B-2016-1837CITY OF CUPERTINO BUILDING PERMIT
BUII.DIING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-1837
10308 N STELLING RD CUPERTINO, CA 95014-1644 (326 30 088)
OWNER/BUILDER
OWNER'S NAME:: RE ACQUISITIONS GROUP INC
DATE ISSUED: 08/29/2016
OWNER'S PHONE: 925-998-0532
PHONE NO: 408-892-5020
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class# .
Contractor OWNER/BUIL DER Date
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 SFD 3769 SQ FT; NEW GARAGE 445 SQ FT;
I.hereby affirm under penalty of perjury one of the following two declarations:
PORCH 848 SQ FT; DECK - 2ND FL. 150 SQ FT '
1. I have and will maintain a certificate of consent to self -insure for Worker's
REV #1 - LOCATION CHANGE OF CARPORT - ISSUED 10/20/16
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
Sq. Ft Floor Area: 4214
Valuation: $490000.00
permit is issued.
APPLICANT CERTIFICATION
1 certify that I have read this application and state that the above
Number:
Occupancy Type:
information is correct. I agree to complywith all city and county ordinances
326 30 088
3 26
R-3 (C(Custom),U (Private Gar /Ag Bldg),U
and state laws relating to building construction, and hereby authorize
Gar
(Privatee Gar ar // Ag Bldg)
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.
PERMIT EXPIRES IF WORK IS NOT STARTED
Additionally, the applicant understands and will comply with all non -point
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source regulations per the Cupertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 10/20/2016
Issued by: MELISSA
Date'0812 f 6 !d Zo l a
ON11 NEIBUIr DER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE -ROOFS:
following two reasons:
1. I, as �o�er of the property, or my employees with wages as their sole
All roofs shall t inspected prior to any roofing material being installed. If a roof is
for
xfipensation, 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
f
inspection.
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).
Signature of Applicant:
Date: 10/20/2016
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
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.
HA?ARDOUS MATERIALS DISCLOSURE
2. I have and will maintain Worker's Compensation Insurance, as provided for by
I have read the hazardous materials requirements under Chapter of the
Section 3700 of the Labor Code, for the performance of the work for which this
346..
California Health &Safety Code, Sections 25505,25533, and 25534. I will
permit is issued.
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
a.G' I certify that in the performance of the work for which this permit is issued, I
Health & Safety Code, Section 25532(a) should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the
WWo ker's Compensation laws of California. If, after making this certificate of
e I become subject to the Worker's Compensation provisions of the
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management Distri I '
will maintain compliance with the Cupertino M ipal Code, Chapter and
mption,
Labor Code, I must forthwith comply with such provisions or this permit shall
the Health & Safety Code, Sectio 5 5,;25533, and 25
be deemed revoked.
T( ANT CERTIFICATION
Owner or authorized agent i
APPi
certify that I have read this application and state that the above information is
Date: 10/20/2016
14ON LENDING AGENCY
correct. I agree to comply with all city and county ordinances and state laws
I hereby affirm that there i construction lending agency for the performance
relating to building construction, and hereby authorize representatives of this city
of work's for which this permit is issued (Sec. 3097;, Civ C.)
to enter upon the above mentioned property for inspection purposes. (Wg),agree
Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilittes,
judgments, costs, and expenses which may accrue against said -iy in
consequence of the gra * g of this permit. Additionally, the plicant understands
Mn
Lender°s Address
and will comply with -point source regulations pe a Cupertino Municipal
ARCHITECT'S DE RATION
Code, Section 9.1
I understand my plans shall be used as public records.
Signature"' Date 10/20/2016
Licensed
Professional
[a
CTTY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
10308 N STELLING RD CUPERTINO,'CA 95014-1644' (326 30 088)
CONTRACTOR: I PERMIT NO: B-2016-1837
HOMEOWNER/BUILD
ER
OWNER'S NAME: RE ACQUISITIONS GROUP INC I I DATE ISSUED: 08/29/2016
OWNER'S PHONE: 925-998-.0532 I 1 PHONE NO:
License Class Lic. #
Contractor HOMEOWNER/BUILDER Date
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:
1. 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
performance of the work for which this permit is issued.
i. 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 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 8/29/2016
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)
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.
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.
3. 1 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 C-
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. N
ature ---- - Date 8/29/2016
PERMIT INFO:
X BLDG —ELECT —PLUMB
_ MECH X RESIDENTIAL COMMERCIAL
JOB DESCRIPTION:
NEW TWO STORY SFD 3769 SQ FT; NEW GARAGE 445 SQ FT;
PORCH 848 SQ FT; DECK- 2ND FL.. 150 SQ FT
Sq. Ft Floor Area: 4214 1 Valuation: $490000.00
i Number: Occupancy Type:
30 088 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: 8/29/2016
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 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, Sec' ns 25505, 25533, and 25534.
Owner or authorized agent:
Date: 8/29/2016
CONSTRUCTI
hereby affirm that there is a construction lendin agency for the performance
of work's for which this permit is issued (Sec. 3097, Civ C-)
Lender's Name
Address
ARCHITECT'S DECLARATION
understand my plans shall be used as public records.
Licensed