The URL can be used to link to this page

07120176 - BUILDING DIVISION PERMITi#Cil^ LtI,TRAC�TQRA10I2NTAT,`ION, PERMIT NO. BUIL111fy,QpRnjtFS�IOMESTEAD RD, BLDG 29A–L WEST BUILDERS, INC. 07120176 N RUS tNAUMEE: PERMIT ISSUE DATE VS :I:I A CALIFORNIA LIMITED 1608 4TH ST STE 120 07/11/2008 PHONEA;?'1'hT SANITARY NO, CONTROL NO. ARCHTECTENGiNEER: BUILDING PERMIT INFO REMODEL–NEW DECK RAILS, BLDG ELECT PLUMB MECH 0 0 0 0 30o LICENSED CONTRACTOR'S DECLARA7TON JobDescri tion YrC 1 hereby affirm that 1 am licensed under provisimm of Codd. 9 my Inceneing "^^^^ ""^'^^^ Description �W with Sceuanmcwti Oivisien3of de Business and Prafessium Cote.andmylccnmu ^ n m fall font and eRect p 3 n f.icenm Clan Llo.M 3 I S Cumulaaar w e 7WI ARCHITECrSDECLARATION y U I understand my plans shall w used as public¢cords g G h Licensed Professional 1 OWNER-BUILDER DECLARATION u �E I hereby aRrm Nat I em exempt from the Caouamors Lc=nse law for Ile zoo following o:ance.(Section 703 1.5,Business and Professions Code:Any city or county which requires a permit In cmmrucL eller.impur e.demolish.m¢pair any stsuctum zi prior he its issuance.than requires use applicant for such permit to file a signed shement < tNi he is licensed purmanua the pm eisi ms of de,ConuecmA Uhtn a Law(Chapter 9 Sq.Ft. Floor Area Valuation �3 (commencing with Seems 7000)of Division 3a17 the B.m.and pmfesuoCoo)or Nat he is exempt Huelrom and He buts for The alleged exemption.My vruiplaus of Section 7031.5 by any applicurt for.permit subjects the applicant m a civil penalty of APN Number Occupancy Type cot mare than fiwun hundred dollars(S500). P Y YP Q I,u Owner of the gvpmy,m my employers with ages u Ne'v sole eompewus. wiumlluwan.mdmeavaaamianatinlendedwonemdmrwe(Sm.ro ,Bu scar Required actions and Prefesdom Cade:The Commetars License Law does nut apply m an owner of e 9 P property who Wildaarhmpm sa Hereon.sod who doesauchwark himselforthrough his own emplay es,pronded that such impro emenu art stimended croRmed fsstle.IL however,the Wilding or impo mmant is mid within one year of completion.the owner. builder will haw the burden of proving TNI M did out build or improve for puryex of sale.). Q 1.u caner of the property,am excluuwly canuacting with Iittved snu.non In cmmmmi the projm(Sec.70th,Business and Profesdou Code)The Caouacmrs U. «me Law does not apply In an Owner of propeny,who builds or impor m Hereon,and who conuacu for such project whH a snuaemr(s)licensed p..,m the Contractors L e"m law. ❑1 am exempt under Sec. .B&P C for His moon Data Oner WORKER'S COMPENSATION DECLARATION 1 hereby air=under penalty,of pmjuty os of ge fallowing deciarations: ❑I Nwand will ounuina Certifcauof Cans=ntmxlf-insureforwadreraCompen- sauon.u provided fell by section 3700 of ite Lubar Code,for the performan a of tae work for which this permit is issued. Q I haw and will maintain Workers Compeuafis Inpuance,as mgcirW by section 371)0 ofthc Labor Coo,for the performutce ofthe wool,for which this permit is leaned. My Workers C1y�o,m��p`e��nsalsia�n Wuunce curia and Policy number am: Cartier: SlaalwA- rl/A''gj PoBry No.: b I Sfls� CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (rmsectis need mtwcompleedlithe permit laforonc hundred dollars(SIM) - or kssl 1 certify Nat in He Inalmmnmen of the work for which His permit u issued,l al Out employ any Owren in any manners as m become subject to the WorkewchropeaWk, laws of California.Dam Applicant NOTICE TO APPLICANT:If,aper making this Cenifnm of Emmpuon.you umuld bcemne subjm m the Waiters Comperwtien previsions of the Labor Cndt you most .,O forthwith comply with such providau M Hu permit shall w deemed rowelled. Zy CONSTRUCTION LENDING AGENCY P: I Nmb)'arm Hal Hem u a coruwcd.st ending agency far the performanceof - a .