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07040173 CITY OF CUPERTINO BUILDING DIVISION PERMITc BUILDING ADDRESS: - PERMIT NO. 10150 CALVERT DR TONY BAIG 07040173 OWNER'S NAME: PERMIT ISSUE DATE SANTTARYNO. CONTROL NO. ARCHITECT/ENGINEER: - BUILDING PERMIT LNFO BLDG ELECT PLUMB MECH C LICENSED CONTRACTOR'S DECLARATION Job Description J 1 hereby affirm that I am licensed under provisions of Chapter 9(commrltring 1) with Section 7000)of Division 3 of the Business and Professions Code.and my license is NEW S FDWL• 17 8 9 ' GARAGE• 4 81 ' PATIO• 17 5 ' SIDE H in full force and effect j2 license Class Lk.If OVERHANG: 4 3 4 ' FRONT PORCH: 2 7 7 ' F„w Date Contractor ARCHITECT'S DECLARATION - I understand my plans shall be used as public records A. tti Licensed Pnrfescional OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the a 0 following reason(Section 70315,Business and Professions Cole:Any city or county which requires a permit to construct,after,improve,demolish,or repair any structure Z a prior to its issuance,alsu requires the applicant for such permit to file a signed statement _ that he is licensed pursuant to the provisions of the Contractor's License law 1Chapter 9 Sq.Ft. Floor Area Valuation t— (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $4 3 7 8 9 9 59 that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 703I3 by any applicant for a permit subjects the appkuL to a Civil penalty of Number Occupancy Type not more than five hundred dollars(SYM 3 7 519 0 2 2 1(' ❑1,as owner of the property,or my employers with wages as thew sole compensation, will do the work and the structure is not intended or offered for sale(Sec.7044,Business l Ure 115 Red Inspections and Professions Code:The Contractors License Law does tot apply to an owner of q 1) property who builds or improves thercon,and who does such work himself or through his own employees,provided that such improvements ate 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 salt,). 1,as owner of the property,am exclusively contracting with Gassed contractors to construct the project(Sec.7044.Business and Professions Code:)Ile Cootractoes L- eone Law does not apply to an owner of property who builds or improves thereon,and. who contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law, ❑ I am exempt 1 hereby affirm 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,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 Workers Compensation Insurance carrier and Policy number are: Carrier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (This section need not be completed if the permit Is for one hundred dollars MOD) or less.) , I certify that in the performance Applicant NOTICE TO APPLICANT:If,after making this Certificate oflxemption.you should become subject to the Workers Compensation provisions of the Labor Code,you mew D z forthwith comply with such provisions or this permit shall be deemed revoked, CONSTRUCTION LENDING AGENCY -+ I hereby affirm that there is a construction lending agency for the performance of ,4 �' the work for which this permit is issued(See.3097,Civ.C.) 4 Q Lenders Name z Lenders Address 0 1 certify that I have read this application and state that the above information is L F-' correct_1 agree to comply with all city and county ordinances and state laws relating to D C-) buildingconstruction,and hereby authorize representatives of this city to enter upon the N W ahove-mentioned properly for inspection pugow& y t1. (We)agree to save,indemnify and keep harmless the City of Cupertino against - cn liabilities.judgments.toss and expenses which may in any way accrue against said City z in consequence of the granting of this permit. / APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT ISSUed Date SOURCE Date HAZARDOUS MATERIALS DISCLOSURE _Type of Roof .. Will the applicant or future building occupant store or handle hay dous matcrial _ -as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)?❑Yes QNo� All roofs shall be inspected prior to any roofing material being installed. Will the applicant or forum building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defied by the Bay Area Air Quality Management - all new materials for inspection. - - - District? - - - O Yes p�fG I have read the hazardous marcrials requirements under Chapter 6.95 of the Cali for- nia Health&Safety Code,Sections 25505.25533 and 25534-1 understand that if the building - does not currently have a tenant.that it is my responsibility to notify the occupant of the - requirements which must be met rior to issuance of a Certificate of Occupancy. _ Signature of Applicant Date Owner or aumora.cd ag t Date All roof coverings to be Cfass"B" or better REVISION CITY OF CUPERTINO BUILDING PERMIT DATE BUILDING ADDRESS: 10150 CALVERT DR CONTRACTOR:ALLSTAR FINANCIAL PERMIT NO:07040173 OWNER'S NAME: CUPERTINO,CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELI ELECT©PLUMB rE License Class Lic.# MECH r ESIDENTIAL©COMMERCIAL Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:NEW SFDWL: 1789'GARAGE:481'PATIO: 175'SIDE (commencing with Section 7000)of Division 3 of the Business&Professions OVERHANG:434'FRONT PORCH:277-RECEIVED SIGNED Code and that my license is in full force and effect. UTILITY LETTER 8/16/2007. 01/14/10 REV-CHG ELVTN TO MATCH EXSNG STRCTR,MDFY BK PATIO TO REDUCE OPENING TO BKYRD,REPLC STAIRS&CONTRETE LANDNG NXT TO NOOK I hereby affirm under penalty of perjury one of the following two declarations: BY WD DECK&MDFY STAIRS/LNDING FOR DINING RM SLIDING DOOR 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:$437899 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 APN Number:37519022.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED granting 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 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date Issued by._ -- —r Date--/L-fro EG OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: RE-ROOFS: I,as owner of the property,or my employees with wages as their sole compensation, All roofs shall be inspected prior to any roofing material being installed.If a roof is will do the work,and the structure is not intended or offered for sale(Sec.7044, installed without first obtaining an inspection,I agree to remove all new materials for Business&Professions Code) inspection. I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). Signature of Applicant: Date: 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 Compensation,as provided for by Section 3700 of the Labor Code,for the HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.9 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections Code,,Chapter and 25534. I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. I certify that in the performance of the work for which this permit is issued,I shall Additionally,should I use equipment or devices which emit hazardous air not employ any person in any manner so as to become subject to the Worker's 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 r Compensation laws of California. If,after making this certificate of exemption,I P P P P become subject to the Worker's Compensation provisions of the Labor Code,I must Health&Safety Code,Sections 25505,25533,and 25534. forthwith comply with such provisions or this permit shall be deemed revoked.. Owner Date: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of work's upon the above mentioned property for inspection purposes.(We)agree to save for which this permit is issued(Sec.3097,Civ C.) indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Name costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply Lender's Address with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I (/ ARCHITECT'S DECLARATION Signature��, � Date l/ `��/l? I understand my plans shall be used as public records. Licensed Professional