B-2016-3047 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-3047
10206 AVOCADO PL CUPERTINO,CA 95014-3323(369 09 015) GREENCOAST
CONSTRUCTION
GROUP INC
SAN JOSE,CA 95119
OWNER'S NAME: CHEN YULIN DATE ISSUED:06/16/2017
OWNER'S PHONE: PHONE NO:(650)222-2285
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO.
License Class B Lic.#982117
Contractor GREENCOAST CONSTRUCTION GROUP INC Date 03/31/2019 X BLDG X ELECT X 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
ENCLOSE ENTRY(50 S.F);ADD(N)COVERED PORCH(59 S.F),
I hereby affirm under penalty of perjury one of the following two declarations: REPLACE ALL WINDOWS(TO MEET EGRESS/TEMPERED PER
1. I have and will maintain a certificate of consent to self-insure for Worker's CODE);PARTIAL REMODEL/RECONFIGURE 1,394 S.F OF(E)SFD
Compensation,as provided for by Section 3700 of the Labor Code,for the (BOTH FLOORS);UPGRADE PANEL TO 200AMPS
•erformance of the work for which this permit is issued. REV#4-FIRE SPRINKLERS REQUIRED-04/26/2018
z., have and will maintain Worker's Compensation Insurance,as provided for by REV#3-NEW SIDING ALL AROUND-(3350 SF);CONVERT(27 SF)
_Section 3700 of the Labor Code,for the performance of the work for which this OF GARAGE TO LIVING SPACE:ADD(2)NEW WINDOWS FAMILY
permit is issued. ROOM,INSTALL (N)HVAC,INSTALL(21)RECESSED LIGHTS
, /� APPLICANT CERTIFICATION THROUGHOUT,INSTALL TANKLESS WATER HEATER-ISSUED
I ce ify an h ve r ad this application and state that the above 3/26/2018
information is correct.I agree to comply with all city and county ordinances REV#2-TEMPORARY POWER POLE(100 AMPS)-ISSUED
and state laws relating to building construction,and hereby authorize 10/25/2017
representatives of this city to enter upon the above mentioned property for REV#1 -ADDITIONAL POINT LUCID PIERS UNDER RAISED
inspection purposes. (We)agree to save indemnify and keep harmless the FLOORS-ISSUED 9/20/2017
City of Cupertino against liabilities,judgments,costs,and expenses which
may accrue against said City in consequence of the granting of this permit.
Additionally,tie applicant undeit
n• end will comply with all non-point Sq.Ft Floor Area:50 Valuation:$250000.00
source reg ati.ns per the Cupn. unicip..l Code,Section 9.18.
Si„ ature \ Date 04/26/2018 APN Number: Occupancy Type:
369 09 015 R-3(Custom)
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the PERMIT EXPIRES IF WORK IS NOT STARTED
following two reasons: WITHIN 180 DAYS OF PERMIT ISSUANCE OR
1. I,as owner of the property,or my employees with wages as their sole
compensation,will do the work,and the structure is not intended or offered for 180 DAYS FROM LAST CALLED INSPECTION.
sale(Sec.7044,Business&Professions Code)
2. I,as owner of the property,am exclusively contracting with licensed Issued by:Abby Ayende
contractors to construct the project(Sec.7044,Business&Professions Code). Date: 06/16/2017
I hereby affirm under penalty of perjury one of the following three declarations:
1. I have and will maintain a Certificate of Consent to self-insure for Worker's RE-ROOFS:
Compensation,as provided for by Section 3700 of the Labor Code,for the All roofs shall be inspected prior to any roofing material being installed.If a roof is
performance of the work for which this permit is issued. installed without first obtaining an inspection,I agree to remove all new materials for
2. I have and will maintain Worker's Compensation Insurance,as provided for by inspection.
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Signature of Applicant.
