08060200COVERSHEET
08060200-D
20800 HOMESTEAD RD #37
nOO6.() DATE 2
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ADDRESS
APPLICANT
74,1,,L
OWNER
WWI
PUBLIC
WORKS
ASSESSOR
APN# �?21<02LS-6
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RES. (LVNG)
(GARAGE)
COMM. SQ. FF. (NEW)
TI.SQ.FT.
RES. REMODEL
VALUATION (Cost of -Project)
n��. C20
REQD. PAID
NOTES:
CONSTRUCTION TAX (Y)
(N)
SCHOOLFEES (Y)
(N)
HOUSING MITIG (Y)
(N)
HEART OF THE CITY (Y)
(N)
ISSUED Big DATE TOTAL FEES
CITY OF CUPEKTINU
BUILDING DIVISION PERNUT
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STEAD RD BLDG 37
OWNER'S NAME:
P P, OMETHEUS
ARCHMCT/ENGINEER:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
with Section and
of of ecDivision 3 of the Business and Professions C�o�d�o„ytd my license is
in. full Corte and effect V C�I1 S
Lcense Class Lie. A
Date f.'l Contractor
ARCHCCECPS DECLARATION
I understand my plans shall he used as public records
Licensed Professional
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractors License Law for the
following reason. (Section 7031.5, Business and Professions Code: Any city or county
which requires a permit to construct, alter, improve, demolish, or repair any structure
prior to its issuance, also requires the applicant for such permit to file a signed statement
that he is licensed pursuant to the previsions of the Contractors License Law (Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that 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 (S500).
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is notintanded or offered forsalc (Sec.7044, Business
and Professions Code: The Conuactors 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 for sale. 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.).
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec. 7044, Business and Professions Code:) The Contractor's Li-
cense Law does not apply to an owner or property who builds or improves thereon, and,
who contracts for such projects with a contractors) licensed pursuant to the Contractor's
License Law.
C]I am exempt under Sea B & P C for this reason
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby aBirr under penalty of perjury one of the following declarations:
❑ I have and will maintain a Certificate of Consent to self -insure for Workers Compen-
sation, as provided for by Section 3700 of the Labor Code, fur 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 Worker's Compensation Insurance tamer and Policy numbeAERS'
Cartier. ��a V �F�.p6licy No.: �LR
CERTIFICATE OF EXEMPTION FROM WO
COMPENSATION INSURANCE
(This section need not be completed if the permit is forone hundred dollars ($I00)
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, after making this Certificate of Exemption, you should
become subject to the Worker's Compensation provisions of the Labor Codc, you must
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a conswction lending agency for the performance of
the work for which this permit Is issued (Sec. 3097, Civ. C.)
Lenders 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 -mentioned property for inspection purposes
(Wa) agree to save, indemnify and keep harmless the City of Cupertino against
liabilities, judgments, costs and expenses which may in any way accrue against said City
in consequence of the g ting this permit.
APP UNDE A AND WILL COMPLY WITH LL N-POINT
.541URCE,XE LA NS
Si atu o plic t/Contraclor Data
AZARDOUS MATERIALS DISCLOSURE
Will the ap Icon, or future building occupant store or handle hazardous material
as defined by the upertino Municipal Codni, Chapter 9.12, and the Health and Safety
Code, Section 25532(a)? �.
❑Yes 3 No
Will the applicant or 114tturt building occupant use equipment or devices which
emit hazardous air contaminants as defined by the Bay Area Air Quality Management
District?
❑ Yes �No
I have mad the hazard(o/us marerials requirements under Chapter6.95 of the Califor-
niaHealth & Safety Codc, Sections25505,25533and 25534.1understand thatiftha building
does not currently have a ant h is my responsibility to notify Pe occupant of the
requiremen ich ust a issuancerooff a Cc 'rcam�f cupan
Owner or au o nt V OV O Dalc
WEST BUILDERS, INC.
1608 4TH ST STE 120
PERMIT NU.
08060200
PERMIT ISSUE DATE
07/18/2008
SANITARY NO. CONTROL NO.
EUIL.DING PERMIT INFO
INSTL TEMP WTR SPLY& RETRN BLODG E� PLO
z-rrrvG;-�P3`sa�NEW ff)� '
.. r Job Description
Sq. Ft. Floor Area
Required Inspections
Issued by:
Re -roofs
Type of Roof
Valuation
Occupancy
Date '7wi-6
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 or better
o 6, ' n o
F
C k TY CF
CUPEkTINO
CITY OF CUPERTINO
NEW SINGLE/MULTI FAMILY DWELLING
PERMIT APPLICATION FORM
APN # 32609056.E ti,�?7
Date: 6/23/2008
Building Address: Building 37, 20800 Homestead Rd.
Mailing Address (if different from building address):
20800 Homestead Rd., Unit 8C
Owner's Name: Prometheus
Phone # : 650-931-3457
Contractor:
Phone #: 510-525-9378
West Builders
Fax #: 510-867-6983
Contractor License #: 825395
Cupertino Business License #: 29961
Contact:
Phone #: 925-250-0576
Scott Thomas
Fax #: 925-846-2243
Alternate Contact:
Phone #: 510-773-0477
Katy Bilodeau
Fax #: 408-746-5033
Single -Story ❑ Two -Story ❑ Three -Story ❑ Basement ❑ Hillside ❑
Multi -family ❑ Apartment ® Condo ❑ Townhouse ❑
Sq.Ft. Living Area (Including Basement & Attached Garage:
Sq. Ft. Garage (Detached Only):
Valuation: $15,000.00
Job Description:
Installation of temporary water supply and return piping. Installation of new commercial water heater.
Type of Construction (Usage Class):
Occupancy Type:
1-A, 11-B ❑ 11, 111, V-A ❑ 11, 111, 1V V-B 0/
(R. \
Project Size: Standard ❑ Large❑ Major ❑
Is the project in the Wildland- Urban Interface Fire Area? Yes ❑ No ❑
Green Building: Must attach completed Green Building Checklist to the plans
Green Building Points Achieved:
For help, contact Build it Green at www.builditgreen.M
CITY OF CUPERTINO
JN0 GENERAL BUILDING APPLICATION
FEE SCHEDULE
entity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
1GENRES or
1GENCOM
1 WINREP
Replacement windows/sliding glass
door (ea 8 windows)
B
1WINMEWSTR
New Window -structural shear
wall/masonry (includes plan ck fee)
B
IEPERMITFEE
Electrical Permit Fee
E
1MPERMITFEE
Mechanical Permit Fee
M
%
1
1PPERMITFEE
Plumbing Permit Fee
P
1 ELCPLNCK
Stand Alone Electric Pln Ck (hourly)
E
1MECPLNCK
Stand Alone Mechanical Pln Ck (hrly)
M
1PLMPLNCK
Stand Alone Plumbing Pln Ck (hrly)
P
1 STPLNCK-(3 Hr Min
when not over counter)
Standard Plan Check (when no E/M/P)
hourly -stand alone
B
1BSEISMICR
Seismic Residential
B
1BSEISMICO
Seismic Commercial
B
/
1TRAVDOC
Travel & Documentation
B
1BUSLIC
Business License
B
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