B-2016-2859 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2859
10436 DENISON AVE CUPERTINO,CA 95014-2429(316 29 073) YOUR WAY
CONSTRUCTION
CENTER
BURLINGAME,CA
94010
OWNER'S NAME: DATE ISSUED:05/01/2017
OWNER'S PHONE: PHONE NO:(650)208-5990
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#985209
Contractor YOUR WAY CONSTRUCTION CENTER Date 07/31/2019 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:
1 ST FLOOR ADDITION OF 3 BEDROOMS(875 SQ FT);REMODEL
I hereby affirm under penalty of perjury one of the following two declarations: BEDROOM INTO BATHROOM AND HALLWAY(131 SQ FT);
1. I have and will maintain a certificate of consent to self-insure for Worker's REMODEL(E)DINING ROOM(130 SQ FT);REMOVAL OF WALL AT
Compensation,as provided for by Section 3700 of the Labor Code,for the KITCHEN AND ADD COUNTER;ADD(9)LIGHTS AND(4)OUTLETS
3700 of the Labor Code,for the performance of the work for which this SQ)-ISSUED 9/12/2017
permit is issued. REV#2-REPLACE PANEL(200 AMP);RELOCATE(N)HVAC IN
APPLICANT CERTIFICATION ATTIC ABOVE KITCHEN-ISSUED 10/17/2017
1 certify that I have read this application and state that the above REV##3-PER PG&E INSTALL MAIN PANEL CLOSE TO WEATHER
information is correct.I agree to comply with all city and county ordinances HEAD-(200 AMP). REPLACE EXISTING MAIM PANEL WITH SUB-
and state laws relating to building construction,and hereby authorize PANEL-(200 AMP)-ISSUED 02/13/2019
representatives of this city to enter upon the above mentioned property for
inspection purposes. (We)agree to save indemnify and keep harmless the Sq.Ft Floor Area:875 Valuation:$200000.00
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 6 plicant understands and will comply with all non-point 31Number: Occupancy Type:
source regulatio` Section 9.18. 316 29 073 R-3(Custom)
Signature_ ' = Date 02/13/2019 PERMIT EXPIRES IF WORK IS NOT STARTED
OWNER-BUILDER DECLARATION WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
I hereby affirm that 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 Issued by:Kiln Dunbar
compensation,will do the work,and the structure is not intended or offered for Date:05/01/2017
sale(Sec.7044,Business&Professions Code)
2. 1,as owner of the property,am exclusively contracting with licensed RE-ROOFS:
contractors to construct the project(Sec.7044,Business&Professions Code). All roofs shall be inspected prior to any roofing material being installed.If a roof is
I hereby affirm under penalty of perjury one of the following three declarations: installed without first obtaining an inspection,I agree to remove all new materials for
1. I have and will maintain a Certificate of Consent to self-insure for Worker's inspection.
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. Signature of Applicant:
2. I have and will maintain Worker's Compensation Insurance,as provided for by Date:02/13/2019
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
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 HAZARDOUS MATERIALS DISCLOSURE
Worker's Compensation laws of California. If,after making this certificate of I have read the hazardous materials requirements under Chapter 6.95 of the
exemption,I become subject to the Worker's Compensation provisions of the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will
Labor Code,I must forthwith comply with such provisions or this permit shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
be deemed revoked. Health&Safety Code,Section 25532(a)should I store or handle hazardous
material. Additionally,should I use equipment or devices which emit hazardous
APPLICANT CERTIFICATION air contaminants as defined by the Bay Area Air Quality Management District I
I certify that I have read this application and state that the above information is will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
correct. I agree to comply with all city and county ordinances and state laws the Health&Safety
relating to building construction,and hereby authorize representatives of this city
to enter enter upon the above mentioned property for inspection purposes. (We)agree -.
Owner car authorized agent:
to save indemnify and keep harmless the City of Cupertino against liabilities, 5
judgments,costs,and expenses which may accrue against said City in Date:02/13/2019
consequence of the granting of this permit. Additionally,the applicant understands CONSTRUCTION LENDING AGENCY
and will comply with all non-point source regulations per the Cupertino Municipal I hereby affirm that there is a construction lending agency for the performance
Code,Section 9.18. of work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
Signature Date 02/13/2019 Lender's Address
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2859
10436 DENISON AVE CUPERTINO, CA 95014-2429 (316 29 073) YOUR WAY
CONSTRUCTION
CENTER
BURLINGAME, CA
94010
OWNER'S NAME: I I DATE ISSUED: 05/01/2017
OWNER'S PHONE: I I PHONE NO: (650) 208-5990 I
LICENSED CONTRACTOR'S DECLARATION
License Class B Lic. 4985209
Contractor YOUR WAY CONSTRUCTION CENTER Date 07/31/2017
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.
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 accrueagainst id City inconsequence of the granting of this permit.
Additionally, the app cant understands and will comply with all non -point
source regulations Section 9.18.
Signature ate 05/1/2017
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
t. 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:
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.
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.
s. 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 05/1/2017
BUILDING PERMIT INFO:
BLDG X ELECT —PLUMB
MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
1ST FLOOR ADDITION OF 3 BEDROOMS (875 SQ FT); REMODEL
BEDROOM INTO BATHROOM AND HALLWAY (131 SQ FT);
REMODEL (E) DINING ROOM (130 SQ FT); REMOVAL OF WALL AT
KITCHEN AND ADD COUNTER; ADD (9) LIGHTS AND (4) OUTLETS
IN KITCHEN/ENTRY/DINING/LIVING ROOMS.
