B-2017-1098CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-1098
10300 TORRE AVE CUPERTINO, CA 95014-3202 (369 31 033)
SPENCON
CONSTRUCTION INC
DANVILLE, CA 94526
OWNER'S NAME: CUPERTINO CITY OF
DATE ISSUED: 08/03/2017
OWNER'S PHONE: 408-777-3245
PHONE NO: (925) 984-2581
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class A Lic. #820205
Contractor SPENCON CONSTRUCTION INC Date 05/31/2019
X BLDG —ELECT —PLUMB
—
X
MECH 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:
REPLACE (2) CURB RAMPS FOR REQUIRED ACCESSIBILITY
I hereby affirm under penalty of perjury one of the following two declarations:
UPGRADES UNDER PERMIT B-2016-3288.
m. I have and will maintain a certificate of consent to self -insure for Worker's
Com ensation, as provided for by Section 3700 of the Labor Code, for the
rfo7cc of the work for which this permit is issued.
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
Sq. Ft Floor Area:
Valuation: $32650.00
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
APN Number:
Occupancy Type:
and state laws relating to building construction, and hereby authorize
369 31 033
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 applic ndersta and will comply with all non -point
source regulations t Cup Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signatur Date 8.3.2017
Issued by: SEAN HATCH
OWNER -BUILDER DECLARATION
Date: 08/03/2017
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 roofmg material being installed. If a roof is
m. 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.1044, 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: 8 3• .2017
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
m. 1 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. I will
permit is issued.
I
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
s. 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 devgich emit hazardous
air contaminants as defined by the Bay Area Air Qunagement District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the Cupertino Mu ' i apter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code, Sections 25 , 25533, 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agent:
APPLICANT CERTIFICATION
Date: 8.3.2017
I certify that I have read this application and state that the above information is
CON STRU ION 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
ARCHITECT'S DECLARATION
Code, Section 9.18.
1 understand my plans shall be used as public records.
Licensed
Signature Date 8.3.2017
Professional
CONSTRUCTION PERMIT.,
COMMUNITY DEVELOPMENT DEPARTMEN',-'•.BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX(4408},777-3333 • buildinb GC).cuaertido.ota
G'UPERTlNO
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PROJECTADDRESS I (}
OWNERNAME
STREET,ADDRESS/J RfS
CONTACT NAME
STREET ADDRESS
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CONTRACTORNAME,
COMPANYNAME
ARCHITECTIENGiN EER NAME
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COMPANY.NAME
STREET ADDRESS
DESCRIPTION of WORK, ! A.(
R r/`` PHONE E-MAIL
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CITY, STA b; i,'
❑ OWNER AGENT
ExISTG NEW FLOOR DEMO
AREA AREA AREA
BATHROOM KITCHEN
REMODELAREA REMODELAREA
, PERMIT #
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LICENS TYPE
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USE I TYPE I OCC:, I SQ.Fr. I: VALUATION (S)
# DWELLING UNITS: ]SASE ONDUNIT ❑YES SECOND STORY ❑YES
BEING ADDED? []NO ADDITION? ❑NO
PRE -APPLICATION ❑YES iF YES, PROVIDE -COPY OF' iS THE BLDG AN ❑YES ;j&CE`CIi3�YTOTAL VALUATION:
PLANNINGAPPLN []NOPLANNING APPROVAL LETTER EICHLERROME? ANO t 3it„ri„�,•s: ,. t R �
By my signature below,'I certify to each of the followi�8j �,am the,property owner or authorized agent to act on the property owner's behalf. Lhave read this
application and the information I have provided is co i�ttave rea ascription of Work and verify it is accurate. I agree to compJly with all applicable local
ordinances and state laws relating to building cons 1 autho . rep sentatives of Cupertino to enter the above-ide`tifie�, pro 1 fori inspection purposes.
I Date {sJ� 9�
Signature of Appltcant/Agent: w
SUPPLEMENTAL INFORMATION REQUIRED
_ New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
_ Commercial Bldgs: Provide a completed Hazardous. Materials Disclosure
form if any Hazardous Materials are being used as part of this project.
_ Copy of Planning Approval Letter or Meeting with Planning prior to
submittal of Building Permit application.
BldgApp 2011. doc revised 06,121111
Building Department
City Of 'Cupertino
10300 Tone Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228 .
CU P E RT I N O Fax: 408-777-3333
CONTRACTOR / SUBCONTRACTOR LIST -
JOB ADDRESS: 1.12 Q .: 1 A1/
PERMIT #
BUSINESS NAME
OWNER'S NAME: rrr✓O
PHONE # • % -a
Cabinets & Millwork
GENERAL CONTRACTOR: 1--'IV-e--o A
BUSINESS LICENSE #"
ADDRESS:
CITY/ZIPCODE:
*Our municipal code requires all businesses working in the city, to have a City of Cupertino business license.
N'O BUILDING FINAL OR FINAL OCC UPANC INSPECT N(S) WILL ,BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUB7x7CT!S'AVE OBTAINED. A CITY. OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature Date •
Please check applicable subcontractors and complete the.following information:
✓
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing '
Electrical
Excavation
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing'
Heating
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing ..
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
i Owner / Contractor Signature Date
ij