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10120133 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20900 HOMESTEAD RD BLDG 78 A-L CONTRACTOR:ALCAL ARCADE PERMIT NO: 10120133 CONTRACTING INC OWNER'S NAME: PROMETHEUS 10600 WHITE ROCK RD STE 100 DATE ISSUED: 12/17/2010 OWNER'S PHONE: 6509313457 RANCHO CORDOVA,CA 95670 PHONE NO:(510)477-9380 ❑ LICENSED CONTRACTOR'S DECLARATION r F 2 p ('� r C- BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class c7 l Lic.# Z�t 7 Z F r F MECH RESIDENTIAL COMMERCIAL Contractor - Date J7-//7 XP I hereby affir that I aplicensed under the provisions of Chapter 9 JOB DESCRIPTION: RE-ROOF OF EXISTING BUILDING,MULTI-FAMILY (commencing with Section 7000)of Division 3 of the Business&Professions RESIDENTIAL REMOVE EXISTING ASPHALT SHINGLE Code and that my license is in full force and effect. (COMPOSITION),1/2"PLY CDX.#15 FELT,30YR COMP 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 Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$19252 permit is issued. APPLICANT CERTIFICATION APN Number:32609065.78 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Issued b��.�Z��"�—_ Date:� �-�u Signature Date Z"7 /4� �� ❑ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: /2� 7�Z� 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROO COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 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. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must Owner or auth a ent: 10 forthwith comply with such provisions or this permit shall be deemed revoked. Date: APPLICANT CERTIFICATION Z CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 9 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN 32609065 .78 DATE ISSUED. . . . . . . : 12/17/2010 RECEIPT #. . . . . . . . . : BS000012296 REFERENCE ID # . . . : 10120133 SITE ADDRESS . . . . . : 20900 HOMESTEAD RD BLDG 78 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 . . . . : ALCAL ARCADE CONTRACTOR . . . . . . . : DARREN MORRIS LIC # 400 COMPANY . . . . . . . . . . : ALCAL ARCADE CONTRACTING INC ADDRESS 10600 WHITE ROCK RD STE 100 CITY/STATE/ZIP . . . : RANCHO CORDOVA, CA 95670 TELEPHONE (510) 477-9380 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 19, 252 . 00 1 .00 0 .00 1 . 00 0 .00 1BSEISMICR VALUATION 19, 252 . 00 1. 93 0 .00 1. 93 0 . 00 1REROOFRES SQ FEET 71. 00 923 .00 0. 00 923 . 00 0 .00 ---------- ---------- ---------- ---------- TOTAL PERMIT 925.93 0 . 00 925. 93 0 .00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 309 EXTERIOR LATH 311 SCRATCH COAT 600 PRE-INSPECTION 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 20900 homestead rd. bldg 78 DATE: 12/17/2010 REVIEWED BY: bobs. APN: BP#: *VALUATION: 1$19,252 ;;�PZERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY Multi-Family Dwelling Building is PENTAMATION 1 R2ROOF USE: 3 Stories Yes No PERMIT TYPE: WORK multi family re-roof. SCOPE FEE ID ROOF AREA s.L 1 REROOFMRES 7,100 1-1f,__ P/ r r.,if�Z S it .z_. P' 1 la` P;v NOTE: Thesefees are based on the preliminayUy in ormation available and are only an estimate. Contact the De t or addn'l info, FEE ITEMS (Fee Resolution 09-051 Ef� 7%1i10j FEE QTY/FEE MISC ITEMS 1!,m C11cf-A Ft"(", Permit Fee:p $923.00 t ts,F?tit1`lt+:'ft=,f, d zr', Work Without Permit? 0 Yes E) No $0.00 Strong Motion Fee: IBSEISMICR $1.93 Select an Administrative Item Bldg;Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $925.93 $0.00 TOTAL FEE: $925.93 Revised: 12/07/2010 :ITY OF CITY OF CUPERTINO REROOF CUPERTINO PERMIT APPLICATION APN# (0 Q 9 .- Date: If residential, is house an Eichler? Yes ❑ No If yes, needs planning approval. Building Address: -78 Owner's Name: Phone #: G S-v 93 3 YS 7 HOA: Yes ❑ No If yes, provide letter from HOA Contractor: Phone #: AS i o V-7 7 - j 3 f O ALCytL Fax#: 3-16 4/ 77 - 17B6 Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: Proposed: Built-Up Roof ❑ Built-Up roof Asphalt Shingles X Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. -,Vv01 6P k-Yt.s7-7.119 fg- vrcp /./ lgvcv F-0,N► 1Z&ZJjVt_vV rte. Job Description: NtdU� Kts't-t�Z l4 .-r CCO'4 Residential ❑ Commercial ❑ Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: ❑ applicable, include in plan set & the sheet index. Valuation: 4 I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: C