The URL can be used to link to this page

10060149 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20350 STEVENS CREEK BLVD APT 317 COP TRACTOR:ORION FINANCIAL PERMIT NO: 10060149 SER'/ICES nWNER'S NAME: PROMETHEUS REAL ESTATE GROUP PO IiOX 693 DATE ISSUED:06/23/2010 . ,NER'S PHONE: 4082537100 ROS EVILLE,CA 95678 PHONE NO:(916)789-8484 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT r— PLUMB License Class 16 �) Lic.# 7 / Z MECH F RESIDENTIAL COMMERCIAL F Contractor On, It�/�� Date G7 2 ? l JOUI DESCRIPTION: REMDL KITCHEN ADD MICROWV LINE&ICE MAKER& I hereby affirm that I am licensed under the provisions of Chapter 9 A/C (commencing with Section 7000)of Division 3 of the Business&Professions 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 Sq. Ft Floor Area: Valuation:$3900 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. (/,r X APN Number:36901021.APT317 Occupancy Type: APPLICANT CERTIFICATION 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Iss,ted� Date: Signature Date 2'3 �v ❑ OWNER-BUIL ER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of ins alled without first obtaining an inspection,I agree to remove all new materials for the following two reasons: ins)ection. 1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Si€nature of Applicant: Date: Business&Professions Code) — 1,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I I ave read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the CE lifornia Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. co upliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material. A4 lditionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this co ntaminants as defined by the Bay Area Air Quality Management District I will permit is issued. m,«ntain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I O vner ar thorizec ►t: become subject to the Worker's Compensation provisions of the Labor Code,I must — Date: forthwith comply with such provisions or this permit shall be deemed revoked. 7 CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I 1 iereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating L order's Name to building construction,and hereby authorize representatives of this city to enter -Nn the above mentioned property for inspection purposes.(We)agree to save L miler's Address mnify and keep harmless the City of Cupertino against liabilities,judgments, u.,sts,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I inderstand my plans shall be used as public records. 9.18. Licensed Professional Signature Date CITY OF CUPERTINO 9 ITEMS OF 9 PERMIT RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Blk: LDt : APN . . . . . . . . : 36901021 .APT317 DATE ISSUED. . . . . . . : 06/23/2010 RECEIPT #. . . . . . . . . BS000010696 REFERENCE ID # 10060149 SITE ADDRESS . . . . . : 20350 STEVENS CREEK BLVD APT 3 SUBDIVISION . . . . . . . CITY CUPERq INO IMPACT AREA . . . . . . . OWNER PROMETHEUS REAL ESTATE GROUP ADDRESS 1900 f. NORFOLK ST STE 150 CITY/STATE/ZIP SAN M.7.TEO, CA 94403 RECEIVED FROM . . . . : VITAL::Y TRUSH CONTRACTOR STEVE WHITESIDES LIC # 29564 COMPANY ORION FINANCIAL SERVICES ADDRESS . PO BO:'� 693 CITY/STATE/ZIP . . . : ROSEV:-LLE, CA 95678 TELEPHONE (916) 789-8484 FEE ID UNIT QUANTITY AMO7NT PD-TO-DT THIS REC --NEW-BAL- ---------- ------------- ---------- ---- ------ ---- 1BCBSC VALUATION 3, 900 . 00 1 . 00 0 . 00 1 . 00 0 . 0 1BSEISMICR VALUATION 3, 900 . 00 0 .50 0 . 00 0 . 50 0 . 00 lELECINSP HOUR 1 . 00 126 . 00 0 . 00 126 . 00 0 . 00 lEPERMITFE 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 1. 00 42 .00 0 .00 42 . 00 ------0_00 1TRAVDOC FLAT RATE ---------- ---------- ---------- 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 CITY OF CU]'ERTINO ELM ADDITION/REMODEL CUPERTINO FEE SCHEDULE APN# Is a 2"d unit-beingadded? Yes LJ Ko ❑ If es, leap a fill out the permit application for 2"d unit. Building Address: 7 &03 S Mailing Address (if different from building address): Owner's Name: Phone# 20 ju P-7/-� .mss- Jo L Phone#: Contractor: ® � � e�T Fax#: Cupertino Business License: State Con ractor License Contact: Phone#: 5 � k/A/ vi e Si��-�S Fax#: 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 Buildiniermit Info: Mech. [� Hillside IDElect Bldg. . Q Plumb. Job Description: Addition-What is being added?(BeS Specific): �� teA I-X What is being remodeled (not including addition)? Remodel Includes Re-Roof: Yes ❑ No [!f- If yes list number of squares Remodel Includes Structural: Yes ❑ No ra/ Do you have the pre-application planning appro-,al? Yes (❑/ No El If yes, please provide a copy of your planning a )roval letter. Planners name: Square Footage: Addition: Porch: Deck: _ Garage: Detached Attached Remodel: Kitchen V1 Bath ✓ Ott er Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ 11/III/V-A ❑ IUIII B, IV-HT, V-B ] Valuation: Please check this box if the project is a Project Size: Express ❑ Standard ❑ Large ❑ Ma', second-story addition ❑ Please complete relevant portion of the Green Building Checklist& attach it to the application or if applicat le, Green Building Points Achieved: include in plan set & the sheet index. Revised 05/18/10