�. the work fe,which this permit is issued(Sec.3097.Civ.e) W Lenora Name z Lenders Address U O I usury the 1 N I mad this application and mm dm dm aww lofosauon in - IL - comcL 1 agree In c=P1Y with all city and county ordinances and sue tan minting to O building construction.and hereby mthuire mp wancmw of his city in mmrupon to y .cave-menuoned property for..erel puryoms (Wc)aerie m saw,immonufy and k¢p Inrrolead tae City of Cupertino against Zc,i in consequence of h,&coming expuueeonit. may in anYnymse against said City U ,Z in conmgucnce of the granting of His pmmit ^n APPLICANT DERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 1icaar Dkc HVConm US MATERIALS DISCLOSURE Type of Roof Wel Oeappihamor fuuuebuilding occuparmslomuro le haordousmamriai as defined by the Cupenino Municipal Code,Chapter 9.11.and He Health and Safety 40 de.Section 155324)? ❑Yet )6�Na All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future wilding occupant use equipment or,dedem which If a roof is installed without first obtaining an inspection,I agree to remove e0mallhuardoes air mountainous u defined by the Bay Area Air Quality Management all new materials for inspection. Q Yrs )kNa 1 hew read the hmeardtu ro mriaus requircrostunder Chapua695 ofde Califor. his Health&SafmyCada Smimm U5 1.25533 and 15534.1 mod rr..W thnifue wilding don ret WOO — All roof coverings to be Class'%."or better CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20800 HOMESTEAD RD BLDG 29A-L CONTRACTOR: WEST BUILDERS, INC. PERMIT NO: 09080056 OWNER'S NAME: VILLA SERRA APTS A CA LTD PAR"i N 1608 4TH ST STE 120 DATE ISSUED: 08/19/2009 OWNER'S PHONE: 6509313457 BERKELEY, CA 94710 PHONE NO: (510) 525-9378 ❑ LICENSED CONTRACTOR'S DECLARATION r r r BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class 1�1 Lic.N �5�� r r r y R� MECH RESIDENTIAL COMMERCIAL Contractor W � Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: REVISION UTILITY CLOSET (commencing with Section 7000) of Division 3 of the Business & Professions ORIGINAL 07120I76 Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: 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 Sq. Ft Floor Area: Valuation: $2500 performance of the work for which this permit is issued. 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. APN Number: 32609056.29AL Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. l agree to comply:,A ith all city and county ordinances and state laws relating PERMIT EXPIRES IF WORK IS NOT STARTED to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities, judgments, 180 DAYS FROM LAST CALLED INSPECTION. 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 source regulations per the Cupertino Municipal Code, Section Issued by: Date: 9.18. 4 Signature Date O 'Z-( RE-ROOFS: ❑ OWNER-BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, Signature of Applicant: Date: will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain Compensation, as provided for by Section 3700 of the Labor Code, for the compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & performance of the work for which this permit is issued. Safety Code, Section 25532(a) should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance, as provided for by Additionally, should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code, for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the permit is issued. Health & Safety Code, Sections 25505, 25533, and 25534. 1 certify that in the performance of the work for which this pennit is issued, I shall ! not employ any person in any manner so as to become subject to the Worker's agent: C Compensation laws of California. If, after making this certificate of exemption, I —Date: Y ' become subject to the Worker's Compensation provisions of the Labor Code, 1 must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION for which this permit is issued (Sec. 3097, Civ C.) I certify that I have read this application and state that the above information is Lender's Name 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 Lender's Address upon the above mentioned property for inspection purposes. (We) agree to save indemnity and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the — granting of this permit. Additionally, the applicant understands and will comply I understand my plans shall be used as public records. with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. Licensed Professional Signature Date_