13110044 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20800 HOMESTEAD RD CONTRACTOR:MONTEREY PERMIT NO: 13110044
CONSTRUCTION COMPANY
OWNER'S NAME: VILLA SERRA APTS 88 MONTEREY-SALINAS HWY STE A DATE ISSUED: 11/12/2013
OWNER'S PHONE: 8314557931 SALINAS,CA 93908 PHONE NO:(831)601-2659
❑
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL E]
License Class Lic.# S BUILDING 64,UNITS A-L REMOVE&REPLACE
Contractor KITCHEN
, e ` 'D —
&BATH CABINETS.REPLACE ELECTRICAL SUBPANEL&
I hereby affirm that I a icensed under the provisions of Chapter 9 SUBFEED.INSTALL NEW WASHER/DRYER&
(commencing with Section 7000)of Division 3 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
IRI 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 authorizerepresentatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FRO LED INSPECTION.
indemnify and keep harmless the City of Cupertino.against liabilities,judgments,
costs,and expenses which may accrueagainst said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply Iss Date: 2
with all non-p ' t s�rceregu�llatiioner the Cupertino Municipal Code,Section
9.18.
Si _ e t any
roofing
g IV 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,Sectio 5505,25533 nd 25534.
Section 3700 of the Labor Code,for the performance of the work for which this \—�Z
permit is issued. Owner or authorized agen. te: .
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
Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY
become subject to.the.Worker's Compensation.provisions of the LaborCode,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
11/07/2013 13:04Mtry Construction Co, (FAX)831 455 7986 P,002/003
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 !,�O
CUPERY'INO (409)777-3228 a FAX(408)777-3333-bullding0cuDertlno. m `�l
[:]NEW CONSTRUCTION ❑ ADDITION ❑ALTERATION/TI REVISION/DEFERRED ORIGINAL PERMIT#
'189FOWomestead Road, Building# , --Units — "N73260 09-3 2 Zocv
Villa��a Apartments
R PHO(850 931-3400 EMAIL
s�1Q GT�jJOMOrfolk Street,#150 cRns ateo, CA 94403 TFAX
U8NVt0 WrIQl1t P ONE MAIL.
660 931-3400 �mwrlghtic�prometheusreg.com
STREET ADDRESS cnf,STA7Ir,ZIP FAX
1900 So, Norfolk Street #150 San Mateo CA 94403
C3 OWNER pit[3OWNER-DUILDER #1 OWNER AOHNI' '3CONTRACTOR ClCONTRACTOR AGENT ❑ ARCH MCT ❑ENOAIEHR 11 DHVELOPBR D THNANr
Ic 3fd KegB11
E LIC 6r gjvt gCA LICENSire nus,LIC 0
MP NY NA E H b197
on�ere onstructlon Co
T2any MAhmryconstruction.com 991)455-7986
ST T ADDRE9s CITY,STATE,ZIP PxONE
88 onterey-Salinas Hwy., Suite A 831 455-7931
ARCHITECTIENOINEER NAMB LICENSE NUMBER BUS.LIC N
COMPANY NAME B-MAIL
FAX
STREET ADDRESS CRY,STATE,ZIP PHONE
AremoveN&ore°lace kitchen&bath cabinets.Replace electrical subpanel&subfeed.Install new W/D&hookups,
Run new hot&cold water lines for all existing fixtures. \ oos=� -
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PXISRNO USE PROPOSED USE CONSTR.TYPE •tl
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ore Dig&
EXISTO NEW FLOOR DEMO TOTAL
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PM.APrLIcArroN ❑Yea Dvaa,PWVaiaMPYOr PLAIM*aNAn�; .
PLANNINO APPL a t,NO RBCEIVED :'I;':'�' ",''lis :..I :I!
PLANNING APPAOVALLQTTtla !..:. .i:i ... " :;1 I',',.77�I :,
By my signature below,I certify to each of tho following: l am the property owner or authorized t n the property owner's behalf. I have read this
application and the intbrmation I have provided is correct, I have read the Description of Work and verity it Is accurate. I agme to comply with all applicable local
ordinances and state laws relating to building etlon. I oulhorize representatives of Cupertino to enter the above-identified property for inspection purposes.
SlgnatureofApplicant/Agent: Date:
SUPPLEMENTAL INFORMATION REQUIRED
.:ii, .I.IP4AtV CII@CKTYPE''' j ';j; ,;•.,•.. ..r;,.. ,i;:"
_ (y dwellings: Apply .ROUTING94W
NowSFDorMultif `Ilii'•;' :I'P%
ami dwe g PP Y for demolition permit for ;::�I:,� ,.;j;;::,�;,'•;:',;:;.:' I.".,•.;�I;.;:.I �,•:.•;.:
i VER;.TIICexisting building($), Demolition permitle required prlorto issuance ofbuilding
;;PVILRING Pr+pNREVIEw:
permit for new building. ,,. i;.'i ; ;i.'I.';::
'
-EXPRESS 1•, d;PLANN2l�C.PL'AN
Commerelal Bldgs: Provide ,;; 9. : 1
g a completed Hazardous Materiels Disclosure ;�❑r
ST
ureR:N•,Go�.o��.:I,:i
form Warty Hazardous Materialsarc being used as art ofthlsproject, -,''pul'.'.'':1 I:I1'.l�',.!.;.i:;.::i;•;I:`,I;i;.,:::'l I.b,.!':'.�j�'I,.'•`...:i': I❑Q;:, ;:,:PF''-•!IUDL•ri:.C�•E>wP�..:.T.O.,;':'R
COPY ofPlanning Approval Lotter or Meeting with Planning prior to
submittal of8ildin Pomit application. i:i..i;'I.'K,•Ij':.s:Ij:;:''.:::,.I.;',.;,',!"',.'iI:.',j.,.`..;'i.;l,�,.Ii,",:,;:'.l.;.::`::j;';'i:;,
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t;;ltrfr�RYSBWER DisTRicri1
ENVIR IVMENTAGIrEAGT l'`• 'I
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D/dgApp 2011.doc revised 03/16/11
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 20800 HOMESTEAD RD#64 DATE: 11/07/2013 REVIEWED BY: MELISSA
APN: 32609073.20.800 BP#: *VALUATION: 1$240,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY Multi-Family Dwelling Buildina is PENTAMATION 1 R2REM
USE: 1 >3 Stories 0 Yes Q No PERMIT TYPE:
wORK BUILDING 64, UNITS A-L REMOVE & REPLACE KITCHEN & BATH CABINETS. REPLACE
SCOPE ELECTRICAL SUBPANEL&SUBFEED. INSTALL NEW WASHER/DRYER& HOOKUPS.RUN NEW p
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