B-2016-3308CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-3308
18890 BARNHART AVE CUPERTINO, CA 95014-3602 (375 33 011) CHUEN YANG YANG
SAN LEANDRO, CA
94579
OWNER'S NAME:
OWNER'S PHONE:
License Class a Lic. #897965
Contractor CHUEN YANG YANG Date 06/30/2017
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
�
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 regulatior4s per the Cupertino Municipal Code, Section 9.18.
Date 6/1/2017
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
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.
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 6/1/2017
DATE ISSUED: 06/01/2017
PHONE NO: (510) 213-9981
BUILDING PERMIT INFO:
BLDG —ELECT —PLUMB
MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
(N) TWO STORY SFD (1991 S.F.); ATTACHED GARAGE (416 S.F.);
PATIO (802 S.F.)
Sq. Ft Floor Area: 1991 1 Valuation: $380000.00
APN Number: Occupancy Type:
375 33 011 I 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
Date: 06/01/2017
RF -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: 6/1/2017
ALL ROOF COVERINGS TO BE CLASS "A"
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.
Owner or authorized agent• ...,
Date: 6/11/2017
CONSTRUCTION LKNI)
I hereby affirm that there is a construction ler}, ng agen5)he performance
of work's for which this permit is issued (Sec. 3097, (-14,
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-2016-3308
18890 BARNHARTAVE CUPERTINO,CA 95014-3602(375 33 Olt) KEN KWAN
CONSTRUCTION
DUBLIN,CA 94568
OWNER'SNAME: DATE ISSUED:06/01/2017
OWNER'S PHONE: PHONE NO:(
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class a Lic.4885354
Contractor KEN KWAN CONSTRUCTION Date 01/31/2020 X BLDG_ELECT_PLUMB
1 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 fall force and effect. JOB DESCRIPTION:
(N)TWO STORY SFD(1991 ST.);ATTACHED GARAGE(416 S.F.);
I hereby affirm under penalty of perjury one of the following two declarations: PATIO(802 S.F.)
i. I have and will maintain a certificate of conscot to self-insure for Worker's REV#1 LANDSCAPE AND IRRIGATION PLAN
Compensation,as provided for by Section 3700 0£the Labor Code,for the
performance of the work for which this permit is issued,
I have and will maintain Worker's Compensation lusuranco,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Arca:1991 Valuation:$380000.00
APPLICANT CERMTION
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 375 33 Oil 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 WORD 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 regulation 1p r the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
ASignature Date 06-01-2018 Issued by:Abby Ayende
Date:06/01/2017
OWNER-BUILDER DECLARA'T'ION
I hereby affirm that I ant exempt from the Contractor's License Law for one of theRN}ROOFS•
following two reasons: All roofs shall be inspected prior to any roofing material being installed.lie roof is
1, 1,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 de the work,and the structure is not intended or offered for inspection.
sato(Sec.7044,Business&Professions Code)
z. I,as owner of the property,am exclusively contracting with licensed Signature ofApplicane
contractors to construct the project(Sec.7044,Business&Professions Cade), Date:06-01-2018
1 hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTERr. 1 have and will maintain a Certificate of Consent to sel&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
z. I have and will maintain Worker's Compensation insurance,as provided for by 1 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,Sultans 25505,25533,and 25534.I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
a. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(x)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 ofCaliforuia,If,after making this certificate of all'contaminants pl defined h the Bay Aren Air Quality Management District I
P B will maintain compliance with the Cupertino Municipal Cade,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Se=,and 25534.
Labor Code,l must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agent:
APPLICA N'C CERTIFICATION Date:06-01-2018
I certify that I have read this application and state that the above Information isCONSTRUCTIONI 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 06-01-2018 Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-3308
18890 BARNHART AVE CUPERTINO,CA 95014-3602(375 33 01 1) KEN KWAN
CONSTRUCTION
DUBLIN,CA 94568
OWNER'S NAME: DATE ISSUED:06/01/2017
OWNER'S PHONE: PHONE NO:(
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class U Lie.#885354
Contractor KEN KWAN CONSTRUCTION Date 0113112020 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:
(N)TWO STORY SFD(1991 S.F.);ATTACHED GARAGE(416 S.F.);
I hereby affirm under penalty of perjury one of the following two declarations: PATIO(802 S.F.)
1. I have and will maintain a certificate of consent to self-insure for Worker's REV#1 LANDSCAPE AND IRRIGATION PLAN
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued.
r. I have and will maintain Worker's Compensation hunnionce,as provided for by
1 Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area:1991 Valuation:$380000.00
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 375 33 Oil 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. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant understands and will comply with all non-point
source regulations per h upertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
/""" Date 5/22/2018 Issued by:Abby yende
Date:06/01/2017
OHNER-BUILD
1 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 thew sole installed without fust obtaining an inspection,I agree to remove all new materials for
compensation,will do the work,and the stm mre is not intended or offered for inspection,
sale(Sce.7044,Business&Professions Code)
z. 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:5122/2018
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
r. 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
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 25534.1 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
material.Additionally,should I use equipment or devices which emit hazardous
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 air contaminants p defined h the Bay Area Air Quality Management District I
P 8 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,Sectio s 2Q505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall (/
be deemed revoked. Owner or authorized agent:
APPLICANT CERTIFICATION Data:5/22/2018
I certify that I have read this application and state that the above Information Is CONS UCTION LLNING 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 5/22/2018 professional