Loading...
B-2016-2753CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 23500 CRISTO REY DR UNIT 504G CUPERTINO, CA 95014-6534 (342 53 225) BAYAREA ENTERPRISE SAN JOSE, CA 95148 NO: B-2016-2753 OWNER'S NAME: GIFFORD HELEN 7 TRUSTEE I I DATE ISSUED: 09/20/2016 'S PHONE: 650-537-1523 1111-1561-01M 011 1 sY ._A_ rem 1 1 License Class E Lic. # 18 7817 Contractor BAY AREA ENTERPRISE Date 03/31/2017 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. 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. z . -I have and will maintain Worker's Compensation Insurance, as provided for by C= Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION certify that 1 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 09/20/2016 �. I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: i. 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) z. 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. 3. 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 tKis 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 09/20/2016 NO: (408) 238-5043 BUILDING PERMIT INFO: X BLDG X ELECT _ PLUMB X MECH X RESIDENTIAL — COMMERcL4,L JOB DESCRIPTION: UPGRADE OUTLETS, LIGHT SWITCHES (28) BATHROOM FAN (1); RECESSED LIGHTS (5) Sq. Ft Floor Area: I Valuation: $25000.00 APN Number: Occupancy Type: 342 53 225 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST Issued by: MELISSf,T�� Date: 09/20/2016 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: 09/20/2016 TO BE CLASS "A" OR 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 th pertino Municipal Code, Chapter 9.12 and the Health & Safetpode, Sections 25505 5333,.and 25534. Owner or authorized Date: 09/20/2016 CONSTRUCTION LENDING AGENCY I 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 ARC HITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CONSTRUCTION PES IT P - COMMUNITY DEVELOPMENT DEPARTMENT < BUILDING DIVISION 10300 TORRE AVENUE e CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) buRding pcuperlino.Gra 1 !' NEW CONSTRIICTIdItiT n ADiIITION ALTERATION f TI 1 .+ REVISION f DEFERREi} ORIGINAL PERMIT 4 PR02 OSS C,il�l �'l - C� �UfV Ij APN;; �l �' ✓ �� 4^* OWNER NAME ,.. _ g fs PHONE. _ (*50-53'7- IS -3 ARCHITECTIENGINEERNAME - E-biAiL �.1 f6''ii ? RSC -Cat% STREETADDRESS COMPANY NANIE E-MAIL. CITY,. STATE, ZIP _ STREET ADDRESS FAX CONTACT NAME &1­e;Fe- St PHONEE-MAIL O - 23 8- S-603 AREA re - ei-N-a c o STR=ADDRESS Z.1 t o - - F n `vti CR'Y,STATE, ZIP T- 5-1 . FAX V 0 OWNER rl o%x NER-8UILDER Q OWNERAGENT !tZ CONTR_ACTOR Ci CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER ❑ TENANT CONTRACTOR NAME LJ�C t� LICENSE NUMBER tZ 0 17 LICENSE TYPE BUS. LIC i' Z COMPANY NAME E-MAIL w a u Ay%ec-- n i `5 FAX STREETADDRESS j 19 cn ,STATE.ZTP 7-110 a c DNF ARCHITECTIENGINEERNAME - LICENSE NUMBER BUS. LIC a. . COMPANY NANIE E-MAIL. FAX STREET ADDRESS CITY, STATE, ZIP _.. PHONE DESCRIPTION' OFWORK -It EXISTING USE PROPOSED USE - - - CONSTR TYPE *STORIES USE TYPE OCG SQ FT. VALUATION ($j . EXISTG NEW FLOOR DEMO TOTAL. AREA AREA AREA NETAREA - BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA - REMODEL AREA PORCH AREA DECKAREA TOTAL DECK/PORCH AREA GARAGE AREA DETACH - - I OATTACH # DWELLING UNITS_ IS A SECOND UNIT ©YES SECONDSTORY OYES - BEINCADDED? ONO ADDITION? ONO PRE -APPLICATION OYES IF YES. PROVIDE COPY OF, THE BLDG AN DYES D TOTAL VALUATION: - •. PLANNLNGAPPLn. ONO PLANNING APPROVAL LFITER EICHLERHOME? ONO �) f):(J� By my signature below, I certify to each of the 10110 g: lam me properly uwuer u, auuiul>< na.». . a�� �u u=� Y= P ' r �••• �� - � - application and the information I have provided is co ct. I ha ead the Description of Work and verify it accurate. I agree to comply with all applicable local ordinances and state laths retating to building co ction. a Drize representatives ofCnpertino to enterthe above -identified property for inspection purposes. Signature of Applicant(Agent Date: CTMVT T,A&PNIT I). -IMP iIZAAATION1 RF0111RED _ nr.anrrrrGrrrTVnA - ROUTTNGSLIP. _ Ne-,vSPIT or Multifamily dwellings: Apply for demolition permit for existing buildings). Demolitionpermit is required prior to issuance of building permit for new building. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials''; are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. OVSR-TH&COUNTER 0 EXPRESS 0 STANDARD 0 LARGE i4TA3O8'. 0 BUILDING PLANREVMW .0 PLAiNPUNGALANREV1ENV, .. 0 PuRL11Cwtlxtcs '0 FIRE DEPT - Q SANITARYSEtVERDISTRICT Ll ENVIRONI4ENlPT-A L REALTR Btdg4pg 2OlL laereuis1. 116./21/11