10120120I CITY OF CUPERTINO BUILDING PERMIT
I BUILDING ADDRESS: 10518 S BLANEY AVE I CONTRACTOR:
MCCLELLAN I PERMIT NO: 10120120 I
DEVEL
'ER's NAME: BLANEY VENTURE LLC
'S PHONE: 9259449108
❑ LICENSED fQNTRACTOR'S�DECLARAATION ]
License Class Lic. # 4 Z
Contractor Date ts rla+ /1
I hereby affirm that 1 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.
1 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.
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 so rce regulations per the Cupertino Municipal Code, Section
9.18. /
iture ' Date
❑ OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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 licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
ieclarations:
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, 1
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
1 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
q the above mentioned property for inspection purposes. (We) agree to save
mnify 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
1448 ENTRADA VERDE PL
ALAMO, CA 94507
BUILDING PERMIT INFO:
MECH
BLDG
DATE ISSUED: 03/10/2011
PHONE NO: (925) 944-9108
r r r
ELECT PLUMB
RESIDENTIAL r COMMERCIAL, r
JOB DESCRIPTION: LOT 2 -CONSTRUCT 2 STORY 2,805 SQ FT SFDWL.
LIVING AREA 2,365 SQ FT, ATTACHED GARAGE 440 SQ
FT)-(ADDR CHANGED FROM 790 S BLANEY)
Sq. Ft Floor Area: I Valuation: $280500
APN Number: 36911062.00 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, 1 agree to remove all new materials for
inspection.
Signature of Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 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 compliancewith the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505, 25533, and 25534. 77
Owner or authorized agent: Date v
CONSTRUCTION LENDING AGENCY
1 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.
Licensed Professional^
U
CITY OF CUPERTINO BUILDING PERMIT Dxm
BUILDING ADDRESS: 10774 S BLANEY AVE
CONTRACTOR: CRAIG A ROGERS
PERMIT NO: 10110083
OWNFR'S NAME: LAM PETER R AND CONCEPCION
3914 WELLINGTON SQ
DATE ISSUED: 12/22/2010
O% ,t'S PHONE: 4089967091
SAN JOSE, CA 95136
PHONE NO: (408) 499-3354
❑ LICENSED CONTRACTOR'S DECLARATION
�I II I I [�
INFO: BLDG ELECT PLUMB
License Class Lic. # /��
BUILDING PERMIT �! , ��—«—�
MECH L_J_JRESIDENTIAL ffn COMMERCIAL
Contraclor�'��� b � G- J Dateiz — 1
I hereby affirm that 1 am licensed under the provisions of Chapter 9
JOB DESCRIPTION' ADD NEW MASTER BEDROOM&
(commencing with Section 7000) of Division 3 of the Business & Professions
BATH{ 16 ENT CHANGING
GARAGE ENTRANCE &REMODEL KITCHEN(120SQ)8t.
Code and that my license is in full force and effect.
BATH(40SQ);NO RE -ROOF & HAS STRUCTURAL -NO PRE -APP
hereby affirm under penalty of perjury one of the following two declarations:
3/8/2011 -REV #I -REVISE SHEAR WALL AT FRONT OF SFDWL-3/8/2011 REV #I ISS'D
I have and will maintain a certificate of consent to self -insure for Worker's
OVER COUNTER
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: $175000
APPLICANT CERTIFICATION_
I certify that 1 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: 36923054.00
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 of this permit. Additionally, the applicant understands and will comply
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all no oint source regulations per the Cupertino Municipal Code, Section
9.18.
180 DAYS FROM LAST CALLED INSPECTION.
v` LV(i>
A
r
Signature Date
A
Issued Date:
by
❑ 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:
1, 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 o fining an inspection, I agree to remove all new materials for
Business & Professions Code)
inspection.
1, as owner of the property, am exclusively contracting with licensed contractors to
Signature of Applicant: y� Date:
construct the project (Sec.7044, Business & Professions Code).
1 hereby affirm under penalty of perjury one of the following three
ALL ROO VERINGS TO BE CLASS "A" OR BETTER
declarations:
1 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.
1 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
Section 3700 of the Labor Code, for the performance of the work for which this
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
permit is issued.
Safety Code, Section 25532(x) should 1 store or handle hazardous material.
