B-2019-0278 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2019-0278
10541 LARRY WAY CUPERTINO,CA 95014-2034(316 02 019) CHANA
CONSTRUCTION INC
UNION CITY,CA 94587
OW—NER'S_NAME-- T-_,-4SS-UED:-05/20_11_1 0I9 --
OWNER'S PHONE: PHONE NO:(510)487-3254
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#554005
Contractor CHANA CONSTRUCTION INC Date 03/31/2021 X BLDG _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:
ONE STORY ADDITIONS(605 SF);KITCHEN REMODEL(160 SF);
I hereby affirm under penalty of perjury one of the following two declarations: BATHROOM REMODEL(40 SF);REMODEL OTHER(110 SF);REAR
1. I have and will maintain a certificate of consent to self-insure for Worker's COVERED PATIO(468 SF);FRONT COVERED PORCH(100 SF);
Compensation,as provided for by Section 3700 of the Labor Code,for the INSTALL NEW FURNACE IN ATTIC;NEW FRONT DOOR.
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:605 Valuation:$150000.00
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 Number: Occupancy Type:
316
and state laws relating to building construction,and hereby authorize 316 02 019 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 Date 5-29-2019 Issued by:Kim Dunbar
-- Date:05/29/2019
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
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)
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:5-29-2019
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
3. 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 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
Labor Code,I must forthwith comply with such provisions or this permit shall -
be deemed revoked. ,-�--�'
Owner or authorized agent:
APPLICANT CERTIFICATION Date:5-29-2019 `�-
I 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 works 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.
Signature Date 5-29-2019 Licensed
Professional
BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS:
OWNER'S NAME: Not provided
OWNER'S PHONE: Not Provided
CONTRACTOR:
CHANA CONSTRUCTION INC, PO BOX 2134 UNION CITY
CONTRACTOR PHONE:
DATE ISSUED 1/3/2020 10:57:29 AM
ISSUED BY: HALEYM
VALUATION: $150000
JOB DESCRIPTION
REMODEL (40 SF); REMODEL OTHER (110 SF); REAR COVERED PATIO (468 SF); FRONT COVERED PORCH (100
CONVERT SUN -ROOM INTO FAMILY ROOM (415 SF); ADD COVERED CEILING IN LIVING ROOM; REVISE SITTING
#1 - TRUSSES ISSUED 08/29/2019 DEVINDER CHANA REV # 2 - REVISE PLANS TO SHOW FIRE SPRINKLERS TO
WALLS AT BEDROOM #1 TO 9 FT IN LENGTH - ISSUED 1/3/20
ONE STORY ADDITIONS (605 SF); KITCHEN REMODEL (160 SF); BATHROOM
SF); INSTALL NEW FURNACE IN ATTIC; NEW FRONT DOOR. REV #1 -
ROOM LAYOUT (20 SF). ISSUED 08/29/2019 TO DEVINDER CHANA DEFERRED
BE INSTALLED; ADD 4 X 12 BEAM IN LIVING ROOM; REVISE (2) SHEAR
LICENSED CONTRACTOR DECLARATION
9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
CONTRACTOR:
CHANA
LICENSED
B GENERAL
LICENSED
554005
EXP
03/31/2021
I hereby
force
I hereby
CONSTRUCTION
CLASS:
BUILDING
NO:
DATE:
affirm
and effect.
affirm
I have and
for which
I have and
I certify that
with
INC
CONTRACTOR
that I am licensed under the provisions of Chapter
under penatiy of perjury one of the following three declarations:
will maintain a certificate of consent to self -insure for
this permit is issued.
will maintain Worker's Compensation Insurance, as provided
in the performance of the work for which this permit
laws of California. If, after making this certificate of exemption,
such provisions or this permit shall be deemed revoked.
Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the
work
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
is issued, I shall not employ any person in any manner so as to become subject to the Worker's
I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith
V
issued.
Compensation
comply
HAZARDOUS MATERIALS DISCLOSURE
& Safety
defined
this
6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance
I have read the hazardous materials requirements under Chapter
the Cupertino Municipal Code, Chapter 9.12 and the Health
V
with
equipment
Municipal
Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use
by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino
25505, 25533, and 25534.
project.
Firm Certification No:
or devices which emit hazardous air contaminants as
Code, Chapter 9.12 and the Health & Safety Code, Sections
An EPA Lead -Safe Certified Renovator will be responsible for
Firm Name:
No EPA Lead -Safe Certified Firm is required for this project.
Certified
v
CONSTRUCTION LENDING AGENCY
lending agency for the performance of the work which this permit is issued (Section 3097, Civil Code).
Lender's Address:
I hereby
Yes
affirm
under penalty of perjury that there is a construction
No
V
Lender's
Name:
APPLICATION CERTIFICATION
information
: