14090179CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: 14090179
10107 N FOOTHILL BLVD (342 32 070)
SBI BUILDERS
1064 ALMARIDA DR
SAN JOSE, CA 95128
OWNER'S NAME: FOOTHILLAUTO SERV & DETAIL INC
DATE ISSUED: 01/04/2016
OWNER'S PHONE:
PHONE NO: 408-203-4397
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class CONTRACTOR - GENERAL Lic. #860997
'Contractor SBI BUILDERS Date 02/29/2016
—BLDG —ELECT — PLUMB
I hereby affirm that I am licensed. under the provisions of Chapter 9 (commencing
T
MECH RESIDENIAL COMMERCIAL
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
LOT 4 - CONSTRUCT (N) DETACHED OFFICE / WORK SPACE
I hereby affirm under penalty of perjury one of the following two declarations:
(411 S.F.)
t. I have and will maintain a certificate of consent to self -insure for Worker's
REV 4 1 - ALL BUILDINGS/OFFICES (14090172-14090182).- REVISE
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
CEDAR SIDING TO FIBER CEMENT - ISSUED 8/11/16
a I have and will maintain Worker's Compensation Insurance, as provided for by
1 Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APPLICANT CERTIFICATION
Sq. Ft Floor Area:
Valuation: $56500.00'
J 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
APN Number:
Occupancy Type:
inspection purposes. (We) agree to save indemnify and keep harmless the
342 32 070
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
PERMIT EXPIRES IF WORD IS NOT STARTED
source regulations er the Cupertino unicipal Code, Section 9.18.
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM, LAST CALLED INSPECTION.
Signature Date
OWNER -BUILDER DECLARATION
Issued by: MELISSA N
Date: q_1/04/2016
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
r. I, as owner of the property, or my employees with wages as their sole
RE -ROOFS:
compensation, will do the work, and the structure is not intended or offered forAll
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
sale (Sec.7044, Business &Professions Code)
inspection.
2. 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code).
Signature ofApplicant:
I hereby affirm under penalty of perjury one of the following three declarations:
Date:
1. 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
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
performance of the work for which this permit is issued.
z. 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
HAZARDOUS MATERIALS DISCLOSURE
permit is issued.
I have read the hazardous materials requirements under Chapter 6.95 of the
3. 1 certify that in the performance of the work for which this permit is issued, I
California Health & Safety Cade, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
shall not employ any person in any manner so as to become subject to the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
Worker's Compensation laws of California. If, after making this certificate of
material. Additionally, should I use equipment or devices which emit hazardous
exemption, I become subject to the Worker's Compensation provisions of the
air contaminants as defined by the Bay Area Air Quality Management District I
Labor Code, I must forthwith comply with such provisions or this permit shall
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
be deemed revoked.
the Health & Safety Code, Sections 25505, 25533, !p_&25534.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
Owner or authorized agent: i, Z, h �i�
correct. I agree to comply with all city and county ordinances and state laws
Date:
CONSTRUC ION LENDING AGENCY
relating to building construction, and hereby authorize representatives of this city
I hereby affirm that there is a construction lending agency for the performance
to enter upon the above mentioned property for inspection purposes. (We) agree
of work's for which this permit is issued (Sec. 3097, Civ C.)
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City in
Lender's Name
consequence of the granting of this permit. Additionally, the applicant understands
Lender's Address
and will comply with all non -point source regulations per the Cupertino Municipal
Code, Section 9.18.
ARCHIT'ECT'S DECLARATION
understand my plans shall be used as public records.
Signature Date
Licensed
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10107N FOOTHILL BLVD
CONTRACTOR: SBI BUILDERS INC PERMIT NO: 14090179
OWNER'S NAME; FOOTHILL AUTO SERV & DETAIL INC
1515 THE ALAMEDA STE 300 DATE ISSUED: 01/04/2016
OWNER'S PHONE:
SAN JOSE, CA 95132 PHONE NO: (408) 549-1305
LICENSED CONTRACTORS DECLARATION❑
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑
License Class ' J ®�
LOT 4 - CONSTRUCT (N) DETACHED OFFICE / WORK
Lic. #
SPACE
Contractor Date i (o
(411 S.F.)
I hereby affirm that I 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.
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: $56500
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
APN Number: 34232070.10107
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. 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
WITHIN 180 DAYS ,O. ERMIT ISSUANCE OR
:� .�
upon the above mentioned property for inspection purposes. (We) agree to save
1810 DGALLED 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
Date: ilAr/16-
granting of Ns permit. Additionally, the applicant understands and will comply
with all n -p int source regulations per the Cupertino Municipal Code, Section
9.18.
r
RE-ROdFS:
Signature Date i0
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection,iI 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
1
the following two reasons:
ALL ROOF COVERINGS TO ) E CLASS "A" OR BETTER
I, 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
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirlements under Chapter 6.95 of the
California Health & Safety Code, Sections 15505, 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) shAuid 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 I
performance of the work for which this permit is issued.
will maintain compliance with the Cuperti o Municipal Code, Chapter 9.1 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Se n 255055533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which thisOwner
or authorized agent: ! Date: t
-�--
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
CONSTRUCTION LENDING AGENCY
Compensation laws of California. If, after making thiscertificateof exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, I must
I hereby affirm that there is a construction leading 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
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
ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
I 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