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08060207COVERSHEET 08060207-D 20800 HOMESTEAD RD #20 Z-.? .*,,-t 0 ATE--c GENCY IN F RETURN Status Init IN RETURN Status Init IN RETURN Status Init / UILDING OUTSIDE PLANNING' PUBLIC WORKS FIRE SANITARY FOOD HEALTH ,2.O� l ASSESSOR APN## RES. (LUNG) (GARAGE) COMM. SQ. FT. (NEW) T:I. SQ.FT. RES. REMODEL, CON -TACT / L2- - PHONE# 9,L = 2 4 0 �5 -L-4 FAX .. �% Z -'-IF, VALUATION (Cost of Project) - RE . PAID NOTES: CONSTRUCTION T (Y) (N) SCHOOL ES (Y) (N) HOUSING MITIG (Y) (N) HEART OF THE CITY (Y) (N) ISSUED BY� - -� DATEES 00 U 7N WU a� a V! fat no 0 �a tx- G IQ CITY OF CUPERTINO DIVISION PERNIIT?��* BUILDING BUILDING ADDRESS: PERMIT NO. 20800 HOMESTEAD RD BLDG 20 WEST BUILDERS, INC. 08060207 OWNER'S NAME: PERMIT ISSUE DATE PROMETHEUS 1 1608 4TH ST STE 120 07/18/2008 PHONE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: INSTL TEMP WTR SPLY& RETRN BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Chapter 9 (commencing - - ^^ - m Job Description I hereby affirm that I am licensed under provisions of with Section 7000) of Division 3 of the Business and Professions Code and my license is in full force and COWL �f JC' � 4 7 - Lice nso C as Lic.if v {{ Dale Ca"tracto A CHrrECCS DECLARATION I understand my plans shall be used as public records Gcenscd Professional OWNER -BUILDER DECLARATION 1 hereby affirm Ihat'l 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 convect, alter. improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement Contractor's License Law (Chapter 9 Sq. Ft. Floor Area Valuation that he is licensed pursuant to the provisions of the (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and die basis for the alleged exemption. Any vlolaUon of APN Number Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sale compensation, Required Inspections will do the work, and the structure is not intended or offered far sale (Sec. 7044, Business and Professions Code: The Contractors 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 Contractors Li- cense Law does not apply to an owner of property who builds or improves thereon, and • who contracts for such projects with a contractors) licensed pursuant to the Contractors License Law. ❑ I am exempt under Sea B & P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a Certificate of Consent to self-insum for Worker's Compen. sation, as provided for by Section 3700 of the Labor Code, for the performance of the. work ror which this permit is Issued. 0 I have and will maintain Workers Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers Compensation Insurance carrier and Policy mber are: _�� fNo: MPolicyCartier° C�1�y FROM WORKERT COMPENSATION INSURANCE (This section need not be completed if the permit Is for one 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 mannerso 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 Workers Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this Permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a convection lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.) Lenders Name Lenders Address I certify that 1 have mad this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building convection, and hereby authorize representatives of this city to enter upon the above -mentioned property for inspgction purposes (We) 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 granting of this permit. APPLICANT U ER TANDS AND WILL COMP Y WITH ALL NON -POINT J (f Issued by: Date S U S. Re -roofs G- Type of Roof C Sign p Tclor Date HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safely Code, Section 25532(a)? ❑Yes )(No Allroofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or ruture building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑ YesNu 1 have mad the hazardous materials requirements under Chapier6.95 of the Caliror- niaHealth&Safety Code, Sections 25505,25533 and 25534. 1 understand that irthe building that it is my responsibility m notify the occupant of the does not currently havefapnL mqulmm ch riortoissu ofac •ficatc cupancy. Signature of Applicant Date O All roof coverings to be Class "jQ.'' or better Owner or a .cd Data ' CITY OF CUPERTINO CITY OF CUPERTINO NEW SINGLE/MULTI FAMILY DWELLING PERMIT APPLICATION FORM APN # 32609056.ALL Date: 6/23/2008 Building Address: Building 20, 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, lV V-B V � 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.org(' 11NO CITY OF CUPERTINO 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 1 EPERMITFEE Electrical Permit Fee E 1MPERMITFEE Mechanical Permit Fee M 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 0*� Uf� �Q�✓�r"� 5 of 5 e V �-'-� fie — d� Lz� *-�...'S