Loading...
B-2017-1454 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1454 23400 VIA VENTURA UNIT 19 CUPERTINO,CA 95014-6550(342 55 004) BAY AREA ENTERPRISE SAN JOSE,CA 95148 OWNER'S NAME: GENDZEL IVAN B TRUSTEE DATE ISSUED:08/31/2017 OWNER'S PHONE:650-537-1523 PHONE NO:(408)238-5043 r I CrI E A y I BUILDING PERMIT INFO: License Class B Lie.#817817 Contractor AY AREA ENTERPRISE Date 03/31/2019 X BLDG _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: REPLACE(2)BATHROOM FANS I hereby affirm under penalty of perjury one of the following two declarations: i. 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 a performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by t ,_Sectin 3700 of the Labor Code,for the peormance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$1500.00 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 342 55 004 representatives of this city to enter upon the above mentioned property for inspection purpoes. (\Ne)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 Cit consequence of the granting of this permit. 'WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applic jderstands and will comply with all non-point source regulation ';: a Cupertino ' 'pal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. -• ,,,,,0 ,:, ' Date 8/31/2017 Issued by:Jasmine Archbold Date:08/31/2017 1 _ OWNER-BUILDER DECLARATION I hereby affirm thai 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:8/31/2017 i I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. I have and will maintain a Certificate of Consent to self-insure for Worker's Compens'atiou,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 air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of 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,S ons , 55.33,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. (i);15,,� or authorized agent: APPLICANT CERTIFICATION 8/31/2017 I certify that I have read this application and state that the above information is c_9NS UCTION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lendingagency 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.' I understand my plans shall be used as public records. Signature Date 8/31/2017 Licensed Professional i l rib CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION psi.,•, 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•building a(�,cupertino.orq b_(�0 I I c /r //� ❑NEW CONSTRUCTION 111 ADDITION 111 ALTERATION/TI [ REVISION/DEFERRED ORIGINAL PERMIT` ' # IAP" 3 7 "--5-.5-- —o© OWNER NAME PHONE r 7 E-MAL e� �P mss. �s 0-s 3 �S�z3 in DDCrrY,STATE,ZIP , FAX Z 5 �RESVA/ I�E��tCG//Z°1 I C LI-f.nY-k-, dl O C A 9 5 01 CONTACT NAME &r,� f_2; 5.j PHONE 0n _Z38 5yt,'/iE-MAE j.eh-,S cOHCCl, o1�' STREET ADDRESS I CITY,SKATE,ZIP ...„S I & I FAX ' .2-U( rittklAi i VL u-I aS.. 3 C `1 0 OWNER 0 OWNER-BUILDER 0 OWNER AGENT CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTRACTOR NAME 1-Q 1 k Sf I LICENSE NUMBER �1' I LICENSE PE' BUS.LIC# l..-YLECj �g�/ / //� COMPANY NAME J L `� �., , �/ ,. E-MAIL (j r,(�i 4 jJ"')CO Lcj cC rt j2 i- FAX STREET ADDRESS CITY,STA rVTEr ZIP DRONE 7-110 T1[sVLGI f A 1.�5c+ tom/ S a f' `�'o S� CFS yS�6� �a >- 233 r ,......coir/3 ARCHITECT/ENGINEERNAME�J LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE - e„,.DESCRIPTION OF WORK (40,9I/` /ey g 8 4fitZF�4L'4,f i _ _ a ` Z-4,...- ti i EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES '' USE TYPE. OCC. SQ.FT. VALUATION(S) EXLSTG ' NEW FLOOR : DEMO ,TOTAL- . AREA ,'AREA AREA .NET AREA I ' BATHROOM 'KITCHEN OTHER.'I;'. REMODEL AREA (REMODEL AREA REMODEL AREA I ` ,I. PORCH AREA DECK AREA TOTAL DECK/PORCH AREA ',.-GARAGE AREA: DEFACE , ' 1 ❑ATTACH . l I: I #DWELLING UNITS: IS A SECOND UNIT El YES ,SECOND;STORY OYES , BEING ADDED? ' NO :ADDITION? , ONO 1 ❑ AD '. I i I I ' / I ' PRE-APPLICATION DYES IF YES,PROVIDE COPY OF, - IS THE BLDG AN ' DYES RECE ,,. TOTAL ALUATION PLANNING APPL# i❑NO PLANNING APPROVAL LETTER EICHLER ROME? ❑NO € 4, l I � I SII! � �;A 4,11,' : �i , 4 =. �� �d By my signature below,I certify:to each of the following: 'I am the Property owner or authorized agent to act on the property owner's behalf. I ave ead�this application and the information.I have provided is orrect. I have'r'ead the Description of Work and verify itis accurate I agree to comply with all applicable local ordinances and state laws relating to buildin co ction.;II authorize representatives of Cupertino to enter the abov d ntifie propertyfor inspection purposes, n ' 1 it it ' / Signature of Applicant/Agent:' - ,, Date: / '-2 -671112 L7 - I SUPPLEMENTAL INF RMATION RE UIRED S , ; I 11 1 II ,PLAN CHECK TYPE� � AOITfING SLIP� � € r � New SFD;or Multifamily dwellings: Apply for demolition permit for ❑ OVER Tai-COUNTEe L nN ,, ❑ BUILDING PL REVIEW �' existing building(s): Demolition permit S required prior tol issuance of building permit for new,building. 1 , , I ❑ EXPRESS ❑ PLANNING PLAIYREVIEW i 1r - Asa _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PDBLICwoRlts 4 form if any Hazardous Materials are being used as part oftins project. ❑ LaRGE 5 , r r�E I I, ❑ FIREDEPT r I Copy of Planning Approval Letter or Meeting with'Pla„II prior to ❑ oR s :❑ SArtcrARY sEwERDLsrIUCT � submittal of Building iPe m t..application. , I ' 1 , 1 1 L s, e-41-. ,, - c !-- ❑KENVIRONMENTAL'REALTH. ,r 9,.3,... Bld 2011.doc revised SAPP06/21/11 _ 3 _Fees I SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE .49-.4940. COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinq(a cupertino.orq P. RMIT CANNOT BE`FINALED=UNTIL THIS CERTIFICATE HAS-BEEN COMPLE1 D,SIGNET);AND RETURNED TO TAR BUILDING_DIVISION PURPOSE _. This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2016 CRC Section R314,2016 CBC Sections 420 6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi-family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations,or repairs to existing dwelling units exceeds $1000 00,CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations. AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of X X the bedroom(s) On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420 6 and shall be approved by the Office of the State Fire Marshal. Power Supply-In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units,alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic,basement or crawl space.Refer to CRC Section R314 and CBC Sections 907.2.114 and 420 6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above-referenced property,I hereby certify that the alarm(s)referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms specified below have been tested and are operational, as of the date signed below p,, Address.-G 3 fly Pr-r r' L-I69- 7i f Permit Nol2®( 7 - f r7'j Specify Number of Alarms: #Smoke Alarms. ! —7 I #Carbon Monoxide Detectors �. I have read and a•ree to co •cly with the terms and conditions of this statement Owner(or Owner Agent's)Name: Si•._ r= Date: Contractor Name: Signature Lic.# Date: • Smoke and CO form.doc revised 12/15/16