The URL can be used to link to this page

B-2017-0072 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-0072 MARYAVE UNIT 10371 CUPERTINO,CA 95014-1341(326 52 028) STREET PLUMBING AND ROOTER SAN JOSE,CA 95128 OWNER'S NAME: SETTY SHARATH S AND GOVINDARAJU SUSHMA DATE ISSUED:01/13/2017 OWNER'S PHONE:408-916-7505 PHONE NO:(408)496-1155 LICENSED D ONTR TOR DECLARATION BUILDING PERNHT INFO: License Class C-36 Lie.#582217 Contractor STREET PLUMBING AND ROOTER Date 12/31/2017 X BLDG —ELECT X 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: I hereby affirm under penalty of perjury one of the following two declarations: REPLACE 40 GALLON WATER HEATER-OUTSIDE CLOSET 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. 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:$1800.00 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 "N Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 326 52 028 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. Wil, F Signature Date 1/13/2017 Issued by:Kim Dunbar Date:01/13/2017 OWNER-BUii SER DECLA_R ATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RF—ROOD following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. 1,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:1/13/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. 1 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 CodeS�ections 25 0 ,25533,and 25534. Labor Code,1 must forthwith comply with such provisions or this permit shall �J be deemed revoked. C Owner or authorized agent: { APPLICANT CERTIFICATION Date:1/13/2017 1 certify that I have read this application and state that the above information is CON STRUC3 N 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. Licensed Signature Date 1/13/2017 Professional i GENERAL PERMIT APPLICATION E P COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 103007ORRE°AVENUE•CUPERTINO,CA 95014-3255 . ��r +CUPER'CWO (408)777-3228•FAX(409)777-3333•buildintzfftuoerlino.ord _ MISC OPLUl14BING � ❑MEcxAnRcal. Q>:LECTluCAL 01,9SCELLANEOUS rxaJECTADDxEss 103 ' . MA7n7 W.-Y A M WC- ,%Z(p 57 07 —00 � O��EttNAt+� S t-*RA- Ste,N�vfis � y P$o �� lG-7Sas EIL - STREETADDRESSt W J037 / /1 �i,t A-VC IV W6� QTY STATE ZZIP /r®a'� Cot I��SO� FAX CONTACT NAME M v`� 1/ V S —rT- PHME(/i'f p)�1�CS'� —1/T—(/�E-MAII �/ �/, STRFETADDRESS Z?13 wat,p - �26v� /�I/r CITY,STATE ZIP q(, U W ©oal m D OxIvER�IIILDER ❑ �O.*�TRACTOR 0 COI.TRACTORAGWr Ll ARCHITECT. CI EMDMM 0 DEVELOM ®r .aM CONMACTORNAA4£ - jr ^D!"l�Y�{3'.1 t�a4r�'RENMHIER gd62-1 1 LICENSE TYPB C`34, BUS.LIC sTREET 4DDn%? 3 CITY,STATE,23PLfL�T�c(� ARCH ITECTIE.NGIIv-EER2�AME LICEtSEAR3MBER ,/(/1 BUs.L€er COMPAI,Y NAME E IvtAII FAX STREETADDRMS ( CITY,STATE,ZIP PHONE 'USE OF Tcommercial FDorDuplex Multi Family I PROJECT WVVILDLAAM PROJECTIN STRUCTURE: 1 ultrtAN R4MZFACE ARF-k ❑ Yes p. No FLOOD ZONE © Yes El No DESCRnMON t F WORK 40' C` a&v-- 1 c- r t TOTALVrw ;; ALLATION: 18�� t .. - By my signature below,I certifyto each of the following: I am the property owner or awborized anent to act on the property owner's behalf l hal a read this application andthe information I have provided is correct !have read the Description of 1k ork and verify it is accurate. I agree to comply with all applicable local ordinances anis state laws relating to ' g constnrcti a orize representatives of Cupertino to enter the above-id 'Deed perty for inspection purposes. Signature of Applicant/Ae-enf Date: / O S ;FORMATION REQUIRED 0M ,� =:; 1 Y�- y tli It_ HE CQL'I��'ER- 2 •J -��•�-t-�t.1= r •.-,.fie>"�a=- MEx��.'� J MI EP-44MCApp ZOILdoc remised 03!16111 I