Sq. Ft Floor Area: 875 1 Valuation: $200000.00
"N Number: Occupancy Type:
316 29 073 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: Kim Dunbar
Date: 05/01/2017
RE -ROOFS:
All roofs shall be inspected prior to any roofmg material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature ofApl
Date:5/10 /2017
11 A 11
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(x) 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
Owner or authorized agent:
Date: 05/1/2017
CONSTRUC ONIENDINGAGENCY
I hereby affirm that there is a construction lending agency for the performance
of work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
I understand my plans shall be used as public records.
Licensed
•
CITY OF CUPERTINO BUILDING PERMIT •
•
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2859
10436 DENISON AVE CUPERTINO,CA 95014-2429(316 29 073) YOUR WAY
CONSTRUCTION
CENTER
BURLINGAME,CA
• 94010
•
•OWNER'S NAME: • DATE ISSUED:05/01/2017
OWNER'S PHONE: PHONE NO:(650)208-5990
LICENSED CONTRACTOR'S DECLARATION • BUILDING PERMIT INFO:
License Class B Lic.#985209
Contractor YOUR WAY CONSTRUCTION CENTER Date 07/31/2019 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:
1ST FLOOR ADDITION OF 3 BEDROOMS(875 SQ FT);REMODEL •
I hereby affirm under penalty of perjury one of the following two declarations: BEDROOM INTO BATHROOM AND HALLWAY(131 SQ FT);
1. I haveand will maintain a certificate of consent to self-insure for Worker's REMODEL(E)DINING ROOM(130 SQ FT);REMOVAL OF WALL AT
• Compensation,as provided for by Section 3700 of the Labor Code,for the KITCHEN AND ADD COUNTER;ADD(9)LIGHTS AND(4)OUTLETS
Section 3700 of the Labor Code,for the performance of the work for which this SQ)-ISSUED 9/12/2017
permit is issued. REV#2-REPLACE PANEL(200 AMP);RELOCATE(N)HVAC IN
APPLICANT CERTIFICATION ATTIC ABOVE KITCHEN-ISSUED 10/17/2017
I certify that I have read this application and state that the above Sq.Ft Floor Area:875 Valuation:5200000.00
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 ehter upon the above mentioned property for APN Number: Occupancy Type:
inspection purposes. (We)agree to save indemnify and keep harmless the 316 29 073 R-3(Custom)
City of Cupertino against liabilities,judgments,costs,and expenses which
may'accrue against said City ih consequence of the granting of this permit.
Additionally,the-pplica'nt understands and will comply with all non-point
source regulati. Municipal Code,Section.9.18. PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
•
S'. ature / Date 10/17/2017 180 DAYS FROM LAST CALLED INSPECTION.
•
OWNER-BUILDER DECLARATION Issued by:ABBYAYENDE
I hereby affirm that I am exempt from the Contractor's License Law for one of the Date:05/01/2017
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 constivct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations: Signature of Applicant:
i. I have and will maintain a Certificate of Consent to self-insure for Worker's Date: 10/17/2017
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
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 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 1 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 9.12 and
the Health&Safety Code, ections 25505,25533,and 25534.
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
ner or authorized agent:
relating to building construction,and hereby authorize representatives of this city Date:10/17/2017
•
to enter upon the above mentioned property for inspection purposes. (We)agree CONSTRUCTION LENDING AGENCY
toI hereby affirm that there is a construction lending agency for the performance
• 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 10/17/2017 I understand my plans shall be used as public records.
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2859
10436 DENISON AVE CUPERTINO,CA 95014-2429(316 29 073) YOUR WAY
CONSTRUCTION
CENTER
BURLINGAME,CA
94010 •
OWNER'S NAME: DATE ISSUED:05/01/2017
OWNER'S PHONE: PHONE NO:(650)208-5990
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
,License Class j3 Lic.#985209 X BLDG X ELECT _PLUMB
Contractor YOUR WAY CONSTRUCTION CENTER Date 07/31/2019
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:
1ST FLOOR ADDITION OF 3 BEDROOMS(875 SQ FT);REMODEL
I hereby affirm under penalty of perjury one of the following two declarations: BEDROOM INTO BATHROOM AND HALLWAY(131 SQ FT);
1. I have and will maintain a certificate of consent to self-insure for Worker's REMODEL(E)DINING ROOM(130 SQ FT);REMOVAL OF WALL AT
Compensation,as provided for by Section 3700 of the Labor Code,for the KITCHEN AND ADD COUNTER;ADD(9)LIGHTS AND(4)OUTLETS
s' formance of the work for which this permit is issued. IN KITCHEN/ENTRY/DINING/LIVING ROOMS.
? I have and will maintain Worker's Compensation Insurance,as provided for by REV#1-REROOF;TEAR OFF;INSTALL OSB;COMP SHINGLES(20
- Section 3700 of the Labor Code,for the performance of the work for which this SQ)-ISSUED 9/12/2017
permit is issued. •
Sq.Ft Floor Area:875 Valuation:$200000.00
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 316 29 073 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 Code,Section 9.18. / 180 DAYS FROM LAST CALLED INSPECTION.
nature• �� Date Issued by:ABBY AYENDE
Date:05/01/2017
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(Sec.7044,Business&Professions Code). Date:
I hereby affirm under penalty of perjury one of the following three declarations:
1. Ihave 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
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
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 District I
exemption,I become subject to the Worker's Compensation provisions of the will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
Labor Code,I must forthwith comply with such provisions or this permit shall the Health&Safety Code,Sections 25505,25533,and 25534.
be deemed revoked.
or authorized agent:
APPLICANT CERTIFICATION Date:
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 ARCEITECT'S DECLARATION
Code,Section 9.18. I understand my plans shall be used as public records.
•
Signature Date Licensed