07120156np-mmoN
CITY OF CUPERTINO BUILDING PERMITDg-rF
BUILDING ADDRESS: 20900 HOMESTEAD RD BLDG 76 A-H
CONTRACTOR: WEST BUILDERS, INC.
PERMIT NO: 07120156
OWNER'S NAME: PROMETHEUS
1608 4TH ST STE 120
DATE ISSUED: 07/08/2008
OWNER'S PHONE: 6509313457
BERKELEY, CA 94710
PHONE NO: (510) 525-9378
0 LICENSED CONTRACTOR'S DECLARATION
r r r
INFO: ELECT
License ClassL_ Lic. # E5,)-9 3
BUILDING PERMIT BLDG PLUMB
MECH r RESIDENTIAL r COMMERCIAL r
Contractor w IF61 %OI, IA) M Date 111110
I hereby afflrm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: REMODEL DECK STAIR RAILS & PAINT ADD HOT WATER
(commencing with Section 7000) of Division 3 of the Business & Professions
HEATER
Code and that my license is in full force and effect.
7/9/10 - REV#1- REVISE STAIRS EXTERIOR (FEE'S,07120154)- 9/9/10 REV#1
I hereby affirm under penalty of perjury one of the following two declarations:
ISS'D
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.
1 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
Sq. Ft Floor Area:
Valuation: $6976
permit is issued. 6_S
APPLICANT CERTIFICATION
APN Number: 32609029.76
Occupancy Type:
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
PERMIT EXPIRES IF WORK IS NOT STARTED
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non -point source regulations per the Cupertino Municipal Code, Section
180 DAYS FROM LAST CALLED INSPECTION.
9.18.
SignatureDate C�14xjtb
Issued by- Date:
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
RE -ROOFS:
the following two reasons:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
1, as owner of the property, or my employees with wages as their sole compensation,
installed without first obtaining an inspection, 1 agree to remove all new materials for
will do the work, and the structure is not intended or offered for sale (Sec.7044,
inspection.
Business & Professions Code)
1, as owner of the property, am exclusively contracting with licensed contractors to
Signature of Applicant: Date:
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
HAZARDOUS MATERIALS DISCLOSURE
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have read the hazardous materials requirements under Chapter 6.95 of the
1 have and will maintain Worker's Compensation Insurance, as provided for by
California Health & Safety Code, Sections 25505, 25533, and 25534. I Will maintain
Section 3700 of the Labor Code, for the performance of the work for which this
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
permit is issued.
Additionally, should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued, I shall
contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Compensation laws of California. If, after making this certificate of exemption, 1
Health & Safety Code, Sections 25505, 25533, and 25534.
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
Own -auuthoriy�l agent: Date: el I i 1►0
APPLICANT CERTIFICATION
CONSTRUCTION LENDING AGENCY
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
I hereby affirm that there is a construction lending agency for the performance of work's
to building construction, and hereby authorize representatives of this city to enter
for which this permit is issued (Sec. 3097, Civ C.)
upon the above mentioned property for inspection purposes. (We) agree to save
Lender's Name
indemnify and keep ham -Jess the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
Lender's Address
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
ARCHITECT'S DECLARATION
9.18.
1 understand my plans shall be used as public records.
Signature Date
Licensed Professional
CM OF CUPERTINO
�y " l
BUILDING DIVISION PERMIT
v
x.... ;x
>
TBDM— TO BE DETERMINED
BUI 1r�G 1�DRF�
UfUU HOMESTEAD RD BLDG 7 A—H
PERMIT NO.
07120156
OWNER'S NAME:
PERMIT ISSUE DATE
VS II A CALIFORNIA LIMITED
07/08/2008
PHONE R'TTTT
SANITARY NO. CONTROL NO.
ARCHLTECT/ENGTNEEt:
REMODEL DECK, STAIR RAILS &
BLDG BUILDING
PLUMB MECH
3 O LICENSED CONTRACTORS DECLARATION
I hereby affirm that I am 1'ncensed under provisions of Chapter 9 (Commencing
with Section 7000) of Divisbn 3 of the Business and Proksdoes Code. and my license Is
O y in full force and erred. g�} S 3G1
C �Llcalenae (may Lie. 9 ~ ! ARCHrrECrS DECLARATMN
I understand my plans shall be used as public records
;yU
Licensed Pmresid m l
y OWNER -BUILDER DECLARATION
1 hereby air= that I am exempt from the.Contractoes Lictmse Law for the
in mOt following reason. (Section 703 M, Business and Professions Cock: Any city or county
$ Y, which mquhes a permit to construct. after, improve, demollsk or repair arty structure
prior to its iswarnce also require the applicant car such permit to filea signed atalement
that be Is licensed pursuant to the provisions of the Contractor's I iccese Low (Chapter 9
3 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
y that be is exempt therefrom and the basis for the Waged exanption. Any violatfm of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil pm icy of
not mac than five hundred dollars (axon).
