05030121JOO
SOU
:Gt"uQi
j U
°s
�q0
—Z`
0C
F�
W?
G1. �
ram- '2
UC
V. F
0
Fa
U�
CITY OF CUPERTINO�
Or
T** T
BUILDING DIVISION PER
;i it ►
BUILDING ADDRESS: % �j/
Gjf
PERMIT NO.0 S 0 3 0 12 1
:
SANITARY NO. CONTROL NO.
ARCHITECTIENGINEER:
BUILDING PERMrr INFO
BLDG ELECT PLUMB MECH
0 0 0 0
LICENSED CONTRACTOR'S DECLARATION
Job Description
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
p
with Section 70W) of Division 3 of the Business and Professions Code, and my license is
in full force and effect.
CONDO-3 STORY (2r682' LIVING)
License Class Uc. q
Date Contractor
NEW ADDR WILL BE ASSIGN (WILDFLOWER WAY)
ARCHITECi's DECLARATION
1 understand my plans shall be used as public records
Licensed Professional
OWNER -BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contractors License Law for the
following reason. (Section 7031.5, Business and Professions Code: Any city or county
which requires a permit to construct, alter, improve, dcmollsh, or repair any structure
prior to its issuance, also inquires the applicant for such permit to file a signed stalcmcra
Sq. Ft. Floor Area
Valuation
that he is licensed pursuant to the provisions of the Contractors License Law (Chapter 9
(commencing with Section 70DO) of Division 3 of the Business end Professions Code) or
$ 3 218 4 0
that be is exempt therefrom and the basis for the alleged exemption. Any violation of
APN Number
Occupancy Type
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars WOO).
❑ 1, as owner of the property, or my employees with wages as their sole compensation,
00
Required Inspections
will do the work and the structure is not intended or offered forsale (Sec. 7044, Business
and Professions Code: The Contractor's License Law does not apply to an owner of
q P
property who builds or improves thereon, and who doessuch work himself or through his
own employees, provided that such improvements are not intended or offered for sale- If,
however, the building or improvement is sold within one year of completion, the owner -
builder will have the burden of proving that he did not build or improve for purpose of
sale ) -
Vaz owner of the property, am exclusively contracting with licensed contractors to
nstruct the project (Sec. 7044. Business and Professions Code:) The Compctors Li-
cense Law does not apply to an owner of property.who builds or improves thereon, and.
who contracts for such projects with a contractor(s) licensed pursuant to the Contractors
License Law`,/
C fo
❑
DECLARATIO!dclamrations:
-
1 hereby of . under penalty of perjury one of the following
❑ 1have and will maintain aCertifiicateofConsenttoself-insurefor Worker's CDmpcn-
sation, as provided for by Section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
❑ I have and will maintain Worker's Compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of the work for which this permit is issued.
My Workers Compensation Insurance carrier and Policy number are:
Carrier: Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100)
or less.)
f certify that In the perform ctgf (c rk or i h s permit is issued, I shall not
employ any person in
revoked.
I
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of
the work for which this permit is issued (Sec. 3097, Civ. C.)
Lenders Name
Lendcrs Address
j I certify that 1 have read -this application and state that the above information is
"
' correct. 1 agree to comply with all city and county ordinances and state laws relating to
building construction, anM%reby authorise representatives of this city to enter upon the
about -mentioned pro art for inspection purposes.
(Wc) agree l rave, indemnify and keep harmless the City of Cupertino against
Iiabilitia,judgmen 5ofts and expenses which may in any way accrue against said City
in consequence o
MATERIALS DISCLOSURE
Will the applicant or future building occupant store or handle hazardous material
as defined by the Cupertino Munici I Code. Chapter 9.12. and the Health and Safety
Code. Sccuon25532(a)?
All roofs shall be inspected prior to any roofing material being installed.
❑ Yes u
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or future bui ing occupant use equipment or devices which
emit hazardous air contamin77incd by the Bay Area Air Quality Managcmcnt
all new materials for inspection.
District?❑Ye
I hav ad the harardnus malcrials requirements underChapter 6.95 of the Califo -
niaHealth c"Code, Secuons25505.25533and25534.Iundcrstan atifthebuil'-g
"
does not dy
� C�
All roof coverings to be Class "B" or better
Owner authorizcd� 1C
CITY OF
CUPERTINO
City of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3228
FAX: (408) 777-3333
BUILDING DEPARTMENT
OFFICIAL NOTIFICATION OF ADDRESS CHANGE
TO: All Agencies
FROM: City of Cupertino
DATE: April 6, 2006
RE: Address Change (APN #366-19-071)
Please note the following address change: 1375 S. DeAnza Blvd has been subdivided.
The commercial bldg 1375 S DeAnza will remain. The added 2nd story will be assigned
1377 & 1379 S DeAnza Blvd. The six condos will be on Wildflower Way. Their
addresses will be 7375, 7373, 7371, 7369, 7367 and 7365 Wildflower Way. Please update
your records accordingly.
The new address will take effect thirty days from the date of this letter. If you have any
questions, please call me at (408) 777-3246.
Sincerely,
Susan Winslow
Administrative clerk
O F F I C E O F C 0 U N T Y A S S E S S O R
1
617150 rNRU 57 AY K� S5
R .s•ST FR NTAGPsE Rp.
Z2
S A N T A C L A R A C O U N T Y, C A L I F O R N I A
BOOK BOOK PAGE
372 366 19
(FMLY. SARATOGA-SUNNYVALE R0.1
S. DE ANZA q —� — BLVC __
2.32AC: NET
66.55
1 57 CT.
Cr WILOfLOWER
7 1 S4tr341-94••r38
ae—ail 1R I I r-- — j I 166 167
31ffi�I
�Q I
IMx .Is ilk I be'
' ee—ie � �_----I� o_b_ olo �A�SI
8 21 -I I I g
4 jw V� F
1. -V sit B I 9 1 10 11
a1 'Ts
' 66 IS en-, 1 70 'I I I I -al I 67
TRACT N26765
AMENDED
!8
60
I
I
cr
w
V 0 55 -
w
PfN. PCL. B
PTN PCL. B
1.88 AC. GR.
SARA7OOA-IMNYVALI
1.76 AC. NET 54
53
(2.48 AC. GR.)
(2.32 AC. NET)
120_31
PCL A ... - zoa.a9 rxoe.yl
�
74 0.19 At
jDRL
PM.407-M-38
PCL. B
I U
73 ti
m
1 V 0.19 At
10 la I
P.M. 640•M-17 +
_o
I
�LAWRENCE E. STONE — ASSESSOR
codmtrd mop for aaaemenl wrwse9 only.
Compiled under R & T. Code. Sec 327.
ENacUw Roll Yew 2005--2006
Cupertino
FLOWER CT
o
-
r
O
m
ti ks
WILDFLOWERWY
CHA. NTEL CT
SSOM DR
z
lJ l