B-2017-1134 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1134
765 STENDHAL LN CUPERTINO,CA 95014-4658(375 42 039) RADCON INDUSTRIES
INC
SAN JOSE,CA 95120
OWNER'S NAME: MURDOCK PAULAAND HUANG MING-HUI DATE ISSUED:09/12/2017
OWNER'S PHONE: PHONE NO:(408)268-6547
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#654789 X BLDG X ELECT X PLUMB
Contractor RADCON INDUSTRIES INC Date 06/30/2018 MECH X RESIDENTIAL COMMERCIAL
l hereby affirm that 1 amlicensed 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:
REMODEL(2)BATHROOMS'(100),REMODEL KITCHEN(275 SF),
I hereby affirm under penalty of perjury one of the following two declarations: REMODEL OTHER(264 SF);REPLACE(6)DOORS AND(8)
i. I have and will maintain a certificate of consent to self-insure for Worker's WINDOWS LIKE FOR LIKE TO MEET EGRESS(14),INSTALL NEW
Compensation,as provided for by Section 3700 of the Labor Code,for the LIGHTING THROUGHOUT WITH EXTERIOR GFCI OUTLETS;RE-
, performance of the work for which this permit"is issued. ROOF-FOAM ROOF(19 SQ),GAS LINE FOR FIRE-PITBBQ,(2)
'1 have-and will maintain Worker's Compensation Insurance,as provided for by WATER FOUNTAINS,CONVERT CARPORT TO GARAGE(400 SQ),
ection 3700 of the Labor Code,for the performance of the work for which this REPLACE(5)SKYLIGHTS AND INSTALL(2)NEW SKYLIGHTS;
permit is issued. PANEL UPGRADE(200 AMP).
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 Sq.Ft Floor Area: Valuation:$300000.00 •
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 APN Number: Occupancy Type:
City of Cupertino against liabilities,judgments,costs,and expenses which 375 42 039
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 Cupe ' tgunicipal Code,Section 9.18. PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
'0ature �- Date 9/12/2017 180 DAYS FROM LAST CALLED INSPECTION.
OWNE'-:UILDER DECLARATION
Issued by:Abby Ayende
I hereby affirm that I ant exempt from the Contractor's License Law for one of the Date:09/I2/2017
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 RE-ROOFS:
sale(Sec.7044,Business&Professions Code) All roofs shall be inspected prior to any roofing material being installed.If a roof is
2. I,as owner of the property,am exclusively contracting with licensed installed without first obtaining an inspection,I agree to remove all new materials for
contractors to construct the project(Sec.7044,Business&Professions Code). inspection.
I hereby affirm under penalty of perjury one of the following three declarations: Signature of Applicant:
1. I have and will maintain a Certificate of Consent to self-insure for Worker's Date:9/12/2017
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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. HAZARDOUS MATERIALS DISCLOSURE
3. I certify that in the performance of the work for which this permit is issued,I I have read the hazardous materials requirements under Chapter 6.95 of the
shall not employ any person in any manner so as to become subject to the California Health&Safety Code,Sections 25505,25533,and 25534. I will
maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Worker's Compensation laws of California. If,after making this certificate of Health&Safety Code,Section 25532(a)should I store or handle hazardous
exemption,I become subject to the Worker's Compensation provisions of the material. Additionally,should I use equipment or devices which emit hazardous
LaborCode,I must forthwith comply with such provisions or this permit shall air contaminants as defined by the Bay Area Air Quality Management District I
be deemed revoked. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
the Health&Safety Code,Sections 2550 , 5533 and 25534.
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 ner or authorized agen .
relating to building construction,and hereby authorize representatives of this city Date:9/12/2017 •
to enter upon the above mentioned property for inspection purposes. (We)agree CONST CTION LENDING AGENCY
to save indemnify and keep harmless the City of Cupertino against liabilities, I hereby affirm that there is a construction lending agency for the performance
judgments,costs,and expenses which may accrue against said City in of work's for which this permit is issued(Sec.3097,Civ C.).
't consequence of the granting of this permit. Additionally,the applicant understands Lender's Name
and will comply with all non-point source regulations per the Cupertino Municipal
Code,Section 9.18. ' Lender's Address
ARCHITECT'S DECLARATION
Signature Date 9/12/2017 I understand my plans shall be used as public records.