07040173 REV2 REVISION#
CITY OF CUPERTINO BUILDING PERMIT DATE
BUILDING ADDRESS: 10150 CALVERT DR CONTRACTOR:ALLSTAR FINANCIAL PERMIT NO:07040173
OWNER'S NAME: ALLSTAR FINANCIAL 10150 CALVERT DATE ISSUED:06/14/2007
or `4ER'S PHONE: 4082304687 CUPERTINO,CA 95014 PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG®ELECT®PLUMB rF1
License Class Lic.#
MECH I` I (RESIDENTIAL COMMERCIAL EF—D
Contractor Date
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:NEW SFDWL: 1789'GARAGE:481'PATIO: 175SIDE
(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
I hereby affirm under penalty of perjury one of the following two declarationREDUCE OPENING TO BKYRD,REPLC STAIRS&CONTRETE LANDNG NXT TO NOOK
s: 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 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
9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature Date
Issued by;-"' � ��..._.r _ Date/---/l �
L 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 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 6.95 of the
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(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
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,I must Health&Safety Code,Sections 25505,25533,and 25534.
forthwith comply with such provisions or this permit shall be deemed revoked. Owner r aighorized agent:
Date: 0
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
cc nd expenses which may accrue against said City in consequence of the
gi g 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. ARCHITECT'S DECLARATION
r
Signature Date [/r I understand my plans shall be used as public records.
Licensed Professional