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10050145 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20900 HOMESTEAD RD BLDG 78 CONTRACTOR:GIACALONE ELECTRICAL PERMIT NO: 10050145 SER'/ICES `VNER'S NAME: PROMETHEUS REAL ESTATE GROUP 6300 MONTEREY RD DATE ISSUED:05/18/2010 vWNER'S PHONE: 5107730770 GILROY,CA 95020 PHONE NO:(408)842-9655 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class f!L� Lic.# Q L/1�f MECH r— RESIDENTIAL r— COMMERCIAL Contractor�«+G y�d��- �[.a��te � I hereby affirm that I am licensed under the provisions of Chapter 9 JOE DESCRIPTION:RELOCATE MAIN ELECTRIC PANEL TO EXISTING (commencing with Section 7000)of Division 3 of the Business&Professions BUR DING 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.I't Floor Area: Valuation:$5000 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:32609065.78PNL 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 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 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. Issued b Date:c;^nature4K� Date f _ ❑ OWNER-BUILDER DECLARATION RE-ROOFS: All r)ofs 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 installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. I,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, 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 HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I ha✓e read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the Cali fornix Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. compliance 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. 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 conlaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain 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 Hea th&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 Ownea}}��thorized agent: _J // become subject to the Worker's Compensation provisions of the Labor Code,I must /�6...�1 Date: S7` forthwith comply with such provisions or this permit shall be deemed revoked. �7� CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby 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 Len ler's Name to building construction,and hereby authorize representatives of this city to enter the above mentioned property for inspection purposes.(We)agree to save Len Ier's Address .mify and keep harmless the City of Cupertino against liabilities,judgments, costs,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 umlerstand my plans shall be used as public records. 9.18. i^ /U Lice used Professional Signature Date '�/ CITY OF CUPERTINO 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 32609D65 . 78PNL DATE ISSUED. . . . . . . : 05/18/2010 RECEIPT #. . . . . . . . . BS000310432 REFERENCE ID # . . . : 10050145 SITE ADDRESS . . . . . : 20900 HOMESTEAD RD BLDG 78 SUBDIVISION . . . . . . : CITY CUPERTINO IMPACT AREA . . . . . . OWNER PROMETHEUS REAL ESTATE GROUP ADDRESS 1900 S NORFOLK ST STE 150 CITY/STATE/ZIP . . . : SAN MATEO, CA 94403 RECEIVED FROM . . . . : GIACALONE ELECT SVC CONTRACTOR . . . . . . . : VINCE GIACALONE LIC # 23118 COMPANY . . . . . . . . . . : GIACALONE ELECTRICAL SERVICES ADDRESS . . . . . . . . . . : 6300 MONTEREY RD CITY/STATE/ZIP . . . : GILROY, CA 95020 TELEPHONE . . . . . . . . : (408) 842-9655 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 5, 000 . 00 1. 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 5, 000 . 00 0.50 0 . 00 0 . 50 0 . 00 1EPERMITFE FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00 1ERT<200 UNITS 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 127 . 50 0 . 00 127 . 50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 127.50 #9433 --------------- TOTAL RECEIPT 127.50 CITY OF CUPERTINO CUPERTINO GENERAL ]BUILDING PERMIT APPLICATION FORM APN# Date: Building Address: ci oo Hot-,s- Mailing -,Mailing Address (if different from building address): Are Hazardous Materials being used as part of this project? Yes ❑ No ❑ HOA: (Exterior work only) Yes ❑ No If es, provide letter from HOA Owner's Name: Phone#: .�t1/--e l kt*0sR.11,4L EVA , 10 '?77 3-02 24) Contractor: Phone: ` C�vic-� Fax: Contractor License#: I L1 Q Uj Cupertino Business License#: Z Contact, Phone: y "4-j- '70`7 Fax: Residential ❑ Commercial ❑ Job Description: -C 4,4-7C,/�► l,D��yr-e Building Permit Info: Bldg ❑ Elect Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B [� Valuation: Square Footage: Project Size: Express ❑---giandard ❑ Large ❑ 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.builditgreen.-)r Revised 07/14/09 .I U S,� CITY OF CL PERTINO CU CITY Of O GENERAL BUILDIT�'G APPLICATION FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM 1STUCOAP Stucco Applications (up to 400 sf) B additional stu-,co 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 Pernit Fee E 1 MPERMITFEE Mechanical Permit Fee M 1PPERMITFEE Plumbing Permit Fee P 1 ELCPLNCK Stand Alone Electric Pln Ck (hourly) E 1 MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M IPLMBLNCK Stand Alone Plumbing Pln Ck (hrly) P 1 STPLNCK-(3 Hr Min Standard Plar Check (when no E/M/P) B when not over counter) hourly-stand ;alone IBCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICR Seismic Residential B 1BSEISMICO Seismic Commercial B 1 TRAVDOC Travel &Documentation B IBUSLIC Business License B / rl2T�2v� 5 of.i M.Indoor Air Quality and Finishes 1.Use Low/No-VOC Paint 1 IAW-iaalth pts y=yes D 2.Use Low VOC,Watar-Based Wood Finishes 2 Irl O/Haalth pts y=yas 0 3.Use Lflw/No VOC Adhesives 3 Ir'O/Hsalth pts y=yes D 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes D 5.Use Engineered Sheat Goods with no added Urea Formaldehyde 6 If G/Health pts y=yes D 6.Use Exterior Grade Plywood for Interior Uses 111 0/Health pts y=yes D 7.Seal all E-Amosad Paraol9bcard Dr MDF _ 41/Wealth. pts r= es D B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim i Fssource pts y=yes D 10.Install Whole House Vacuum System 3 l,>QlHealth pts y=yes D H.Flooring 1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 RE30UTCe pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAXHaalth pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 RE3DUTD-3 pts y=yas 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 Total Points Available: 14OF 130 57 Total Points Project Recelved: a-- 1 01 0 0 G:data/progs/greenbuil{iingguidelines/ramodelars/greenpointsfina12.12.04protested.xis Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR / SUBC'ONTRACTOR LIST JOB ADDRESS: Z2rt Gx' PERMIT# O.S�c> �YS OWNER'S NAME: t 42 PHONE# r ,' "077v GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: of,) CITY/ZIPCODE: `7 Ceo *Our municipal code requires alrfiusinesses working in 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 SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete -:he following information: s/ 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/ ontractor Si imnre Date