Loading...
B-2016-3221 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-3221 10624 JOHNSON AVE CUPERTINO,CA 95014-3817(375 28 026) DELUXE AIR WOODLAND,CA 95776 OWNER'S NAME: ANANTH SHARATH AND BHAT SUPRIYA DATE ISSUED:12/07/2016 OWNER'S PHONE:858-208-8718 PHONE NO:(530)662-5008 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C20 Lic.#994539 Contractor DELUXEAR Date 07/31/2018 X BLDG _ELECT _PLUMB X 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: REPLACE TWO(2)WALL FURNACES,HALL&LIVING ROOM I hereby affirm under penalty of perjury one of the following two declarations: 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 r 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: Valuation:$3000.00 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 375 28 026 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 Municipalode Section 9.18. 180 DAYS FRO►/ A a :' - ' CTION. Signature Date 12/07/2016 Issued by:MELI • N .•�. Date: 12/07/2016 OE 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:12/07/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 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 maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the permit is issued. Health&Safety Code,Section 25532(a)should I store or handle hazardous 3. I certify that in the performance of the work for which this permit is issued,I 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 25505,25533,and 25534: Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: ..- G / - A APPLICANT CERTIFICATION Date:12/07/2016 I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance correct.I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued(Sec.3097,Civ C.) relating to building construction,and hereby authorize representatives of this city 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, Lender's Address judgments,costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands ARCHITECT'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code,Section 9.18. Licensed Signature Date 12/07/2016 Professional GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinqP.cupertino.orqCUPERTINO ,S ,- ` Zoi6" Z ❑PLUMBING Q MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS /� / DPN# — V/ Q /� ��.J � 5 11AV �l 02_6 OWNER NAME PHONE ), „ r-, i / _ C s T ?1 t E-MAIL STREET ADDRESS0 6,5.2 U ✓I`L So e/ 'OY CITY,STATE,ZIP l i V',1'e-iZ Iyl/0 014- ( 5-0!t FAX CONTACT NAME °y PHONE S/ y ° V rU �t - I. E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX OWNER ❑ OWNER-BUILDER 0 OWNER AGENT LEJ"CONTRACTOR 0 CONTRACTOR AGENT ❑ ARCHITECT 0 ENGINEER. ❑ DEVELOPER 0 TENANT CONTRACTOR NAME LICENSE NUMBER .opy 3� �LICENSE T- ��YPE BUS.LIC# `dgA . FS,SS� COMPANY NAME D e L' 1 6 4 j E-MAIL FAX STREET ADDRESS ...Ars. STATE,7IP