B-2018-0231 (2) CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2018-0231
10407 LAS ONDAS WAY CUPERTINO, CA 95014-3107 (369 29 041) OPULENT BAY
HOMES INC
SAN JOSE, CA 95128
OWNER'S NAME:
BUILDING PERMIT INFO:
License Class a Lip. #lQ44055
Contractor OPULENT BAY HOMES INC Date 09/30/2020 X BLDG X ELECT X 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:
(N) 2ND FLOOR ADDITION (213 SF); (N)2ND FLOOR BALCONY (125
I hereby affirm under penalty of perjury one of the following two declarations: SF); (N) 1 ST FLOOR ADDITION (308 SF); (N) 1 ST FLOOR PORCH (118
1. I have and will maintain a certificate of consent to self-insure for Worker's SF); REMODEL KITCHEN (248 SF); REMODEL BATHROOMS (205
r� Compensation, as provided for by Section 3700 of the Labor Code, for the SF); REMODEL OTHER (1632 SF);
'; . performance of the work for which this per=mit is issued. PANEL UPGRADE (250 AMPS) SAME LOCATION; REPLACE WATER
2. I have and will maintain Worker's Compensation Insurance, as provided for by HEATER (SAME LOCATION), NEW HVAC SYSTEM, RE-ROOF;
Section 3700.of the Labor Code, for the performance of the work for which this TEAR-OFF; COMP SHINGLES (18 SQ)) `
permit is issued. DEF # 1 - TRUSS CALCS - ISSUED 10/9/18
APPLICANT CERTIFICATION Sq. Ft Floor Area: 513 Valuation: $211000.00
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
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 369 29 041 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 WORD IS NOT' STARTED
Additionally, the applicant understands and will comply with all non-point
source regulations perhe Cup rtino Municipal Code, Section 9.18. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
a.
11-19-2018
Sig 180 DAYS FROM LAST CALLED INSPECTION,
� �
Issued by: Jasmine Archbold
OWNER-BUILDER DECLARATION Date: 07/18/2018
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: 11-19-2018
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 ALL ROOF 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 Cuperti Municipal Code, Chapter 9.12 and
the Health & Safety
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. ARCHITECT'S DECLARATION
understand my plans shall be used as public records.
Signature Date 11-19-2018
Licensed
Professional