B-2017-0850 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-0850
10425 ALICIA CT CUPERTINO,CA 95014-2634(342 45 027) DI Ll CONSTRUCTION .
COMPANY INC
SARATOGA,CA,95970
OWNER'S NAME: LIU YAN AND ZHU JUN DATE ISSUED: 11/09/2017
OWNER'S PHONE: PHONE NO:(408)866-6238
•
•
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#678886
Contractor DI LI CONSTRUCTION COMPANY INC Date 01/31/2018 X 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:
MASTER BEDROOM ADDITION(425 S.F.);CONSTRUCT(N)PORCH
I hereby affirm under penalty of perjury one of the following two declarations: (220 S.F.);(N)DECK(150 S.F.)
i. 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
.p°""formance of the work for which this permit is issued.
'I have and will maintain Worker's Compensation Insurance,as provided for by •
`y,yo . Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$240000.00
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 342 45 027 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 CupertinoaMunicipCode,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
gnature \ ` Date 11/9/2017 Issued by:Abby Ayende
,
Date: 11/09/2017
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: 11 9/ /2017
I hereby affirm under penalty of perjury one of the following three declarations:
1. I h'ave1and will maintain'a Certificate of Consent to self-insure for Worker's ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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 noGemploy any person in any manner so as to become subject to the material. Additionally,should I use equipment or device's 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 25505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall Iit ,.-� r
•,
be'deemed revoked, ' a Owner or authorized agent:
�
I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY
correct.I,agree to comply withall 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 abovementioned'property for inspection purposes. (We)agree Lender's Name
to save Indemnify'end 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.
1 Signature Date 11/9/2017 Licensed
Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-0850
10425 ALICIA CT CUPERTINO,CA 95014-2634(342 45 027) DI LI CONSTRUCTION
COMPANY INC
SARATOGA,CA 95970
OWNER'S NAME:LIU YAN AND ZHU JUN DATE ISSUED:11/09/2017
OWNER'S PHONE: PHONE NO:(408)866-6238
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#678886
Contractor DI LI CONSTRUCTION COMPANY INC Date 01/31/2018 X BLDG X ELECT_PLUMB
1 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 fall force and effect. JOB DESCRIPTION:
MASTER BEDROOM ADDITION(425 S.F.);CONSTRUCT(N)PORCH
I hereby affirm under penalty of perjury one of the following two declarations: (220 S.F.);(N)DECK(150 S.F.)
r. I have and will maintain a certificate of consent to self-insure for Worker's REV#1-CHANGE FOUNDATION DESIGN-ISSUED 02/07/2018
Compensation,as provided for by Section 3700 of the Labor Code,for the REV#2-EXTEND IST FLOOR BEDROOM TO A MASTER
[✓ .performance of the work for which this permit is issued. BEDROOM;EXTEND BACK WALL-PULL OUT A FEW INCHES;
( z. I have and will maintain Worker's Compensation hisurn—,as to for by EXTEND ONE WINDOW TO AN ENTRANCE&DECK-SEE
Section 3700 of the Labor Code,for the performance of the work for which this INSPECTION NOTICE UPLOADED TO PDX-ISSUED 4/19/2018
.permit is issued. REV#3-UPGRADE PANEL(200 AMP)-ISSUED 06/07/2018
APPLICANT CERTIFICATION Sq.Ft Floor Are.: Valuation:$240000.00
1 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'rype:
representatives of this city to enter upon the above mentioned property for 34245 027 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 WORT{IS NOT STARTED
source regulations per the Cupertino Municipal Code,Section 9.18. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
06/07/2018 180 DAYS FROM LAST CALLED INSPECTION.
Date
OWNER-BUILDER DECLARATION Issued I/O/2017Abby ende
Date:11/09/2017
I hereby affirm first I am exempt from the Comracto's License Lmv for one of the
following two reasons: RE-ROOFS•
a. 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 nspection,I agree to remove all new materials for
sale(Sec.7044,Business&Professions Code) inspection.
z. I,as ownei of the property,am exclusively contracting with licensed
contractors to crash uct the project(Sec.7044,Business&Professions Code), Signature ofApplicane
1 hereby affirm under penalty of perjury one of the following three declarations: Date:06/07/2018
r. I have and will maintain a Certificate of Consent to self-insure for Worker's
Compensation,n 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.
z. 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 25534.1 will
s. I certify that in the perfernmove of the work for which this permit is issued,I maintain compliance with the Cupertino Municipal Code,Chapter 9.12 sad the
shall not employ any person in any manner so as to become subject to the u Health&Safety Code,Section 25532(x)should 1 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,l become subject to the Worker's Compensation provisions o£ther ertain!...(a 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 Code,Chapter 9.12 and
be deemed revoked. the Health&Safety Code,Sections 25505,25533,and 25534.
