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B-2017-1643 CITY OF CUPERTINO BUILDING PERMIT • BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1643 1575 JAMESTOWN DR CUPERTINO,CA 95014-5312(366 10 095)• TALENT DECIDE INC LOS GATOS,CA 95030 OWNER'S NAME: DATE ISSUED: 11/28/2017 OWNER'S PHONE: PHONE NO:( LICENSED CONTRACTORS DECLARATION BUILDING PERMIT INFO: License Class a Lic.#808951 Contractor TALENT DECIDE INC Date 06/30/2018 X BLDG _ELECT X 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: 1ST FLOOR ADDITION(159 SF);KITCHEN REMODEL(140 SF); I hereby affirm under penalty of perjury one of the following two declarations: CLOSETS REMODEL(90 SF);(3)BATHROOMS REMODEL(128 SF); 1. I have and will maintain a certificate of consent to self-insure for Worker's (N)2ND FLOOR BATHROOM#3(41 SF);(N)SLIDER DOOR;(N)BAY Compensation,as provided for by Section 3700 of the Labor Code,for the WINDOW;(N)3 WINDOWS;(N)TANK-LESS WATER HEATER;RE- , per°mance of the work for which this permit is issued. ROOF ENTIRE HOUSE(2,000 SF) ' I 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:$85000.00 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 366 10 095 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 regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. '° ature Date 11/28/2017 Issued by:Abby Ayende Date:11/28/2017 OWNER-BUILDER DECL TION I hereby affirm that I am exempt from the Contractor's License Law fortune 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:11/28/2017 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 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall / be deemed revoked. 04t -r or authorized agent: APPLICANT CERTIFICATION 41 '-te:11/28/2017 I certify that I have read this application and state that the above information is CONSTRU - ON LE 'INC 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 11/28/2017 Professional CITY OF CUPERTINO BUILDINGG PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1643 1575 JAMESTOWN DR CUPERTINO, CA 95014-5312 (366 10 095) - TALENT DECIDE INC LOS GATOS, CA 95030 OWNER'S NAME: DATE ISSUED: 11/28/2017 OWNER'S PHONE: PHONE NO, (408) 306-3968 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. X808951 XBLDG ELECT X PLUMB Contractor TALENT DECIDE INC Date 06/30/2020 — — — I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing X 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: 1ST FLOOR ADDITION (l 59 SF); KITCHEN REMODEL (140 SF); I hereby affirm under penalty of perjury one of the following two declarations: CLOSETS REMODEL (90 SF); (3) BATHROOMS REMODEL (128 SF); 1, I have and will maintain a certificate of consent to self-insure for Worker's (N) 2ND FLOOR BATHROOM #3 (41 SF); (N) SLIDER DOOR; .(N) BAY Compensation, as provided for by Section 3700 of the Labor Code, for the WINDOW; (N) 3 WINDOWS; (N) TANK-LESS WATER HEATER; RE- performance of the work for which this permit is issued. ROOF ENTIRE HOUSE (2,000 SF) I have and will maintain Worker's Compensation Insurance, as provided for by REV#1 - RECONFIGURE BATHROOM - ISSUED 6-18-2018 Section 3700 of the Labor Code, for the performance of the work for which this REV#2 - REPLACE FURNACE (SAME LOCATION)-ISSUED 10-12- permit is issued. 2018 APPLICANT CERTI.FICATION Sq. Ft Floor Area: Valuation: $85000.00 1 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 and state laws relating to building construction, and hereby authorize APN Number: Occupancy Type: representatives of this city to enter upon the above mentioned property for 366 10 095 inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. PERMIT EXPIRES IF WORK IS NOT STARTED Additionally, the applicant understands and will comply with all non-point source regulations Code, Section 9. 18: WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 10-12-2018 Issued by: Abbbbyey nde OWNER-BUILDER DECLARATION Date: 11/28/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: RE-ROOFS: 1. 1; as owner of the property, or my employees with wages as their sole All roofs shall be inspected prior to any roofing material being installed. If a roof is compensation, will do the work,and the structure is not intended or offered for installed without first obtaining an inspection, I agree to remove all new materials for sale (Sec.7044, Business & Professions Code) inspection. 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec,7044, Business & Professions Code). Signature of.Applicant: I hereby affirm under penalty of perjury one of the following three declarations: Date: 10-12-2018 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 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER performance of the work for which this permit is issued. 2. 