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B-2017-1810
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1810 20525 MARIANI AVE CUPERTINO,CA 95014-6201(326 56 001) BARRON BUILDERS INC • SANTA CLARA,CA 95054 OWNER'S NAME: 20525 MARIANI DRIVE LP DATE ISSUED: 10/26/2017 OWNER'S PHONE:408-996-1010 PHONE NO:(650)964-4493 .__I •._ . s t'- i- --:41_4 VO r-I. BUILDING PERMIT INFO: ` License Class B Lic.#916366 Contractor BARRON BUILDERS INC Date 07/31/2019 X BLDG _ELECT _PLUMB MECH RESIDENTIAL x 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 isin full force and effect. JOB DESCRIPTION: APPLE TENANT IMPROVEMENT-2ND FLOOR BREAK ROOM(175 I hereby affirm under penalty of perjury one of the following two declarations: SQ FT);3RD FLOOR BREAK ROOM AND COPY ROOM(318 SQ FT). 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 erformance of the work for which this permit is issued. • .s4I 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.Ft Floor Area: Valuation:$80000.00 ' 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 56 001 B(Tenant Improvements) representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnifyand 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. " ISSUANCE OR Additionally,the applicant understands anWITHIN 180 DAYS OF PERMIT; d will comply with all non-point ,, source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signet ‘k"---1 r Date 10-26-2017 Issued by:Kim Dunbar Date: 10/26/2017 . 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 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:10-26-2017 • 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 CupertinolMunicipal 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 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall II-- be deemed revoked. • Owner or authorized age•�' -P - 201726 10 - - APPLICANT CERTIFICATION Date: -a 1 '� I certify that I have read this application and state that the above information is CO` TRUCTION 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 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 10-26-2017 Professional CONSTRUCTION PERMIT APPLICATION \`'.0",' !' COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION " . B 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 ''� (408) 777-3228 • building@cupertino.org PEMIT#B-db 17 - I bJO CUPERTINO • REVS DEF✓{ ❑ NEW CONSTRUCTION ❑ADDITION ❑ALTERATION T.I. ❑MEP ❑RE-ROOF ❑SWIMMING POOL/SPA PROJECT ADDRESS2-0625 APN q q ^6 , 5• . 66 OWNER NAME -- ----- PHQ E-MAIL � :,% 4i�4Ni PO. 4U' ci% Io to STREET ADDRESS •- ` CITY-STATE"7IP d-go/ 7-4-0,7 ")/v �? 5v/70 aao fArr." X 97 1 C. 9 505 `;. . 7CONTRACTOR NAME 0 OWNER-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE SAES 21204 5Ae-go&I bu it..061eS qib 366 i5 STREET ADDRESS CITY,STATE, ZIPI ZY}(o CAl lL.E.L MUAIDO ' ot../\11CcA CA,1 C. SOS+ • E-MAIL PHONEBUS.LIC t ..-.,,E.r ise<S'C„d e ' (l=4r�f180t :Dt2Sf G0N1 &50-261-7o61 ❑'ARCHITECT' ❑OWNER.❑OWNER AGENT ,C CONTRACTOR AGENT ENGINEER❑DEVELOPER 0 TENANT CONTACT NAME ' E-MAIL 1 -gN S 5P.42-a-c. E( ESTb e $ eRo J Ev 1 L D-rzS , W M ' STREET ADDRESS '` CITY,STATE,ZIP 1 PHONE 234(6 C(-L& DEL p.4dN©o sts.WQ.c.A-2_A , C`/ ' 5f cos-0 , -2WW -7O DECRIPTON , . ; 1'; IA►ao,2 `1-WrJT I M?2oVEft .c3T S FT 2 C 2) f4K�b154Jt S p ro 114 e z h d AA-3° j2 Z.0 F 1 /'t`3 -r vJ.�N . ' ' C )750 , (3o2A) , ❑SINGLE-FAMILY/DUPLEX 121MULTI-FAMILY 0 INDUSTRIAL XCOMMERCIAL I EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES A TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION(S) REMODEL ' :1 , REMODEL KITCHEN REMODEL OTHR GARAGE El ATTACHED ' BATHROOM SF , " ! SF _ SF SF 0 DETACHED /1.5 Fl 17' • • EXISING ❑`YES EICHLER 0 YES SECOND'STORY ADDITION ONO )/f 3 FIRESPRINKLERS 0'NO ❑ NO .5 31 Y , • c V DWELLING' ,SECOND DWELLING DYES ❑ATTACHED DETACHED OTHER ' ' UNITSE 1 UNITADDITON: 0 N SF r POOLSI ' 0 FIBERGLASS 0 VINYL-LINED 0 GUNITE 'El PREFABRICATED ' POOL-SF ' ,;SPA-SF. I SPA ATTACHED 1=1 YES 0 NO I TOTAL-SF ' 1' 1 RECEIV D BY: TOTAL VALUATION: Commercial or'M:dti-Faniilii Buildings with Public Swinnning Pools requires Deparfnient.ofEnvironmental Heath approval ^ w' 1 RE-ROOF EXISTING ROOF TYPE: ❑BUILT-UP ROOF E ASPHALT SHINGLES E WOOD SHAKES❑WOOD SHINGLES❑TILE i OTHER(SPECIFY) REMOVE/REPLACE Q'NO IF NO PLYWOOD ❑1/2 ❑3/B" PLYWOOD TYPE: 1 PITCH: ROOF CLASS 'Q),YES if OF LAYERS THICKNESS El 5/8 OTHER DOSE ❑CDX OTHER .12 A PROPOSED ROOF TYPE:UBUILT-UP ROOF ❑ASPHALT SHINGLES 0 WOOD SHAKES❑WOOD SHINGLES ❑OTHER •*Provide a signed copy of the Cupertino's Tear-Off Policy SF ;of 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 building construction. I authorize representatives of Cupertino to enter the above identified property for inspection purposes. I acknowledge and authorize all information contained on this application form to be made available'for public record. •. / Signature of Applicant/Agent: /.1,..._ '� Date:. l 9'r 23( I, - SUPPLEMENTALIINFORMATION REQUIRED , , " 1 I 1 • *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 bleing 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 i ' , • Bldg,4pp_2017.doc revised 08/01/17 I.