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10070010 CITY OF CUPERTI NO BUILDING PERMIT BUILDING ADDRESS: 20080 RODRIGUES APT A CONTRACTOR:DEVERA CONSTRUCTION PERMIT NO: 10070010 INC. 'NER'S NAME: PROMETHEUS 941 D BERRYESSA RD DATE ISSUED:07/01/2010 OWNER'S PHONE: 6509313476 SAN JOSE,CA 95133 PHONE NO:(408)441-9598 9f LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT r PLUMB License Class _ Lic.# (0(404[S' � iWir MECH RESIDENTIAL COMMERCIAL r Contractor e i�6" Cof—r+I%tti Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:APT A&B;DRYER VENT TO OUTSIDE BY ADDING DUCTING (commencing with Section 7000)of Division 3 of the Business&Professions &ROOF JACK 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 permit is issued. Sq.Ft Floor Area: Valuation:$300 APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is APN Number:36903008.APTA 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 0 DAYS OF PERMIT ISSUANCE OR with all non-point source regulations per the Cupertino Municipal Code,Section 180 DA ROM LAST CALLED INSPECTION. 9.18. i lature � Date I6 a Issued by .' Date: ❑ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one o' RE-ROOFS: the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is I,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) 1,as owner of the;property,am exclusively contracting with licensed contractors to Signature of Applicant: Date: construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS 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 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& 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. OwOwne� ut ed_ !!r!f=A� Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 1 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 relatin; 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.) the above mentioned property for inspection purposes.(We)agree to save Lender's Name nnify 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. n 1 understand my plans shall be used as public records. Signature Date4r Ir O Licensed Professional CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: "VALUATION: $0 'PERMIT TYPE: Mechanical Permit I PLAN CHECK TYPE: Alteration/Addition / Repair PRIMARY 100 I APPLICATION USE: SFD or Duplex r T O(WRf-I, TYPE: xW xa C) 3 � APPLIANCE/EQUIP TYPE CAPACITY FEE ID QTY BP FEES Vent, Appliance (only) 0 $0 TOTALS: F $0.00 Mech.Plan Check 0.0 hrs $0.00 Mech.Permit Fee: 1 MPERMIT Other Mech.Insp. 0.01 hrs $42.00 NOTE: Theseees are based on the preliminary in ormatiot available and are only an estimate. Contact the De t or addn 7 info. FEE ITEMS (1-'ee Resolution 09-051 Ff: T 1,Y)9j FEE QTY/FEE MISC ITEMS PME Plan Check: 50.00 PME Unit Fee: 30.00 PME Permit Fee: $42.00 Travel Documentation Fee: 1TRAVDOC $12.00 Select an Administrative Item Bld�-j Stds Commission Fee: $0.00 SUBTOTALS $34.00 $0.00 TOTAL FEE: $84.00 Revised: 5/27/2010 CITY OF' CUPERTINO 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: B--.k: Lot: APN . . . . . . . . : 3F1'903008 .APTA DATE ISSUED. . . . . . . : 0'1/01/2010 RECEIPT #. . . . . . . . . BS000010754 REFERENCE ID # • • • 10070010 SITE ADDRESS . . . . . : 20080 RODRIGUES APT A SUBDIVISION . . . . . . CITY CUPE RT I NO IMPACT AREA . . . . . . . OWNER PROMETHEUS ADDRESS . . . . . . . . . . : 1900 SOUTH NORFOLK ST STE 150 CITY/STATE/ZIP . . . : SAN MATEO, CA 94403 RECEIVED FROM . . . . : Dl-,VERA CONSTRUCTION CONTRACTOR H]iNRY DEVERA LIC # 24605 COMPANY D:,,VERA CONSTRUCTION INC. ADDRESS . . . . . . . . . . : 9-11 D BERRYESSA RD CITY/STATE/ZIP . . . : SAN JOSE, CA 95133 TELEPHONE (,108) 441-9598 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 300 . 