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B-2017-1608
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1608 10036 CRESCENT RD CUPERTINO,CA 95014-1012(326 17 052) BABEL CONSTRUCTION SAN JOSE,CA 95111 OWNER'S NAME: HENGYE LLC DATE ISSUED:09/20/2017 OWNER'S PHONE:408-891-8059 PHONE NO:(408)561-7041 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic.#890563 Contractor BABEL CONSTRUCTION Date 02/28/2019 X BLDG X 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)TEMPORARY POWER POLE(100 AMP) 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 performance of the work for which this permit is issued. 1,,?i-vtz;; I have arid 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.Ft Floor Area: Valuation:$500.00 • 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 326 17 052 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 ap'� Int understands and will comply with all non-point source regulatio .p- the C pertin. .'cipal Code Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. '4g: ''ature jy l Date 9/20/2017 Issued by:Abby Ayende �� Date:09/20/2017 1 .►"�': LI_RDE L.R. I I he`•y 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 !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) 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:9/20/2017 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 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 a: 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,Sect 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall / be deemed revoked. Q rrc'r or authorized agent: • APPLICANT CERTIFICATION Date:9120/2017 // I certify that I have read this application and state that the above information is CONSTRU ION LENDIN' AGENCY correct:l agree to comply with all city and county ordinances and state laws I hereby affirm that there is a onstruction 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;indemriify and keep harmless the City of Cupertino against liabilities, judgments,costs,end,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. •Si nature Date 9/20/2017 Licensed gProfessional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION \,,,,„ 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 '4.47.-!,P,..;,, 1 1r,,/, (408) 777-3228 • buil ding@cupertino.org PEMIT#B- O-O�� - Iced CUPERTINO REVS DEFF ❑ NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T.1. ❑MEP ❑RE-ROOF ❑SWIMMING POOL/SPA PROJECT ADDRESS • 00- C,) ©0-C,) Cies l • APN# -5r o s^ OWNER NAME PHONE/►„._Of,1 rQ„�q E-MAIL` C/� ‘�S en ov h 0'll I ((JJ��JJ�� STREET ADDRESSCITY, STATE,ZIR 10 O (1-c cell {-. , ,Co D e Y l(M) C- a S 0 1 N CONTRACTOR NAME ❑OWNER-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE Ian IAQ Z O-ck e CO)' -C.1/4( �qos 67) ISTREET ADDRESS (&,I a 1 1"I ( CITY,J CSV IIP..._. ...0v e c4 G 1 1 I E-MAy� PHONBUS.LIC S ' fJa -Pk1 { Q Q Id c4c ) _SCS[ _70E4 0 ARCHITECT ❑OWNER ❑OWNER AGENT CONTRACTOR ENT ENGINEER 0 DEVELOPER(2 TENANT CONTACT NAME E-MAIL STREET ADDRESS CITY,STATE,ZIP PHONE DECRIPTON 10 VCAVA V ` hA `)O SINGLE-FAMILY/DUPLEX 0 MULTI-FAMILY ❑INDUSTRIAL ❑COMMERCIAL EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES 0 TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION(5) REMODEL REMODEL KITCHEN REMODEL OTHR GARAGE 0 ATTACHED BATHROOM SF SF SF SF ❑DETACHED FIREEXISS SPRINKLERS 0 NO NG 0 YES EICHLER 0 YESNO SECOND STORY ADDITION DYES DWELLING SECOND DWELLING ❑YES ❑ATTACHED❑DETACHED OTHER UNITS a UNIT ADDrrON: ❑NO S F POOLSI ❑FIBERGLASS 0 VINYL-LINED ❑GUNITE 0 PREFABRICATED POOL-SF SPA-SF I SPA ATTACHED❑YES 0 NO J TOTAL-SF • REC( VED BY: TOU.L VALUATION:, Commercial or Multi-Family Buildings with Public Swimming Pools renuires Department of Environmental Heath approval I�O..,1 � �i1�'��\ RE-ROOF`EXISTING ROOF TYPE: D BUILT-UP ROOF❑ASPHALT SHINGLES❑WOOD SHAKES❑WOOD SHINGLES❑T E OTHER(SPECIFY) YF�Jt�`/ REMOVE/REPLACE 0 NO IF NO PLYWOOD El 2" El 3/8" PLYWOOD TYPE: PITCH: ROOF CLASS ❑YES t OF LAYERS THICKNESS❑5/8" OTHER ❑OSB ❑CDX OTHER .12 A PROPOSED ROOF TYPE:❑BUILT-UP ROOF ❑ASPHALT SHINGLES 0 WOOD SHAKES❑WOOD SHINGLES 0 OTHER *Provide a signed copy of the Cupertino's Tear-Off Policy SF aof SQUARES 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 have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to b ilding construction. I authorize represeitatives of Cupertino to enter the above-identified property for inspectie . "es. I ackno e.ge and authorize all information c. tame. on this application form to be made available for public record. Signature of Applicant/Agent: I/..t Date: SUPPLEMENTAL INFORMATION REQUI;y/' *New SFD/Second Dwelling Units/Multifa 7 Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction. *Commercial Buildings: Provide a comple Al Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. *Copy of Planning Approval Letter or Me-ting with Planning prior to submittal of Building Permit application. *HOA-Provide a letter of approval from the Home Owner's Association BldgApp_2017.doc revised 08/01/17