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B-2016-2607CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2607 10170 N BLANEYAVE CUPERTINO, CA 95014-2330 (316 31 023) ALPS CONSTRUCTION & REMODELING INC SAN JOSE, CA 95129 OWNER'S NAME: License Class a Lic. #909433 ContractorALI'S CONSTRUCTION & REMODELING INC Date 01/31/2018 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 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 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 CodA%�Sgction 9.18. I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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). DATE ISSUED: 12/05/2016 PHONE NO: (408) 441-0967 BUILDING PERMIT INFO: BLDG —ELECT —PLUMB MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: 1 ST FLR - 2 BEDROOMS / LIVING RM / DINING RM / 1/2 BATH ADDITION (988 S.F.). REMODEL (E) SFD - 1,908 S.F. (INCLUDING (N) TRUSS ROOF SYSTEM, REPLACE A/C, FURNACE, WATER HEATER & UPGRADE PANEL 200 AMPS); NEW PORCH (30 S.F.) 04/20/2017 -DEFERRAL #1 - TRUSSES - ISSUED 5-15-2017 05-12/2017 - REV#1,— EXISTING FOUNDATION AT GARAGE, FRONT EXTERIOR WALL, AND (1) GUEST BEDROOM EXTERIOR WALL TO REMAIN; ADD CEILING BEAM ALONG BATHROOM ADJACENT TO GUEST BEDROOM.ISSUED 5-24-2017 Sq. Ft Floor Area: 988 Valuation: $400000.00 APN Number: Occupancy Type: 31631 023 R-3 (Custom) PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Abby Ayende Date: 12/05/2016 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. I hereby affirm under penalty of perjury one of the following three declarations: Signature of Applicant: 1. I have and will maintain a Certificate of Consent to self -insure for Worker's Date: 05/24/2017 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 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 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. Date 05/24/2017 ALL 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 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, Sections 25505, 25533, 25 Owner or authorized agent: Date: 05/24/2017 COT,��CTI DING 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2607 10170 N BLANEYAVE CUPERTINO, CA 95014-2330 (316 31 023) ALPS CONSTRUCTION & REMODELING INC SAN JOSE, CA 95129 OWNER'SNAME: DATE ISSUED: 12/05/2016 OWNER'S PHONE: PHONE NO: (408) 441-0967 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class ¢ Lic. #909433 ContractorALI'S CONSTRUCTION & REMODELING INC Date 01/31/2018 X BLDG —ELECT —PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing MECH X RESIDENTIAL_ COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: 1ST FLR - 2 BEDROOMS / LIVING RM / DINING RM / 1/2 BATH I hereby affirm under penalty of perjury one of the following two declarations: ADDITION (988 S.F.). REMODEL (E) SFD - 1,908 S.F. (INCLUDING (1) 1. I have and will maintain a certificate of consent to self -insure for Worker's TRUSS ROOF SYSTEM, REPLACE A/C, FURNACE, WATER HEATER Compensation, as provided for by Section 3700 of the Labor Code, for the & UPGRADE PANEL 200 AMPS); NEW PORCH (30 S.F.) performance of the work for which this permit is issued. 04/20/2017 -DEFERRAL #1 - TRUSSES - ISSUED 5-15-2017 p, A Vz. I have and will maintain Worker's Compensation Insurance, as provided for by 05-12/2017 - REV#1 - FOUNDATION Section 3700 of the Labor Code, for the performance of the work for which this Sq. Ft Floor Area: 988 Valuation: $400000.00 permit is issued. 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 316 31 023 R-3 (Custom) 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. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal CSection 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 05/15/2017 Issued by: KIM DUNBAR Date: 12/05/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is following two reasons: 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 of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code), Date: 05/15/2017 1 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 z. 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(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of -California. 