B-2018-0725 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-0725
10177 N PORTAL AVE CUPERTINO,CA 95014-2322(316 21 039) C&D FREITAS
CONSTRUCTION INC
SANTA CRUZ,CA
95060
OWNER'S NAME: DATE ISSUED:05/01/2018
OWNER'S PHONE: PHONE NO:(408)353-1900
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class b Lic.#286517
Contractor C&D FREITAS CONSTRUCTION INC Date 01/31/2020 X BLDG X ELECT —PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing 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:
REMODEL KITCHEN( 192 SF);REMOVE WALL AND INSTALL PSL
I hereby affirm under penalty of perjury one of the following two declarations: BEAM WITH PAD FOOTINGS;REMODEL(2)BATHROOMS(178 SF
1. I have and will maintain a certificate of consent to self-insure for Worker's TOTAL);RECESSED LIGHTS IN FAMILY AND LIVING RMS(8);
Compensation,as provided for by Section 3700 of the Labor Code,for the INSTALL ELEC.FIREPLACE INSERT IN(E)FIREPLACE
performance of the work for which this permit is issued. REV#1 -(E)FOOTING IN LOCATION OF(N)PIER APPROVAL-
I have and will maintain Worker's Compensation Insurance,as provided for by 4/18/19
Section 3 700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$2200.00
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 316 21 039
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.
Signature �`�.., Date 4/18/19 Issued by: Kim Dunbar
Date:05/01/2018
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 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)
i. 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:4/18/19
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
material. Additionally,should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the 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
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agent:
APPLICANT CERTIFICATION Date:4/18/19
1 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 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 4/18/19 Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-0725
10177 N PORTALAVE CUPERTINO,CA 95014-2322(316 21 039) C&D FREITAS
CONSTRUCTION INC
SANTA CRUZ,CA
95060
OWNER'SNAME:RAMESH ANANTHAKRISHNA AND SAPNA TRUSTEE DATE ISSUED:05/01/2018
OWNER'S PHONE: PHONE NO:(408)353-1900
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.9286517
Contractor C&D FREITAS CONSTRUCTION INC Dale 01/31/2020 X BLDG X ELECT—PLUMB
I hereby affirm that 1 am licensed under the provisions of Chapter 9(commencing —MECH X RESIDENTIAL_COMMERCIAL
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force xad effect. JOB DESCRIPTION:
REMODEL KITCHEN(192 SF);REMOVE WALLAND INSTALL PSL
I hereby affirm under penalty of perjury one of the following two declarations: BEAM WITH PAD FOOTINGS;REMODEL(2)BATHROOMS(178 SF
t. I have and will maintain a certificate of consent to self-insure for Worker's TOTAL);RECESSED LIGHTS IN FAMILY AND LIVING RMS(8);
Compensation,as provided for by Section 3700 of the Labor Code,for the INSTALL ELEC.FIREPLACE INSERT IN(E)FIREPLACE.
performance of the work for which this permit is issued.
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:$2200.00
APPLICANT CER'PIF'ICATION
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 316 21 039
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
spper the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature ��� Date 05-01-2018 Issued by:Kim Dunbar
Date:05/01/2018
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 roofing material being installed.I£a roofis
1. I,as owner of the property,or my employees with wages us their sole installed without first obtaining an inspection,1 agree to remove all new materials for
compensation,will do the work,and the structure is not intended an offered for inspection.
sale(Sce.7044,Business&Professions Code)
z. 1,as owner ofthe property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sce,7044,Business&Professions Code), Date:05-01-2018
1 hereby affirm tinder penalty of perjury one of the following three declarations: AL1.ROOF COVERINGS TO 13E CLASS"A"OR BE'fl'ER
t. 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
performance mfthe work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE
z. I have and will maimain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 or the
Section 3700 of the Labor Code,for the perfarnmuee of the work far which this California Health&Safety Code,Sections 25505,25533,and 25534.1 will
permit is issued. m aintain complianceith wthe 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 1 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
contaminants as defined by the Bay Area Air Quality Management District 1
Worker's Compensation laws of Califords,IF,atter making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
emptimn,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 she][
be deemed revoked. Owner or authorized agent:
APPLICANT CERTIFICATION Date:05-01-2018
I certify that I have read this application and slate 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 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
ccusequence 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 UECLARATI ON
Code,Section 9.18. 1 understand my plans shall be used as public records.
SignatureLicensed
Date 05-01-2018
Professional