I certify that in the performance of the work for which this permit is issued, I shall
Additionally, should 1 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
Compensation laws of California. If, after making this certificate of exemption, I
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
become subject to the Worker's Compensation provisions of the Labor Code, 1 must
alth & Safety Code, Sections 25505, 25533, and 25534.
forthwith comply with such provisions or this permit shall be deemed revoked.
wr autho or. agent:
r ('/
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
1 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.)
ir,'--inify and keep harmless the City of Cupertino against liabilities, judgments,
Lender's Name
and expenses which may accrue against said City in consequence of the
g __ .,ng of this permit. Additionally, the applicant understands and will comply
Lender's AddressT
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
ARCHITECT'S DECLARATION
Signature Date
I understand my plans shall be used as public records.
Licensed Professional
C�
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10518 S BLANEY AVE
CONTRACTOR: MCCLELLAN
PERMIT NO: 10120120
DEVELOPMENT
OWNER'S NAME: BLANEY VENTURE LLC
1448 ENTRADA VERDE PL
DATE ISSUED: 03/10/2011
OWNER'S PHONE: 9259449108
ALAMO, CA 94507
PHONE NO: (925) 944-9108
❑ LICENSED CONTRACTOR'S DECLARATION
r r
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic. !6�
22 �.,*Aa
F F
A
(& -la+ //
MECH RESIDENTIAL COMMERCIAL
Contractor C: Date
I hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: LOT 2 -CONSTRUCT 2 STORY 2,805 SQ FT SFDWL.
LIVING AREA 2,365 SQ FT, ATTACHED GARAGE 440 SQ
(commencing with Section 7000) of Division 3 of the Business & Professions
FF)-(ADDR CHANGED FROM 790 S BLANEY)
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: $280500
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: 36911062.00
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. 1 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 FROM LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
,
costs, and expenses which may accrue against said City in consequence of the
' A'
"Y/D - !
granting of this permit. Additionally, the applicant understands and will comply
Issued by: Date:
with all non -point so rce regulations per the Cupertino Municipal Code, Section
9.18.
-/d .
RE -ROOFS:
Signature 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)
1, as owner of the property, am exclusively contracting with licensed 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. I 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 1
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
Section 3700 of the Labor Code, for the performance of the work for which this
the Health & Safety Code, Sections 25505, 25533, and 25534.
permit is issued.:
Owner or authorized agent: Date
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
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I 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
1 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,
ARCHITECT'S DECLARATION
costs, and expenses which may accrue against said City in consequence of the
1 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 PERMMTE
BUILDING ADDRESS: 10518 S BLANEY AVE
OWNER'S NAME: BLANEY VENTURE LLC
OWNER'S PHONE: 9259449108
❑ LICENSED CONTRACT'OR'S DECLARATION
License Class} �1 �_ I ` Lic. N o 4�
Contractor MG�`1l.7tn Date % t
I hereby affirm that I aro 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.
APPLICANT CERTIFICATION
I certify that 1 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. 7' l
Signature Date �" I
❑ OWNER -B LDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
1, as owner of the property, or my employees with wages as their sole compensation,
wil l do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
1, 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, 1
become subject to the Worker's Compensation provisions of the Labor Code, 1 must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
1 certify that 1 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
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.
CONTRACTOR: MCCLELLAN PERMIT NO: 10120120
DEVELOPMENT
1448 ENTRADA VERDE PL DATE ISSUED: 03/10/2011
ALAMO, CA 94507 PHONE NO: (925) 944-9108
BUILDING PERMIT INFO: BLDG r— ELECT F_ PLUMB r
MECH r RESIDENTIAL F_ COMMERCIAL r—
JOB DESCRIPTION: LOT 2 -CONSTRUCT 2 STORY 2,805 SQ FT SFDWL.
LIVING AREA 2,365 SQ FT, ATTACHED GARAGE 440 SQ
FT}{ADDR CHANGED FROM 790 S BLANEY)
4/7/11 DEFERRED #1 -TRUSS CALCS - 5//24/2011 DEFR'D# l ISS'D
Sq. Ft Floor Area: I Valuation: $280500
APN Number: 36911062.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued l, All 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, 1 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(x) 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 adi ed ;rt: / f
Date
OCONSTRUCTION LENDING AGENCY
1 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 I Licensed Professional