B-2017-0918 CITY OF CUPERTINO BUILDING PERMIT '
BUILDING ADDRESS: - CONTRACTOR: PERMIT NO:B-2017-0918
19732 DRAKE CT CUPERTINO,CA 95014-2432(316 32 017) • ARTUR'S HOME
' : IMPROVEMENT
SUNNYVALE,CA -
94088
OWNER'S NAME: DHARMAJI SRINIVASA M AND REKHA S DATE ISSUED:09/11/2017
OWNER'S PHONE:408-348-6005 PHONE NO:(408)506-7711 .
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#929164 '
Contractor ARTUR'S HOME IMPROVEMENT Date 02/28/2019 X BLDG _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:
1ST FLOOR MASTER BEDROOM/CLOSET/BATH ADDITION(489 SF)
I hereby affirm under penalty of perjury one of the following two declarations: REV#1 -MOVE BACK WALL 4 FT FROM PROPERTY LINE-ISSUED
1. I have and will maintain a certificate of consent to self-insure for Worker's 10-6-2017
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued.
ea,_ I have and will maintain Worker's Compensation Insurance,as provided for by .
de Section 3700 of the Labor Code,for the performance of the work for which this
a permit is issued. Sq.Ft Floor Area:489 Valuation:$146700.00 ,
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 32 017 R-3(Alternate Materials)
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 againspsaid City ie'consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Addtionally,,the applicant understands and will comply with all non-point
source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Si .natu .,•P:•,;I,./
.
9s.tel Date 10-06-2017 Issued by:Jasmine Archbold
Date:09/11/2017
OWNER-BUILDER DECLARATION .
•
1 hereby affirm thatiI am exempt from the Contractor's License Law for one of the RE-ROOFS:
• following two reasons: i All roofs shall be inspected prior to any roofing material being installed.If a roof is
;i. ' '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:
I.. contractors to construct the project(Sec.7044,Business&Professions Code). Date: 10-06-2017 .
I hereby affirm sunderpenaltyof'perjury one of the followingthree declarations:
ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
t. 1 have.andwill maintains 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
Sectio'ti.6700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will
maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
perrtut is-issued. Health&Safety'Code,Section 25532(a)should I'store or handle hazardous
3. I certifj%that in,the performance of the work for which this permit is issued,I -
sha111noCernploy anyperson 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 becomesubject to the Worker's Compensation provisions of the the Health&Safety Code,Sectio s 25505,25533,and 25534.
LaborCode,I must forthwith comply with such provisions or this permit shall
be)deemed revoked. -4 ,
Owner or authorized age
APPLICANT CERTIFICATION Date:10-06-2017
I certify that 1 have read,:this application and state that the above information is CONST CTION 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 construdtion;'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 oflthis 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! I understand my plans shall be used as public records.
•
, Licensed
Signature. ; :a Date 10-06-2017 Professional '
Ii
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-0918
19732 DRAKE CT CUPERTINO,CA 95014-2432(316 32 017) ARTUR'S HOME
IMPROVEMENT
SUNNYVALE,CA
94088
OWNER'S NAME: DHARMAJI SRINNASA M AND REKHA S DATE ISSUED:09/11/2017
OWNER'S PHONE:408-348-6005 PHONE NO:(408)506-7711
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class a Lic.#929164
Contractor ARTUR'S HOME IMPROVEMENT Date 02/28/2019 XBLDG _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:
1ST FLOOR MASTER BEDROOM/CLOSET/BATH ADDITION(489 SF)
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
erformance of the work for which this permit is issued.
, have and will maintain`Worker's Compensation Insurance,as provided for by
,,p Section 3700 of the Labor Code,for the performance of the work for which this •
/4 Q`+`;permit is issued. Sq.Ft Floor Area:489 Valuation:$146700.00
/ 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's
tate laws''relating to building construction,and hereby authorize 316 32 017 R-3(Alternate Materials)
representatives of this city to enter upon the above mentioned property for ,
• in pection.putposes. (We)agree to'!save indemnify and keepharmless the ,
City of Cupertino against liabilitias,ljudgments,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 i
source'regulations per the Cupeitin6 Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
•nature Date 9/11/2017 Issued by:ABBY AYENDE
Date:09/11/2017
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:9/11/2017
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
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 Laboi 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 thelBay 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 Sr Safety Code,Sections 25505,25533,and 25534.
Labor;Code,I must forthwith comply with such provisions or this permit shall !(.4.....4
be deemed revoked. r
Qj er or authorized agent: I.
APPLICANT CERTIFICATION ate:9/11/2017
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 I
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.
Licensed
Signature_ Date 9/11/2017
Professional