D: R-2018-0308 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-0308
1258 S STELLING RD CUPERTINO,CA 95014-5257(366 11 109) BABEL
CONSTRUCTION
SAN JOSG,CA 95111
OWNEWSNAME: DATE ISSUED:08/06/2018
OWNER'S PLIONE: PHONE NO:(
LICENSED CONTRACT'OR'S DECLARATION BUILDING PERMIT INFO:
License Class a Llc,#2jIQ 63
Contractor BABEL CONSTRUCTION Date 02/28/2019 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 fall farce and effect. JOB DESCRIPTION:
1ST FLOORADDITION(1401 S.F.);GARAGEADDITION(113 S.F.);
I hereby affirm under penalty of perjury one ofthe following two declarations: REMODEL EXISTING RESIDENCE(1234 S.F.);(N)PORCH(37 S.F);
a. I have and will maintain a certificate of consent to self-insure for Worker's PANEL UPGRADE(400 AMPS);(N)FURNACE AND TANICLESS
Compensation,as provided for by Section 3700 of fire Labor Code,for the NATER HEATER.
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 the Labor Code,for the performance ofthe work for which this
permit is issued, Sq,Ft Floor Area:7514 Voluation:$500000.00
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: Oceupmtry Type:
and state laws relating to building construction,and hereby authorize 366 It 109 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
th
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.
SlgnatureT �' Date 08/06/2018 Issued by:Jasmine Archbold
Date:08/06/2018
OWNER-BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of the RF-ROOFS:
following two reasons: All root's shall be inspected prior to any roofing material horns insrslled,If a.of is
t, f,as owner ofthe property,or my employees with wages as their sole installed without first obtaining a',inspection,I agree to remove all new materials for
compensation,will do the work,and the structure is rot intended or offered for inspection.
sale(Sm.7044,Business&Professions Code)
z. 1,as owner ofthe property,am exclusively contracting with licensed Signature of Applicant:
contractors to canshuct the project(Sec.7044,Business&Professions Code), Date:08/06/2018
I hereby offirm tinder 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 selMosue,for Worker's
Compensatioa,as provided for by Section 3700 ofthe 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 under Chapter 6.95 of the
Section 3700 ofthe 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
s. 1 certify that in the performance orthe work for which this perraft is issued,I h Health&Safety Code,Section 25532(a)should I store an,handle hazardous
shall not employ n in an material.Additionally,should 1 use equipment or devices which emit hazardous
p y a y penton y manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District 1
Worker's Compensation laws of Cnli£ornia,fl',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 255313,..ad 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall _
be deemed revoked. Owner or authorized agent: ~-~—'--•--
APPLICANT CEW114FICATION Date:0 810 612 0 1 8
I certify that I have read this application and stale that the above information Is CONSTRUITT'
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.Addltlonally,the applicant understands
and will comply with all non-polnt source regulations per the Cupertino Municipal ARCHI'TECT'S DECLARATION
Code,Section 9.18, 1 understand my plans shall be used as public records.
Signature Date 08/06/2018 LIconsed
Professional