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CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1387
10521 STOKES AVE CUPERTINO,CA 95014-1234(32648034) ALPS CONSTRUCTION
&REMODELING INC
S NAME: DAYAL MANiSI-I AND CHANDRA SHALI E ISSUED:W/
WNER'S PHONE:408-398-2446 PHONE NO:(408)4440967
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Liu.9909433 X BLDG X ELECT_PLUMB
Contractor AI I'S CONSTRUCTION&REMODELING INC Date 01/31/2020
I hereby affirm that I am licensed under the provisions of Chapter 9(commencingX MECH X RESIDENTIAL COMMERCIAL
with Section 7000)of Division 3 or'the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
REV41-CONVERSION OF COVERED BALCONY PER APPROVED
I hereby offirm under penalty of perjury one of the following two declarations: PLANS TO NOW CONDITIONED SPACE-
r, I have and will maintain a certificate of consent to self-insure for Worker's (N)IST STORY ADDITION(247 SQ FT);(N)PORCH(26 SQ FT);(N)
Compensation,as provided for by Section 3700 of the Labor Code,for the 2ND STORY ADDITION(761 SQ FT)WITH BALCONY(65 SQ FT);
performance of the work for which this permit is issued. REMODEL OTHER(670 S.F.);REMODEL BATHROOM(151 S,F.);
'[gave and will maintain Worker's Compensation hannionce,as provided for by REMODEL KITCHEN(179 S.F.);PANEL UPGRADE(200 AMP);
V"- Section 3700.f the Labor Code,for the performance of the work for which this RELOCATE FURNACE IN ATTIC;RE-ROOF(1700 S.F,);FULLY
permit is issued. SPRINKLER BLDG;DEMOLISH SHED AND HOT TUB,
APPLICANT CERTIFICATION Sq.Ft Floor Area:1008 Vnluattun:$300000.00
1 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
and slate laws relating to building construction,and hereby authorize APN Number: Occupancy Type:
representatives of this city to enter upon the above mentioned property for 32648 034 R-3(Custom)
inspection purposes.(We)agree to save Indemnify and keep harmless the
City of Cupertino against liabilities,judgments,costs,and expenses which
may accrue against said City In consequence of the granting of this permit. PERMIT EXPIRES IF WORK IS NOT STARTED
Additionally,the applicant understands and will comply with all non-point
source regulations per the Cupertino Municipal Code,Section 9.18. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 08-20-2018
Issued by:Abby¥de
OWNER-BUILDER DECLARATION Date:01/19/2018
I hereby affirm that I am exempt from the Contractri License Law for one of the
following two reasons: RE-ROOFS:
r. I,as owner of the property,or my employees with wages as their sole All roofs shall be inspected In to any roofing material being installed.Ira roof is
compensation,will do the work,and the structure is not intended or offered for installed without first obtaining au inspection,I agree to remove all new materials for
sale(Sec.7044,Business&Professions Code) inspection.
z. I,as owner of the pmpcay,am exclusively contracting with licensed
contractors to construct the project(Sm.7044,Business&Professions Code). Signature of Applicant
I hereby affirm under penalty of perjury one of Che fallowing three declarations: Date:08-20-2018
1. I have and will maintain a Certificate of Consein to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the ALL 1200E COVERINGS TO BE CLASS"A"OR BETTER
performance of the work for which[Iris permit is issued.
z. 1 have and will maintain Worker's Compensation Insurance,as provided for by HAZARDOUS MATERIALS DISCLOSURE
Section 3700 of the Labor Code,for the performance of the work for which this I have read the hazardous materials requirements under Chapter 6.95 of the
permit is issued. California Health&Safety Code,Sections 25505,25533,mrd 25534.1 will
I. I certify that in the performance of the work forwhich this permit is issued,I maintain emmplir—with the Cupertino Municipal Code,Chapter 9.12 and the
shall not employ any person in any manner so as to become subject to the Health&Solely Code,Section 25532(x)should I store or handle hazordnna
Worker's Compensation laws of California.If,after making this certificate o£ material.Additionally,si m ld I use equipment or devices which emit hazardous
exemption,I becoure subject to the Worker's Compensation provisions of the air contaminants as defined by the Bay Area Alr Quality Management District 1
Labor Code,I mint forthwith comply with such provisions or this permit shall `III maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
be deemed revoked. the Health&Safety Code,Sections 25505,25533,and 25534.
APPLICANT CERTIFICATION Owner 8-authorized agent:��
I certify that I have read this application and state that the above Information is Date:08-20-2018
correct.I agree to comply with all city and county ordinances and state laws CONSTRUCTION LI INC AGENCY
relating to building construction,and hereby authorize representatives of this city I hereby affirm that there is a construction lending agency for the performance
to enter upon the above mentioned property for inspection purposes. (We)agree of work's for which this permit is issued(Sec.3097,Civ C.)
to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Name
Judgments,costs,and expenses which may accrue against said City in
consequence of the granting of this permit.Additionally,the applicant understands Lender's Address
and will comply with all non-point source regulations per the Cupertino Municipal
Code,Section 9.18. ARCHI'TECT'S DECLARATION
I understand my plans shall be used as public records.
Signature Date 08-20-2018
Llcensed
Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1387
10521 STOKES AVE CUPERTINO,CA 95014-1234(326 48 034) ALI'S CONSTRUCTION
&REMODEL
CA 95129
OWNER'S NAME: DAYAL MANISH AND CHANDRA SHALINI DATE ISSUED:01/19/2018
OWNER'S PHONE: PHONE NO:(408)441-0967
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#909433
ContractorALI'S CONSTRUCTION&REMODELING INC Date 01/31/2020 X BLDG X 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:
REV#1-CONVERSION OF COVERED BALCONY PER APPROVED
I hereby affirm under penalty of perjury one of the following two declarations: PLANS TO NOW CONDITIONED SPACE-ISSUED 8/31/18
r. I have and will maintain a certificate of consent to self-insure for Worker's (N)1 ST STORY ADDITION(247 SQ FT);(N)PORCH(26 SQ FT);(N)
Compensation,as provided for by Section 3700 of the Labor Code,for the 2ND STORY ADDITION(761 SQ FT)WITH BALCONY(65 SQ FT);
performance of the work for which this permit is issued. REMODEL OTHER(670 S.F.);REMODEL BATHROOM(151 S.F.);
2. I have and will maintain Worker's Compensation Insurance,as provided for by REMODEL KITCHEN(179 S.F.);PANEL UPGRADE(200 AMP);
Section 3700 of the Labor Code,for the performance of the work for which this RELOCATE FURNACE IN ATTIC;RE-ROOF(1700 S.F.);FULLY
permit is issued. SPRINKLER BLDG;DEMOLISH SHED AND HOT B.
APPLICANT CERTIFICATION Sq.Ft Floor Area: 1008 Valuation:$300000.00
1 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
and state laws relating to building construction,and hereby authorize APN Number: Occupancy Type:
representatives of this city to enter upon the above mentioned property for 326 48 034 R-3(Custom)
inspection purposes. (We)agree to save indemnify and keep harmless the
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 applicant understands and will comply with all non-point PERMIT EXPIRES IF WORK IS NOT STARTED
source regulations per the Cupertino Municipal Code,Section 9.18. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
�
fp 180 DAYS FROM LAST CALLED INSPECTION.
,,
Signature 4 Ve;� Date 08/31/18
Issued by:Abby Ayende
OWNER-BUILDER DECLARAIION Date:01/19/2018
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons: RE-ROOFS:
1. I,as owner of the property,or my employees with wages as their sole All roofs shall be inspected prior to any roofing material being installed.If a roof is
compensation,will do the work,and the structure is not intended or offered for installed without first obtaining an inspection,I agree to remove all new materials for
sale(Sec.7044,Business&Professions Code) inspection.
2. I,as owner of the property,am exclusively contracting with licensed
contractors to construct the project(Sec.7044,Business&Professions Code). Signature of Applicant:
I hereby affirm under penalty of perjury one of the following three declarations: Date:08/31/18
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 F COVERINGS TO BE CLASS"A"OR BETTER
performance of the work for which this permit is issued.
2. I have and will maintain Worker's Compensation Insurance,as provided for by HAZARDOUS MATERIALS DISCLOSURE
Section 3700 of the Labor Code,for the performance of the work for which this I have read the hazardous materials requirements under Chapter 6.95 of the
permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will
3. I certify that in the performance of the work for which this permit is issued,I maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
shall not employ any person in any manner so as to become subject to the Health&Safety Code,Section 25532(a)should I store or handle hazardous
Worker's Compensation laws of California. If,after making this certificate of material. Additionally,should I use equipment or devices which emit hazardous
exemption,I become subject to the Worker's Compensation provisions of the air contaminants as defined by the Bay Area Air Quality Management District I
Labor Code,I must forthwith comply with such provisions or this permit shall will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
be deemed revoked. the Health&Safety Code,Sections 25505,25533,,and 25534.
APPLICANT CERTIFICATION Owner or authorized agent: �V`„'
I certify that I have read this application and state that the above information is Date:08/31/18
correct.I agree to comply with all city and county ordinances and state laws CONSTRUCTION LENDING AGENCY
relating to building construction,and hereby authorize representatives of this city y affirm that there is a construction lending agency for the performance
to enter upon the above mentioned property for inspection purposes. (We)agree of work's for which this permit is issued(Sec.3097,Civ C.)
to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Name
judgments,costs,and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally,the applicant understands Lender's Address
and will comply with all non-point source regulations per the Cupertino Municipal
Code,Section 9.18. ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Signature Date 08/31/18
Licensed
Professional