APPLICANT CERTIFICATION ��
I certify that I have read this application and state that the above information Is Owner authorized agent:
pp Date:066!/07/2018
correct.I agree to comply with all city and county ordinances and state laws CONSTRUCTION LENDING AGENCY
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 complywith all non-point source regulations per the Cupertino Municipal
Code,Section 9.18. ARCHITECT'S DECLARA'T'ION
I understand my plans shall be used as public records.
Signature Date 06/07/2018
Licensed
Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-0850
10425 ALICIA CT CUPERTINO,CA 95014-2634(342 45 027) DI LI CONSTRUCTION
COMPANY INC
SARATOGA,CA 95970
OWNER'S NAME: DATE ISSUED: 11/09/2017
OWNER'S PHONE: PHONE NO:(408)866-6238
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#678886
Contractor DI LI CONSTRUCTION COMPANY INC Date 01/31/2020 x BLDG X ELECT X 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:
MASTER BEDROOM ADDITION(425 S.F.);CONSTRUCT(N)PORCH
I hereby affirm under penalty of perjury one of the following two declarations: (220 S.F.);(N)DECK(150 S.F.)
1. I have and will maintain a certificate of consent to self-insure for Worker's REV#4-RELOCATE THE AC UNITS(2 TOTAL)AND CHANGE TO
Compensation,as provided for by Section 3700 of the Labor Code,for the TANKLESS WATER HEATER-ISSUED 6-17-2019
performance of the work for which this permit is issued. REV#1 -CHANGE FOUNDATION DESIGN-ISSUED 02/07/2018
I have and will maintain Worker's Compensation Insurance,as provided for by REV#2-EXTEND 1 ST FLOOR BEDROOM TO A MASTER
Section 3700 of the Labor Code,for the performance of the work for which this BEDROOM;EXTEND BACK WALL-PULL OUT A FEW INCHES;
permit is issued. EXTEND ONE WINDOW TO AN ENTRANCE&DECK-SEE
APPLICANT CERTIFICATION INSPECTION NOTICE UPLOADED TO PDX-ISSUED 4/19/2018
1 certify that I have read this application and state that the above REV#3-UPGRADE PANEL(200 AMP)-ISSUED 06/07/2018
information is 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 upon the above mentioned property for Sq.Ft Floor Area: Valuation:$240000.00
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. APN Number: Occupancy Type:
Additionally,the applicant understands and will comply with all non-point 342 45 027 R-3(Custom)
source regulations per the Cupertino Municipal Code,Section 9.18.
Signature
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
OWNER-BUILDER DECLARATION 180 DAYS FROM LAST CALLED INSPECTION.
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons: Issued by:Abby A,eY nde
1. I,as owner of the property,or my employees with wages as their sole Date: 11/09/2017
compensation,will do the work,and the structure is not intended or offered for
sale(Sec.7044,Business&Professions Code)
2. I,as owner of the property,am exclusively contracting with licensed RE-ROOFS:
contractors to construct the project(Sec.7044,Business&Professions Code). 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 under penalty of perjury one of the following three declarations: inspection.
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 Signature of Applicant:
performance of the work for which this permit is issued. Date:6-17-2019
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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
permit is issued.
3. I certify that in the performance of the work for which this permit is issued,I
shall not employ any person in any manner so as to become subject to the HAZARDOUS MATERIALS DISCLOSURE
Worker's Compensation laws of California. If,after making this certificate of I have read the hazardous materials requirements under Chapter 6.95 of the
exemption,I become subject to the Worker's Compensation provisions of the California Health&Safety Code,Sections 25505,25533,and 25534. I will
maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Labor Code,I must forthwith comply with such provisions or this permit shall Health&Safety Code,Section 25532(a)should I store or handle hazardous
be deemed revoked. material. Additionally,should I use equipment or devices which emit hazardous
APPLICANT CERTIFICATION air contaminants as defined by the Bay Area Air Quality Management District I
certify that I have read this application and state that the above information is will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
the Health&Safety Code,Sections 25505,25533,and 25534.
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 upon the above mentioned property for inspection purposes. (We)agree Owner or authorized agent:
to save indemnify and keep harmless the City of Cupertino against liabilities, Date:6-17-2019
judgments,costs,and expenses which may accrue against said City in CONSTRUCTION LENDING AGENCY
consequence of the granting of this permit. Additionally,the applicant understands I hereby affirm that there is a construction lending agency for the performance
and will comply with all non-point source regulations per the Cupertino Municipal of work's for which this permit is issued(Sec.3097, Civ C.)
Code,Section 9.18. Lender's Name
Lender's Address
Signature Date 6-17=2019
ARCHITECT'S DECLARATION