B-2016-2301CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2301
10271 BONNY DR CUPERTINO, CA 95014-2905 (359 13 002) BAOTRAN
CONSTRUCTION
COMPANY
SAN JOSE, CA 95126
OWNER'S NAME: KUO CHING SUNG AND LEE KUEI CHIN ET AL
OWNER'S PHONE:
1- _ \. 1 : M 1
License Class a Lie. #1023353
Contractor BAOTRAN CONSTRUCTION COMPANY Date 02/28/2019
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.
I Lhave 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 ment peed property for
inspection purposes. (We) agree to save indemnify nd keep harmless the
City of Cupertino aTeerJ
st liabilities, judgments, c sand expenses which
may accrue againsd City in consequen f the granting of this permit.
Additionally, the apnt understands will comply with all non -point
source regulations ie Cupprtt� unicipal Code, Section - -
Date 04/07/2017
I hereby afrWiwi - at 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. 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.
a. 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 CERIMCATION
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.
Signature Date 04/07/2017
ISSUED: 04/07/2017
NO: (408) 314-0362
PERMIT INFO:
BLDG X ELECT _ PLUMB
MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
ONE STORY ADDITION (1180 SQ FT) WITH COVERED PATIO (70 SQ
FT); NEW FOYER AT FRONT (56 SQ FT); INTERIOR REMODEL (300
SQ FT); UPGRADE PANEL TO 200 AMPS.
Sq. Ft Floor Area: 1236 1 Valuation: $180000.00
APN Number: Occupancy Type:
359 13 002 1 Deferred Submittal (R -3),R-3 (Custom)
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FRO INSPECTION.
Issued by: MELI1
Date: 04/07/2017
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.
Signature of Applicant:
Date: 04/07/2017
TO BE CLASS "A" OR
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. will
maintain compliance with the Cupertino Municipal Code, Chapter 912#d the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use eq mentor devices which emit hazardous
air contaminants as defined by the Ba Area Air Quality Mrpagement District I
will maintain compliance with the Cu ertino Municipal C de, Chapter 9.12 and
the Health & Safety Code, cti,#ns 255j15, 25 , and 25534. f
Owner_ or authorized
Date: 04/07/2017 �-
CONSTRUE AGENCY
I hereby affirm that there is a&6ngfrEuction 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