Loading...
11050122CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20900 HOMESTEAD RD BLDG 75 CONTRACTOR: MONTEREY PERMIT NO: 11050122 CONSTRUCTION COMPANY OWNER'S NAME: PROMETHEUS 88 MONTEREY- SALINAS HWY STE DATE ISSUED: 05/27/2011 OWNER'S PHONE: 6509313400 SALINAS, CA 93908 PHONE NO: (831) 601-2659 LICENSED CONTRACTOR'S DECLARATION r BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class If Lic. # f— I— F_ MECH RESIDENTIAL COMMERCIAL � ' Contractor/�� lDate I hereby affirm that 1 IJ - am licensed under the provisions of Chapter 9 JOB DESCRIPTION: BLDG 75 UNIT B- REMODEL 50 SQ FT TO KITCHEN, INSTALL NEW WASHER/DRYER HOOKUP AT EX. CLOSET, A/C (commencing with Section 7000) of Division 3 of the Business & Professions (M,E,P) 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 Sq. Ft Floor Area: Valuation: $20000 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 APN Number: 32609072.75 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 DAY ROM LAST CALLED INSP CTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Issued by: Date: 7 granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulationo per the Cupertino Municipal Code, Section 9.18. / RE -ROOFS: _ Signatur 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 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 & Professions Code) I, as owner of the property, am exclusively contracting with Iicensed 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 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 Owner or authorized agent: Date: permit is issued.. 1 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, 1 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. 1 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 CITY OF CUPERTINO BUILDING PERMIT„ BUILDING ADDRESS: 20900 HOMESTEAD RD BLDG 75 CONTRACTOR: MONTEREY PERMIT NO: 11050122 CONSTRUCTION COMPANY OWNER'S NAME: PROMETHEUS 88 MONTEREY-SALINAS HWY STE A DATE ISSUED: 05/27/2011 OWNER'S PHONE: 6509313400 SALINAS, CA 93908 PHONE NO: (831) 601-2659 ❑ LICENSED CONTRAC/T"�OR'S DECLARATION BUILDING PERMIT INFO: BLDG'ELECT r PLUMB r- _2 -7 Class G _") Lie. # COMMERCIAL /MECH all_1 RESIDENTIAL Contractor ( Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: BLDG 75 UNIT B- REMODEL 50 SQ FT TO KITCHEN, (commencing with Section 7000) of Division 3 of the Business & Professions INSTALL NEW WASHER/DRYER HOOKUP AT EX. CLOSET, A/C (M,E,P) Code and that my license is in fill force and effect. 10/4/2011- REV#1- ADD NEW BATHROOM TO EXISTING 1 BATH UNIT -11/14/2011 I hereby affirm under penalty of perjury one of the following two declarations: REV#1 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. 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. Sq. Ft Floor Area: Valuation: $20000 APPLICANT CERTIFICATION APN Number: 32609072.75 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. '/` // � < �r— Signature gn i �` Date 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, I 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) I, 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 I have and will maintain Worker's Compensation Insurance, as provided for by California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Section 3700 of the Labor Code, for the performance of the work for which this Safety Code, Section 25532(x) 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, I 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. Owner or aut agent: 4 Date: 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 «ork'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 harmless 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. I understand my plans shall be used as public records. Signature Date Licensed Professional _____ CITY OF CUPERTINO W . FEE ESTIMATOR - BUILDING DIVISION r ADDRESS: 20900 homestead rd. DATE: 10/04/2011 REVIEWED BY: bobs. Plan Check Fee: APN: BP#: VALUATION: 1$5,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY USE: Multi -Family Dwelling Buildina is >3 Stories 0 Yes 0 No PENTAMATION PERMIT TYPE: 1 GENRE WORK multi -family revision add new bathroom. SCOPE Suppl. Insp. Fee:) Reg. 0 OT A,Iech, Platt Cheek phinrb. Flat kc. Plu,a Ow, , lJ<celr, Pt�+,rart tr ,e; phw? a, Pcrmil rt:[r: i,t,',, t'<-raft%l f'cr (hh�-, 1{�-r�it, f�a.;p. � ltira�tP�'atrrrt> Iirr,'z ;idl,<rr r;'1a'c. hzti,ta, NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitaty Seiver District, School District. (!t C. %. These fHe.0 are haml on the nrelindnart/ information availahle and ore ank an estimate. Contact the Dent for addn'l into. FEE ITEMS (Fee Resohrtton 11-053 L ': 7� FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Mise Bldg/Structure or Element of a Building Suppl. PC Fee: 0 Reg. 0 OT 0.0 1 his $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:) Reg. 0 OT 0,0 his $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C'on4trucli"m 7tax 11dl7Pilds-Iralt ."Feye; 0 Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential G) Building or Structure 0 (TL7Vt'I T)Ot'tf377C'�'IIL771(577 n�'E:;': Strong Motion Fee: 1BSEIS1IICR $0.50 1 # Revision $783.00 1REVSFDWL SFDWL Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $1.50 $783.00 TOTAL FEE: $784.50 Revised: 10/01/2011