B-2016-3310CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-3310
11700 REGNART CANYON DR CUPERTINO, CA 95014-4830 (366 33 002)
DE ANZA BUILDERS
CAMPBELL, CA 95008
OWNER'S NAME:
BUILDING PERMIT INFO:
License Class a Lic. #243227
Contractor DE ANZA BUILDERS Date 02/28/2018
X BLDG X ELECT —PLUMB
—
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:
1 ST FLOOR GARAGE ADDITION (372 S.F.); 2ND FLOOR DINING
I hereby affirm under penalty of perjury one of the following two declarations:
ROOM, LIVING ROOM AND MASTER SUITE ADDITION (496 S.F.);
t. I have and will maintain a certificate of consent to self -insure for Worker's
REMODEL (1,798 S.F.); (N) EXTERIOR STAIRWAY; REMODEL
Compensation, as provided for by Section 3700 of the Labor Code, for the
GARAGE TO CREATE (1) BATHROOM (51 ST) AND CREATE
performance of the work for which this permit is issued.
SMALLER WORK ROOM (86 S.F); EXPAND (E) DECKS (326 S.F.);
I have and will maintain Worker's Compensation Insurance, as provided for by
RELOCATE (E) 200 AMP ELECTRICAL PANEL
Section 3700 of the Labor Code, for the performance of the work for which this
Sq. Ft Floor Area: 496
Valuation: $200000.00
permit is issued.
APPLICANT CERTIFICATION
I certify that 1 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
366 33 002
R-3 (Hillside, 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 again t Ii ilities, judgments, costs, and expenses which
PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against sa' Ci in consequence of the granting of this permit.
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
following two reasons:
t. 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: 05-19-2017
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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.
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 M 'cipal 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 sho Id 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 equi men or devices which emit hazardous
air contaminants as defined by the Bay ea ' Quality Management District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the Cupe tin unicipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code, ec 'o 25505, 25533, and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agent:
APPLICANT CERTIFICATION
Date: 05-19-2017
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
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 05-19-2017
professional
CITY OF CUPERTINO
Finance Department • 10300 Torre Avenue • Cupertino, CA 95014 • (408) 777 – 3221
BUSINESS LICENSE CERTIFICATE
CONTRACTOR
CUT ALONG DOTTED LINE
LICENSEE NAME: BILL BROWN CONSTRUCTION CO.
BUSINESS NAME: BILL BROWN CONSTRUCTION CO.
BUSINESS ADDRESS: 242 PHELAN AVE CA
SAN JOSE, CA 95112
BUSINESS PHONE: (408) 297-3738
BUSINESS EMAIL : SJAIMES@BBROWNCONSTRUCTION.COM
PLEASE DETACH THE BELOW LICENSE CERTIFICATE AND PLACE IN A CONSPICUOUS PLACE ON BUSINESS PREMISES
This license has been paid and issued in accordance with the Cupertino Municipal Code, for the specified business location. For questions
or further assistance, please see our website at www.cupertino.org or call the City Cupertino Business License Clerk at (408) 777-3221.
LEGAL STATUS: CORPORATION
FEDERAL TAX ID: 770361621
STATE TAX ID:
LICENSE NUMBER: 404568
EFFECTIVE DATES: 6/1/2019 to 5/31/2020
TOTAL PAID: $152.20
BILL BROWN CONSTRUCTION CO.
242 PHELAN AVE CA
SAN JOSE, CA 95112
CITY OF CUPERTINO
BUSINESS LICENSE CERTIFICATE
CONTRACTOR LICENSE
BUSINESS LICENSE #404568
BILL BROWN CONSTRUCTION CO.
242 PHELAN AVE CA
SAN JOSE, CA 95112
NOT TRANSFERABLE
EFFECTIVE DATE: 6/1/2019 EXPIRATION DATE: 5/31/2020
THIS LICENSE IS ISSUED IN ACCORDANCE WITH CHAPTER 5.04 OF THE CUPERTINO MUNICIPAL CODE AND DOES NOT SANTION ANY BUSINESS ACTIVITY OR USE OF PERMISES WHICH ARE IN VIOLATION
OF FEDERAL, STATE, OR LOCAL LAWS. THIS LICENSE IS ISSUED WITHOUT VERIFICATION THAT THE LICENSEE IS SUBJECT TO OR EXEMPT FROM LICENSING BY THE STATE OF CALIFORNINA.
__________________________________________ DIRECTOR OF ADMINISTRATIVE SERVICES
BUSINESS LICENSE MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON THE PREMISES OR VEHICLE