B-2018-1286 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-1286
10210 ALPINE DR CUPERTINO,CA 95014-0945(326 15 026) MICHAEL MC KINZIE
CONSTRUCTION
MORGAN HILL,CA
95037
OWNER'S NAME: DATE ISSUED:08/02/2018
OWNER'S PHONE: PHONE NO:(
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class GENERAL BUILDING CONTRACTOR Lic.#Z22112
Contractor MICHAEL MC KINZIE CONSTRUCTION Date 09/30/2018 X BLDG —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:
REPLACE GUARD RAILS ONLY ON EXTERIOR DECK-(275 LF)
I hereby affirm under penalty of perjury one of the following two declarations: REV#1 -DEMOLISH(33 L.F.)(E)DECK,REPLACE PIER&POST
r. A I have andwill maintain a certificate of consent to self-insure for Worker's REMOVE AND REPLACE REAR EXTERIOR STAIRS-SAME
Compensation,as provided for by Section 3700 of the Labor Code,for the LOCATION-ISSUED 09/10/2018
1� perfonnance of the work for which this permit is issued.
bb 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. Sq.Ft Floor Area: Valuation:$39000.00
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 15 026
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 Cupertin Munici al Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature 01 Issued by:Kim Dunbar
Date:08/02/2018
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
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:09/10/2018
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
t. 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 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:09/10/2018
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.)
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.
Licensed
Signature Date 09/10/2018
Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO;B-2018-1286
10210ALPINE DR CUPERTINO,CA 95014-0945(326 15 026) MICHAEL MC KINZIE
CONSTRUCTION
MORGAN HILL,CA
95037
OWNER'S NAME: DATE ISSUED:08/02/2018
OWNER'S PHONE: PI4ONE No:(
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class a Lio,#222119 -
Contractor MICHAEL MC KINZIE CONSTRUCTION Date 09/30/2018 X BLDG_ELECT—PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH X RESIDENTIAL_COMMERCIAL
with Section 7000)of Divislon 3 ofthe Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
REPLACE GUARD RAILS ONLY ON EXTERIOR DECK-(275 LF)
I hereby affirm under penalty of perjury one of the followhtg two declarations:
r. I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 ofthe Labor Code,for the
performance ofthe work for which this permit is issued.
is issued, Sq.Ft Floor Area: Valuation:$39000.00
APPLICANT'CERTIFICATION
I certify that I have read this appllcatlon and state that the above
information is correct.I agree to comply with all city and county ordinances APN Number: Occupancy'fype:
and state laws relating to building construction,and hereby authorize 326 15 026
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.
yypp --
Signature /-
I hereby affirm that I.m exempt from the Contractor's License Law for one ofthe RE-ROOFS:
following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
r. 1,as owner ofthe property,or my employees with wages as their sole installed without first obtaining an inspection,l 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. 1,as owner of dre property,am exclusively contracting with licensed Signature of Applicant:
connectors to construct the project(See.7044,Business&Professions Code). Date:8-2-2018
1 hereby affirm under penalty of perjury one ofthe following three declarations; ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
r. 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
v 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 ofthe Labor Code,for the performance of the work for which this California Health&Safety Cade,Sections 25505,25533,and 25534.1 will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
�. 1 certify that in the performance of the work for which this permit is issued,I Health&Safety Code,&rtim,25532(.)shurdle should I store m• hazardous
shall not employ any person in any manner so as to become subject to the mMoid.l.Additionally,should I use equipment or devices which emit hazardous
ah•contaminants as defined by the Day Area Air Quality Management District I
Worker's Compensation laws of Ccliforairt.If,ager making this cenificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions o£tlie the health&Safety Code,Sections 25505,illl3,.,of 25534.
Labor Codd,I must forthwith comply with such provisions or this permit shall
be deemed revoked, Owner or authorized agent:
APPLICANT CERTIFICATION Date:88-2-2018 FA2�
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.)
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 ron-point source regulations per the Cupertino Municipal ARCHI'fEC'f'S DECLARATION
Code,Section 9.18. 1 understand my plans shall be used as public records.
SignatureDate 8-2.2016 Licensed
Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2018-1286
10210 ALPINE DR CUPERTINO, CA 95014-0945 (326 15 026) MICHAEL MC KINZIE
CONSTRUCTION
MORGAN HILL, CA
95037
OWNER'S NAME: DATE ISSUED: 08/02/2018
OWNER'S PHONE: PHONE NO: (669) 888-3800
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic. #729119
Contractor MICHAEL MC KINZIE CONSTRUCTION Date 09/30/2018 X BLDG — 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:
REPLACE GUARD RAILS ONLY ON EXTERIOR DECD. - (275 LF)
I hereby affirm under penalty of perjury one of the following two declarations: REV# 1 - DEMOLISH (33 L.F.) (E) DECK, REPLACE PIER & POST
1. I have and will maintain a certificate of consent to self-insure for Worker's REMOVE AND REPLACE REAR EXTERIOR STAIRS - SAME
Compensation, as provided for by Section 3700 of the Labor Code, for the LOCATION - ISSUED 09/10/2018
performance of the work for which this permit is issued. REV # 2 - REVISE PLANS TO SHOW (1) BEAM AND DELETE NOT
2. I have and will maintain Worker's Compensation Insurance, as provided for by NEEDED 2ND BEAM - ISSUED 10/16/2018
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. Sq. Ft Floor Area: Valuation: $39000.00
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 26 Number: Occupancy Type:
326
and state laws relating to building construction, and hereby authorize 3 15 026
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
Date: 08/02/2018
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)
2. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project (See.7044, Business & Professions Code). Date: 10/16/2018
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 2551, 5, 25533, and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revolted,
Owner or authorized agent:
APPLICANT CERTIFICATION Date: 10/16/2018
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. I understand my plans shall be used as public records.
Signature Date 10/16/2018 Licensed
Professional