B-2017-1547 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR; PERMIT NO:B-2017-1547
18634 LOREE AVE CUPERTINO,CA 95014-3838(375 25 071) GIULIANI
CONSTRUCTION AND
RESTORATIO
ER'S NAME:NUKALA SRINIVASA N AND EMANI SRILAKSI-IMI :08/08/2018
OWNER'S PHONE: PHONE NO:(408)452.8700
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#609914
Contractor GI ULAN CONSTRUCTION AND RESTORATION INC Date X BLDG—ELECT—PLUMB
10/31/2018 MECH X RESIDENTIAL_COMMERCIAL
I hereby affirm thut I am licensed render the provisions of Chapter 9(commencing
with Section 7000)of Division 3 of the Business&Professions Code and that my JOB DESCRIPTION:
license is in full foie and effect. FIRE DAMAGE-REPLACE WINDOWS,ROOFING,2X4 FRAMING,
REPLACE INSULATION
I hereby affirm under penalty of perjury one of the following two declarations: CLEAR CODE CASE;LEGALIZE CONVERSION OF 2 BEDROOMS
u I leave and will maintain a certificate of consent to self-insure for Worker's TO ONE WITH FULL BATI-I;REMOVE UN-PERMITTED WORK AT 3
Compensation,as provided for by Section 3700 of the Labor Code,for the LOCATIONS-
performance of the work For which this permit is issued,
have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of hie Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$30000.00
permit is issued,
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above APN Number: Occupancy Type:
information is correct.I agree to comply with all city and county ordinances 37525 071
and state 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 PERMIT EXPIRES IF WORK IS NOT STARTED
City of Cupertino against liabilities,judgments,costs,and expenses which WITHIN 180 DAYS OF PERMIT ISSUANCE OR
may accrue against said City In consequence of the granting of this permit.
Additionally,the applicant understands and will comply with all non-poin AYS FROM LAST CALLED INSPECTION.
source regulations per the Cupertino Municipal Code,Section 9.18.
Issued by:Jasmine Archbold
Signature Date 08/!08/2018 Date:08/08/2018
OWNER-BUILDER DECLARATION
RE-ROOFS• -
I hereby affirm that I am exempt from,the Contractor's License Law far one of the All roofs shall be inspected prior to any roofing material being installed.If a roof is
following two reasons: installed without first obtaining an inspection,1 agree to remove all new materials for
r. 1,as owner of the property,ar my employees with wages as their sole inspection.
compensutien,will do the work,and the structure is not Intended or offered for
sale(Sec.7044,Business&Professions Code) Signature ofApplica.t:
z. I,as owner of the property,am exclusively contracting with licensed Date:08//08/2018
contractors to construct the project(See.7044,Business&Professions Code).
1 hereby affirm under penalty of perjury one of the following throe declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
u 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 HAZARDOUS MATERIALS DISCLOSURE
performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the
z. I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534.1 will
Section 3700 of the Labor Code,for the performauae of the work Por which this maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
permit is issued. Health&Safety Code,Section 25532(a)should I store or handle hazardous
s. I certify that in the performance.17th.work Cor which this permit is issued,I material.Additionally,should r use equipment or devices which emit hazordous
air conta
shall not employ any person in any manner so as to become subject to the minants.ns defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
Worker's Compensation laws o£California.If,after makingthis certificate of the Health&Safety Code,Sections 2550.5,25533,
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 Owner or authorized agent: -
be deemed revoked. Date:08110812018
APVLICANf CERTIFICATION CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is I hereby affirm that there Is a construction lending agency for the performance
correct.I agree to comply with all city and county ordinances and state laws of work's for which this permit is Issued(Sec.3097,Civ C,)
relating to building construction,and hereby authorize representatives of this city Lender's.Name
to enter upon the above mentioned property for Inspection purposes. (We)agree
to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address
judgments,costs,and expenses which may accrue against said City in
consequence of the granting of this permit.Additionally,the applicant understands ARCHITECT'S DEC
I.At2ATION
and will comply with all non-point source regulatlons per the Cupertino Municipal I understand my plans shall be used as public records.
Code,Section 9.18.
Licensed
Signature Date 08/!08/2018 Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-1547
18634 LOREE AVE CUPERTINO, CA 95014-3838 (375 25 071)
GIULIANI
CONSTRUCTION AND
RESTORATION INC
SAN JOSE, CA 95125
OWNER'S NAME:
DATE ISSUED: 08/08/2018
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class B Lic. # 06 9914
Contractor GIULIANI CONSTRUCTION AND RESTORATION INC Date
X BLDG —ELECT —PLUMB
MECH X RESIDENTIAL _ COMMERCIAL
10/31/2018
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
JOB DESCRIPTION:
license is in full force and effect.
FIRE DAMAGE - REPLACE WINDOWS, ROOFING, 2X4 FRAMING,
REPLACE INSULATION CLEAR CODE CASE; LEGALIZE
I hereby affirm under penalty of perjury one of the following two declarations:
CONVERSION OF 2 BEDROOMS TO ONE WITH FULL BATH;
t. I have and will maintain a certificate of consent to self -insure for Worker's
REMOVE UN -PERMITTED WORK AT 3 LOCATIONS -
Compensation, as provided for by Section 3700 of the Labor Code; for the
performance of the work for which this permit is issued.
REVISION #l: REVISE ROOF FRAMING PLAN AT LIVING ROOM
z. I have and will maintain Worker's Compensation Insurance, as provided for by
WITH 4X4'S. ISSUED 8.30.18
Section 3700 of the Labor Code, for the performance of the work for which this
Sq. Ft Floor Area:
Valuation: $30000.00
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
APN Number:
Occupancy Type:
information is correct. I agree to comply with all city and county ordinances
375 25 071
and state 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
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.
SignatureDate 8.30.18
Issued by: SEAN HATCH
Date: 08/08/2018
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
following two reasons:
installed without first obtaining an inspection, I agree to remove all new materials for
t. I, as owner of the property, or my employees with wages as their sole
inspection.
compensation, will do the work, and the structure is not intended or offered for
sale (Sec.7044, Business & Professions Code)
Signature of Applicant:
z. I, as owner of the property, am exclusively contracting with licensed
Date: 8.30.18
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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
HAZARDOUS MATERIALS DISCLOSURE
performance of the work for which this permit is issued.
z. 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
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
permit is issued.
Health & Safety Code, Section 25532(a) should I store or handle hazardous
s. I certify that in the performance of the work for which this permit is issued, I
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:'
Date: 8.30.18
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance
correct. I agree to comply with all city and county ordinances and state laws
of work's for which this permit is issued (Sec. 3097, Civ C.)
relating to building construction, and hereby authorize representatives of this city
Lender's Name
to enter upon the above mentioned property for inspection purposes. (We) agree
to save indemnify and keep harmless the City of Cupertino against liabilities,
Lender's Address
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understands
ARCHITECT'S DECLARATION
and will comply with all non -point source regulations per the Cupertino Municipal
I understand my plans shall be used as public records.
Code, Section 9.18.
Licensed
Signature Date 8,30, 18
Professional