The URL can be used to link to this page

10090249 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20350 STEVENS CREEK BLVD APT 304 CONTRACTOR:ORION FINANCIAL PERMIT NO: 10090249 SERVICES NER'S NAME: PROMETHEUS PO BOX 693 DATE ISSUED:09/27/2010 OWNER'S PHONE: 6509313457 ROSEVILLE,CA 95678 PHONE NO:(916)789-8484 ❑ LICENSED CONTRACTOR'S DECLARATION r LARATION BUILDING PERMIT INFO: BLDG ELECT r— PLUMB� License Class Lic.# 74 ` �> MECH r- RESIDENTIAL r COMMERCIAL� Contractor D� ��19/v Date � � � � �/ JOB DESCRIPTION:KITCHEN REMODEL,NON-STRUCTURAL,ADD A/C UNIT I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions ICE MAKER WATER LINE&ADD MICROWAVE LINE 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. 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:$3900 permit is issued. V APPLICANT CERTIFICATION APN Number:36901021.304 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, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point so regulations per the C ertmo Municipal Code,Section 9.18. Date: /F-2,77-,/.J C� � Issued by• iture Date ll ❑ 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, Signature of Applicant: Date: Business&Professions Code) 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. I 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& Safety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this 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 muss Owner or agent: f� 7 v Date: l forthwith comply with such provisions or this permit shall be deemed revoked. /QNSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION 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 relatini, 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 the above mentioned property for inspection purposes.(We)agree to save ,. tnnify 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 9 ITEMS OF 9 PERMIT' RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: B1<: Lot: APN 36901021.304 DATE ISSUED. . . . . . . : 09/27/2010 RECEIPT #. . . . . . . . . BS000011571 REFERENCE ID # . . . : 10090249 SITE ADDRESS . . . . . : 20350 STEVENS CREEK BLVD APT 3 SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : PROMETHEUS ADDRESS . . . . . . . . . . : 1900 S NORFOLK ST STE 150 CITY/STATE/ZIP . . . : SAN MATEO, CA 94403 RECEIVED FROM . . . . : O&ION FINANCIAL SVC CONTRACTOR . . . . . . . : STEVE WHITESIDES LIC # 29564 COMPANY . . . . . . . . . . : O&ION FINANCIAL SERVICES ADDRESS . . . . . . . . . . : PC BOX 693 CITY/STATE/ZIP . . . : RCSEVILLE, CA 95678 TELEPHONE . . . . . . . . : (S16) 789-8484 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- - --------- ---------- ---------- -- 1BCBSC VALUATION 3, 900. 00 1.00 0 .00 1. 00 0 .00 1BSEISMICR VALUATION 3, 900 . 00 0 .50 0 .00 0 .50 0 . 00 1ELECINSP HOUR 1.00 126 . 00 0. 00 126 .00 0 .00 1EPERMITFE FLAT RATE 1. 00 42 .00 0 .00 42 . 00 0 . 00 1MECHINSP HOUR 1.00 126 . 00 0.00 126. 00 0 .00 1MPERMITFE FLAT RATE 1. 00 42 .00 0 .00 42 . 00 0 .00 1PLMBINSP HOURS 1.00 126 . 00 0. 00 126.00 0 .00 1PPERMITFE FLAT RATE 1. 00 42 .00 0 .00 42 . 00 0 . 00 1TRAVDOC FLAT RATE 1. 00 42 .00 0. 00 42 .00 0 .00 ----------- ---------- ---------- ---------- TOTAL PERMIT 547 .50 0 .00 547.50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 547 .50 VISA --------------- TOTAL RECEIPT 547 .50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- --------------------------- - -------- ------------- 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 512 FINAL HANDI-CAP Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: J0 -3c,-0 PERMIT# d ZYT OWNER'S NAME: 0/z v n-, t v4 A P u PHONE# q/, GENERAL CONTRACTOR: OP BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working it the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND 7ALLUBCO TF.ACTORS HA OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. 2 �. /.G7 I am not using any subcontractors: Si;nat re Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/ Carpeting Linoleum /Wood Glass /Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date C09 CITY OF CUPERTINO CM Of CUPS TING GENERAL BUILDING PERI%MT APPLICATION FORM APN# C" Date: Z2 711-Z�� Building Addres T.03 �4ailiHgA-ddre,ss-ff diff m7eff rfrom butdmg rddnMly A' a dousMaterials being-used-as-part-Gf this-project? Yes 0 -No T OA: (Exterior work only) Yes [:] No If yes, provide letter from HOA 1 7 er's Name: Phone#: Co Phone: le C 4-,, t ('41i ,-f :Fax: C:?1110 Contractor License#: 7�, 1.P_ Cupertino Business License Contact: Phone: Fax: Residential Commercial D Job Description: C)( 1,7 C)e&z e, A 0( Building Permit Info: ' Bldg E-1 Elect [0 Plumb LTJ Mech 11 Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ E/MN-A B, IV-HT, V-*3 Valuation- Square Footage: 03F v Fee) Project Size: Express [!r Standard ❑ Large 1:1 Major E Green Building: Please complete relevant portion of the Green Building(LEED Checklist& attach it to the application or if applicable, include in plan set& the sheet index. 'oints Achieved: For help, contact Build it Green at www.budlditgL(!en.org Revised 07/14/09