B-2016-1938CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1938
7411 WILDFLOWER WAY CUPERTINO, CA 95014-5309 (366 18 035) CRAIG A ROGERS
CONSTRUCTION INC
SAN JOSE, CA 95136
OWNER'S' NAME:
DATE ISSUED: 08/03/2016
OWNER'S PHONE: PHONE NO: (408) 978-5484
LICENSED CONTRACTOR'S DECLARATION
License Class B Lc. #978553
Contractor CRAIG A ROGER,9 QQNSTRUCTION INC Date 11/30/2016
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:
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
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, costs, and expenses which
may accrue against said City in consequence of the granting of this permit.
Additionally,
Municipal Code, Section 9.18.
Date/8 3/2016
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
1. 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)
2. 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 declarations:
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
performance of the work for which this permit is issued.
2. 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.
s. 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 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
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 source regulations per the Cupertino Municipal
Code, Section 9.18.
Signature Date 8/3/2016
BUILDING PERMIT INFO:
X BLDG _ ELECT , _ PLUMB
— MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
NEW TWO STORY RESIDENCE WITH BASEMENT (4086 SQ FT);
GARAGE (431 SQ FT).
Ft Floor Area: 4517 1 Valuation: $1000000.00
APN Number: Occupancy Type:
36618 035 R-3 (Custom),R-3 (Custom),U (Private Gar /Ag Bldg),U
(Private Gar / Ag Bldg)
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Abby Ayende
RE -ROOFS:
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: 8/3/2016
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(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined
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
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-1938
7411 WILDFLOWER WAY CUPERTINO, CA 95014-5309 (366 18 035)
CRAIG A ROGERS
CONSTRUCTION INC
SAN JOSE, CA 95136
OWNER'S NAME:
DATE ISSUED: 08/03/2016
OWNER'S PHONE:
PHONE NO: (408) 978-5484
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class -fl Lic. #978553
Contractor CRAIG A ROGERS CONSTRUCTION INC Date 11/30/2016
X BLDG _ELECT _PLUMB
—
MECH X RESIDENTIAL COMMERCIAL
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.
JOB DESCRIPTION:.
NEW TWO STORY RESIDENCE WITH BASEMENT (4086 SQ FT);
I hereby affirm under penalty of perjury one of the following two declarations:
GARAGE (431 SQ;FT).
i., I have and will maintain a certificate of consent to self -insure for Worker's
DEF #1 - ROOF TRUSS CALCS - ISSUED 7/24/2017
Compensation, as provided for by Section 3700 of the Labor Code, for the
erformance of the work for which this permit is issued.
ItI have and=will maintain Worker's Compensation Insurance, as provided for by
3700, of the Labor Code, for the performance of thI e work for which this
Sq. Ft Floor Area.; 4517
Valuation: $1000000.00
permitis issued.
APPLICANT CERTIFICATION
I certifythat'l have read this application and state that the above
information, is correct. I agree to comply with all city and county ordinances
APN Number:
Occupancy Type:
and state laws relating to building construction, and hereby authorize
36618 035
R-3 (Cust6m),R-3 (Custom),U (Private Gar/ Ag Bldg),U
representatives of. this city to enter'upon the above mentioned property for
(Private Gar /Ag Bldg)
inspection purposes. (We) agree to save indemnify and keep harmless the
City of: Cupertino against liabilities, judgments, costs, and expenses which
may accrue againstsaid City in consequence of the granting of this permit.
PERMIT EXPIRES IF WORK IS NOT STARTED
Additionall the applicant understantnd
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
RE -ROOFS:
m. I, as owner of the property, or my employees with wages as their sole
All roofs shall be inspected prior to any roofing material being installed. If a roof is
compensation, will do the work, and the structure is not intended or offered for
installed without first obtaining an inspection, I agree to remove all new materials for
sale 'leg .7044, Business & Professions Code)
inspection.
2. I, as owner ofahe property„ am exclusively contracting with licensed
contractors ;to construct the project (Sec.7044, Business & Professions Code).
Signature of Applicant:
Date: 07-24-2017
I hereby affirm under penalty of perjury one of the following three declarations:
m. I have and will,maintain a Certificate of Consent to self -insure for Worker's
ALL ROOF COVERINGS TO. BE CLASS "A" OR BETTER
Compensation,, as provided for by Section 3700 of the Labor Code, for the
performance of the work', for which this permit is issued.
2. I have and Wil lima intain Worker's Compensation Insurance, as provided for by
HAZARDOUS MATERIALS DISCLOSURE
Section 3700 of the.Labor Code, for the performance of the work for which this
I have read the hazardous materials, requirements under Chapter 6.95 of the
permit is issued. I .
California Health & Safety Code; Sections 25505, 25533, and 25534. I will
3. I certify that in the performance of the work for which this permit is issued, I
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
material. Additionally, should I use equipment or devices which emit hazardous
Worker's Compensation laws of California. If, after making this certificate of
air contaminants as defined by the Bay Area Air Quality Management District I
exemption,'I become subject to the Worker's Compensation provisions of the
will maintain compliance with
relating to building construction,! arid 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,
Lender's Name
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of ihis,permit. Additionally, the applicant understands
Lender's Address
and will comply with all non -paint source regulations per the Cupertino Municipal
Code, Section 9.1 &
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Signature Date 07-24-2017
Licensed
Professional