B-2016-1484 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR. PERMIT NO:B-2016-1484
21731 STEVENS CREEK BLVD CUPERTINO,CA 95014-1119(326 20 048) METHOD
CONSTRUCTION INC
GILROY,CA 95021
OWNER'S NAME: FREELAND URI AND BATIA TRUSTEE DATE ISSUED: 11/01/2016
OWNER'S PHONE:605-823-4543 PHONE NO:(408)842-0054
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO•
License Class ji Lic.#857112
Contractor METHOD CONSTRUCTION INC Date 04/30/2017 X BLDG _ELECT _PLUMB
MECH_RESIDENTIAL X 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
CONSTRUCT(N)SHELL BUILDING(2,600 S.F)
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 REV#1-REMOVE 3 DOORS FROM STOREFRONTS,UPDATE ON
Compensation,as provided for by Section 3700 of the Labor Code,for the SITE UTILITIES,REVISE TRASH ENCLOSURE TO PROVIDE
performance of the work for which this permit is issued. ACCESSIBLE PATH AND ENTRY
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
X1,1=have
permit is issued. Sq.Ft Floor Area.2600 Valuation.$700000.00
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 APN Number- Occupancy Type:
and state laws relating to building construction,and hereby authorize 326 20 060 ,A-1,M(Mercantile)
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 PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City i con equence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant und-rstand and will comply with all non-point
source regulations per the Cusertino eil5al Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION
iftSignature �� Date 12/22/2017 Issued by Abby Ayende
Date: 11/01/2016
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS.
following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
1. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an 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 of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:12/22/2017
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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. HAZARDOUS 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 6.95 of the
Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will
permit is issued. maintain compliance with the Cupertino Municipal Code,,C4pter 9.12 and the
3. 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 ha le hazardous
shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devi(es which:•mit hazardous
air contaminants as defined by the Bay Area Air Qu ty Manage, ent District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Munk' Code,Ch:pter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety CSections 25505 25533,and 2'534.
Labor Code,I must forthwith comply with such provisions or this permit shall C/ /)///
be deemed revoked. //I}
Owner or authorized agent:
APPLICANT CERTIFICATION 'Date:12/22/2017 r
I certify that I have read this application and state that the above information is CONSTRUCTION LENDIN AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a 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.3Civ C.)
to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name
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 Address
consequence of the granting of this permit. Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION
Code,Section 9.18. I understand my plans shall be used as public records.
Licensed
Signature Date 12/22/2017 Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-1484
21731 STEVENS CREEK BLVD CUPERTINO, CA 95014-1119 (326 20 048)
METHOD
CONSTRUCTION INC
GILROY, CA 95021
OWNER'S NAME: FREELAND URI AND BATIA TRUSTEE
DATE ISSUED: 11/01/2016
OWNER'S PHONE: 650-523-1543
PHONE NO: (408) 842-0054
LICENSED CONTRACTOR'S AR TION
BUILDING PERMIT INFO:
License Class B Lic. #857112
Contractor METHOD CONSTRUCTION IN • Date ()4/30/2017
X BLDG _ELECT —PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing.
MECH
— _ RESEDENTIALXCOMMERCIAL — ,
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
CONSTRUCT (N) SHELL BUILDING (2,600 S.F.)
I hereby affirmunder penalty of perjury one of the following two declarations;
i. 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.
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.
Sq. Ft Floor Area: 2600
Valuation: $700000.00
APPLICANT CERTIFICATION
I certify than I have read this application and state that the above
APN Number:
Occupancy Type:
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize
326 20 048
A -1,M (Mercantile)
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
PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit.
Additionally, the applicant understands and will co with all non -point
WITHIN' 180 DAYS OF PERMIT ISSUANCE OR
source regVkMunEk per the Cupertino Mun' ' al C de, section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
,Signature Date _11/1/2016
Issued by: Abby Ayende
OWNER -B ]LD •RDECLARATION
Date: 11/01/2016
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE -ROOFS:
following two reasons:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
1. I, as owner of the property, or my employees with wages as their sole
installed without first obtaining an 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)
2. I, as owner of the property, am exclusively contracting with licensed
Signature ofApplicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 11/1/2016
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
i. 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.
HAZARDOUS 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 6.95 of the
Section 3700 of the Labor Code, for the performance of the work for which this
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
3. I 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 manner so as to become subject to the
material. Additionally, should I use equipment or devices which emit hazardous
'strict
air contaminants as defined by the Bay Area Air Quality Manageme I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the Cupertino Municipal Code, Cht .12 and
X534.
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety C e, ctions 255
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agent:
APPLICANT CERTIFICATION
Date: 11/1/2016
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
I hereby affirm that there is a 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. (We) agree
Lender's Name
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 Address
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
ARCHITECT'S DECLARATION
Code, Section 9.18.
1 understand my plans shall be used as public records.
Signature Date 11/1/2016
Licensed
Professional