3. I certify that in the performance of the work for which this permit is issued,I Date:04/26/2018
shall not employ any person in any manner so as to become subject to the
Worker's Compensation laws of California. If,after making this certificate of ALL ROOF COVERINGS TO BE CLASS"A”OR BETTER
exemption,I become subject to the Worker's Compensation provisions of the — -- - ' --
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
APPLICANT CERTIFICATION California Health&Safety Code,Sections 25505,25533,and 25534. I will
I certify that I have read this application and state that the above information is maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
correct.I agree to comply with all city and county ordinances and state laws Health&Safety Code,Section 25532(a)should I store or handle hazardous
relating to building construction,and hereby authorize representatives of this city material. Additionally,should I use equipment or devices which emit hazardous
to enter upon the above mentioned property for inspection purposes. (We)agree air contaminants as defined by the Bay Area Air Quali Management District I
to save indemnify and keep harmless the City of Cupertino against liabilities, will maintain compliance with the Cupertino Municip.00o.• Chapter 9.12 and
judgments,costs,and expenses which may accrue against said City in the Health&Safety Co. ections 25505,2 e33 and 25534.
consequence of the granting of this permit. Additionally,the applicant understands ,
and will comply with all non-point source regulations per the Cupertino Municipal tier authorized agent: -
Code,Section 9 18
f7 •te. 04/26/2018
CONSTRUCTION LENDING AGENCY
Signature Date 04/26/2018 I hereby affirm that there is a construction lending agency for the performance
of work's for which this permit is issued(Sec.3097,Civ C)
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-3047
10206 AVOCADO PL CUPERTINO,CA 95014-3323(369 09 015) GREENCOAST
CONSTRUCTION
GROUP INC
SAN JOSE,CA 95119
OWNER'S NAME: CHEN YULIN DATE ISSUED:06/16/2017
OWNER'S PHONE: PHONE NO:(650)222-2285
• LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#982117 •
Contractor GREENCOAST CONSTRUCTION GROUP INC Date 03/31/2019 x BLDG X 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:
• ENCLOSE ENTRY(50 S.F.);ADD(N)COVERED PORCH(59 S.F.);
I hereby'affirm under penalty of perjury one of the following two declarations: REPLACE ALL WINDOWS(TO MEET EGRESS/TEMPERED PER
1. I have and will maintain a certificate of consent to self-insure for Worker's CODE);PARTIAL REMODEL/RECONFIGURE 1,394 S.F.OF(E)SFD
Compensation,as provided for by Section 3700 of the Labor Code,for the (BOTH FLOORS);UPGRADE PANE,TO 200AMPS
ge' ormance of the work for which this permit is.issued. REV#1-ADDITIONAL POINT LUCID PIERS UNDER RAISED
I ltsve and will maintain Worker's Compensation Insurance,as provided for by FLOORS-ISSUED 9/20/2017
• (Secti5113700 of the Labor Code,for the performance of the work for which this REV#2-TEMPORARY POWER POLE(100 AMPS)-ISSUED •
• permit is issued. 10/25/2017
APPLICANT CERTIFICATION Sq.Ft Floor Area:50 Valuation:$250000.00
I certify that I have read this application and state that the above
information is correct)II agree to comply.with all city and county ordinances
and state laws relating to building construction,and hereby authorize APN Number: Occupancy Type:
representatives of this'city to enter upon the above mentioned property for 369 09 015 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. PERMIT EXPIRES IF WORK IS NOT STARTED
Additionally,th- applicant•u •ers nds and will comply with all non-point
source regulap
'•f r Issued by:Abby Ayende
OWNER-BUILDER DECLARATION Date:06/16/2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons: RE-ROOFS:
1. 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 inspection,I agree to remove all new materials for
sale(Sec.7044,Business&Professions Code) inspection.
2. I,as owner of the property,am exclusively contracting with licensed
contractors to construct the project(Sec.7044,Business&Professions Code). Signature of Applicant:
I hereby affirm under penalty of perjury one of the following three declarations: Date:10/25/2017
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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
performance of the work for which this permit is issued.
2. 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. I will
3. I certify that in the performance of the work for which this permit is issued,I maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
shall not employ any person in any manner so as to become subject to the Health&Safety Code,Section 25532(a)should I store or handle hazardous
Worker's Compensation laws of Califomia. If,after making this certificate of material. Additionally,should I use equipment or devices which emit hazardous
exemption,I become subject to the Worker's Compensation provisions of the air contaminants as defined by the Bay Area Air Q 'ty Management District I
Labor Code,I must forthwith comply with such provisions or this permit shall will maintain compliance with the Cupertino Mun al Code,Chapter 9.12 and•
the Health&Safety Cod• .ections 2551 553 ,and 25534.
be deemed revoked.
