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B-2018-0910
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-0910 10042 MOSSY OAK CT CUPERTINO,CA 95014-5615(342 32 108) MARTZ DESIGNS PLUMBING LLC TRACY,CA 95304 OWNER'S NAME:VENTIMIGLIA JOSEPH A AND ESKENAZI JANET A T DATE ISSUED:05/29/2018 OWNER'S PHONE:408-206-3823 PHONE NO:(669)3004103 LICENSED CONTRAC'1.OWS DECLARATION BUILDING PERMIT INFO: License Class$Lic.#1010543 Contractor MARTZ DESIGNS PLUMBING LLC Date 11130/2019 X BLDG_ELECT_PLUMB pro p (commencing MECH X RESIDENTIAL_COMMERCIAL 1 hereby affirm that 1 am licensed under file visions of Chn ter 9 with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect, JOB DESCRIPTION: KITCHEN REMODEL(144 SF) I hereby affirm under penalty of perJm•y one of the following two declarations: t. I have and will maintain acertificate of couseut to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Cade,For the z performance of the work fur which this permit is issued, I have and will maintain Worker's Compensation Iusnrance,as provided far by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Flom-Area: Valnatimn:$20000.00 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 342 32 108 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 WORT{IS NOT STARTED may accrue against scanunn in of the granting of this permit. Additionally,the applicant understands and will comply with all non-point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cu pertin oMunicipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature ' IJ(/('IP Z Date 05-296-2018 Issued by:Kim Dunbar Date:05/29/2018 OWNER-BUILDER DECLARATION I hereby al'tirm that I am exempt from it.,Conn actur's License Low tar one of'the RE- Oils: billowing bvo reasons: All roofs shall be inspected prior to any roofing material being installed.lfa reoF 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 fo compensation,will do the work,and the structure is not intended or offered for inspection. sale(Ser.7044,Business&Professions Code) z. 1,as owner of the property,am exclusively contracting with licensed Signature ofApplieauu contractors to construct the project(Sve.7044,Business&Professions Cede), Date:05-296-2018 I hereby affirm under penalty of perjury one of the following three declarations: Alit 1200E COVERINGS TO BE CLASS"A"OR BE'P'I'Eli r, 1 have and will maintain a Certificate ot•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 z. I have and will maintain Worker's Compensation Insurance,as provided for by I have read file 1—mdous materlots 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 25534.1 will is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Permitt Health&Safety Code,Section 25532(x)should I store or handle hazardous a. I certify that in y any person of the neer far which this penult is issued,I material.Addltiomdly,should 1 use equipment or devices which emit lu-n' 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 Compensafion laws of California, If,alter nicking this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,l become subject to the Worker's Compensation provisions of the the If 11&Safefy Cade, actions 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked, Owner or authorizetl agent CA— Cw- i� 2 APPLICANT CER'ITF'ICATION Date:05-296-201 B 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 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.) toenter 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 ARCHI'TECT'S DECLARAI ION Code,Section 9.18. 1 understand my plans shall be used as public records. SignatureLicesed Date 05-296-2018 n Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-32550 (y (408)777-3228• building@cup -ertino.org PEMIT#B log o o CUPERTINO REV# DEF#_ ❑NEW CONSTRUCTION []ADD ITION'5qALTERATION❑T.I. ❑MEP ❑RE-ROOF ❑SWIMMING POOL/SPA PROJECT ADDRESS Old oC ll (�f v '` APN# OWNER NAME •J PHO E-MAIL ff J �L/I I. STREET ADDRESS CITY,STATE,ZIP [CJ�TCON CTOR NAME ❑OWNER-BUILDER CO/MPPANY NCAME LICENSE NUM`BlER LICENSE TYPE STREET ADDRESS CITY T�E,ZIP 17. E-MAIL PFIONE BUS.LIC I L r! f" •Y.y f 4�?-3©e- 03 ❑ARCHITECT ❑OWNER❑OWNER AGENT ❑CONTRACTOR AGENT❑ENGINEER❑DEVELOPER[I TENANT CONTACT NAME E-MAIL STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTON U�91NGLE-FAMILY/DUPLEX ❑MULTI-FAMILY ❑INDUSTRIAL ❑COMMERCIAL HXISTINGUSE EXISTINGSF NEWPLOORSP PORCHSP DECKSP DEMOSF STORIES# TOTALNETSF USE TYPE OCC SQ.FT. VALUATION($) REMODEL REMODEL KITCIMN IIEMODELOTIIR GARAGE I]A'ITACHED BATHROOM SF SF %q,/ SF Sr ❑DETACHED RXISING ❑YES EICHLER E]YES SECOND STORY ADDITION ❑YES HRC SPRINKLERS ElNO [:]NO ❑NO DWELLING SECONDDWELLING E]YES❑ATTACHED❑DETACHED OTHER UNITS# UNIT ADDrrON: [I NO S F POOLS ❑FIBERGLASS E]VINYL-LINED [-]GUNITE I]PREFABRICATED POOL-SF SPA-SF SPA ATTACI-IED[I YES ❑NO I 'T'O'TAL-SF KECEIr!D B/l': TOTAL VALUATION: C--1,A or Multi-Fnmih,BONE 1mith A&Ii,S,,ilnllllnx Pools-0,.,DernrinioJ,fEnoirannr dd IWth nw ml RE-ROOP EXISTING ROOF TYPE: ❑BUILT-UP ROOF❑ASPHALT SHINGLES❑WOOD SHAKES❑WOOD SHINGLES L]TILE OTHER(SPECIFY) REMOVE/REPLACE❑NO 1 IF NO PLYWOOD ❑1/s" ❑3/E" PLYWOODTYPE: PITCH: ROOFCLASS ❑YES XOFLAYERS THICKNESS❑5/E" OTHER ❑OSB ❑CDX OTHER •12 A PROPOSED ROOF TYPE:❑BUILT-UP ROOF❑ASPHALTSHINGLES❑WOOD SHAKES(]WOOD SHINGLES El OTHER "Provide a signed copy of the Cupertino's Trar-Off Policy SF I.f 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 or inspection p rpos�s. I acknowledge and authorize all information ontained on this application form to be made available for public n Do d. y� '7 Signature of Applic<Tnt/Agent: VG� Cr j`>flL Dale: CT 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_2017.doc revised 08/01/17