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10120132 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20900 HOMESTEAD RD BLDG 79 A-B CONTRACTOR:ALCAL ARCADE PERMIT NO: 10120132 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 BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class —3 Lic.# � 25 (o MECH RESIDENTIAL COMMERCIAL Contractor_ Date l7 I hereby affirm at I a uensed under the provisions of Chapter 9 JOB DESCRIPTION: BLDG 79-RE-ROOF OF EXISTING BUILDING,MULTI- (commencing%ZSect n 7000)of Division 3 of the Business&Professions FAMILY RESIDENTIAL REMOVE EXISTING ASPHALTIC COMPOSITION Code and that my license is in full force and effect. SHINGLES,USE EXISTING 1/2"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 b Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$15996 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:32609065.79 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 regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. Signature Date Z (Z ld Issued by:.����' Datel7-12-4V ❑ WNER-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) I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date: l Z�17�C�J construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three ALL ROOF4,OVERINGS 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 I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain 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,I 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 g Date: 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Lender's Address granting 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 CITY OF CUPERTINO 3 ITEMS OF 9 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32609065 .79 DATE ISSUED. . . . . . . : 12/17/2010 RECEIPT #. . . . . . . . . : BS000012296 REFERENCE ID # . . . : 10120132 SITE ADDRESS . . . . . : 20900 HOMESTEAD RD BLDG 79 A-B 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 15, 996 . 00 1 . 00 0 .00 1. 00 0. 00 1BSEISMICR VALUATION 15, 996 . 00 1 . 60 0. 00 1.60 0 .00 1REROOFRES SQ FEET 60 . 00 780 .00 0. 00 780. 00 0 .00 ---------- ---------- ---------- ---------- TOTAL PERMIT 782 .60 0 .00 782 . 60 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 79 DATE: 12/17/2010 REVIEWED BY: bobs. APN: BP#: *VALUATION: 1$15,996 O';PERMITTYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY Multi-FamilyDwellin Buildina is PENTAMATION 1 R2ROOF USE: g >3 Stories C) Yes (F) No PERMIT TYPE: WORK multi-family re-roof SCOPE FEE ID ROOF AREA s.f. 1REROOFMRES 6,000 F',. . t..��.. LFti+p Ll NOTE. Thesefees are based on the preliminatUy in ormation available and are only an estimate. Contact the Dept-for addn'l info, FEE ITEMS (Fee Resolution 09-051 E 7.'1%70) FEE QTY/FEE MISC ITEMS 1'/on C heck 1 5rrj 1,T// PC f cl7 c [ 7 I�ttltlf123.,"IIC(11. 1:/i:(1 17f Permit Fee: $780.00 Pi zi tai h,' I t?.( ?.,[I�,!(,L (}cl iwi d ?.:C_ ,�c�C}IfSIt<'tt% �it't'7C f F's'; Work Without Permit? 0 Yes (F) No $0.00 Tl-al el 1)o"_1 oi;'c'tttuliwl Fc'c. , I Strona Motion Fee: IBSEISMICR $1.60 Select an Administrative Item Bldp:Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $782.60 $0.00J TOTAL FEE: $782.60 Revised: 12/07/2010 CITY OF CITY OF CUPERTINO ELI] REROOF CUPERTINO PERMIT APPLICATION APN# U Cl Date: If residential, is house an Eichler? Yes ❑ No ❑ If yes, needs planning approval. Building Address: Owner's Name: �p,�,l nye � ? Phone # � S-0 �71 _ 3 ys 7 HOA: Yes ❑ No ❑ If yes, provide letter from HOA Contractor: Phone #:C�/ 77 At L/ AuHvlt� telv"ZItc n1lG Fax#• sid X177 -9781v Cupertino Business License #: Contractor License #: Lj O-V (o 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. 4�DE 4E &V—Sr/Al o9vit-,014 /, ;;�1'6�11-7 It � A)60 t,1,W4_L Job Description: n I > Q W\J(- 1:m tt q It I S' tz� 3a `�/�' �6,qp 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: I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: