B-2018-0655 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-0655
11147 LINDA VISTA DR CUPERTINO,CA 95014-4754(356 26 018) A TO Z QUALITY
CONSTRUCTION
CAMPBELL,CA 95008
OWNER'S NAME: DATE ISSUED:08/31/2018
OWNER'S PHONE: PHONE NO:(
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.# 01 31149
Contractor A TO Z QUALITY CONSTRUCTION Date 09/30/2019 X BLDG —ELECT _PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing X 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:
BEDROOM AND ENTRANCE ADDITION(399 S.F.);(N)FRONT
I hereby affirm under penalty of perjury one of the following two declarations: PORCH(70 S.F.);KITCHEN REMODEL(202 S.F.);BATHROOM
1. I have and will maintain a certificate of consent to self-insure for Worker's REMODEL(146 S.F.);REMODEL OTHER(897 S.F.);RE-STUCCO
Compensation,as provided for by Section 3700 of the Labor Code,for the (380 S.F.);NEW HVAC/FURNACE
performance of the work for which this permit is issued.
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:399 Valuation:$226500.00
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 356 26 018 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. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant under n and will comply with all non-point
source regulatio er t Cu ino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 08/31/2018 Issued by:Haley McKee
Date:08/31/2018
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)
2. 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:08/31/2018
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
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
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
s. 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 uality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupe o nicipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,S n 505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agen .
APPLICANT CERTIFICATION Date:08/31/2018
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 08/31/2018 Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2018-0655
11147 LINDA VISTA DR CUPERTINO, CA 95014-4754 (356 26 018) A TO Z QUALITY
CONSTRUCTION
CAMPBELL., CA 95008
OWNER'S NAME: DATE ISSUED: 08/31/2018
OWNER'S PHONE: PHONE NO: (408) 590-2783
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class GENERAL BUILDING CONTRACTOR Lic. #1031149
Contractor A TO Z QUALITY CONSTRUCTION Date 09/30/2019 X BLDG _ ELECT — PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing X 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:
BEDROOM AND ENTRANCE ADDITION (3 99 S.F.) (N) FRONT
I hereby affirm under penalty of perjury one of the following two declarations: PORCH ( 70 S.F.); KITCHEN REMODEL (202 S.F.); BATHROOM
have and will maintain Worker's Compensation Insurance, as provided for by 10/24/2018
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. Sq. Ft Floor Area: 399 Valuation: $226500.00
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 56 Number: Occupancy Type:
3
and state laws relating to building construction, and hereby authorize 356 26 018 R-3 (Custom)
representatives of this city to enter upon the above mentioned property for
inspection purposes. (We). agree to save indemnify acid keep harmless the
City of Cupertino agains,t. liabilities, judg nts, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED .
may accrue against s lld City in conseq once of the granting of this permit.
