13060059 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20800 HOMESTEAD RD CONTRACTOR:MONTEREY PERMIT NO:13060059
CONSTRUCTION COMPANY
OWNER'S NAME: VILLA SERRA APTS 88 MONTEREY-SALINAS HWY STE A DATE ISSUED:06/13/2013
OWNER'S PHONE: 6509313400 SALINAS,CA 93908 PHONE NO:(831)601-2659
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL)
License Class Lic.# � � � BUILDING 5 UNIT m REMODEL KITCHEN,BATH,
_� � ELECTRICAL SUBFEED,W/D HOOKUPS HOT&COLD
Contracto Date WATER
I hereby affirm that I a licensed under the provisions of Chapter 9 LINES FOR ALL(E)FIXTURES.750 S.F.TOTAL
(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:$20000
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 the above mentioned property for inspection purposes. (We)agree to save 180 DAYS LLED 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 Issue b � }
granting of this permit. Additionally,the applicant understands and will comply y'
with all non-point source regulations per the Cupertino Municipal Code,Section
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
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,
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 3700 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, d 25534. 7
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: �J
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
06/06/2013 11:02Mtry Construction Co, (FAX)831 455 7986 P.003/004
CONSTRUCTION PERMIT APPLICATION o( 11
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION �O
10300 TORRE AVENUE-CUPERTINO,CA 95014-3266 M0
CUPERTINO (408)777-3228-FAX(408)777-3333-buildinnQcuoertlno.ora
❑NEW CONSTRUCTION ❑ ADDITION ALTEUTION/TI ❑ REVISION/DEPERRED O1UGINAL PERMIT p I O 6 U O 6!
78IRb1 S esIsad Road, Building# , Units APNe Z - 0}—D �- , ZD$O C)
�/I1fa Berra Apartments PHO 650)931-3400 II-MAIL
S1WW oforfolk Street,#160 Mn�lateo,CA 94403 FAX
PH650 931-3400 mwright@promethousrog.com
STREBTADDRBSS Ct1Y,9TATE ZIP FAX
1900 So, Norfolk Street # 1y50 San Mafeo CA 94403
I&3 owNER p�tL) OWNER-BUILDER IN OwNERAuEN'r O CONTRACTOR 13CONiRACTORAOENT 13 ARCIRrECT 13 SNOAIEER O DEVELOPER O TENANT
RIC IC
FIe AO LICBtr$S]a�lj AR L1CeNS�T1TB BUS,LIC 0
MA erey�onstructlon Company K ti�e�nJab�mryconstruction.com (991)455-7986
STREET ADDRESS CITY,STATE,ZIP PHONE
88 Monterey-Salinas Hwy.,Sulte A 831 455.7931
ARCHrMCTIENOINEeR NAME LICENSE NUMBER BUS.LIC N
COMPANYNAME E-MAIL PAX
STREBT ADDRESS CITY,STATE,ZIP PHONE
9emoveN&creplace kitchen &bath cabinets.Replace electrical suh onel&subfeed.Install new W/D&hookups.
Run new hot&cold water lines for all exlsting fixtures.
:,
E%c9nN0usE PROPOSED USE cON9TRTYPB aSTORlES �::;:.i .•.:':. ' , ;<:•.:' IFFICK 119Tnrr
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ERISTO NEWFLOOR DEMO TOTAL
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PPS-APPLICAT= OTse Wrvs.?RAV=copy of PLUM's .�..��„�,..�.
M1N010 APDL No wAl's: a TOTw VALU TION';
PI ANND�IO APPROVAL LEMR
'•bL';I'I:•'' I;: ..'x ..'I;' rill•
By my signature below,I certify to each of the following: I am the property owner o orized a ct or
jAkfroperty owner's h-half. I have road this
application and the Information I have provided Is correct. I have read the Description of Work end verify it i accurate. I agree to comply with all applicable local
ordinances and state laws relating to building c9piquetiom I au orizc represontatives of Cupertino to enter the above-identified property for Inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFORMATION REQUIRED
:..,�'..•,i:�PWNCIIBCICTYPE'' '.;•::.'� �.:I�:;':�I:�':;'AOtiitNGBLIP;1'':i',�s'I':•�I..:•
_New SFD or Multifamily dwellings-. Apply for demolition permit forI'_'!: �'i ::;i i.,':I',::;:'::-' "• ":: i.';.
exlsting building(s). Demolitionor to Issuance ''"A'"F;;CovNreR •ir'f! 0 7pIj►1:DING:PLAN REVIEW'rt�' c:
permit is required prior of building :..,. ,. :I• i''';;
ormitf r ,.::,.I.•
p o new building. ....
>rXl!R SS"a I; :` '''i•i'i O:l? 11 ING PLAN.REVSEW.i'i ' I.ail
_Commercial Bldgs: Provide it completed Hazardous Materials Disclosure :;l]�'
form if an iBT,1xDaRD .I. ;�,'; ;�IP, E tC,WORKB�;:
y Hazardous Materials are being used as part of this I'
LAkog `:: ' is '.O'Flxe'n
Copy of Planning Approval Letter or Meeting with Planning to
:;1 MAJOR' !':'.,;:;::..'t;:, ; ,j`I 9ANtTAftYSEwERDi
submittal of Building Permit Application. ,.,..,,,. i...,,., •. ,,, ,ST �� •:
r:";i' .•:1: S ^I ..,ENV 0 ENTALvmALTB';
BIdg.4pp_2011.doc rsvlsed 08/16/11
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 20800 HOMESTEAD RD 5 UNIT D DATE: 06/10/2013 REVIEWED BY: MELISSA
APN: 32609073.20800 BP#: *VALUATION: 1$20,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY SFD or Duplex PENTAMATION 1 R3SFDREM
USE: PERMIT TYPE:
WORK BUILDING 5 UNIT D REMODEL KITCHEN BATH, ELECTRICAL SUBFEED W/D HOOKUPS 750
SCOPE IS.F.
y/5 \ °�� yoft
x
h£: .I'.`£sst L,,a£r£: Plumb.PIiin t,aa£;£:k
4.l£'.f.::. ;e'i"Flllt "'£:£::
LiI.11dd€rb. Elec". hiFp. 1.1`00.
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 preliminar information available and are only an estimate. Contact the De t or addn'1 info.
FEE ITEMS Fee Resolution 11-053 E . 7/1112) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 750 s.f. Remodel,Other
Suppl.PC Fee: (F) Reg. 0 OT 0.0 hrs $0.00 $534.00 1REMRESOTx
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Fee-0 Reg. 0 OT0 0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Constr"icHon Tax:
Work Without Permit? ®Yes No $0.00 G
Advanced Planning Fee: $0.00 Select a Non-Residential G)
Building or Structure 0
I•I"C€T'F'l�.J€)fZdt�L'I2XCX17£1x7.�`f.?t'.S'; ,
Strong Motion Fee: IBSEISMICR $2.00 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $1.001 1
tm
h ` $3.00 $534.00 TOTALFEE : 537.00
Revised: 04/29/2013
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: 408-777-3228
C O P E RT I N O Fax: 408-777-3333
CONTRACTOR/SUBCONT TOR LIST
JOB ADDRESS: 7,0300 PERMIT# (3 a&O
OWNER'S NAME: G. PHONE# 31 2Go
GENERAL CONTRACTOR: BUSINESSLICENSE#
ADDRESS: N S i CITY/ZIPCODE.' ; S 3 O
*Our municipal code requires all businesses wortMg in the city to have a City of Capertinwbusiness 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 the following information
V 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
r
Ow er/Contractor Signature Date