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13090210CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20800 HOMESTEAD RD CONTRACTOR: MONTEREY PERMIT NO: 13090210 CONSTRUCTION COMPANY OWNER'S NAME: VILLA SERRA APTS 88 MONTEREY - SALINAS HWY STE A DATE ISSUED: 09 /30/2013 OWNER'S PHONE: 6509313400 SALINAS, CA 93908 PHONE NO: (831) 601 -2659 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIALLJ q5__1?1'1 7 BUILDING 22, UNITS A - L REMOVE & REPLACE License Clas�? Lic. # ry,, n ] .. Contractor n [�/1�Y �nY�i�'V Date KITCHEN & BATH CABINETS. REPLACE ELECTRICAL SUBPANEL & I hereby affirm that I am licensed under the provisions of Chapter 9 SUBFEED. INSTALL NEW WASHER/DRYER & (commencing with Section 7000) of Division of the Business & Professions HOOKUPS.RUN 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: $240000 1 have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 32609073.20800 Occupancy Type: ction 3700 of the Labor Code, for the performance of the work for which this it 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 18 AYS 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 LAST CALLED INSPEC ION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, which may accrue against said City in consequence of the Q costs, and expenses Issued by: Date: granting of this permit. Additionally, the applic understands and will comply with all non -point source regulations per the ertino Municipal Code, Section RE- ROOFS: 9.18. )3 9v 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 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 Municipa Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505 a 5534. 7 Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: 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 09/26/2013 13 : 15 Mtry ,Construction Co. CUPERTINO (FAX)831 455 7986 P.002/002 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014 -3255 (408) 777 -3228 - FAX (408) 777 -3333 - buildina(dtcupertlno.om 130<� Rio B ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / Ti ❑ REVISION / DEFERRED ORIGINAL PERMIT!! PS1O'Pomestead Road, Building , Units ��� "y 0`7 5, ,Zo (� WR AMe i a erra Apartments PHONE 650 931.3400 13-MAIL s1� ITWorfolk Street, # 150 C%ns ateo, CA 94403 FAx vI D VNht PH650 931 -3400 dmviright@prometheusreg,com STRBETADDRESS CITY, STATE 21P 1900 So, Norfolk Street # 160 San Mateo CA 94403 FAX D OWNCR OWNER- BUILDER 9 OWNHRAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCItrECr 17 HxcIrEHR ❑ DEVELOPER Q TENANT Qjl❑ Che d tiega LICE P pHR LiCHNSPgTYPE 1J(I' BUS. LiCa W NY NA `donstructlon Company ebn mryconstructlon,com (01) 455 -7986 STREET ADDRESS CiTY, STATP, ZIP 88 Monterey - Salinas Hwy., Suite A PHONE 831 455 -7931 ARCHITEC IENO1NEERNAME LICENSENUMi1ER BUS. LICB COMPANY NAME E-MAIL FAX STREET ADDRESS CiTY, STATE, ZIP PHONE remove " & °re °race kitchen & bath cabinets. Replace electrical sub panel & subfeed. Install new W/D & hookups. Run new hot & cold water lines for all existing fixtures. 1, QSkS Me, .0�. vG\Vc—A4�cY\ 16 wasrtna USE PROPOSED USE CONSTR. TYPE 1 A STORE=S " :.. . EXISTO NEW FLOOR DEMO TOTAL ` AREA AREA AREA NET AREA DATIMOOM KITCIMN OnMR REMODBLARPA RHMOCEL AREA REMODEL AREA PORCH AREA DECK AREA TOTALDECMPORCII ARIA GARAGE AREA; DHTACIt AM CH . DwHLLMe UNrtf; U A {iCOND UNfl' 13 vas LLCOND!TORY C3 �II.VQADDrdt a NO ADDITION} NO : i.. PRE%UrLrCAttoN YGa aYBO,PROVGRI COPY or PLANNER1NAAI iREC2IVED BY: " PLANNING APPI,- ❑ NO PLAW"APPROVAL LCTfGR .TOTALVALUATION:: By my slgnoture below, i certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I havo read this application and the information I have provided is correcL t have read the Description of Work and verify it is accurate. I agrea to comply with all applicable local ordinances and state laws relating to building ction. l au ouzo representatives of Cuportino to enter the above - identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED %.,,PLAN HECK TYPE'......'. • .: I;:: ;.' : `:.ROITTINGSLIP,—: . New SFD or Multifamily dwellings: Apply for demolition permit for Ovtwniti 01::.II6iLDMG C00NTt:ri' .:. , :. existing building(s). Demolition permit Is required prior to issuance of building ; PLAN. REVIEW''' permit for new building. I� EXP: R-E -SS. ` , 'h:.`:' '" ::'.' . =PLANNING PLAN REVIEW'.:. `:.. Iii l Commercial Bldgs: Provide It completed Hazardous Materials Disclosure 0 'STANDARD form If any Hazardous Materials are being used as part of this project .: : : j. ❑' LARGE; . Cl : :F1�i� bt rC• :•.f' I; _ CO Of Planning A COPY g Approval Letter or Meeting with planning prior to ; `. :•: : :': :' submittal of Building Permit application. i7 'MAJOR' , . :. • : •'; ', .' : ,! : © :'SAN.ITARYSE,WER DISTtrtCT '. : :.• .I b'ENVIiONM@NTALHEALTH :: 9/dgApp_2011.doc revised 03116111 [—,—�''����� CITY OF CUPERTINO [ _m__'li�l Ii F.F. FCTIMATOR — RITII,DING DIVISION ADDRESS: 20800 HOMESTEAD FEE DATE: ?/, REVIEWED BY: Plan Check Fee: APN: BP #: ' 02 C./ *VALUATION: $240,000 *PERMIT TYPE: Building Permit $0.00 I PLAN CHECK TYPE: Alteration / Repair PRIMARY Multi-Family g Dwellin USE: Building is >3 Stories 0 Yes Q No PENTAMATION 1 R2REM PERMIT TYPE: A WORK 0,0 hrs $0.00 SCOPE ' - 44 d ` x MA . 15,116 : zfqk�.�d �� IA Phimb. Plan Elec. 1'lun Check 1Wech- Permitfi-ee; Plunib, hermit Fee: Elea. hernakFee: Oi/i ,,r .We(:! 10129/2013 13:20 f AX) P.0011001 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014 -3255 C U P E RT I N O Telephone: 408- 777 -3228 Fax: 408- 777 -3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESSQ - PERMIT # OWNER'S NAME: PHONE # GENERAL CONTRACTO - , BUSINESS LICENSE # c ADDRESS: F c TY /ZIPCODE: qgctn *Our municipal.code requires l businesses working in .the city to ve a City of Cupertino business license. NO BUILDING FINAL. OR FINAL OCCUPANCY INSPECTIONS) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not ustng any subcontractors: Signature Date Please check applicable subcontractors. and complete the following information: ✓ SUBCONTRACTOR -.BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical r Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing 2—C;��-- �- Roofing Septic Tank Sheet Metal Sheet Rock Tile C1C) — 2: caner / Contractor Signature ate