulldlno(Qcuoertlno.ora
❑NEW CONSTRUCTION ADDrriON ❑ALTERATION/TI ❑ REVISION/DBFERREDORIGINAL PERMIT O
PROJEcr 20808 oD Ress mestead Road,Building^15fi� ,Units P\- L, "�'" 2,6 07p D ;L3. ZOYCO
208
Tl a terra Apartments
PHONE E-MAIL
(650)931-3400
97 966 9o'Norfolk Street,#150 cSail�v�SA17CA 94403 FAX
CorJev2d" r�ght (0%0 931-3400 A.MAw(Q,
m �ght @prometheusreg.Colm
STREET ADDRESS CITY,STATE,ZIP PAX
1900 So.Norfolk Street #160Sen Mateo CA 94403
[3OOWxNERR ClOWPIDR•DUIIMER, 6OWNERAGEW O CONTRACTOR OCONTRACTOR AOBM CI ARCHITECT' ❑ENGINEER 11DIIVBLOPBR ❑TENANT
WrR cl rieAra RNAMe
ega LmIty MISER LtgeNSB TYPR BUS.LIC a 32275
COMPANY NAME
Montere Construction Company BM ben m construction.com 831 455-7986
sW vfon°t°erey Seilna9 Hwy„Suite A CITY,
grana CA 93908 t93T1466-7931
ARCHITECTIBNOTNEER NAME LICENSE NUMBER BUS.LIC a
COMPANY NAME E-MAIL
FAX
STReeT ADDRESS CITY,STATE,ZIP
PHONE
°Remove*repPoce kitchen&bath cabinets.Replace electrical subpenel&subfeed. Install new W/D&hookups.Run new hot&cold
water lines for all existing fixtures. X a
Valuation S a �$ end M •}
WOSTINGUSS,
PROPOSED USe CONSTA M STORlBS
USE TYPE OCC. SQYT, VALUATION(S)
Px1sro NEW FLOOR DEMO TOTAL
AREA AREA AREA NET AREA
BATHROOM HEN OTHER
REMODELAREA REMODELAREA REMODEL AREA
_=CK ARBA TOTAL DzuripoxciiAAaA I GARAOSARSA; ETACN
ATTACH
MDWELLING UNITS: 15 A SECOND UNrr Y11,9 9ECONDSTORY YES
DCINCADDED? NO ADDITION! 13NO
PRE.APPLICATION YES IFYaS,PROVIDE Copy OP ISTIMBLUCAN
PLANNING APPLY NO PLtNNINO APPAOVALL131TER CICIILBR n0a Et 0 YNE09 D BY; ;; ?'. i's'.,;d.•: TOTAL VALUATION;
By my signature below,I conily to each of the fbllowing: I am the property owner or authorl2ed agent to act on the property owner's bchelf. I have read thio
application and the Inrormation I have provided is correct t have read the Description of Work and verity It is accurate. I agree to comply with all applleablo local
ordinances and state laws relating to buWal construetio . I authorize representatives of Cupertino to enter the above-Id ntiCod roperty for inspection purposes.
Slgnature of Applicant/Agent Date: 3
SUPPLEMENTAL INFORMATION REQUIRED ',Ptr�N CItBCK.7YP&.. ItOU7llVO SLIP
New SFD or Multifamily dwellings; Apply for demolition mtlrfor
existing building(s). Demolition permit is required prior to issuance of buildln °. R'TII&cotnv�,>R <!:.i.;' l7:,avaniNo PLAN.iiEV1EW'
permit for new building, g
❑''&XPRE98 ;'°.:.; :.:;: :::,i, ❑;i:PLA
NN{NO'PL'AN1il;V1EW$W:";;:
_Commercial Dldge: Provide a completed Hazardous Materials Disclosure
I O':ruoiic woiei;
form if any Hazardous Materials are being used as part of this project.
_ .
A$Copy ofPlannin Approval Letter or Meeting with Planning prior to '
�.
•;,.:�'.:;,�;;�::'-' � �: �';,,','.
submittal of Building Permit application,
O 'MgJOR:::;' i "l., "❑'8ANI7ARVISEWKII DISTRICT
F.
NVIAONM£NTALHEALTH;
BldgApp Z011.doc revised 06/21/11
y
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 20800 HOMESTEAD RD BLDG 58 DATE: 03/06/2013 REVIEWED BY: MELISSA
APN: 32609073.20800 BP#: *VALUATION: 1$240,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY Multi-Family Dwelling Buildina is PENTAMATION 1 R2REM
USE: 3 Stories Yes ® No PERMIT TYPE:
WORKREMODEL UNITS A-L- 1,025 SQ FT EACH 12300 SQ FT TOTAL REPLACE KITCHEN &
SCOPE BATHROOM CABINETS & ELECTRICAL SUBPANELS. INSTALL (N)W/D & HOOKUPS, RUN NEW
s
;�ech.T'icr,;r£i=£r£:u, 1'izarrFl>.1'i�rr i;iFE:ck �i c,i;;'<a:t:Itf:f;it
:I1. ;c'i'FnZ?Fee
0"her vfr ch' 7% €.lr/a�F'.�'/Fi e>Irti}3. I.)r'eri'k icc,in;i.;.
19E:ch, I t'z>, f't: t'honb..Ings .Fee: 1"ee:
NOTE.This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc.). Theseees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 11-053 E . 7/1112) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 12,300 s.f. Remodel,Other
Suppl. PC Fee: Reg. ® OT 0.0 hrs $0.00 $11,640.00 1REMRES3
PME Plan Check: $0.00
Permit Fee: $0.00
Supp/. Insp.FeeQ Reg. ® OT0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
("Ons truct7on. rx.'
Work Without Permit? 0 Yes (E) No $0.00 E)
Advanced Planning Fee: $0.00 Select a Non-Residential E)
Travel Building or Structure 0
i
Strong Motion Fee: IBSEISMICR $24.00 Select an Administrative Item
Bld,2 Stds Commission Fee: IBCBSC $10.00
ti �8� $34.00 11,640.00 TOTALFEEe $11,674.00
, a 11 .. r. .... ._.. .e.� ..._,...
Revised: 01/01/2013