41,f /
APPLICANT CERTIFICATION
�ate:10/25/2017 r
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 comply with all non-point source regulations per the Cupertino Municipal
Code,Section 9.18. ARCHITECT'S DECLARATION
',understand my plans shall be used as public records.
Signature Date 10/25/2017
Licensed
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-3047
10206 AVOCADO PL CUPERTINO,CA 95014-3323(369 09 015) GREENCOAST
CONSTRUCTION
GROUP INC
SAN JOSE,CA 95119
OWNER'S NAME: CHEN YULIN DATE ISSUED:06/16/2017 -
OWNER'S PHONE: PHONE NO:(650)222-2285
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class a Lic.#982117
Contractor GREENCOAST CONSTRUCTION GROUP INC Date 03/31/2019 X BLDG X 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:
ENCLOSE ENTRY(50 S.F.);ADD(N)COVERED PORCH(59 S.F.);
I hereby affirm under penalty of perjury one of the following two declarations: REPLACE ALL WINDOWS(TO MEET EGRESS/TEMPERED PER
1. I have and will maintain a certificate of consent to self-insure for Worker's CODE);PARTIAL REMODEL/RECONFIGURE 1,394 S.F.OF(E)SFD
Compensation,as provided for by Section 3700 of the Labor Code,for the (BOTH FLOORS);UPGRADE PANEL TO 200AMPS
rformance of the work for which this permit is issued. REV#1-ADDITIONAL POINT LUCID PIERS UNDER RAISED
ve and will maintain Worker's Compensation Insurance,as provided for by FLOORS-ISSUED 9/20/2017
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area:50 Valuation:$250000.00
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 369 09 015 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 regula' s per the Cu rtin 1Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
4ijgure Date 9/20/2017 Issued by:Abb A e
fifi Date�___4�( o-
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:9/20/2017
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1. I hive 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 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 Muni 'pal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code ectiions 25 0,,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall /
be deemed revoked. 4 caner or authorized agent:
APPLICANT CERTIFICATION Date:9/20/2017
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 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. I understand my plans shall be used as public records.
Signature• Date 9/20/2017 Licensed
Professional •
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-3047
10206 AVOCADO PL CUPERTINO, CA 95014-3323 (369 09 015) GREENCOAST
CONSTRUCTION
GROUP INC
SAN JOSE, CA 95119
OWNER'S NAME: CHEN YULIN
OWNER'S PHONE: 408-239-3466
License Class B Lic. #982117
Contractor GREENCOAST CONSTRUCTION GROUP INC Date 03/31/2019
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.
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
y Compensation, as provided for by Section 3700 of the Labor Code, for the
J 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.
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
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 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
source regulations per the Cupertino Municipal Code, Section 9.18.
Date 6/16/2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec.7044, Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code).
ISSUED: 06/16/2017
PHONE NO: (650) 222-2285
BUILDING PERMIT INFO:
X BLDG X ELECT —PLUMB
_ MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
ENCLOSE ENTRY (50 S.F.); ADD (N) COVERED PORCH (59 S.F.);
REPLACE ALL WINDOWS (TO MEET EGRESS/TEMPERED PER
CODE); PARTIAL REMODEL/RECONFIGURE 1,394 S.F. OF (E) SFD
(BOTH FLOORS); UPGRADE PANEL TO 200AMPS
Sq. Ft Floor Area: 50 1 Valuation: $250000.00
APN Number: Occupancy Type:
369 09 015 R-3 (Custom)
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Abby Ayende
Date: 06/16/2017
RE -ROOFS:
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
inspection.
Signature of Applicant:
Date: 6/16/2017
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.
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.
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
Worker's Compensation laws of California. If, after making this certificate of
exemption, I become subject to the Worker's Compensation provisions of the
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
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 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
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 source regulations per the Cupertino Municipal
Code, Section 9.18.
Signature Date 6/16/2017
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 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
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Co , ections 25505, 25533, and 25534.
Owner or authorized agent:
Date: 6/16/2017
N LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance
of work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
Professional