B-2016-2471CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR: I
PERMIT NO: B-2016-2471
19090 MEIGGS LN CUPERTINO, CA 95014-3511 (375 35 049)
MAKIE CORP
SANTA CLARA, CA,
j
95055-2070
OWNER'S NAME:
DATE ISSUED: 02/02/2017
OWNER'S PHONE:
PHONE NO: (408) 763-4689
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class B Lic. #1000247
Contractor MAKIE CORP Date 01/31/2019
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
I
license is in full force and effect.
JOB DESCRIPTION:
(N) 2 CAR ATTACHED GARAGE (400 S.F.); REPLACE (1) DOOR.
I hereby affirm under penalty of perjury one of the following two declarations:
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.
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
Sq. Ft Floor Area:
Valuation: $350000.00
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
"N Number:
I
Occupancy Type:
and state laws relating to building construction, and hereby authorize
375 35 049
Deferred Submittal (R-3),Deferred Submittal (R -
representatives of this city to enter upon the above mentioned property for
3),Deferred Submittal (R-3),Deferred Submittal (R -
inspection purposes. (We) agree to save indemnify and keep harmless the
3),Deferred Submittal (R-3),Deferred Submittal (R -
City of Cupertino against liabilities, judgments, costs, and expenses which
!
3),Deferred Submittal (R-3),Deferred Submittal (R -
may accrue against said City in consequence of the granting of this permit.
3),Deferred Submittal (R-3)
Additionally, the applicant urlderstands and will comply with all non -point
source regulationser th ertino Municipal Code, Section 9.18.
PERMIT EXPIRES IF WORK IS NOT STARTED
signature Date 2/2/2017
WITHIN i, 80 DAYS OF PERMIT ISSUANCE OR
OWNE _UI �DZECLARATIONi
180 DAYS FROM LAST CALLED INSPECTION.
I hereby affirm that I am exempt from the Contractor's License Law for one of the
Issued by: Abby Ayende
following two reasons:
Date: 02/02/2017
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
RE -ROOFS:
sale (Sec.7044, Business & Professions Code)
All roofs shall bef inspected prior to any roofing material being installed. If roof is
2. I, as owner of the property, am exclusively contracting with licensed
rials for
installed withoutt first obtaining an inspection, I agree to remove all new materials
contractors to construct the project(Sec.7044, Business & Professions Code).
inspection.
I hereby affirm under penalty of perjury one of the following three declarations:
t. I have and will maintain a Certificate of Consent to self -insure for Worker's
Signature ofApplic'ant:
Compensation, as provided for by Section 3700 of the Labor Code, for the
Date: 2/2/2017
performance of the work for which this permit is issued.
2. I have and will maintain Worker's Compensation Insurance, as provided for by
ALL RO`,OF COVERINGS TO BE CLASS "A" OR BETTER
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
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
shall not employ any person in any manner so as to become subject to the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
Worker's Compensation laws of California. If, after making this certificate of
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
exemption, I become subject to the Worker's Compensation provisions of the
Health & Safety Code, Section 25532(x) should I store or handle hazardous
Labor Code, I must forthwith comply with such provisions or this permit shall
material. Additionally, should I use equipment or devices which emit hazardous
be deemed revoked.
air contaminants 'as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino M ' ipal Code, Chapter 9.12 and
APPLICANT CERTIFICATION
the Health & Safety CodZSe:ctio2 25533, and 25534.
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
relating to building construction, and hereby authorize representatives of this city L
Owner or authorized agent:
r ort
to enter upon the above mentioned property for inspection purposes. (We) agree
®ate:
CONSTRUCTION LENDING AGENCY
to save indemnify and keep harmless the City of Cupertino against liabilities,
I hereby affirm that there is a construction lending agency for the performance
judgments, costs, and expenses which may accrue against said City in
this Additionally, the understands
of work's for which this permit is issued (Sec. 3097, Civ C.)
consequence of the granting of permit. applicant
Lender's Name
and will comply with all non -point source regulations per the Cupertino Municipal
Code, Section 9.18.
Lender's Address
Signature Date 2/2/2017
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2471
19090 MEIGGS LN CUPERTINO,CA 95014-3511(375 35 049) MAKIE CORI'
SANTA CLARA,CA
95055-2070
OWNER'S NAME: DATE ISSUED:02/02/2017
OWNER'S PHONE: PHONE NO:(408)763-4689
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#1000247 X BLDG ELECT—PLUMB
Contractor MAKIE CORP Date 01/31/2019 —
I herebyform that I am licensed under the provisions of Chapter 9 —MECH Ys RESIDENTIAL_COMMERCIAL
a p p (commencing
With Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
(N)2 CAR ATTACHED GARAGE(400 S.F.);REPLACE(1)DOOR.
I hereby affirm under penalty of perjury one of the following two declarations: REV#1-PANEL UPGRADE(200 AMPO SAME LOCATION-ISSUED
C. I have and will maintain a certificate of consent to self-insure for Worker's 06-04-2018
Compensation,as provided for by Seen.,,3700 of the Labor Code,for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation hu prance,as provided for by
Section 3700 of the Labor Code,for the performance of Clic work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$350000,00
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 375 35 049 Deferred Submetal(R-3)
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 WORI{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 under n and will comply with all non-point
source regulations per the Cu into Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature -Date 06-04-2018 Issued by:AbbyAAyende
Date:02/02/2017
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Lav for one of theRE-ROORS:
so
following two reans: All roofs shall be inspected prim to any roofing material being installed.If a root'is
1. 1,as owner of the property,or my employees with wages as their sale nstalled without first obtaining an inspection,I agree to remove all new materials for
compensation,will do the work,and the strecture is not intended or offered far impection.
rude(Sce.7044,Business&Professions Code)
z. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant
contractors to construct the project(See.7044,Business&Professions Cade). Date:06-04-2018
1 hereby affirm under penalty of perjury one of the following three doctor Still ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
r. 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 Per otit 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
r t is issued maintain compliance with tire Cupertino Municipal Cade,Chapter 9.12 and the
pe nv m
s. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(x)should I stare or handle hazardous
,should 1 use e material.Additional) t Dr devices Which emit hazardous
shall not employ any person in any manner so as to become subject to the Y equipment
air eontxminants defined by the Bay Area Air Quality Management District I
Worker's Compensation laws ot'Califomia,If,after making this certificate of will maintain complplinntt with the Cupertino M gyicipal Cade,Chapter 9,12 xad
exemption,)bormur subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections .....
and 25519.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked Owner or authorized agent:
APPLICANT CERTIFICATION Date:06-04-2018
I certify that I have read this application and state that the above information is CONSTRUCTION LENDING 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.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. understand my plans shall be used as public records.
Licensed
Signature Date 06-04-2018 Professional