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B-2017-1760 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1760 20735 STEVENS CREEK BLVD CUPERTINO,CA 95014(326 32 054) REEVE-KNIGHT CONSTRUCTION INC ROSEVILLE,CA 95661 OWNER'S NAME: LAU ALLAN COOK YEE AND LINDA YIM SEUNG ET DATE ISSUED: 10/19/2017 OWNER'S PHONE:408-867-2002 PHONE NO:(916)865-1504 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: I License Class B Lic.#659107 Contractor REEVE-KNIGHT CONSTRUCTION INC Date 11/30/2018 X BLDG _ELECT _PLUMB MECH_RESIDENTIAL XCOMMERCIAL 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: VERIZON-1ST FLOOR;T.I.'-SALES FLOOR REFRESH,RELOCATE I hereby affirm under penalty of perjury one of the following two declarations: LIGHTING(2040 S.F.) • 1. I have and will maintain a certificate of consent to self-insure for Worker's .mpensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. .fi I have and will maintain Worker's Compensation Insurance,as provided for by A Section 3700 of the Labor Code,for the performance of the work for which this l". permit is issued. Sq.Ft Floor Area: Valuation:$33000.00 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 32 054 A(Tenant Improvements),M(Tenant Improvements) 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 Cupertinoagainst 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 regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. ature I - Date 10/19/2017 Issued by:Abby Ayende Date: 10/19/2017 • .I► i-- UILDER 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:10/19/2017 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 Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,255 3,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall r be deemed revoked. ner or authorized agent: f/t. Ad •• APPLICANT CERTIFICATION p ate:10/19/2017 .. I certify that I have read this application and state that the above information is CONSTRIJ ON 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 Cupertinoagainst 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-stintsource/.e•ulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Sectio I understand my plans shall be used as public records. it- f_4 Licensed Signature � �< 7i, Date 10/19/2017 Professional / CONSTRUCTION PERMIT APPLICATION /',/ COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ( 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 '4'.'•":Dsr (408) 777-3228building@cupertino.org - 1—©1-4-- I`i 0 CUPERTINO REV# DEF# ❑ NEW CONSTRUCTION El ADDITION El ALTERATION T.I.1p ❑MEP ❑RE-ROOF ❑SWIMMING POOL/SPA finnq€ tg�?4? ':'� APN# • otagimiiii IA-`4 $4y,ye$44,..a,,,� PHONE E-MAIL vi' C -.X. L A'i 4 j - 402-f-7a20Z, STR .,r.,..F;W.V. CIT, STATE,ZIP (CONTRACTOR NAME 0 OWNER-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE r1..e—VoN STREET ADDRESSI • STATE, ZIP 11. 01 .N'tc. In7- pc - ry2 E-MAIL PHONE BUS.LIC n YVV vCn V �►4C AGE LNco C � � `s‘ El ARCHITECT OWNER WNER AGENT 0 CONTRACTOR AGENT❑ENGINEER❑DEVELOPER❑TENANT M�TT/N o2�U2—ECh %aA^.CCn • CON AME E-MAIL 2 � y`,�_ STREET ADDRESS CITY,STATE,ZIP �`' PHONE � �, S ,e c�_. cz_ \io�-. CA—of C: 9((-,-L 7 ' % DECRIPT ( •.,) / c s Com_ -22 e� L n M f I�P.� • vt A.- uao r 1, 's�ky--5\,...-5— �4. Z 1f O ❑SINGLE-FAMILY/DUPLEX 0 MULTI-FAMILY 0 INDUSTRIAL,/ COMMERCIAL I EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMOSFF STORIES(' TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION(5) V42.64,1 V005- REMODEL REMODEL KITCHEN REMODEL OTHR GARAGE 0 ATTACHED A . 7,5 BATHROOM SF SF SF ^l�bh SFr� 3?C 15O �(,�V 0DETACHED , \ � ✓✓✓ vvv EXISINGYES EICHLER 0 YES SECOND STORY ADDITION DYES FIRE SPRINKLE 0 NO ,g—NO .4E1Vt7 DWELLING SECOND DWELLING ❑YES ❑ATTACHED El DETACHED OTHER UNITS s UNIT ADDITON: ❑NO SF POOLS! D FIBERGLASS ❑VINYL-LINED 0 GUNITE 0 PREFABRICATED POOL-SF SPA-SF I SPA ATTACHED❑YES 0 NO I TOTAL-SF ^---- REQEIVED BY: ka TOTAL VALUATION: Commercial or Multi-Family Buildings with Public Swimming Pools requires Deportment of Environmental Heath apw•oaal \jL/{��/Ap�M� O`L RE-ROOF!EXISTING ROOF TYPE: ❑BUILT-UP ROOF E ASPHALT SHINGLES❑WOOD SHAKES❑WOOD SHINGLES E TILE OTHER(SPECIFY) REMOVE/REPLACE❑NO IF NO PLYWOOD ❑W' 1=13/8" PLYWOOD TYPE: PITCH: ROOF CLASS DYES n OF LAYERS THICKNESS❑5/8" OTHER ❑OSB ❑CDX OTHER _ •12 A, PROPOSED ROOF TYPE:'❑BUILT-UP ROOF ❑ASPHALT SHINGLES 0 WOOD SHAKES❑WOOD SHINGLES ❑OTHER *Provide a signed copy of the Cupertino's Tear-Off Policy SF lot SQUARES By my signature below I certify to each of the fol ..' :: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the informa:.n 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 ord• ances and sta'e laws relatin: •. ouilding construction. I authorize representatives of Cupertino to enter the above-identified property fo inspection pyoses I . a' led y. , authorize all information contained on this application form to be made available for public record J,` .i Signature of Applicant/Agent: Date: --��@ _4 • SUPPLEMENTAL INFORMATION R =`SIRED *New SFD/Second Dwelling U ' ' ultifamily Dwellin: • Demolition permit is required prior to issuance of a building permit for all new construction. *Commercial Buildings: P ide 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_2017.doc revised 08/01/17