PHONE ,. ICS sI � Si() o c .,vi .0�l '5770 �yP ) s877 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND El YES PROJECT IN 0 YES IS THE BLDG AN 0 YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA 0 NO FLOOD ZONE ❑NO EICHLER HOME? 0 NO DESCRIPTION OF WORK el 6047i. s' st TOTAL VALUATION:'��� 30o0RECEIVED E - By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the prope owner's behalf. I have read thus application and the information I have provided is con-ect. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildingn.nstruction. I authorize representatives of Cupertino to enter the above-identified-tiproperty for inspection purposes. Signature of Applicant/Agent: Date: 1 / !/ 1 UPI/EMENTAL INFORMATION REQUIRED `,OFFICE USE ONt.X, -ten r v OYER,THE COUNTER 0: EXPRESS • D' STANDARD D MAJOR MEPMiscApp_2011.doc revised 06/21/11 (Li M - .N N O N 4.. O a) 1- O O N 0. 'C w (Li1 J ei e4 > O "O V W I 1p a) Co d' Q '� ,..i C M U CL0 c 0 0a.+-" N. O N e-i co vO Cr v) c) a, w .. Y x a w aJ CU w -0 ifjo .j aT, >, Z N 1- (n t t C U Q Y c-1 Co t ' t= C C C) 7 c-1 co O C Q O O f6 �' A O iea O U c ) (/) a-t S'I O, ` fY/1 i . -a -a y n;l y LO °,. a, 0) C v dto0 C a TS 0 N a4,° o E E C N a+ a ,,O , a, O Z NI C C (4 0 c, 0 C E J'Fry\ C L }a ch to a) Z 0 (o v D o- 11 - O a, +� o Qt 611 C, 12 LA on to N.,`. `'-moi 'E V " N 0 1-T n D to o = s a, Ca) da C C i L O .3 °4. A N '. LO O chi h00 . Q -a 'a e 1 „y.. C in .o ° e0-i O O D as 1- i c 1a = 3 3 0 7 0 y f. o,' 12.0 O a, C 0 — o .3 0 GO 0 O U- Z04, �} C T 0.O Z O Y N C a N 4.13W 0 f 1 . sn - Q p CO o C `n a r' O CO Y CO g '" c ) o Q) tis 'n (a Y to O cCtVC N i ) Iff o •c6 b0 .i+ Q. Z ,-.1CO Y Z C 1 � C OE C V c ' L U U O a, 4, to O f 1- E a) a) a� U N ._,.. o +SO+ V) 7 T Z. O e-i. H in vTf "0 , O .Q O C > C po o a f° o a _ o N o O C r "a U N ~ 00 ao ++ In O C Y L O -47' VI v CD C Y s,.. )n O O C L C. -C 0 (1S. m d O to O -a CV v 0 ;F' -a —O C •E 0 , 'L a, 0) o m tn U 7 CD NLO v cam-( - U T h O l0 Q O 7 N O O +.) Q= V) 5-1 U 6l d" "- a) O N. N a, a, a) a, ,n E co Q ., C ato C Q H O 'D _ .0 >. C 6 C t d L -0 C Y .--i -0 w O ( co Ni H 0 a) O V d- C cu Z a= O N. V 0 to O a) u 0 N Q L C cu LO U 'a+ V) O t1Q Q v Vf CD J C C C U ,Y co c C C C v C0 fl- cu 6 0 L- v w V- V1 0 ;1-3`-p 0 N 10 0 O Z a, C C to ' ,' n co CUO Z L H 'o oaddV O _ o a co + +' C Q Q V U V = Zn Q) a CC CilN tmV X F- � a � CL - H C LI .t704 '0 ,-I ‘-'1 -i N 0) o a, UU 0 0 m a tV Q LQ U jOOO ' M eq H 4 o p w N I- N V CO U o LL v - O o .>` N - ci d m ci cc Q W . LL a) Wm O cc C ra `s D , N cm • in o C r O , .,<:,,-^` o 1 CV U ri . F O • U U U N 4) +'' Q) IDf M 1.11 LD Q a) fa. Q, ..r'-- A £ co A ++ N ? ' t O Q z O 0 4 •v) 0_ 0 a in 0. c ., co E ca a-1 coO d a) y c z t o c t ; 1 , 2? N a E o 0 o E o .0 = -0 a) ;- I 3 v) ›. CU U 'p n S' •H V) v) >. C f6 H t 1- C F-- 1„ 3 .