B-2017-0107 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-0107
10832 LEAVESLEY PL CUPERTINO,CA 95014-4747(356 15 035) ALI'S CONSTRUCTION
&REMODELING INC
SAN JOSE,CA 95129
OWNER'S NAME: MENON JOBY AND PRIYA TRUSTEE DATE ISSUED:04/11/2017
OWNER'S PHONE:408-429-0938 PHONE NO:(408)441-0967
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class Ii Lic.#909433
Contractor ALI'S CONSTRUCTION&REMODELING INC Date 01/31/2018 X BLDG X ELECT _PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing X 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 FLOOR BEDROOMBATHROOM/LIVING ROOM ADDITION(250
I hereby affirm under penalty of perjury one of the following two declarations: S.F.);COVERED PORCH(30 S.F.);INTERIOR REMODEL OF
1. I have and will maintain a certificate of consent to self-insure for Worker's BEDROOMS/BATHROOMS/DINING ROOMS(863 S.F.);MINOR
as provided for by Section 3700 of the Labor Code,for the KITCHEN REMODEL TO INSTALL ISLAND W/ELEC AND REPLACE
erfotrnance of the work for which this permit is issued. BAY WINDOW WITH GARDEN WINDOW;UPGRADE ELECTRICAL
/ompensation,
have and will maintain Worker's Compensation Insurance,as provided for by PANEL(200 AMP);REMOVE/RELOCATE FURNACE TO ATTIC.
ection 3700 of the Labor Code,for the performance of the work for which this 6-19-17 REV#1 -DETAIL FOR FOUNDATION-ISSUED 6/22/2017
permit is issued. REV#2-REVISE SHEAR WALL AND HOLD DOWN DESIGN PER
APPLICANT CERTIFICATION FIELD CORRECTION NOTICE-ISSUED 9/27/2017
I certify that I have read this application and state that the above Sq.Ft Floor Area:250 Valuation:$30000.00
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 APN Number: Occupancy Type:
inspection purposes. (We)agree to save indemnify and keep harmless the 356 15 035 R-3(Custom)
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 c....ly with all non-point
source regulations per the Cupertino Munici•. ..e,Section 9.18. PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
s' - /` , Date 9/27/2017 180 DAYS FROM LAST CALLED INSPECTION.
iiiipp.-- Aw—
'ER-BUILDER DECLARATION Issued by:Abby Ayende
I hereby affirm that I am exempt from the Contractor's License Law for one of the Date:04/11/2017
following two reasons:
1. I,as owner of the property,or my employees with wages as their sole RE-ROOFS:
compensation,will do the work,and the structure is not intended or offered for All roofs shall be inspected prior to any roofing material being installed.If a roof is
sale(Sec.7044,Business&Professions Code) installed without first obtaining an inspection,I agree to remove all new materials for
2. I,as owner of the property,am exclusively contracting with licensed inspection.
contractors to construct the project(Sec.7044,Business&Professions Code).
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:9/27/2017
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
a. 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 HAZARDOUS MATERIALS DISCLOSURE
permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the
3. I certify that in the performance of the work for which this permit is issued,I California Health&Safety Code,Sections 25505,25533,and 25534. I will
shall not employ any person in any manner so as to become subject to the maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Worker's Compensation laws of California. If,after making this certificate of Health&Safety Code,Section 25532(a)should I store or handle hazardous
exemption,I become subject to the Worker's Compensation provisions of the material. Additionally,should I use equipment or devices which emit hazardous
Labor Code,I must forthwith comply with such provisions or this permit shall air contaminants as defined by the Bay Area Air Quality Management District I
be deemed revoked. will maintain compliance with the Cupertino Municipal Code,Chapter and
the Health&Safety Code,Sections 25505,25533,and 25
APPLICANT CERTIFICATION i
I certify that I have read this application and state that the above information is Owner horized agent:
correct.I agree to comply with all city and county ordinances and state laws D
relating to building construction,and hereby authorize representatives of this city
CONSTRUCTION LENDING AGENCY
to enter upon the above mentioned property for inspection purposes. (We)agree I hereby affirm that there is a construction lending agency for the performance
to save indemnify and keep harmless the City of Cupertino against liabilities, of work's for which this permit is issued(Sec.3097,Civ C.)
judgments,costs,and expenses which may accrue against said City in Lender's Name
consequence of the granting of this permit. Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal Lender's Address
Code,Section 9.18.
ARCHITECT'S DECLARATION
Signature Date 9/27/2017 I understand my plans shall be used as public records.
