B-2018-1325 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-1325
10850 E ESTATES DR CUPERTINO,CA 95014-4534(369 22 005) VARGAS
CONSTRUCTION
BRENTWOOD,CA
94513
OWNER'S NAME: DATE ISSUED:02/04/2019
OWNER'S PHONE: PHONE NO:(925)437-9468
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#589216
Contractor VARGAS CONSTRUCTION Date 02/29/2020 X BLDG —ELECT X PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing 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:
ADDITION OF(N)DINING,ENTRY,LAUNDRY AREAS-(256 SF);
I hereby affirm under penalty of perjury one of the following two declarations: (N)2-CAR GARAGE-(526 SF);REMODEL KITCHEN-( 154);
1. I have and will maintain a certificate of consent to self-insure for Worker's REMODEL OTHER-(706 SF);NEW WATER HEATER
is issued. Sq.Ft Floor Area:256 Valuation:$250000.00
APPLICANT CERTIFICATION
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 369 Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 369 22 005 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 nsequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant andpstands and will comply with all non-point
source regulations p4 on 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 4-19-2019 Issued by: Kim Dunbar
Date: 02/04/2019
OWNER-BUILDER DECLA" J ION
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 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)
i. 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:4-19-2019
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
Code
3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Section 25532(a)should I Zices
�a or handle hazardous
material. Additionally should I use equipment or which emit hazardous
shall not employ any person in any manner so as to become subject to the r'
air contaminants as defined by the Bay Area Aid uu,aality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino i�cipaI Co a ter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agent:
APPLICANT CERTIFICATION Date:4-19-2019 �-
I certify that I have read this application and state that the above information is CONSTRUCTION LENDI c "GENCY
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
Ito 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. I understand my plans shall be used as public records.
Licensed
Signature Date 4-19-2019 Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-1325
10850 E ESTATES DR CUPERTINO,CA 95014-4534(369 22 005) VARGAS
CONSTRUCTION
, 664 RED ROME LANE
BRENTWOOD,CA
94513
OWNER'S NAME: DATE ISSUED:02/04/2019
OWNER'S PHONE: PHONE NO:None
LICENSEDCONTRACTOR'S D Cr ARnTION BUILDING PERMIT INFO:
'License Class B Lie.#589216 ,
Contractor VARGAS CONSTRUCTION Date 02/29/2020 X BLDG _ELECT X PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing —MECH X RESIDENTIAL—COMMERCIAL
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in f l'force and effect. JOB DESCRIPTION:
ADDITION OF(N)DINING,ENTRY,LAUNDRY AREAS-(256 SF);
I here y ffirm under penalty of perjury one of the following two declarations: (N)2-CAR GARAGE (526 SF);REMODEL KITCHEN-(154);
have and will maintain a certificate of consent to self-insure for Worker's REMODEL OTHER-(706 SF);NEW WATER HEATER
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued.
permit is issued.
Sq.Ft Floor Area:256 Valuation:$250000.00
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 369 22 005 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,i consequence of the granting of this permit.
Additionally,the applicant12-rstands and will comply with all non-point WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source regulations pert r ape '.. Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Date:02/04/2019
OWNER-BUILDER DECL'RSP •N
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
i. 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:2-4-2019
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
t. 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
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 o :ndle hazardous
shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devic•.+rch emit hazardous
air contaminants as defined by the Bay Area Air Q anagement District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino i ci-t`Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,
APPLICANT CERTIFICATION Date:2-4-2019
I certify that I have read this application and state that the above information is N TR TI N LENDIN A °N Y
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending .ge - or the performance
relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.309-, iv 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. I understand my plans shall be used as public records.
Licensed
Signature Date 2-4-2019