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B-2018-1086 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-1086 10280 SCENIC BLVD CUPERTINO,CA 95014-2726(357 08 045) ROCKWOOD CONSTRUCTION CORP SARATOGA,CA 95070 OWNER'S NAME: DATE ISSUED: 10/05/2018 OWNER'S PHONE: PHONE NO:(408)568-6474 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic.#685684 Contractor ROCKWOOD CONSTRUCTION CORP Date 04/30/2020 X BLDG X ELECT —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: I hereby affirm under penalty of perjury one of the following two declarations: CONSTRUCT(N)TWO STORY SINGLE FAMILY DWELLING(41253) SF •SF);ATTACHED GARAGE(472 SF);(2)PORCHES 293 ( );( 1. I have and will maintain a certificate of consent to self-insure for Workers BALCONIES(150 SF) Compensation,as provided for by Section 3700 of the Labor Code,for the REV#1 -RELOCATED EV CHARGING;(N)SUB-PANEL(100 AMP)IN performance of the work for which this permit is issued. GARAGE;(N)SUB-PANEL(200 AMP)IN LAUNDRY ROOM;REMOVE I have and will maintain Worker's Compensation Insurance,as provided for by EXTERIOR DOOR AT MUD ROOM;ATTIC ACCESS LOCATION; Section 3700 of the Labor Code,for the performance of the work for which this RELOCATE FURNACE IN ATTIC-ISSUED 6/21/19 permit is issued. DEF#1 -TRUSSES-ISSUED 4/2/2019 APPLICANT CERTIFICATION Sq.Ft Floor Area:4125 Valuation:$850000.00 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 357 08 045 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 Cupertin Municipal Signature - ate 6/21/19 Issued by:Jasmine Archbold OWNER-BUILDER DECLARATION Date: 10/05/2018 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 beinginstalled.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:6/21/19 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 Cupertino Municipal C de,Chapter 9.12 and be deemed revoked. the Health&Safety Code, 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:6/21/19CONSTRUCTIO relating to building construction,and hereby authorize representatives of this city N LE ING AGENCY 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 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.) Lenders 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 6/21/19 Licensed CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2018-1086 10280 SCENIC BLVD CUPERTINO, CA 95014-2726 (357 08 045) ROCKWOOD CONSTRUCTION CORP SARATOGA, CA 95070 OWNER'S NAME: DATE ISSUED: 10/05/2018 OWNER'S PHONE: PHONE NO: ( LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class A & B Lic. #685684 Contractor ROCKWOOD CONSTRUCTION CORP Date 04/30/2020 2{ BLDG —ELECT —PLUMB 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: CONSTRUCT (N) TWO STORY SINGLE FAMILY DWELLING (4125 I hereby affirm under penalty of perjury one of the following two declarations: SF); ATTACHED GARAGE (472 SF); (2) PORCHES (293 SF); (3) t. 1 have and will maintain a certificate of consent to self-insure for Worker's BALCONIES (150 SF) Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 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 permit is issued. Sq. Ft Floor Area: 4125 Valuation: $850000.00 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 357 08 045 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 understands and will comply with all non-point source regulations Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signaturz� Date 10/05/2018 Issued by: Jasmine Archbold Date: 10/05/2018 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: 10/05/2018 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 3. 1 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 Quality Management District I Worker's Compensation laws of California. If, after making this certificate of 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, Sections 25505, 25 33, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agen-f —— APPLICANT CERTIFICATION Date: 10/05/2018 - 1 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. Signature Date 10/05/2018 Licensed Professional CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-1086 10280 SCENIC BLVD CUPERTINO,CA 95014-2726(357 08 045) ROCKWOOD CONSTRUCTION CORP SARATOGA,CA 95070 OWNER'S NAME: DATE ISSUED: 10/05/2018 OWNER'S PHONE: PHONE NO:(408)568-6474 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B A Lic.#685684 Contractor ROCKWOOD CONSTRUCTION CORP Date 04/30/2020 X BLDG —ELECT —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: CONSTRUCT(N)TWO STORY SINGLE FAMILY DWELLING(4125 I hereby affirm under penalty of perjury one of the following two declarations: SF);ATTACHED GARAGE(472 SF);(2)PORCHES(293 SF);(3) 1. I have and will maintain a certificate of consent to self-insure for Worker's BALCONIES(150 SF) Compensation,as provided for by Section 3700 of the Labor Code,for the DEF#1 -TRUSSES-ISSUED 4/2/2019 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:4125 Valuation:$850000.00 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 57 Number: Occupancy Type: 357 and state laws relating to building construction,and hereby authorize 3 08 045 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 understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature ate 4-2-2019 Issued by:Jasmine Archbold Date: 10/05/2018 OWNER-BUILDER DECLARATION I hereby affirm that 1 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 rernove 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:4-2-2019 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 i. 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 Quality Management District I Worker's Compensation laws of California. If,after making this certificate of 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,Sections 25505,2 33,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revolted. Owner or authorized agent=.----. -. APPLICANT CERTIFICATION Date:4-2-2019 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. I understand my plans shall be used as public records. Licensed Signature Date 4-2-2019 Professional