Licensed
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
10832 LEAVESLEY PL CUPERTINO, CA 950144747 (356 15 035)
OWNER'S NAME: MENON JOBYAND PRIMA TRUSTEE
OWNER'S PHONE: 650-273-0404
III I 1 ., EIR4.311101� _; 1►
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.
d / 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 er a Cupertino Municipal Code, Section 9.18.
Signature .-z ',—Date 4/11/2017
I hereby affirm that I &nf 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
CONTRACTOR: PERMIT NO: B-2017-0107
ALPS CONSTRUCTION
& REMODELING INC
SAN JOSE, CA 95129
DATE ISSUED: 04/11/2017
PHONE NO: (408) 441-0967
BUILDING PERMIT INFO:
X BLDG X ELECT _ PLUMB
X MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
1 ST FLOOR BEDROOMBATHROOM/LIVING ROOM ADDITION (250
S.F.); COVERED PORCH (30 S.F.); INTERIOR REMODEL OF
BEDROOMS/BATHROOMS/DINING ROOMS (863 S.F.); MINOR
KITCHEN REMODEL TO INSTALL ISLAND W/ELEC AND REPLACE
BAY WINDOW WITH GARDEN WINDOW; UPGRADE ELECTRICAL
PANEL (200 AMP); REMOVE/RELOCATE FURNACE TO ATTIC.
Sq. Ft Floor Area: 250 1 Valuation: $30000.00
"N Number: Occupancy Type:
35615 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 Ayende
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.
sale (Sec.7044, Business & Professions Code)
a I, as owner of the property, am exclusively contracting with licensed Signature ofApplicant:
contractors to construct the project (Sec.7044, Business & Professions Code). Date: 4/11/2017
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A"
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.
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.
Signature Date 4/11/2017
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, and 25534.
t C
Owner or authorized agent: d
bate: 4/11/2017 f
CONS CTION LENDING
I hereby affirm that there is a constructi646nding 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
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-0107
10832 LEAVESLEY PL CUPERTINO, CA 950144747 (3 56 15 035)
ALPS CONSTRUCTION
& REMODELING INC
SAN JOSE, CA 95129
OWNER'S NAME: MENON JOBY AND PRIYA TRUSTEE
DATE ISSUED: 04/11/2017
OWNER'S PHONE: 408-429-0438
PHONE NO: (408) 441-0967
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class GENERAL BUILDING CONTRACTOR Lic. #909433
ContractorALI'S CONSTRUCTION & REMODELING INC Date 01/31/2018
X BLDG X ELECT _PLUMB
X 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:
I ST FLOOR BEDROOM/BATHROOM/LIVING ROOM ADDITION (250
I hereby affirm under penalty of perjury one of the following two declarations:
S.F.); COVERED PORCH (30 S.F.); INTERIOR REMODEL OF
1. I have and will maintain a certificate of consent to self -insure for Worker's
BEDROOMS/BATHROOMS/DINING ROOMS (863 S.F.); MINOR
Compensation, as provided for by Section 3700 of the Labor Code, for the
KITCHEN REMODEL TO INSTALL ISLAND W/ELEC AND REPLACE
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation hisurance, as provided for by
BAY WINDOW WITH GARDEN WINDOW; UPGRADE ELECTRICAL
PANEL (200 AMP); REMOVE/RELOCATE FURNACE TO ATTIC.
!!! Section 3700 of the Labor Code, for the performance of the work for which this
6-19-17 REV#1 - DETAIL FOR FOUNDATION - ISSUED 6/22/2017
permit is issued.
APPLICANT CERTIFICATION
Sq. Ft Floor Area: 250
Valuation: $30000.00
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
and state laws relating to building construction, and hereby authorize
356 15 035
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.
Additionally, the applicant understands and will comply with all non -point
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source regulations per the Cupertino Municipal C e, Se tion 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signa re
Issued by: Abby Avende
OWNER -BUILDER DECLARATION
Date: 04/11/2017
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 (Sec.7044, Business & Professions Code).
Date: 6/22/2017
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
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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
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
Worker's Compensation laws of California. If, after making this certificate of
air contaminants as defined by the Bay Area Air Quality Management Dist '
exemption, I become subject to the Worker's Compensation provisions of the
will maintain compliance with the Cupertino Municipal Code, Chapter . 2 a
Labor Code, I must forthwith comply with such provisions or this permit shall
the Health & Safety Code, Sections 25505,255;33, and 255
be deemed revoked.
Owner or authorized agent:
APPLICANT CERTIFICATION
Date: X2/2017
1 certify that I have read this application and state that the above information is
E
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.
Signature Date 6/22/2017
Licensed
Professional