� <) `.. C �__ . CD. N '� um )a ° onC y O o La oOo U a-4 tjQJ C C p v 'a o = E E Ea) w U OH , fa p N ) ¢VT a Q a) N oTc to C CC o CO c a) - -0 mwC C ++ Nz a m o *-', E E a a C 0 0 ° a) o . v- o N a 0 s_ y .. S- 0 0. U 3 3 a ca o E o o Z z z w 1- ' -a a _ as U 0 LJ a). a) -- LL 13 Y .- _ cc Q U..1w +' u 1 aa)) Q U Q 6 W LL. K U a)LLI N I— :71 cc yo ra= V.w L 2_ m Q GJ • o a v o m m O0% i (-11• a OLL r1V WO > L0 CO V d N - C 4EC N 0 O Cu m p LU LY N aI.' U c u J 2 2 p V E U O o O ++ Y 3 — ra al u m Cu C C w C C C (....3 � Cu \J co •at Q •vl ?� \J C C.9 t, ', LL p •3 ,,^ 0.O a- m z aJ. 1 U Uw "tea__ m j U a > m C� m m o C� _ vas v a r Cu a as raV .+ .L'irp�. EL of "� �. y C p a 0. o Cu Cu N ma A b - O 4 0 c w f gar' 6 a=•,:•4 y O 10 v o c oi` m Y'.:'' a 0 o N o,O (Yj �C a7 -o 4— Y ,.2m coC'7. a c0 c;o v v, -no d- 5 o o LO 0 .cu. a , o N E' n N el 1.0 to y m 3 LO :m O w 00 0 _'asa_ a ,•� Q co. a O o ai � � 0O c t c 3 , E _= .0 O - 00 m •ai .-1 O .7, Cu i U U) °°0 CV v, O ,_.0 N t',',Cu -d 1 Ln 4 E c0-1 N• = y r (V v °J nn 3`';'Ys T N a O }I N - 1 W 79 al 'y C: W 1 to �' Y CD E 4. CO = ai to npo u '' a;to u'-Ti', o in co Ln ui LD 3 r6 c O Q o cO Q OO v a �`- -_ 0 ai m O „,c ri - M _ C 0 al a n N U a n a • m s v u aa O N Cr) a Lr) C o cu N Q c�' o E C o = Q— 3 yo E m m u ra >- c W �< '` E • z n E.3 E • o c „U a(a m 7.:.-,.. o tti 6 L '� ro O m al e p• m U .a ;a) Q a) N U U�JCu -Pu a)--M - ,h h i m' U CO Cu C Cen E al Q IPa V U_• a h I 0 O U r0' E Oa V H u'. O. a U ..= m J -ria m .N$3 C4`Cr:.a+'v O c a) Q = o 'LI -0 .ro. o a) C a1 «C.. G CL L p. 7 w a E m m 0 @ O m + V M ' v LL. Eo N u CO E ra N Q EO a+ rt Y 'C.. O E C) Cu c O a U + L O 0 C y •m: v C 4c, .a� U p' U. .. -a. o Q. ti O .- v a) y © m E O E i.+ O a V U O'm O O i : d) U 3 U -o m Cu u 0 O a/ Q. y. C C m C U +L.+ ..O-a ;+- >- `m O '6 4— co CD N LA sem+ Y v 0 *' U. p .0 O K a O O ate+ Y m E a E . v ? 0 0 N ++ N 7 a) vl o in O N VI L. 4.. C i H y 4O m N O 0- v R 0. a. to t6 0 0 v- 0 m 0 m 0 -o C G7 a). O a 0 w u v O. RI w 'C' CD . i a p, c a a v v v Y .r 0 ra 'a v 0 CI V co o a o m a s ai a c O +m.+ ZZ :7173 L O u a •j m V v -p F h O a o N C 0 I- LU Q c .o ., O m N m. Q c� -4 0 _ : w a, a w i= Lw. m y w .01 ( c d U V w N n c -0 >.o a m m a ai I-" LO a U -p 0 N 'N I_ O bia 7 N _ 0 v Q •H z Ln ^ O c m v v oa v m L/) Lu U Q. C - o I- i E .0 v - C cc z I- m .0 >- U V) 0 y, -c w v ao 'n_o v E g w o v LU vi. own 0 0 ;F. t6 w Q C. '� v •'5 s C LU U v LY U 3 - H H LC, �i+ F N o a E m . a u 1 a 'v N F- p Z L� U 0 N `t m - Q H N z :cat m m N v ° 3 c 0 Q N a.Z U Q. no J N C Ce w O 0 U � EJ Ez -8 C. .y cV m v N acC aMI J t- Z �O a on COtil In CJ < 0 ri o (.7 ° 0 aO v > CL .`_' C2U u0 ¢ o u > cc U m ;a 0