Loading...
B-2017-0397CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0397 10313 BLANEY CT CUPERTINO, CA 95014-3123 (369 32 015) HERITAGE CONSTRUCTION GROUP INC SAN JOSE, CA 95136 OWNER'S NAME: POON RONNIE K L TRUSTEE & ETAL DATE ISSUED: 03/10/2017 OWNER'S PHONE: 510-508-9234 PHONE NO: (408) 266-8303 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C1I Lic. #931230 Contractor HERITAGE CONSTRUCTION GROUP INC Date 04/30/2017 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: REPLACE 8 WINDOWS (TO MEET EGRESS & BE TEMPERED PER I hereby affirm under penalty of perjury one of the following two declarations: CODE); 2 SLIDING GLASS & 1 FRENCH DOOR 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. Jhave and will maintain Worker's Compensation Insurance, as provided for by �J Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $11900.00 APPLICANT CERTIFICATION 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 and state laws relating to building construction, and hereby authorize 369 32 015 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 Code, Section 9.18. 180 DAYS CAL- PECTION. / Signature % 01 Date 03/10/27 Issued by: MELI AN I Date: 03/10/2017 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) 2. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (See.7044, Business & Professions Code), Date: 03/10/2017 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, Chapter 9.12 and the s. 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 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 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, 2553 , and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent:,' IA- x� APPLICANT CERTIFICATION Date: 03/10/2017 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. 1 understand my plans shall be used as public records. Licensed Signature Date 03/10/2017 Si 9 Professional COMMUNITY DEVELOPMENT DEPARTMENT , BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 • build6rEq(CY_"Cllpe€ tino.Orq ❑ NEW CONSTRUCTION ❑ ADDITION ALTERATION / TI REVISION /DEFERRED ORTGTNAL PARMTT tt PROJECT ADDRESSAO313 6eAilea C-.. CG fart o fp CJS APN# _ 3Z-0/ OWNER NAME Cmj�%1 �. 9NOh 1?0,9h PHONE 510-505. 9 23� E-MAIL CM;e- IV00(1486 @ Qma.f,v CC77FAX �'�'"�"' STREET ADDRESS 1oCJ31-2 QtA.,� /' Kv-i CITCY,, STATE,,Z�4_;'0' C q � o14 CONTACT NAME,• PHONE510.r-0'b 123i„�FMAILLil.�,P� 190 STREET ADDRESS t�31 `%, 1 �fj C�r� ITY, STATE, ,ZI e _ q f 1 ,� FAX OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT 0 CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME mctk-\,,, vt A 1''i - 7��SCS LICENSE NUMBER C '1 1 'D �g ® LICENSE TYPED , 1 BUS LTC # � (i'� COMPANY NAME"�r\'1f11 �^d� 5 �AG�dJ, WS �"(� e E-MAII�e1eS�7•' FAXLM� ,!P–(k 6 cJ & STREETADDRESS9��� e� CITY, STATE, ZIP PHO_l NFN4(:)9-y6®0&) ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LTC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK 1 _ C � � q\ �w `4 O� w©oocs �iI.S � � iR• `G 5 Gu d our r lit UI -ro EXISTING USE PROPOSED USE CONSTR TYPE # STORIES USE TYPE OCC. SQ FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGEAREA: EIDETACH ❑ ATTACH I # DWELLING UNITS: ISA SECOND UNIT ❑ YES SECOND STORY []YES BEING ADDED? ❑NO ADDITION? ❑NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER IS THE BLDG AN TOTAL VALUATION: EICHLER HOME? J V L) By my signature below, I certify to each of the following: 1 am the property owner or authorized agent to ac o e property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building const r ction. I authorize representatives of Cupertino to enter the abov7e-identifi d property for inspection purposes. Signature Applicant/Agent: Date: Q� 0 1 of SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP © A VER -THE COUNTERBI ILDINGPLANREV]IEW existing New SFD or Multifamily dwellings: Apply for demolition permit for building(s). Demolition permit is required prior to issuance of building - permit for new building. EXPRESS 1] PLANNING PLANRENIM _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 0 STANDARD Q P€ BLIC lvA PjI;s form if any Hazardous Materials are being used as part of this project. 14ARGF 0 Fi?21E APT _ Copy of Planning Approval Letter or Meeting with Planning prior to © MAJOR 11 S tNFTARY SEtVFSA 33TSTIiICT submittal of Building Permit application. 1 ENS'iRONMFNTAL HEALTH BldgApp_2011.doc revised 06/21/11