07020040 - PUB1013
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Permit Information
Permit Number " 07020040
Status +r
Master Number IClI Notes
Project
Apply Date "
0210712007Operator
Permit Issue Date
09113I2007 Operator
Certificate Issued
_
11119I2008 Operator
Certificate Type
F
Certificate Number
Location Information -
Address " 20670 GREENLEAF CT LOT 3
City/State/Zip CUPERTINO ® A95014
p APN 32656029.03
Unit
counter Oa:mer Entih,, infcrmatinn
patg _ Owner Name l
CUPERTINO GREENLEAF LLC
PALM Use Default
Address
Business - 20662 GREENLEAF CT
City1S tate2ip
Permit " i Property
Zoning Applicant
Contractor' ?i Defined Fields
Permit Details
—
Permit Type "
SFDWL-NEW1
DO NOT USE
Usage Class x
IDWL-WHEW
J
DWELLING TYPE 5 WOODNEW
Applied Value %
610700 j
SQUARE FT.
2993;
Calculated Value
670169 rR
US C-404 Type
1101
NEW: SFD, DETACHED
Permit Form x
jAUTOPERM - PERMIT
Ownership
1 - Private +�
Project Size
v
You have chosen to bypass the holds for this permitjparcel
Enter permit status
CUPERTINO
v
CA 95014
Purpose/Special Conditions
NEU 2 STORY SFDWL- 1ST: 2014', 2ND: 979', GARAGE: A.
400', PORCH: 156' REVISION #08020013 FLR
PLANS,SETBACKS,ARCHITECTURAL_
GARAGE: 400 X 56.38 = 22552
PORCH: 168 X 38.51 = 6007.56
REV #08020013
REV #08050060
REV #08080078
FILMED- 2011
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CITY OF CUPERTINO
BUILDING DIVISION PERMIT
�+ ,
BUILDING ADDRESS:
PERMrr NO.
GREENLEAF LOT3
TBD — TO BE DETERMINED
07020040
OWNER'S NAME:
PERMIT ISSUE DATE
GREENLEAF ASSOCIATES LLC
09 13 2007
PHONE:
SANITARY NO. CONTROL NO.
ARCHITECTIENGINEER:
BURRING PERMIT INFO
NEW 2 STORY SFDWL— 1ST:
BLDG ELECT PLUMB MECH
2814'0
0 0
LICENSED CONTRACTORS DECLARATION
r2NDr
oescription
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business and Professions Code, and my license is
in full force and effect
License Class Lic. R
Data Q
A CH=CI-S DEC O
I undcrstarA my plans shall be used asp tc records
Licensed Professional
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the
following reason. (Section 703 L5, Business and Professions Code: Any city or county
which requires a permit to cnnstruct alter, improve, demolish, or repair any structure
prior to its issuance, also requires the applicant for such permit to file a signed statelnmt
S Ft. Floor Area Valuation
that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9
q.
(commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he is exempt therefrom and the basis for the alleged exemption. Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
APN Number Occupancy Type
not more than five hundred dollars
F1 L as owner of the property, or my employees with wages as their sole compertmdon,
will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business
Required Inspections
and Professions Code: The Contractor's License Law door not apply to an owner of
q P
property who builds or improves thereon, and who does such work himself or through his
own employees, provided that such improvements arc not intended or offered for aia if.
however, the building or improvement is sold within one year of completion, the owoer-
builder will have the burden of pmving that he did not build or improve for purpose of
sale.).
0 I, as owner of the property am exclusively contracting with licensed contractors to
construct the project (Sec 7044. Business and Professions Code:) The Contractors Li-
cense Law does not apply to an owner of property who builds or improvers therwq and.
who contracts for such projects with a contractor(s) licensed pursuant to the Contractors
License Law.
0 1 am exempt under Sec , B & P C for this reason
Owner Date
WORKER'S COMPENSATION DECLARATION
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 Workcrs Compen-
sadon, as provided for by Section 3700 of the Labor Code, for the performance of the
work for which this perMit is issued
M I have and will maintain Workers Compensation Insurance, as required by Section
J100 of the Labor Code, for the performance of the wort for which this permit is Lamed.
My Worker's C mpensa . Insurance r . and Policy number are: aodl� /
Carrier. olicyNo.: M600003'
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(this section need not be completed if the permit is for one hundred dollars ($100)
or less.)
I certify that in the performance of the work for which this permit is issued, 1 shall not
employ any person in any manner so as to become subject to the Workers'.Compavtion
Laws of California- Date
Applicant
NOTICE TO APPLICANT. If. after making this Certificate of Exemptior4 you should
become subject to the Workers Compensation provisions of the Labor Code, you roust
' forthwith comply with such provisions or this permit shall be deemed revoker-
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of
' the work for which this permit Is issued (Sec. 3097, Civ, C.)
"
Lender's Name
,
Lender's Address
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 stale laws relating to
building construction, and hereby amhoris mpmscmarives of this city to enter upon the
above -mentioned property for impecuon purposes
(We) agree to save, indemnify and keep harmless the City of Cupertino against
sus and expenses which may in any way accrue against said City
j liabilities, judgmenV7;
' in consequence o(1ting of this permit.APPLICANT UNANDS AND WILL COMPLY WITH ALL NON -POINT
Issued bv: Date
SO GU ONS
Sign o! pp icant/Contractor Data
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or future building occupanL store or handle hazardous marrnal
as defined by the Cupertino Municipal Code, Chapter 9.12. and the Health and Safety
Code, Section 25532(a)?
❑Ycs 3RNo
Will the applicant or futum building occupant use equipment or devices which
emit hazardous air contaminants as defined by the Bay Area Air Quality Management
District?
❑ Yes TVNo
I have read the hanrdous materials requirements under Chapter6.95 of the Califor-
nia Hcalth & Safety C Sections 2-1505, 25533 and 25534.1 undcrsund thrudthe laa'lding
dots not curtcntJy h n tenant- th it is my responsibility io nodry the occupant of die
require cots whi must be met p r to issuance of a Certificate of Occupancy.
O r or authorized agent Date "
Re -roofs
Type of Roof
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.
Signature of Applicant
Date
All roof coverings to be Class "B" or better