Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
B-2017-1696
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1696 1161 S STELLING RD CUPERTINO,CA 95014-5020(362 22 018) VISIONARY HOME REMODELING INC SAN JOSE,CA 95126 OWNER'S NAME: WOODIE KERMIT D TRUSTEE DATE ISSUED:09/29/2017 OWNER'S PHONE:408-314-2893 PHONE NO:(866)990-8474 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class j3 Lic.#1001351 Contractor VISIONARY HOME REMODELING INC 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: MASTER BEDROOM AND HALLWAY BATHROOMS REMODEL(86 I hereby affirm under penalty of perjury one of the following two declarations: S.F.) 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. doerihave 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.Ft Floor Area: Valuation:$16000.00 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 362 22 018 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 under tands and will comply with all non-point source regulations per the Cup ino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. nature Date 9/29/2017 Issued by:Abby Ayende Date:09/29/2017 OWNER-BUILDER DECLARATION I hereby affirm that I ant 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. 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:9/29/2017 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 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 Cupertin Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Section 25505,25533,Iand 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked caner or authorized agent: • APPLICANT CERTIFICATION Date:9/29/2017 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 i 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 Cl) 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 9/29/2017 Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION(1' . B w � �W �' 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • building@cupertino.org, PEMIT#B-a©l.-4— - CUPERTINO REV# DEF# ❑ NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T.1. ❑MEP El RE-ROOF ❑SWIMMING POOL/SPA PROA ADDRES E.J'i P APN p 3(172. , l Z1 ON l_Jl OWNERt PHONE /T�n �7 I (' E-MAIL Verrni. -1-STREET ADDRESS CITY, STATE,ZIP CONTRACTOR NAME 0 OWNER-BUILDER COMPANY NAME LICENSE NUI IBEE jib -4 LICENSE TYPE STREET ADDRESS CITY,STATE, ZIP 4121W 0 rCA eft E-MAIL PHONE BUS.LIC I u1 s e,h .Pii .�&u J gQcn�(o -otgo zit '` • i 0 ARCHITECT /t..J'OWNER El OWNER AGENT fr •NTRACTORAGENT UENGINEER❑DEVELOPER 0 TENANT CONTACT NAIvJE I E-MAI_ I`J`e LAI,,; Le-4_ Cocom STREET ADDRESS CITY,STATE,ZIP PHONE -v/y / -9-11") DECRIPTON 2 (jam, QePNC40( — . &ce*eir -- feQ'P ce S1 e f, Vct Y;4y , -b;(e 1 F4 to , V e eWiectl Mt\ , IiiivroNon by Cpcle. . L' * \P 9u4+� Yee r � �t 1 Vov7 tl- un cots et-004\5 t ,r ) OSINGLE-FAMILY/DUPLEX 0 MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL EXISTING USE 1 EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES I TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION($) I REMODEL REMODEL KITCHEN REMODEL OTHR GARAGE D ATTACHED BATHROOM SF SF SF SF ❑DETACHED EXTSTNG 0 YES EICHLER ❑ YES SECOND STORY ADDITION O YES FIRE SPRINKLERS El NO 0 NO NO DWELLING ' SECOND DWELLING ❑YES 0 ATTACHED DETACHED OTHER UNITS u UNIT ADDITON: ❑NO S F IPOOLS' ❑FIBERGLASS ❑VINYL-LINED ❑GUNITE 0 PREFABRICATED POOL-SF SPA-SF I SPA ATTACHED❑YES 0 NO I TOTAL-SF REC T$L VALUATION: Commercial or Multi-Family Buildings with Public'Swimming Pools renuires Department of Environmental Heath approval K_,,Iflt RE-ROOFI EXISTING ROOF TYPE: ❑BUILT-UP ROOF❑ASPHALT SHINGLES❑WOOD SHAKES❑WOOD SHINGLES❑TI E OTHER(SPECIFY) 4V/ �U� REMOVE/REPLACE 0 NO IF NO . PLYWOOD ❑1„ ❑3/8" PLYWOOD TYPE: PITCH: ROOF CLASS ❑YES #OF LAYERS THICKNESS❑5/8" OTHER El OSB E CDX OTHER •12 A PROPOSED ROOF TYPE:❑BUILT-UP ROOF DASPHALT SHINGLES ❑WOOD SHAKES❑WOOD SHINGLES 0 OTHER *Provide a signed copy of the Cupertino's Tear-Off Policy SF Pot 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 provide s correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state law relating to building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. acknowledge and authorize all informationol�ingdon��lltl s application form to be made available for public record. Signature of Applicant/Agent: i✓ - Date: 7 SUPPLEMENTAL INFORMATION REQUIRED *New SFD/Second Dwelling Units/Multifamily Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction. *Commercial Buildings: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. *Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. *HOA-Provide a letter of approval from the Home Owner's Association . BldgApp_20/7.doc revised 08/01/17 ae`VISIONARY HOME !".44:› REMODELINGIC. Visionary Home Remodeling Inc #1001351 1400 Coleman Ave suite D24 Santa Clara Ca 95050 1-866-990-847 To whom it may concern, Lee Lihi Lee has the authority to pull permits for Visionary Home,'Remodeling on the behalf Kfir Muller C.E.O I li I _ iI Ii I I 'I 1' ,;