❑ win 4ai owner of the property. a my employees with wages as their sole compenodam,
o the wort, and the structure is not intended or ot[amd forsak (SeC 7044, Business
am! Professions Code The Contractor's Lkonse Law does not apply to an owner of
property who buildsor improves tbmman, and who does aoeh wort bimself a through his
own employees, podded that such hnpmvemam ate not intmtded or offered for ale. If.
however, the building or hmprovmuant Is sold within one year of Completim the owner -
builder will have the burden of proving that he did not bow or improve for papoum of
sale),
❑ Lax mrwnaer of property. am exeludvely contracting with Hemmed monvacton to
conmoct the pro' (Sec. 7W4. Business and Professions code:) The Contractors Li-
cense raw does 9M apply to an owner of property who bulls or improves thereon. and
who A f with a contracla(s) licensed pursuant to the Conuamors
Llmnse La
❑ 1 am B P C for thiss mason
Owner Date"e
COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations
❑ 1 have and will maintain a Cmrtificato of Consent to seif-insure for Workees Compen-
sation, as provided for by Secdon 3700 of the Labor code. for the performance of the
wart for which this pumitis inued.
❑ I have and will maintain Wor er's Compmuadon Imwramm, as required by Semler
3700 of the Labor Code, for the performance of the wart for which this permit is Weed
My W s amp adma/y� carrier and Policy number arc
Cartic `-^� Policy Na:
CERTMCATE OF EMF ION FROM WORKEIS'
COMPENSATION INSURANCE
(Inds section reed not be cemplm cd Ir the permit is for one hundred dollars (SIOO)
or less.)
I Certify that in the performance of the wort for which this permit Is issued 1 shall ant
employ any permit in any manner so as to became subject to the Waicrs' Compensadon
Laws or Califormia Date
Appllaml
NOTICE TO APPLICANT. If, after mating this Cardfiate of Exerapdon, you should
became subject to the Workees Compenution provisions of the Labor Code, you must
O forthwith comply with such provisions or this permit shall be deemed revoked
"~ CONSTRUCTION LENDING AGENCY
►�-r 1 hemby M. that them is a construed. lending agency for the perfamorcm of
ix duo wort for which this permit is Issued (Sec. 3097, Clv. C)
�Wi Q Leadces Nun
i.1 z Landers Address
U O I a+tllp that I have read this applicatim and sum that the she information is
M, 1� 4 comet 1 agree to comply with all city and county orflnarrces and sure laws relating to
0 ► v b.Was 'on, and hereby anhoda representatives of this city to mac upon the
W above- Property far inspectim parpaea,
to nee, indemnify and lump harmlea the City of Cupertino against
n.. rA fiablh Is. cats and expenses which may in arty way accrue against said City
U z In the granting of this Permit.
►-i A ERSTANDS AND WILL COMPLY WITH ALL NON -POINT
so if0N3.
SIgnkum ( I traam Dale
US MATERIALS DISCLOSURE
WIU applicant or (moue building occupant store or handle baardous material
as defined by due Cupertino lX Code. Chapter 9.12. tad the Health and Safety
Code, Section 25532(a)7
❑ Yes
VAII the applicant or future building occupant use equipment or devices which
emit harardons air anr•..,t.�No
ued by the Bay Area Air Quality Mansgencm
District?
❑ ices
Ih the haardmusmaterials requirememsunder Chaplerd93oftheCalifor-
niaHalth& ay Section s25505.25533atd25534.1undmamdthat ifdue building
dos sly a msm, that lt is my responsibility to notify the occupant of the
mquirchic m he met prior to issuance of a Cmtifiate of
OwWorau&o&a'zczJ Data
Area
APN
Issued by:
Re -roofs
Type of Roof
Job Description
Required Inspections
Valuation
Date --;? — to
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.
Signature of Applicant Date
All roof coverings to be Class 'R> ' or better
CITY OF CUPERTINO
wN. FEE ESTIMATOR — BUILDING DIVISION
ADDRESS:
DATE:
REVIEWED BY:
APN:
BP#:
'VALUATION:
Iso
PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY SFD or Du lex
USE: p
OVER THE
COUNTER? Q Yes 0 No
APPLICATION 1R3SFDADD/REM
TYPE:
MECHANICAL Q Yes Q No PLUMBING Q Yes Q No I
ELECTRICAL Q Yes (F) No
�4 w
revise stairs at existing R-2 complex
00
3�
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s .ft.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
R-2 (Apartment)
II-B,III-B,IV,V-B
0
$0.00
$0.00
TOTALS:
0
$0.00
$0.00
Of1w -h. fits!'
I'lnmh. PI'mOw(A
Piva lh, Pry Im" i oc
Uihcr Pitimb htr;)
/ibr P/a/101'(�
F,k°r _ P<�rmil
Odic'-Ne". hip,
NOTE: These fees are based on the nreliminary information available and are onlv an estimate. Contact the Dent for addn'1 info.
FEE ITEMS (Fee Resolution 09-051 Eff 711 /09)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
Select a N isc Bldg/Structure
or Element of a Building
Suppl. PC Fee: 0 Reg. Q OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee:E) Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Q
E)
Acoustical Fee: Q Yes Q No
$0.00
Work Without Permit? Q Yes Q No
$0.00
Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
Q
Q
Strong Motion Fee:
$0.00
Select an Administrative Item
Bldjz Stds Commission Fee:
$0.00
SUBTOTALS:
$0.001
$0.00
TOTAL FEE:
$0.00
Revised: 6/30/2010