1 have and will maintain Worker's Compensation Insurance, as provided for by HAZARDOUS MATERIALS DISCLOSURE Section 3700 of the Labor Code, for the performance of the work for which this I have read the hazardous materials requirements under Chapter 6.95 of the permit is issued. California Health & Safety Code, Sections 25505, 25533, and 25534. I will 3. I certify that in the performance of the work for which this permit is issued, I maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the shall not employ any person in any manner so as to become subject to the Health & Safety Code, Section 25532(a) should I store or handle hazardous Worker's Compensation laws of California. If, after making this certificate of material. Additionally, should .I use equipment or devices which emit hazardous exemption, I become subject to the Worker's Compensation provisions of the air contaminants as defined by the Bay Area Air Quality Management District I :Labor Code' I must forthwith comply with such provisions or this permit shall will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and be deemed revolted, the Health & Safety Code, Sections 25505, 25533, and 25534. APPLICANT CERTIFICATION � - Owner or authorized agent: I certify that I have read this application and state that the above information is Date: 10-12-2018 correct. I agree to comply with all city and county ordinances and state laws CONSTRUCTION LEX6ING AGENCY relating to building construction, and hereby authorize representatives of this city I hereby affirm that there is a constructia lending agency for the performance to enter upon the above mentioned property for inspection purposes. (We) agree of work's for which this permit is issued (Sec. 3097, Civ C.) to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Name judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands Lender's Address and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Signature Date 10-12-2018 Licensed Professional CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1643 1575 JAMESTO WN DR CUPERTINO,CA 95014-5312(366 10 095) TALENT DECIDE INC LOS G REN AND TAY SICK HUANG ET AL DATE ISSUED OWNER'S PHON PHONE NO:(408)306-3968 LICENSED CONTRACTOR'S DECLARATION - BUILDING PERMIT INFO: License Class B.Lie.#80895 Contractor TALENT DECIDE INC Date 06/30/2018 X BLDG_ELECT X PLUMB I herebyaffirm that I am licensed under the provisions of Chapter 9 —MECH X RESIDENTIAL_COMMERCIAL pr p (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: IST FLOOR ADDITION(t59 SF);KITCHEN REMODEL(140 SF); I hereby affirm under penalty of perjury one of the following two declarations: CLOSETS REMODEL(90 SF);(3)BATHROOMS REMODEL(128 SF); a. I have and will maintain a certificate of consent to self-insure for Worker's (N)2ND FLOOR BATHROOM#3(41 SF);(N)SLIDER DOOR;(N)BAY Compensation,as provided for by Section 3700 of the Labor Code,for the WINDOW;(N)3 WINDOWS;(N)TANK-LESS WATER HEATER;RE- pe,formance E- performance of the fm which this permit is issued. ROOF ENTIRE HOUSE(2,000 SF) P/LI I have and will maintain Worker's Compensation Insurance,as provided for by RpV#1-RECONFIGURE BATHROOM-ISSUED 6-18-2018 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued Sq.Ft Floor Area: Vnluatton:$85000.00 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 slate laws relating to building construction,and hereby authorize 366 00 095 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 regulations per th e v' � Date 06-18-18 Issued by:Abby Avende Date:11/28/2017 OWNER-BUILDER DEO ARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All root's shall be inspected prior to any roofing material being installed,If a roof is 1. 1,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 pr jwt(Sce,7044,Business&Professions Code). Date:06-I8-I8 I hereby affirm under penalty of perjury one at'the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER a. I have and will maintain a Coo dficate of Consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance ofthe work for which Ibis 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 trader Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Cade,Sections 25505,25533,and 25534.I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the a. 1 certify that in the performance of the work for which this permit is issued,I Health&Safety Coda,Section 25532(a)should I store or handle hazardous shall not employ an reon in an manner so as to become subject m the material.Additionally,should I use equipment m'devices which emit hazardous p y y pe y man J r contaminants as defined by the Bay Area Air Quality Management District 1 Worker's Compensation laws of California.If,after making this certificate of w'fll maintain compliance with the Cupertino Munfetpal Cade,Chapter 9.12 and exemption,l.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 be deemed revoked, Owner or authorized agent: APPLICANT CERTIFICATION Date:06-18 I certify that I have read this application and state that the above information Is CON TRUCTIO LE DI CY 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 ARCBITECT'.1 DECLARATION Code,Section 9.18. 1 understand my plans shall be used as puhl a records. Licensed Signature Date 08"18-18 professional