B-2017-2052I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS:
864 KIM ST CUPERTINO, CA 95014-4323 (359 19 036)
OWNER'SNAME:
OWNER'S PHONE:
LICENSED CONTRACTOR'S D.A ATION
License Class E Lic. #875818
Contractor SHER CONSTRUCTION INC Date 04/30/2020
l 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.
hereby affirm under penalty of perjury one of the following two declarations:
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.
z. 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.
APPLICANT CERTIFICATION
certify that I have read this application and state that the above
nformation Is correct. I agree to comply with all city and county ordinances
ind stale laws relating to building construction, and hereby authorize
epresentatives of this city to enter upon the above mentioned property for
nspectlon purposes. (We) agree to save Indemnify and keep harmless the
:ity of Cupertino against liabilities, judgments, costs, and expenses which
nay accrue against said City In consequence of the granting of this permit.
Wditionally, the applicant understands and will comply with all non -point
source regulations per the Cupertino Municipal Code, Section 9.18.
Date 412412018
shy affirm that I am exempt from the Contractor's License Law for one of the
ving two reasons:
1. 1, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for
sale (See.7044, Business & Professions Code)
2. 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sce.7044, Business & Professions Code).
shy affirm under penalty of perjury one of the following three declarations:
A. 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,
2. 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.
3. I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the
Worker's Compensation laws of California, If, after making this certificate of
exemption, I become subject to the Worker's Compensation provisions of the
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked,
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 and stale laws
relating to building construction, and hereby authorize 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 may accrue against said City In
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
Code, Section 9.18.
Date 4/24/2018
)NTRACTOR:
PERMIT NO: B-2017-2052
1ER
)NSTRUCTION INC
ANTECA, CA 95336
DATE ISSUED: 04/24/2018
PHONE NO: (510) 2246462
JILDING PERMIT INFO:
BLDG X ELECT —PLUMB
MECH X RESIDENTIAL_ COMMERCIAL
B DESCRIPTION:
ADDITION OF LIVING SPACE (662 S.F.); (N) GARAGE ADDITION
1 S.F.); (N) FRONT PORCH (27 S.F.); REMODEL KITCHEN it 80
); REMODEL BATHROOM (80 ST.); REMODEL OTHER (433 S.F.);
GRADE ELECTRICAL PANEL (200 AMP); REMOVE (E)
PACHED GARAGE (468 S.F.)
Ft Floor Area: 662 Valuation: $150000.00
19 036
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
by:
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Lure of Applicant;
4/24/2018
OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code,,, /Section 25505, 25533, and 25534.
Owner or authorized agent:
Date: 4/2412018
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance
of work's for which this permit Is issued (Sec. 3097, Civ C.)
Lender's Name
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-2052
864 KIM ST CUPERTI NO,CA 95014-4323(359 19 036) ARIA BUILD&
CONSTRUCTIONINC
SAN.JOSE,CA 95128
OWNER'S NAME: DATE ISSUED:04/24/2018
OWNER'S PHONE: PHONE NO:(
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B C20 Lic.#1018395
Contractor ARIA BUILD&CONSTRUCTION INC Date 09/30/2018 X BLDG X ELECT—PLUMB
I hereby affirm that t nm 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 fall force and effect. JOB DESCRIPTION;
(N)ADDITION OF LIVING SPACE(662 S.F.);(N)GARAGE ADDITION
I hereby affirm under penalty of perjury one of the Following two declarations: (551 S.F.);(N)FRONT PORCH(27 S.F.);REMODEL KITCHEN(180
t. I have and will maintain a certificate of consent to self-insure for Worker's S.F.);REMODEL BATHROOM(80 S.F.);REMODEL OTHER(433 S.F.);
Compensation,as provided for by Section 3700 of the Labor Code,for the UPGRADE ELECTRICAL PANEL(200 AMP);REMOVE(E)
performance of the work for which this permit is issued. ATTACHED GARAGE(468 S.F.)
z. 1 have and will maintain Worker's Compensation Insurance,as provided for by REV#I-NEW SUB-PANEL(I 10 AMPS)-LOCATED IN THE GARAGE-
Section 3700 of the Labor Code,for the performance of the work for which this ISSUED 7-20-2018
permit is issued.
Sq.Ft Floor Area:662 Vxlantion:5150000.00
APPLICANT CERTIFICATION
I certify that I have read this application and stale that the above
Information Is correct.I agree to comply with all city and county ordinances APN Number: Ovintymcy'fype:
and state laws relating to building construction,and hereby authorize 359 19036 R-3(Custom)
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.
Additionally,the applicant understands and will comply with all non-point WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature -..---"' Uate 7-20-2018 Issued by:Abby AY ende
—
Date:04/24/2018
OWNER-BUILDER DECLARATION
I hereby affirm that I nm exempt from the Contractor's License Law for one of the RF-ROOFS:
following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
t. 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)
z 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:7-20-2018
1 hereby affirm under penalty of perjury one of the following three declarations:
t. I have and will maintain n Certificate of Consent to self-insure for Worker's ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance ofthe 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 the hazardous materials requirements order Chapter 6.95 of the
Section 3700 of the Labor Code,for the performance of the work for which this Calif ornfa Health&Safety Code,Sections 25505,25533,and 25534.I will
permit is issuedm aintain compliance with the Cupertino Municipal Cade,Chapter 9.12 and the
a. I certify that in the performance of the work for which this permit is issued,I Health&Safely Code,Section 25532(n)should I stare or handle hazardous
shall not employ any person in any manner so as to become subject to the anterial.Additionally,should I use equipment or devices which emit hazardous
Worker's Compensation laws of California.If,after making this certificate of air contaminants as defined by the Bay Area Air Quality Management District I
exemption,I became subject to the Worker's Compensation provisions of the will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
Labor Cade,I must forthwith comply with such provisions or this permit shall the Health&Safety Code,Se-tions 25505,25533,and 25534.
be deemed revoked.
Owner or authorized +" --.-
APPLICANT CERTIFICATION Date:7-20-2018
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. 1 understand my plans shall be used as public records.
Signature Data 7-20-2018 Licensed
Professional