B-2016-1564CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-1564
10418 PALO VISTA RD CUPERTINO, CA 95014-2708 (357 02 047)
ALMO
CONSTRUCTION INC
REDWOOD CITY, CA
94063
OWNER'S NAME: STERN ROGER A
DATE ISSUED: 01/05/2017
OWNER'S PHONE:
PHONE NO: (650) 610-9300
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class @ Lic. #866347
Contractor ALMO CONSTRUCTION INC Date 11/30/2017
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:
CONSTRUCT (N) 1 ST FLOOR REAR ADDITION (247 S.F.); (N) 2ND
I hereby affirm under penalty of perjury one of the following two declarations:
FLOOR ADDITION (177 S.F.); (N) COVERED PATIO (60 S.F.); (N)
t. I have and will maintain a certificate of consent to self -insure for Worker's
FRONT PORCH (10 S.F.); REMODEL PANTRY, KITCHEN AND
Compensation, as provided for by Section 3700 of the Labor Code, for the
DINING ROOM (455 S.F.); REMODEL BATHROOMS (88 S.F.);
performance of the work for which this permit is issued.
REPLACE FIREPLACE IN LIVING ROOM; ADD (I) FIREPLACE IN
2. I have and will maintain Worker's Compensation Insurance, as provided for by
MASTER BEDROOM
Section 3700 of the Labor Code, for the performance of the work for which this
REV #1 - REVISE STRUCTURAL ROOF FRAMING - ISSUED
permit is issued.
6/12/2017
Sq. Ft Floor Area: 504
Valuation: $200000.00
APPLICANT CERTIFICATION
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
APN Number:
Occupancy Type:
and state laws relating to building construction, and hereby authorize
representatives of this city to enter upon the above mentioned property for
357 02 047
Deferred Submittal (R -3),R-3 (Custom)
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
source regulations per the Cup !no Municipal Code, Section 9.18.
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
,,
Signature � Date 6/12/2017
Issued by: ABBY AYENDE
OWNER -BUILDER DECLARATION
Date: 01/05/2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
RF. -ROOFS:
t. I, as owner of the property, or my employees with wages as their sole
All roofs shall be inspected prior to any roofing material being installed. If a roof is
compensation, 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 for
sale (Sec.7044, Business & Professions Code)
inspection.
2. I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code).
Signature of Applicant:
I hereby affirm under penalty of perjury one of the following three declarations:
Date: 6/12/2017
r. 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
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
performance of the work for which this permit is issued.
z. I have and will maintain Worker's Compensation Insurance, as provided for by
HAZARDOUS MATERIALS DISCLOSURE
Section 3700 of the Labor Code, for the performance of the work for which this
I have read the hazardous materials requirements under Chapter 6.95 of the
permit is issued.
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
3. I certify that in the performance of the work for which this permit is issued, I
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
shall not employ any person in any manner so as to become subject to the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
Worker's Compensation laws of California. If, after making this certificate of
material. Additionally, should I use equipment or devices which emit hazardous
exemption, I become subject to the Worker's Compensation provisions of the
air contaminants as defined by the Bay Area Air Quality Management District I
Labor Code, I must forthwith comply with such provisions or this permit shall
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505, 25533, and 25534.
be deemed revoked.
APPLICANT CERTIFICATION
Owner or utho�ized agent:
I certify that I have read this application and state that the above information is
Date: 6/12/2017
correct. I agree to comply with all city and county ordinances and state laws
CONSTRUCTION LENDINGAGENCY
relating to building construction, and hereby authorize representatives of this city
I hereby affirm that there is a construction lending agency for the performance
to enter upon the above mentioned property for inspection purposes. (We) agree
of work's for which this permit is issued (Sec. 3097, Civ C.)
to save indemnify and keep harmless the City of Cupertino against liabilities,
Lender's Name
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understands
Lender's Address
and will comply with all non -point source regulations per the Cupertino Municipal
Code, Section 9.18.
AR HIT ..T'S DECLARATION
understand my plans shall be used as public records.
Signature Date 6/12/2017
Licensed
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-1564
10418 PALO VISTA RD CUPERTINO, CA 95014-2708 (357 02 047)
ALMO
CONSTRUCTION INC
REDWOOD CITY, CA
94063
OWNER'S NAME: STERN ROGER
DATE ISSUED: 01/05/2017
OWNER'S PHONE:
PHONE NO: (650) 610-9300
LICENSED CONTRACT D RATION
BUILDING PERMIT INFO:
License Class $ Lic. #866347
Contractor ALMO CONSTRUCTION INC Date 11/30/2017
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:
CONSTRUCT (1) 1ST FLOOR REAR ADDITION (247 S.F.); (N) 2ND
I hereby affirm under penalty of perjury one of the following two declarations:
FLOOR ADDITION (177 S.F.); (N) COVERED PATIO (60 S.F.); (I)
1. I have and will maintain a certificate of consent to self-insure for Worker's
FRONT PORCH (10 S.F.); REMODEL PANTRY, KITCHEN AND
Compensation, as provided for by Section 3700 of the Labor Code, for the
DINING ROOM (455 S.F.); REMODEL BATHROOMS (88 S.F.);
performance of the work for which this permit is issued.
REPLACE FIREPLACE IN LIVING ROOM; ADD (I) FIREPLACE IN
-2. I have and will maintain Worker's Compensation Insurance, as provided for by
r .-
MASTER BEDROOM
Section 3700 of the Labor Code, for the performance of the work for which this
Sq. Ft Floor Area: 504
Valuation: $200000.00
\ permit is issued.
APPLICANT CERTIFICATION
I certify that 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
357 02 047
Deferred Submittal (R-3),R-3 (Custom)
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) aree to save indemnify and keep harmless the
City of Cupertino against Iia i ities, judgments, costs, and expenses which
PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said Ci n consequence of the granting of this permit.
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally, the licant r torte, and will comply with all non-point
source regulatio s er h e ino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signatu ` Date .1(5/2017
Issued by: Ellen Yau
JEZION
Date: 01/05/2017
OVVNER-1W9
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 offlic property, am exclusively contracting with licensed
Signature of Applicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 1/5/2017
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-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
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
permit is issued:
Health & Safety Code, Section 25532(a) should I store or handle hazardous
s. I certify that in the performance of the work for which flus permit is issued, I
in to become to the
material. Additionally, should I use equipment or devices which e hazardous
'
shall not employ any person any manner so as subject
air contaminants as defined by the Bay a Air u ty Management District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the C er ' o M ic' at Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code, ectio s 05 533, 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: 1/5/2017
I certify that I have read this application and state that the above information is
CONSTRUC7
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,
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
ARC be used a public RATION
I understand my plans shall be used as public records.
Code, Section 9.18.
Licensed
Signature Date 1/5/2017
Professional