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, Sections 25505, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: _ APPLICANT CERTIFICATION Date: 05/15/2017 I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance correct. I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued (Sec. 3097, Civ C.) relating to building construction, and hereby authorize representatives of this city 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, Lender's Address judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands ARCHITECT'S DECL ATION and will comply with all non -point source regulations per the Cupertino Municipal a r I understand my plans shall be used as public records. Code, Section 9.18. Licensed Signature Date 05/15/2017 Professional CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: i PERMIT NO: B-2016-2607 10170 N BLANEY AVE CUPERTINO, CA 95014-2330 (316 31023) ALI'S CONSTRUCTION & REMODELING INC SAN JOSE, CA 95129 LOWNER'SNAME: I (DATE ISSUED: 12/05/2016 I OWNER'S PHONE: I I PHONE NO: (408) 441-0967 License Class a Lie. #909433 i ContractorAL1'S CONSTRUCTION & REMODELING INC Date. 01/31/2018 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 C mpensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ,/performance 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 a� plicant understands and will comply with all non -point source regula9�1'1per tb.e Cupertino Municipal Code, Section 9.18. Date 12/5/2016 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. 1 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 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 12/5/2016 BUILDING PERMIT INFO: X_ BLDG —ELECT —PLUMB _ MECH X RESIDENTIAL_ COMMERCIAL JOB DESCRIPTION: 1 ST FLR - 2 BEDROOMS / LIVING RM / DINING RM / 1/2 BATH ADDITION (988 S.F.). REMODEL (E) SFD -1,908 S.F. (INCLUDING (1) TRUSS ROOF SYSTEM, REPLACE A/C, FURNACE, WATER HEATER & UPGRADE PANEL 200 AMPS); NEW PORCH (30 S.F.) Sq. Ft Floor Area: 988 I Valuation: $400000.00 APN Number: Occupancy Type: 316 31 023 1 R-3 (Custom) PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Abby Aeti nde Date: 12/05/2016 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: 12/5/2216 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 Co_ ecdons 25505, 25533, and 25534. Owner or authorized agent: Date: 12/5/2016 UONSTRUCTION LENDING AGENCY 1 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING REVISION 10300 TORRE AVENUE • CUPERTINO, CA 950143255 REVISION V '�/ I_- . 4 (408) 777-3228 •FAX (408) 777-3333 • buildinga(7cupertino.ora11 �'^1 Gt.IF'ERTfNO 17 '" ❑ NEW CONSTRUCTION ❑ ADDITION ❑ AL. ­0N/T1 ❑ REVISION /DEFERRED ORIGINAL PERMIT ii PROJECT ADDRESS A /A �J ` j AFN # OWNER NAME I�%,p l/ �] ` f (�S/ / 1 PHONE J / f� �(J! iiMA1L STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAME jC PHONE r E-MAIL (J /�! f • fI V �J �/ f ' O STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR FCONTRACTORAGENT 11 ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORLICENSENW& LICENSE TYPE BUS, LIC# l•o COMPANY NAME E- ` FAX D CrIY,ST�A'IE, PHONE �� _d ARCHITECT/ENOINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP P[DONE DESCRIPTION OF WORK 1e4 T11211 EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPH OCC, SQ.FT, VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODELAREA REMODELAREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA; DETACH ❑ ATTACH I R DWELLING UNITS: IS A SECOND UNIT Q YES SECOND STORY [] YES BEINGADDED? E]NO ADDITION? [INO PRE -APPLICATION []YES IF YES, PROVIDE COPY OF IS TIDE DLDG AN I] YES_ !I I 1 .�. _-�:. TOTAL VALUATION: PIANNINOAPPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO _ _ ( By my signature below, I certify to each of the following: I am the property owner or authrized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description o rk and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction, I authorize representa ' of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: -- SUPPLE IALMFORMATioNR.EQUIRED _.:�PLArN4HECKT'YPE;�rr ....e;�.-x .. �iStri'B�CSLTP '^ . New SFD or Multifamily dwellings; Apply for demolition permit for ❑ gv$R�Bx coul�r tx. s CI'BurLn LAIR–f existing building(s). Demolition permit is required prior to issuance of building - permit for new building. D EXp�SS f'LhlvAmTGYLAIV REVIEW tT Commercial Bldgs: Provide Hazardous Materials _ a completed Disclosure Q srAhDAR1I' r PIIeL7GvoRxs To—nn if any Hazardous Materials are being used as part of this project. ❑ 7`.ARGEr-' _._ L,�. - � L.7 FIRE DEPT � _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJAk ORS x :" . �I�.. SATQITABYSEwER])ISTRZ�7 submittal Gf Building Permit application, s r _ BldgApp_201 Ldoe revised 06/21/11