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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