B-2017-1010 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1010
19200TH-SON AVE CUPERTINO,CA 95014-3529(37540061) RADIANT HOME
CONSTRUCTION LLC
14
OWNER'S NAME:LEE JOHN CAND NGUYEN TE ISSUED;09/
OWNER'S PHONE:408-88-2898 PHONE NO:(408)866-2898
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B tic.4856154
Contractor RADIANT HOME CONSTRUCTION LLC Date 03/31/2019 X BLDG ELECT_PLUMB
I hereby affirm that I am licensed tinder 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 SPD(2300 SF)ATTACHED GARAGE(442 SF)
I hereby affirm under pe lty of perjury one of the following two declarations: PORCH/DECK(408 SF)
r. 1 have and will maintain a certificate of consent to self-insure for Worker's REV#I-BALCONY&RAILING DESIGN CHANGE;RELOCATE GAS
Compensation,as provided for by Section 3700 of the Labor Code,for the METER AND MAIN PANEL;LANDSCAPE PLAN-ISSUED 6-29-2018
z performance of the work for which this permit is issued.
1 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. Sq.IT Floor Area:2300 Valuation:$441600.00
APPLICANT CERTIFICATION
I certify that I have read(his 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 40 061 R-3(Custo
tives 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 a Inst said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,t�pplicant understands an}will comply with all non-point
source regula'ons\\�er the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 06-19-2018 Issued by:Abby Ayende
Date:09/15/2017
FR-BUILDER D
I hereby affirm that I am exempt from the Contractor's License Low for one of the RE-ROOFS:
following two reasons: All roofs shall be inspected prior m any roofing material being installed Its roof is
r. I,as owner of the properly,or my employees with wages as their sole Inst¢lied without first obtaining an inspection,I agree to remove all new materials for
compensation,will do the wore,and the structure is not intended or offered for inspection.
sale(Sec.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:06-19-2018
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
t. I have and will maintain a Certificate of Conscut 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. 1 have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 or 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
s. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(.)should I store or handle hazardous
shall not employ any person in any rozmrer so as to become subject to the material.Additionally,should I use equipment or devyces which emit hazardous
oar contaminants as defined bV tI Bay Area Air Qua ity Management District I
Worker's Compensation laws of California.If,after making this certificate of will nnahat.in camp hat.with he n,4711.Mnnicf aI Cade,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety ode,Sections 25505 25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked Owner or authorized agent:
APPLICANI•CERTIFICATION Date:06-19-2018
1 certify that I have read this application and state that the above information Is - 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 Cupertlno 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 DECLARA'P10N
Code,Section 9.18. 1 understand my plans shall be used as public records.
SignatureLicensed
Date 06-19-2018
Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1010
19200 TILSON AVE CUPERTINO,CA 95014-3529(375 40 061) RADIANT HOME
CONSTRUCTION LL
A 95014
OWNER'S NAME: LEE JOHN C AND NGU DATE ISS
OWNER'S PHONE:650-862-6828 PHONE NO:(408)888-2898
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class j3 Lic.#856154
Contractor RADIANT HOME CONSTRUCTION LLC Date 03/31/2019 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:
(N)TWO STORY SFD(2300 SF)ATTACHED GARAGE(442 SF)
I hereby affirm under penalty of perjury one of the following two declarations: PORCH/DECK(408 SF)
1. I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provide
for which this
permit is issued. Sq.Ft Floor Area:2300 Valuation:$441600.00
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 40 061 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 reg icipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 9/15/2017 Issued by:,AbbyAyende
Date:09/15/2017
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 roofmg 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:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:9/15/2017
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1. 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
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 Di
mpensation laws of California. If,after making this certificate of will maintain compliance with the Ctypertin 4unictpa Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Section 550 „ 33,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agent:
APPLICANT CERTIFICATION Date:9/15/2017
I certify that I have read this application and state that the above information is CONSTRUCTIO ENDING 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. I understand my plans shall be used as public records.
Licensed
Signature Date 9/15/2017
Professional