14020043 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20800 HOMESTEAD RD CONTRACTOR:MONTEREY PERMIT NO: 14020043
CONSTRUCTION COMPANY
OWNER'S NAME: VILLA SERRA APTS 88 MONTEREY-SALINAS HWY STE A DATE ISSUED:02/10/2014
OWNER'S PHONE: 6509313400 SALINAS,CA 93908 PHONE NO:(831)601-2659
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL E]
BUILDING 40 UNITS A-H REMODEL KITCHEN,BATH,
License Class ELECTRICAL SUBFEED,W/D HOOKUPS HOT&COLD
WATER
Contractor Date LINES FOR ALL(E)FIXTURES.750 SQ FT PER
I hereby affirm that I a licensed under the provisions of Chapter 9
(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 the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FR ALLED 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: Z
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.
��� / RE-ROOFS:
Signature 7/"�c �— 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. 1 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,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this nn
Owner or authorized agent: ��.Y Date: zlld&pf1l
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
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 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
02/05/2014 10:44Mtry Construction Co. (FAX)831 455 7986 P.002/003
CONSTRUCTION PERMIT APPLICATION 3
12 COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
10300 TORRE AVENUE-CUPERTINO,CA 95014-3266 IU
CUPERTINO (408)777-3228-FAX(408)777-3333-bulldlna(Mcuoertlno.ora I
NEW CONSTRUCTION U ADDITION ❑ALTIIRATION/TI ❑ REVISION/DEPEMD ORIGINAL PERMIT 0
P1896BIONestead Road,Building# , Units APN0
%1118'5 rre a Apartments "1650)931-3400 &'
MAA"florfolk Street,#1b0 %YdnfNeo, CA 94403 FAX
dYfI fia'W" t PHONE
650 931-3400 8mwRight@prometheusreg.com
ATRHET ADDRESS CttY,STATE ZIP FAX
1900 So.Norfolk Street #1x50 San Mafeo CA 94403
M OWNER ❑ OWNMBIMMEt CI OWNERAGBNT 13 CONTRACTOR 13 CONTRACTOR AGENT ❑ ARCltnLr El HNMUR 13 DEVELOPER O TENANT
ATCla'rdnesga LICER ER LICENSPJYPH BUS.LICA
IWon�e a IL
160nstruction Companyben mryconstructlon.com t3
(101)465-7986
TREET ADDRESS CITY,STATE,ZIP PHONE
8 Montero -Sallnas Hwy.,Sults A inas CA-93908 831 455-7931
ARCHITECT/ENGWEER NAME LICENS9 wjMD1K EUA.WC 0
COMPANY NAME EMAIL FAX
9TA88T ADDR1359 CITY,STATE,ZIP PHONE
9emoveN&ore'lace kitchen&bath cabinets.Replace electrical subpanel&subfeed. Install new W/D&hookups.
Run new hot&cold water lines for all existing fixtures,
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By my signature below,I cortity to each of the following: I am the property owner or authorized agent o property owner's behalf. I have read this
application and the Information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building etion, 1 au Orize representatives of Cupertino to enter the above-identifiod pr rty for inspection purposoe.
Signature dApplicant/Agent: Date: ,
SUPPLEMENTAL INFORMATION R@ UIRED I: :;rl'alr I: x!,'.11mn11•:c n1,nP.•'x•.
Q II+:uII,;;Ide PLAN CBECK' 11.1 I III u'.;:1.:1•ox.1.1
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ly dW011ings: APPY for demolidon permit for ,i'..,°;,1111!Iil''!Ili!i,IIL!;.i'!''mil!6'!iEi lijll:Pl pl"'• CI;I,:p;i;.;;i1;ll�llllilll::;!ll;?�II!lii•!:°gill pli,Y��,;fill:"il'. I•.
existing building(s), IIC1TOVE&TII&Cov A1,;Ill�III'lla J I i.
Demolition permit is required prior to issuance of building 1: I ;I I:i!I:!'.I; :11;., '1,11 I C71BuILDING pUA ttu T +lilt•1.1,l�l!I
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Commercial Bldgs: Provide a completed Hazardous Mateials Disclosure li;:-.�S1n1T�i 1N'•iaDAI.I IR1D .' I`i.;F
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—Copy of Flaming Approval Lotter o Meeting with Planning to
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BldgApp 201 Ldoc revised 03116/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 20800 Homestead rd 40 DATE: 02/05/2014 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 (D No PERMIT TYPE:
WORK BUILDING 40 UNITS A- H REMODEL KITCHEN BATH ELECTRICAL SUBFEED W/D HOOKUPS
SCOPE HOT& COLD WATER LINES FOR ALL (E) FIXTURES. 750 SQ FT PER UNIT,6000 S.F. TOTAL
Y
rec: .
Man I'drmib. i'tcztt Check I''mz Chu:
A'rch. 1'eordi.1'c e: f'ltmh, I'r r n Zz'Fee.,
t3ilt'r Ie l I,rr.
Other Pliwib MIT, C iherEle�e In n
1c:caa, lav). f't e: f'/wnb'Ir sp, Fee: glee'hi 1s . Fee:
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 E . 7/1/13 FEEQTY/FEE MISC ITEMS
Plan Check Fee: $0.00 6,000 s.f. Remodel,Other
Suppl. PC Fee: Reg. 0 OT 0.0 hrs $0.00 $7,960.00 1REMRES3
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Feer Reg. ® OT 10701hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Adrnhd,�,'fra-fnre Fee: 0
Work Without Permit? 0 Yes (F) No $0.00 G
Advanced Planning Fee: $0.00 Select a Non-Residential E)
Fees Building or Structure 0
Strong Motion Fee: IBSEISMICR $16.00 Select an Administrative Item
Bld,a Stds Commission Fee: IBCBSC $7.00
x ""* �3
TALS $23.00 $7,960.00 AL $7,983.00
.: TOT FEE:
a .,.
Revised: 01/15/2014
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
CONTRACTOR/SUBCON3LCTORLIST
JOB ADDRESS: ROO0Xdq PERMIT#
OWNER'S NAME: PHONE# 6S-0 31 OCA
GENERAL CONTRACTOR: BUSINESS LICENSE#
ADDRESS: -Sj CITY/ZIPCODE: -SA W4,03 O$
*Our municipal code requires all businesses 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 the following information:
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
Z'/
Owner/Contractor Signature Date