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B-2016-1937 CITY OF C I ERTINO BUILDING PERMIT BUILDING ADDRESS- CONTRACTOR: PERMIT NO.,B-2016-143' 10100 LEBANON DR CUP RTINO,C.A.95014(34214 026) OUTERTAIIOVIENT CONSTRUCTION INC M1LPrrAS,CA 95035 OWNER'S NAME: h1ANGHNANI PlLA.I{fs.51-I AND REKHA DATE ISSUED:05113/2016 OWNER'S PHONE:408-857-7138 PHONE NO.(408)91+4-tUO3 LICENSED COMEACIM'S DECLARLAILMN I3UILI)ING PERAHT INP`G: License Class fl Lic.#1 Q1307 Contractor QUIE 16AM1EyNTCONSTRUCTION INDate M31=18 XBLDG —ELECT,,,_PIIIi4I8 I iaerehy arterio thatl am licensed underthe provtsfons of Chapter 9(commenting — CH X RESIDENTIAL-COMMERCIAL with Section 7000)ofi3ivlslom 3 afthe Business&Professions Cade and that my license is in full force and effect, JOB DES ION: I hereby affirmunder penalty of perjury one of the fallowing two declarations: CONSTRUCTADETACHED COVERED PATIO AMH KITCHEN(457 Q T) L I have and will maintain a certificate off-consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the 94 performance sof the worm for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for b Section 3700 of the Labor Code;for the performance of the work for which this Permit is issued. Sq,Ft Floor Area: Valuation:$70000.00 ,$P&ICAN'T CE �Tt1iX I certify that I have read this application and state that the above APIY Number: OccupancyType: information is correct.t agree to comply with all city and county ordinances 342 14.026 and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned properly for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit, 1�'IT �� PERMIT ISSUANCE ORAdditionally,the applicant understands and will comply with all anon-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM.LAST CALLED INSPECTION. Signature * ., Bate 5ft3M Issued by:SEAN HATCH Bate:051131201 b LBUILDELECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RF ROOPS- following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. 1,as owner of the property,or my employees with wages as their sole installed without first obtaining aro inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) Z I,as owner of the property;am exclusively contracting with licensed Signature ofApplicant: contractors to construct the project(S=706A,Business&Professions Code). DaYe:5/1311 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER t. I have and will maintain a Certificate of Consent to self=;nsure for Worker's Compensation,as provided for by Section 3700 of the tabor Code,for the performance of the work for which this permit is issued. HAZARDOUS,MATERIALS DISCLOSURE 2. 1 have and will maintain 'erker's Compensation Iaawrance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 ortbe Section 3700 of the Labor Codi:,for the performance of the work for which this California health&Safety trade,Sections 295005,25533,and 25534. 1 will permit is issued. ;maintain compliance with the Cupertino Municipal Coale,Chapter 9.12 and the s. 1 certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(x)should.I store or handle hazardous shall not employ any person in any uramier so as to become subject to the material.Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation la%,s ofCalifornia. If,after making this certificate of: will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,S ions 25505,25533,and 25534. Labor Code;l must forthwith comply with such provisions or this permit shall _ be deemed revoked. Qw er or authorized agent- APPLICANT CE€T�IDN ate: aAGENCY 1 certify that t have read this th al l tion and state trdi me esran istatel wsion is I hereb affirm that there is a construction lendin a enc for the erformance correct.i agree to comply with BII city and county ordinances and state laws y g agency P 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. (We)agree Lender's,dame to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may ague against said City in Lender's Address consequence of the granting of this permit.Additionally,the applicant understands ARCIRTECT'S DECi A.RATT i and will comply with all non-point source regulations per the,Cupertino Municipal Code,Section 9.18, 1 understand my plans shall be used as public re=ds. Licensed Signature Date 511ME Professional CONSTRUCTION [T APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT®BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 CPT � {408}777-329-8_ <(408)777-3333 lauildRn cR�cul�ettino.nrg 407 EINEw Cts S'fIIIICrIO [:1 ADDITIONtit fl tTION t TI I 4ISIi?1v�I D FLRRED ORIGINAL PERMIT01 +� PROJECT ADDRES 5 OWNER NAME j PHONE £-�]1ti A STREET ADDRESS CIE,STATE.ZIP mx CONTACT NAMEo PHONE g� p E=4 Q 0 u4t STREETADDRES IT]',STATE ZIP FAX f OWNER ® fD5 NEN-BIJILD R 0 4SWNEP,AGENT CONTRACTOR QCONTRACTOR AGENT 11 ARCHITECT ElYNOWE.ER 0 DEVELOPER ®TENA€q CONTRACTOR NA E i LICEkS .J EA LICENSE TYPE ALIS_LTC•_1,10b% COMPANYNAME i E-MAIL FAX �t STREET ALDDI2E5 CITY,STATE,ZIPPS d0 vE CIIITECTIEry TEERi XXTIE €.ICENSENt.J MER BUS_LIC 0C } COMPANY NIAME E-UML FAX STRUT ADDRBES$C. a C1TY,STAT ,ZIP4 rd PH O\E s { -� DESCRIPTION'OF WORK wl m {'if ' in eile"ef° } E'ISTI SE PROPOSED USE CONS JT . E `STO RFS 77 tt,,P}} - V ITA EXISTO 2EwFLCtOR DEMO TOTAL. AREAAREA AREA NET AREA ` BATHROOM KrTCHEN --- _.. OTHER REMODELAREA RE,IOISELAREA RE-IaDELAR`==% PORCHAREA DECK. T07ALDEt:I-TORCn ARLA GARAGE AREA- DETACH i.. 0 ATTACH 5DW-FLUNG bNa'ss, MA-S,ECON"@iStia; n tFs SECi,3S➢%Torrf l]5'Es HUNG ADurras E:'o ADDITION? 0 NO p�-:3raa.€cnraox �9 tis ut�c.��o{sn€c�rv� Q��a�*�,�•s� g may' �' '�: PL'v`43Ly.°Ce APPLr +A`f3 PLAN"d GAPPRQYAL LSTMP. I .... L .,- By my signature blow,I certify to each of the following I am the property owner or authorized agent to act on the property owner's behalf. I have react this application and tic infoanatinn 1 have pi-ovided is correct. I have read the Description of lvWorl,and verify it is accurate. l agree to comply with all applicable local ordinances ands to laws relating to bu• constru 'on I authorize representatives of Cupertino to eater the aboe e-identilied property for inspection purposes. Signature of Art licautfAgent: � Date; ^" 3UPPI-EmENTALINFoRMATION REQUIRED PtANMEC K'fY'P I E AWMGasug: New SEI3 L r Multifamily dwellings- Apply for demolition pennit for � al LNLASt w existing build' g(s). Demolition permit is required prior to issuance of building peruTitfornea�building. s .` � �� . _ Commercial BIdgs: Provide n completed hazardous Materials Disclosure STANDARD . �.� olw farm if any Hazardous Materials are being used as part of this project, 0 0 _Copy of t'janning Approval better or Meeting with Planning prior to � AtUOR submittal of Byilding Pern-ait application. Bl dgApp 2011-Floc revised 073116111 i �Za 621 Tully Road Suite 206Q San Jose,CA 951 1 1 Tel.408-899-0220 ~�" }... QROFESSIp�rq� October 1 , 201 G W Philip Shinn No. C 056117 it Exp. 12/31/16 THE MANGHNANI 'RE51DENCE CIVIL 10100 LEBANON DRIVE �4��Q CUPERTINO, CA 95014 OF CA1-� - RE: Ceiling beam connection. To whom it may concern: The plan call for an installation of 5imp5on "GL.TV 3.5 1 G" top flange hanger to hang beam #2 to ceiling beam #1 Per field verification the connections were installed per plan and it is acceptable. 51ncerely, Project Engineer, Tony Truong 1 �f I fig L I t \ I,