00 1 . 00 0. 00 1. 00 0 . 00 1BUSLIC FLAT RATE 1. 00 114 .00 0 .00 114 . 00 0 .00 1MPERMITFE FLAT RATE 1. 00 42 . 00 0 . 00 42 . 00 0 . 00 1TRAVDOC FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 199 . 00 0 .00 199. 00 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 199 .00 #24781 --------------- TOTAL RECEIPT 199. 00 C, c 7 1 r,,.- CITY OF CUPERTINO CUPEkTINO GENERAL BUILDING PERMIT APPIACATION FORM APN C � n Date:7�IZQ o: .- 1- �� Building Address: (�o Mailing Address (if differe t from building address) Are Hazardous Materials being used as part of this project? Yes El No HOA: Exterior work only) Yes ❑ No L','yes, provide letter from HOA Owner's Name: Phone#: Contractor: Phone:((o S— qe��t Co �,�, Fax: p - V (- G -" � Contractor License 4- Cupertino Cu ertino Business License t Contact: Phone: 0� S o Fax: 737$ R sidential Commercial Job Description"Ilk� U Q Q 0--Q , Building Permit Info: Bldg ❑ Elect ❑ Plumb ❑ Mech K� Type of Construction (Usage Class): Occupancy Type: 1-A5 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B E]—. V--- Valuation: ari Square Footage: 0 '0 Project Size: Express Standard ❑ Largf ❑ Major ❑ 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. Points Achieved: For help, contact Build it Green at www.bui1dit14 reen.or Revised 07/14/09 CITY OF CUPERTINO CITY OF GENERAL BUILDING APPLICATION CUPEkTINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM 1STUCOAP Stucco Applications (up to 400 sf) B additionE l stucco application 1 WINREP Replacement windows/sliding glass B door (ea 8 windows) 1 WINMEWSTR New Window-structural shear B wall/masonry (includes plan ck fee) IEPERMITFEE Electrical Permit Fee E 1MPERMITFEE Mechanical Permit Fee M 1 PPERMITFEE Plumbin o,Permit Fee P 1 ELCPLNCK Stand Al one Electric Pln Ck (hourly) E 1 MECPLNCK Stand A:one Mechanical Pln Ck(hrly) M 1PLMBLNCK Stand A'one Plumbing Pln Ck(hrly) P 1 STPLNCK-(3 Hr Min Standard Plan Check(when no E/M/P) B when not over counter) hourly-stand alone j 1BCBSC Cal Bld;; Standards Commission Fee B ALL PERMIT 1 TYPES 1BSEISMICR Seismic Residential B 1BSEISMICO Seismic Commercial B 1 TRAVDOC Travel &Documentation B 1BUSLIC Business License B 5 of 5 c be June 30, 2010 To.Whom It May Concern: This letter is to confirm that DeVera Construction, Inc. is approved to do the Attic Extension project in Building 20080 for The Biltmore Apartments located in 10159 S. Blaney Ave Cupertino, CA 95014. Please generate and release the building permit to this vendor. Should you have a:iy questions, please contact me at the Leasing Office, 408-255-8787 or e-mail at ctan )rometheusreg com. Sincerel , Clarisse Tan Property Manager 408-255-8787 408-255-4815 fax v 10159 South Blaney,_Cupertino, California 95014 Phone: (408) 255-4787 Fax: (408) 255-4815 Email: the.bilti-nore(("Proinetheuw,-�,.t,,.com Web: www.prometheusreg.com 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: a00S p PERMIT# OWNER'S NAME: omC_ PHONE# q�5y GENERAL CONTRACTOR:L� VwtA BUSINESS LICENSE# ADDRESS: er G /L� '� CITY/ZIPCODE: / 3 *Our municipal code requires all businesses wor ing ir.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 ALL SUBCONTUACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. :7 b // -D — I am not using any subcontractors: �� Signature I t 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 T Date Owner/Contractor Signature