The URL can be used to link to this page

B-2018-1386 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-1386 7612 RAIN13OW DR CUPERTINO,CA 95014-5247(366 11 036). MIKE COUNSIL PLUMBING INC SAN JOSE,CA 95131 OWNER'S NAME: PHONE NO:(408)272-4900 LICENSED NSED CON ACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C36 Llc.4679261 Contractor MIKE COUNSIL PLUMBING INC Date 04/30/2019 X BLDG_ELECT X PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing —MECH$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 WATER LINE RISER WITH COPPER PIPES I 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. 1 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:$7000.00 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 Type: and state laws relating to building construction,and hereby authorize 366 11 036 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 Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 46/15/18 Issued by:SEAN HATCH Date:08/15/2018 OWNFR.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. 1,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), Data:08/15/18 - 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 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 Cade,for the performance of the work for which this Cahfornin 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 shall not employ any person in ally manner so as to become subject to the material.Additionally,should I use equipment or devices which emit hazardous Mir contaminants as defined by the Buy 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,Sec ions 25505,A5533,mrd 25534. Labor Code,I at forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date:08115118 I certify that I have read this application and state that the above Information Is CO STRUC--LENDiNGZENCY 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 08/16116 Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION is 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228• buildingncupertino.org PEMITNIi- l� A�� CUPERTINO REV M_ DEE9 ❑NEW CONSTRUCTION ❑ADDITION �`j ALTERATION❑T.I. ❑MEP ❑RE-ROOF ❑SWIMMING POOL/SPA PROJECT ADDRESSZ// - ��n� OWNER APN# - �� (�r E '!Yl' ,L P EE-MAIL STREHSA��3 A CITY,STATE,ZIP PQ CONTRACTOR NAME ❑OWNER-BUILDL'R COMPANYNAME C 01 Cn/`f, ILICENSE NUMBER G% LICENSE TYPE ST EET DDRE55 CITY,STA ZIP � 1:w- C.� �l-57 E-MAIL P ONE �Q La r011ClVPKV1 n .Cd K4 Ya 2,7Z- e, 7 3((�3ci ❑ARCHITECT []OWNER[]OWNER AGENT ❑CONTRACTOR AGENT[]ENGINEER[]DEVELOPER❑TENANT CONTACT NAME E-MAIL STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIP'1'ON 2tN 11 tvol,kZC fine, �'z5fW i A Ca eX' i .at, SINGLE-FAMILY/DUPLEX ❑MULTI-FAMTLY []INDUSTRIAL []COMMERCIAL r STING USE EXISTING SF NEWFI.00RSF PORCIi SF DECKSF DEMOSF S'1'ORIFS# TOTALNE'I'BF USE 'TYPE OCC SQ.FT. VALUATION($) REMODEL REMODCL KITCHEN REMODEL anTR GARAGE []ATTACKED BATHROOM SF SF SF Sr []DETACFIED EXISING C1 YES HICHLHR []YES SECOND STORY AUDITION []YES El []NO [I NO DWELLING SECONDDWELLING []YES[]ATTACHED[]DETACHED I OTHER UNITS# UNIT ADDITON: ONO SF []FIBERGLASS []VINYL-LINED []GUNITE []PREFABRICATED POOL-SF SPA-SF SPAATTACFIED[]YES []NO TOTALL-SF RECEIVED Y: #, 1(� TO'T'AL VALUATION, Couinmrcial or Multf-Frsn,fbr Huildulgs with Public Swirnrv�ir�Poalscpl_r�s�pmfE c it,[Hmlh nyyoanl I1VA`I/ M^ EXISTING ROOF TYPE: LJ BUILT-UP ROOF❑ASPHALT SI-[INGLES❑WOOD SHAKES OTHER (N� REMOVE/REPLACE n NO IF NOPLYWOOD ❑��" ❑3/8" PLYWOOD TYPE: PITCH: ROOF CLASS YES #OF LAYERS THICKNESS❑5/8" OTHER ❑OSB ❑CDX OTHER —'12 A PROPOSED ROOF TYPE:❑BUILT-UP ROOF []ASPHALT SHINGLES❑WOOD SHAKES[]WOOD SHINGLES[]OTHER *Provide a signed copy of the Cupertino's Tear-Off Policy SF #of 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 for inspection purposes. I so owledge and authorize all information contained on this application form to be made available for public record.I —1. ' Signature of Applicant/Agent: Date: U SUPPLEMENTAL INFORMATION REQUIRED 611 *New SPD/Second Dwelling Unite/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 is 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 BldgApp2017.doc revised 08/01117