07120161CITY OF CUPERTINO BUILDING PERMIT 171
0
BUILDING ADDRESS: 20900 HOMESTEAD RD BLDG 78 A-L CONTRACTOR: WEST BUILDERS, INC.
q"- q � 1
PERMIT NO: 07120161
OWNER'S NAME: PROMETHEUS 11608 4TH ST STE 120 ! DATE ISSUED: 07/08/2008 1
OWNER'S PHONE: 6509313457 1 BERKELEY, CA 94710 1 PHONE NO: (510) 525-9378 1
�. LICENSED CONTRACTOR'S DECLARATION
License Class Ci Lie. # TJ2� tJ'
Contractor W'5_ %U\LA)e 1 S Date C1IOt �o
I hereby affirm that I am 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.
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
permit is issued. 1 s
APPLICANT CERTIFICATION
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,
costs, and expenses which may accrue against said City in consequence of the
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.
Signature Date l
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
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.
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
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
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.
APPLICANT CERTIFICATION
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,
costs, and expenses which may accrue against said City in consequence of the
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.
BUILDING PERMIT INFO: BLDG r ELECT r— PLUMB r
MECH r RESIDENTIAL r COMMERCIAL r
JOB DESCRIPTION: REMODEL DECK,STAIR RAILS & PAINT ADD HOT WATER
HEATER
7/9/10 - REV#1- REVISE STAIRS EXTERIOR (FEE'S,07120154)- 9/9/10 REV#1
ISS'D
Sq. Ft Floor Area: I Valuation: $6976
APN Number: 32609029,78 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: -- - Date:
RE -ROOFS:
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 "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or au ed a e rt:
Date: Ctlellto
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C,)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
BUILDING DIVISION V PERNHT
PERMIT NO.
RD BLDG 9 A—L I TBD TO BE DETERMINED 1 07120161
OWNER'S NAME: PERMIT ISSUE DATE
VS II A CALIFORNIA LIMITED 07/08/2008
SANITARY NO. CONTROL NO.
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ARCHITEC (ENGINEER:
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under previsions of Chapter 9 (commencing
rith Section 7000) of Division 3 of the Business and Professions Codc, and my license is
t full force and effect � S-
.icense Cl s Lie. k
)ate —� 6t Contractor
ARCHITECI'S DECLARATION
I understand my plans shall be used as public records
.icensed Professional
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law rar the
bllowing reason. (Section 7031.5, Business and Professions Code: Any city or county
vhich requires a permit to construct, alter, improve, demolish, at repair any structure
irior to its issuance, also requires the applicant for such permit to file a signed statement
hat he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9
,commencing with Section 7000) of Division 3 of the Business and Professions Code) or
Thal he is exempt therefrom and the basis for the alleged exemption. Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500).
❑ 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
and Professions Code: The Contractoes License Law does not apply to an owner of
property who builds or improves thereon, and who does such work himself or through his
own employees, provided that such improvements are not intended or offered forsale. If,
however, the building or improvement is sold within one year of completion, the owner.
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
O 1, as owner of the property, am exclusively contracting with licensed contractors to
construct the proj ct (Sec. 7044, Business and Professions Code:) The Contractor's Li.
cense Law does t apply to an owner of property who builds or improves thereon, and.
who contrac fo uqh projects with a contractor(s) licensed pursuant to the Contractors
License La
❑ 1 am eze pt der , B & P`C�for
{this mason
"N
Owner Date ` " v`og
W 'S COMPENSATION DECLARATION
I hereby i r penalty of perjury one of the following declarations:
❑ I have and will maintain a Certificate of Consent to self -insure for Worker's Compen-
sation, as provided for by Section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
❑ I have and will maintain Worker's Compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of the work for which this permit is Issued.
My Worke�Ca pensa(ion Insurance carrier and Policy number arc:
Cartier. L Polity No.:
�
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not ba completed if the permit is forone hundred dollars ($100)
or less.)
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 Workers' Compensation
Laws of California. Date
Applicant
NOTICE TO APPLICANT: If, alter making this Certificate of Exemption, you should
become subject to the Workers Compensation previsions of the Labor Code, you must
forthwith comply with such provisions or this pernil shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of
the work for which this permit is issued (Sec. 3097, Civ. C.)
Lender's Name
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-m tinned property for inspection purposes
) agree to save, indemnify and keep harmless the City of Cupertino against
liabilid , udgmcnts, costs and expenses which may in anyway accrue against said City
in n q cc of the granting of this permit.
AP Ll NDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
so G ATIONS. - f
l-.
Sight pli UContraclor Data
HAZARDOUS MATERIALS DISCLOSURE
ill the applicant or future building occupantstom or handle hazardous material
is defined by the Cupertino Muni 'pal Code, Chapter 9.12, and the Health and Safety
Code, Section 25532(a)T
❑ Yes No
Will the applicant or future building occupant use equipment or devices which
emit hazardous air contaminants defined by the Bay, Area Air Quality Management
District?
❑ Yes No
BUILDING PERMIT INFO
REMODEL DECK, STAIR RAILS & BL�nG EO PLUMB
Job Description
q. Ft. Floor Area
Required Inspections
Issued by:
Re -roofs
Type of Roof
Valuation
Occupancy
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.
1 AvereadthehazardousmatcrialsrequimmcnlsunderChapter6.95oflheCalifor-
niaHeal ctyCode, Sections 25505,25533and 25534.Iunderstand that ifthe building
do4not have a tenant that it is my responsibility to notify the occupant of the
req n wh h must be met prior to issuance of a Certificate of - aancy.�
Owner tfyibarrcd agent Date
Signature of Applicant Date
All roof coverings to be Class 'j'' or better
CITY OF CUPERTINO
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 Duplex
USE:
OVER THE
COUNTER. Q Yes G No
APPLICATION 1 R3SFDADD/REM
TYPE:
MECHANICAL ® Yes (F) No
PLUMBING YesNo
ELECTRICAL ' ® Yes Q No
ww
revise stairs at existing R-2 complex
O�
U
U2
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
Al", h Pharr C Ytc
Urirev ,blo-��°/t. 1u�1�.
Plnmb. Plou Clreck
P1,111h, lle,,,mil f (w:
Uiho Plumb lr.vp.
0 ec"
li(et. Permit l'"cc
NOTE: These fees are based on the nreliminary information availahle and are nnly an Pwimate_ rnntart rho 1)ont fnr adds,11 lnfn
FEE ITEMS (Fee Resoltdion 09-051 Ell' 711/09)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
Select a Misc Bldg/Structure
or Element of a Building
7
Suppl. PC Fee: (F) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee:(D Reg. 0 OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
�Ut7.1'?Placalt?!J 1L!,
Acoustical Fee: Q Yes (F) No
$0.00
0
E)
Work Without Permit? C) Yes (D No
$0.00
Plannink Fee:
$0.00
Select a Non -Residential Q
Building or Structure 0
Trucrl Po(o willativu Fcc s.
Strong Motion Fee:
$0.00
Select an Administrative Item
Bldg Stds Commission Fee:
$0.00
SUBTOTALS: 1
$0.00
$0.00 TOTAL FEE:
$0.00
Revised: 6/30/2010