13050022 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20800 HOMESTEAD RD CONTRACTOR:MONTEREY PERMIT NO:13050022
CONSTRUCTION COMPANY
OWNER'S NAME: VILLA SERRA APTS 88 MONTEREY-SALINAS HWY STE A DATE ISSUED:05/07/2013
OWNER'S PHONE: 6509313400 SALINAS,CA 93908 PHONE NO:(831)601-2659
LI ENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL[]
License Class Lic.# BUILDING 8 UNITS A-H- REMODEL KITCHEN,BATH,
ELECTRICAL SUBFEED,W/D HOOKUP,CREATE FULL
Contracto Date — BATH
I hereby affirm that I airrlrcensed under the provisions of Chapter 9 WITHN EXISTING SQ. 1,025 SQ FT PER UNIT
(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. Sq.Ft Floor Area: Valuation:$160000
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 APN Number:32609073.20800 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon theabove mentioned property for inspection purposes. (We)agree to save 180 DAYS CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Date:
granting of this permit. Additionally,the-applicant understands and will comply I by:
with all non-point source regulations per the pertmo Municipal Code,Secti
9.18.
RE-ROOFS:
Signature Date.-�� All roofs shall be inspected prior to any roofing material being installed,If a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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,
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business.&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. I will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3740 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and ZU34.
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: ate:s=
permit is issued.
I certify that in the performance of the work for which this permit is issued,I shall
not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY
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 I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
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 ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
05/02/2013 14:59Mtry Construction Co. (FAX)831 455 7986 P.003/003
CONSTRUCTION PERMITAPPUCATION
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
10300 TORRE AVENUE I CUPERTINO,CA 95014-3255 d�0
CUPERTINO (408)777-3228•FAX(408)777-3333-bulidinaldlcuoertlno.ora I✓
--[:]NEW CONSTRUCTION ADDITION ❑ALTERATION/TI REVISION/DEFERRED ORIOINAL PERMrf#
P118956Womestead Road, Building# ,Units "Y
I �a a Apartments "1650 931.3400
s1TKIDO'Worfolk Street,#150 Tdn' ateo, CA 94403 FAX
UBlA
YIQ VVrlg%t P ONE -MAIL
650 931-3400 rmwright@prometheusreg,com
STRHETADDRESS CITY,STATE,ZIP FAX
1900 So, Norfolk Street #1xf C350 San Mateo CA 94403
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re constructionn Company tien6mryconstructlon.com (dl)455-7986
ADDRESS CITY,STATE,LIP
onterey-Salinas Hwy,,Suite A P83HONE1 455-7931
ARCHITBCr&ND1NEER NAME LICENSE NUMBER BUS,LIC Y
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHOS
f�emoveN&°re°AX
lace kitchen&bath cabinets. Replace electrical subpanel&subfeed. Install new W/D&hookups.
Run new hot&cold water lines for all exIsting fixtures.Add additional full bath within existing apartment footprint.
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By my signature below,I earthy to each of the following: lain the property owner or nuthorized ont t et on rho property owner's behalf. I have road this
application and the information 1 have provided Is correct I have read the Description of Work and vcr' It'll aecuralo. 1 agreO to comply with all applicable local
ordinances and stato laws relating to building ation, I outhoriza representatives of Cupertino ro r the abov ldentl ed property for Inspection purposes.
Signature of Applicant/Agent: Date: 4b, 3
SUPPLEMENTAL INFORMATION REQUtRED i.
P CHFCKTYPF'
Now SFD or Multifamily dwellings: Apply for demolition permit for i
existing building(s),
Demolition permit is required prior to issuance of buildin nu....... •
•r:.,.. .,.,..: ,I;: �, O,PLAiY
permit for new building. -1"
.j• I•.;,;,,' !i ':.:,.:,.;.:;.; !i
1 XPFiESS';i 1� CO PLANii1NG PLAN REv(sw
Bldgs: Provide a completed '
Commercial Bldg .
`! ;;
pleted Hazardous Materials Disclosure
D ,STANDARD ❑iPUBLICVIORK6',
form if any Hazardous Materials are being used a9 part of this protect. � :'i::�"' • ::, . . ,; '
'FIRE-bEPf r :!' 1'•• •'
_Copy of Planning Approval Lettcr or Meeting with Planning prior to :;;.''
submittal of Building Permit application. i�;:;SNJo[t:;::il!ii'',;i!:::; :1'i;': `r.!i;: .�'6AlYITARY SE!'�'.: '`•:,!'.. ''''•:
...
i WER DISTRICT:
L7'.ENVIRONME?JTAL HEALTH'
BldgApp 2011.doc revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 20800 Homestead rd DATE: 05/03/2013 REVIEWED BY: Mendez
APN: BP#: *VALUATION: 1$160,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY Multi-Family Dwelling Building is PENTAMATION 1 R2REM
USE: >3 Stories 0 Yes (F) No PERMIT TYPE:
WORK BUILDING 8 UNITS A-H- REMODEL KITCHEN BATH ELECTRICAL SUBFEED W/D HOOKUP
SCOPE CREATE FULL BATH WITHN EXISTING SQ.
llhavb. I'ia€i Cheek
>1 ;7€.Ijr r,ttii.I'nrc:
Phan!), p r tit'I'r i:'lr 1'e>s?aii Fee:
Ot4e?' Imp, 01�ler Phen-1h Insp, Li Oihe,r E_5e,�' h?sl-
Lup, Fc-p.'
NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc.). These ees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 11-053 ElfL 12, FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 8,200 s.f. Remodel,Other
Suppl.PC Fee: (E) Reg. 0 OT 0.0 hrs $0.00 $8,966.00 1REMRES3
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Feer Reg. 0 OT 0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Work Without Permit? 0 Yes (E) No $0.00 G
Advanced Planning Fee: $0.00 Select a Non-Residential 0
Building or Structure 0
t""`s%':%C'€zo'£}£.'af?77E':;i:lG?�s'i37Z `ees
I
Strong Motion Fee: IBSEISMICR $16.00 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $7.00
�: ... .
-TSB $23.00 $8,966.00 TOTAL FEE: $8,989.00
Revised: 04/29/2013