Additionally, the applicant understa�n4A,and will comply with all non-point WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source regulatio'p) per the uper r �� nicipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
�°� Date 10/24/2018 Issued by: Haley McKee
Date: 08/31/2018
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 ower 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: 10/24/2018
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 pen-nit 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 ualit Management District I
Worker's Compensation laws of California. If, after making this certificate of & yana g
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, Seegons 5505 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: 10/24/2018 �
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 10/24/2018 Professional
CIT° ' OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2018-0655
11147 LINDA VISTA DR CUPERTINO, CA 95014-4754 (356 26 018) A TO Z QUALITY
CONSTRUCTION
CAMPBELL, CA 95008
OWNER'S NAME: DATE ISSUED: 08/31/2018
OWNER'S PHONE: PHONE NO; (408) 590-2783
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT I.NFO:
License Class B Lic. #1031149
Contractor A TO Z QUALITY CONSTRUCTION Date 09/30/2019 X BLDG X ELECT _ PLUMB
X MECH X RESIDENTIAL COMMERCIAL
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
license is in full force and effect. JOB DESCRIPTION:
BEDROOM AND ENTRANCE ADDITION (3 99 S.F.); (N) FRONT
I hereby affirm under penalty of perjury one of the following two declarations.: PORCH ( 70 S.F.); KITCHEN REMODEL (202 S.F.); BATHROOM
1. I have and will maintain a certificate of consent to self-insure for Worker's REMODEL (146 S.F.); REMODEL OTHER ( 897 S.F.); RE-STUCCO
Compensation, as provided for by Section 3700 of the Labor Code, for the ( 3 80 S.F.); NEW HVAC/ FURNACE
performance of the work for which this permit is issued. REV#1 CHANGE HARDY FRAME TO 12' SHEAR WALL - ISSUED
have and will maintain Worker's Compensation. Insurance, as provided for by 10/24/2018
Section 3700 of the Labor Code, for the performance of the work for which this REV#2 - RELOCATE AC AND FURNACE; RELOCATE SKYLIGHT;
permit is issued. RELOCATE PLUMBING IN MASTER BATHROOM AND POWDER
APPLICANT CERTIFICATION ROOM; UPGRADE MAIN PANEL - (200 AMP) -ISSUED 12-06-2018
1 certify that I have read this application and state that the above Sq. Ft Floor Area: 399 Valuation: $226500.00
information is correct. I agree to comply with all city and county ordinances
and state laws .relating to. building construction, and hereby authorize
representatives of this city to enter upon the above mentioned property for APN Number: Occupancy Type:
inspection purposes. (We) agree to save indemnify and keep harmless the 356 26 018 R-3 (Custom)
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 applica t under tands and will comply with all non-point
source regulation per e Cu 6rtino Municipal Code, Section 9.18. PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Signature - Date 12-06-2018 180 DAYS FROM LAST CALLED INSPECTION.
OWNER-BUILDER DECLARATION Issued by: Haley McKee
I hereby affirm that I am exempt from the Contractor's License Law for one of the Date: 08/31/2018
following two reasons:
1. I, as owner of the property, or my employees with wages as their sole RE-ROOFS:
compensation, will do the work, and the structure is not intended or offered for All roofs shall be inspected prior to any roofing material being installed. If a roof is
sale (Sec.7044, Business & Professions Code) installed without first obtaining an inspection, I agree to remove all new materials for
2. I, as owner of the property, am exclusively contracting with licensed inspection.
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations: Signature of Applicant:
1. I have and will maintain. a Certificate of Consent to self-insure for Worker's Date: 12-06-2018
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued. ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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 HAZARDOUS MATERIALS DISCLOSURE
perinit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the
3. I certify that in the performance.of the work for which this permit is issued, I California Health & Safety Code, Sections 25505, 25533, and 25534. I will
shall not employ any person in any manner so as to become subject to the maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Worker's Compensation laws of California.. If, after making this certificate of Health & Safety Code, Section 25532(a) should I store or handle hazardous
exemption, I become subject to the Worker's Compensation provisions of the material. Additionally, should I use equipment or devices which emit hazardous
Labor Code, I must forthwith comply with such provisions or this permit shall air contaminants as defined by the Bay Area Air Quality Management District I
be deemed revoked. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sec ions 25 , 25533, and 25534.
APPLICANT CERTIFICATION
certify that I have read this application and state that the above information is Owner or authorized agent:
/
correct. I agree to comply with all city and county ordinances and state laws Date: 12-06-2018
relating to building construction, and hereby authorize representatives of this city CONSTRUCTION LENDING AGENCY
to enter upon the above mentioned property for inspection purposes. (We) agree I hereby affirm that there is a construction lending agency for the performance
to save indemnify and keep harmless the City of Cupertino against liabilities, of work's for which this permit is issued (Sec. 3097, Civ C.)
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understands Lender's Name
and will comply with all non-point source regulations per the Cupertino Municipal Lender's Address
Code, Section 9.18.
ARCHITECT'S DECLARATION
Signature Date 12-06-2018 1 understand my plans shall be used as public records.
Licensed