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11020106 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20900 HOMESTEAD RD BLDG 75 (�;'r e- CONTRACTOR:MONTEREY PERMIT NO: 11020106 CONSTRUCTION COMPANY OWNER'S NAME: PROMETHEUS 88 MONTEREY-SALINAS HWY STE A DATE ISSUED:02/28/2011 :R'S PHONE: 6509313457 SALINAS,CA 93908 PHONE NO:(831)601-2659 ❑ LICENSED CONTRACTOR'S DECLARATION r BUILDING PERMIT INFO: BLDG ELECT PLUMBFF F r License Class Lic.# - MECH RESIDENTIAL COMMERCIAL Contractor AA ` Cis. Date Z I hereby affirm that I licensed under the provisions of hapte 9 JOB DESCRIPTION:BLDG 75-UNIT C-INSTALL NEW WASHER/DRYER AT (commencing with Section 7000)of Division 3 of the Business&Professions EXISTING NTNGCLOSU(IO SQFT);I DEL EL NEW AIR Code and that my license is in full force and effect CONDITIONING UNIT&REMODEL EXISTING KITCHEN(50 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 Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$20000 permit is issued. APPLICANT CERTIFICATION ,f`> APN Number:32609065.75 Occupancy Type: I certify that I have read this application and state that the above inftirmation 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 by: / - Date: Signature-� Date C� 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: I,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 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 b the Ba Area Air y y 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 authorised agent: forthwith comply with such provisions or this permit shall be deemed revoked. Date: f' APPLICANT CERTIFICATION CONSTRUCTION LENITiING 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 i, nify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address . 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. 1 understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 7 ITEMS OF 42 PERMIT RECEIPT OPERATOR: patg COPY ## 1 Sec : Twp: Rng: Sub: Blk: Lot : APN 32609065 .75 DATE ISSUED. . . . . . . : 02/28/2011 RECEIPT #. . . . . . . . . BS000012789 REFERENCE ID # . . . : 11020106 SITE ADDRESS . . . . . : 20900 HOMESTEAD RD BLDG 75 SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER PROMETHEUS ADDRESS 1900 SOUTH NORFOLK ST STE 150 CITY/STATE/ZIP . . . : SAN MATEO, CA 94403 RECEIVED FROM . . . . : MONTEREY CONSTR CO 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 ---------- ------------- ---------- ---------- ---------- ---------- ---------- 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 50 .00 570 . 00 0 .00 570 . 00 0 . 00 1REMRESOTH SQ FEET 10 . 00 380 . 00 0 .00 380 . 00 0 . 00 1TRAVDOC FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 1100 . 00 0 . 00 1100 . 00 0. 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 301 ROUGH PLUMBING 302 TUB & OR SHOWER 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 305 FRAME 307 INSULATION 308 SHEETROCK 309 EXTERIOR LATH 310 INTERIOR LATH 311 SCRATCH COAT 313 ROOF NAIL 317 MECHANICL ABOVE CEILING 318 ELECTRICAL ABOVE CEILING 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL 516 FINAL BUILDING CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 20900 homestead rd. bldg:7Sm'__q DATE: 02/28/2011 REVIEWED BY: bobs. MA� PN: ---7BP#: *VALUATION: $20,0000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION USE: p PERMIT TYPE: 1 R3 E WORK remodel apt, unit kitchen add W/D at exisitnq closet location add new A/C. SCOPE Mech.Plan Check0.0 hrs $0.00 Mech.Permit Fee: IMPERMITF" '. Lther Mech.Insp. 0.0 hrs $42.00 Lj �.,,r . ., .. NOTE. Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resohition 09-051 Eff 7;1:'10) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = s.£ Remodel,Kitchen(<=300 sf) Suppl. PC Fee: E) Reg. 0 OT 0.0 hrs $0.00 $570.00 IREMRESKIT PME Plan Check: $0.00 = s.f. Remodel, Other Permit Fee: $0.00 $380.00 IREMRESOT Suppl. Insp. Fee.e Reg. 0 OT0.0 hrs $0.00 0 # Mechanical PME Unit Fee: $0.00 $63.00 IBREMAIR A/C Units(<=10K cfm) PMEr Permit Fee: $42.00 Acoustical Fee: Yes G No $0.00 C Work Without Permit? 0 Yes E) No $0.00 E) Planning Fee: $0.00 Select a Non-Residential E) Travel Documentation Fee: ITRAVDOC $42.00 Building or Structure i Strong Motion Fee: IBSEISMICR $2.00 Select an Administrative Item Bld,Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $87.00 $1,013.00 TOTALFEE.T $1,100.001 Revised: 01/15/2011 4 CITY OF CITY OF CUPERTINO ADDITION/REMODEL CUPERTINO FEE SCHEDULE APN# Date: Is a 2" unit being added? Yes ❑ No ® If yes, please fill out the permit application for 2" unit. Is this a 2"d story Addition? Yes ❑ No Is this house an Eichler? Yes ❑ No If yes, needs Planning approval. Building Address: 20900 Homestead Road Building Unit# Cl- Mailing Mailing Address (if different from building address): 88 Monterey-Salinas Hwy., Suite A, Salinas, CA 93908 Owner's Name: Phone# Prometheus Real Estate Group 650)931-340 Contractor: Phone#: (831)455-7931 Monterey Construction Company Fax/e-mail:(831)455-7986/thalia@mryconstructii)n.com Cupertino Business License: State Contractor License#: 32275 885297 Contact: Phone #:(831)455-7931 Thalia Tardivet/Ben Rega Fax/e-mail:(831)455-7986 Landscape Ordinance Compliance: Landscape area in sq. ft. (includes all irrigated areas): If 2,500 sq. ft. or less,compliance with the Landscape Water-Efficiency Checklist is required. If more than 2,500 sq. ft., a complete Landscape Project Submittal is required. Compliance Method: ❑ Plant Type ❑ Water Budget Building Permit Info: Bldg. X Elect. LN Plumbing ® Mechanical Hillside ❑ Project Size: Counter ❑ Express ❑ Standard ❑ Large ❑ Major ❑ Job Description: Addition-What is being added?(Be Specific):Install new washer/dryer at existing closet(10sq ft); install new air conditioning unit What is being remodeled (not including addition)?Remodel existing kitchen (50 sq ft) cabinets, lights Remodel Includes Re-Roof: Yes ❑ No ® If yes list number of squares Remodel Includes Structural: Yes ❑ No Do you have the pre-application planning approval? Yes ❑ No ❑ If yes, please provide a copy of your planning approval letter. Planners name: Square Footage: Addition: Porch: Deck: Garage: Detached Attached Remodel: Kitchen 50 Bath Other 10 Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B ❑ Valuation:$ `2C� Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, Green Building Points Achieved: include in plan set & the sheet index.