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Home My WebLink AboutB-2018-1132CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2018-1132 19917 TWILIGHT CT CUPERTINO, CA 95014-2304 (316 31 032) SPRINGER CONSTRUCTION AROMAS, CA 95004 OWNER'S NAME: Scott Gregory M Trustee DATE ISSUED: 07/12/2018 OWNER'S PHONE: PHONE NO: ( LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. #770676 Contractor SPRINGER CONSTRUCTION Date 10/31/2019 3X 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: SECOND FLOOR - CONVERT AREA TO (N) BATHROOM (50 SF) AND I hereby affirm under penalty of perjury one of the following two declarations: INSTALL 1) NEW WINDOW, BATHROOM REMODEL MASTER (150 t. I have and will maintain a certificate of consent to self -insure for Worker's SF); FIRST FLOOR - REMOVE BRICK FIREPLACE, INSTALL (N) Compensation, as provided for by Section 3700 of the Labor Code, for the SLIDING DOOR; PANEL UPGRADE (200 AMP). performance of the work for which this permit is issued. REV#1 - MOVE MASTER BATH TUB LOCATION (BACK TO I ve and will maintain Worker's Compensation Insurance, as provided for b ORIGINAL LOCATION) - BUILD DECK OUTSIDE FRENCH DOORS - ec ' n 3700 of the Labor Code, for the performance of the work for which 4 SUED 8/28/18 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above Sq. Ft Floor Area: Valuation: $25000.00 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 APN Number: Occupancy Type: inspection purposes. (We) agree to save indemnify and keep harmless the 316 31 032 City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against aid City in consequence of the granting of this permit. Additionally, the ap icant understands and will comply with all non -point PERMIT EXPIRES IF WORK IS NOT STARTED source regula' n erthe up i Municipal Code, Section 9.18. WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Signature a 08/28/18 R DECLARATION Issued by: Kim Dunbar Date: 07/12/2018 I hereby affix at I am exempt from the Contractor's License Law for one of the following two reasons: t. I, as owner of the property, or my employees with wages as their sole RE -ROOFS. compensation, will do thework, and the structure is not intended or offered for All roofs shall be inspected prior to any roofing material being installed. If a roof is sale (Sec.7044, Business & Professions Code) installed without fust obtaining an inspection, I agree to remove all new materials for 2. I, as ownerof the property, am exclusively contracting with licensed inspection. 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: 08/28/18 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 Section 3700 of the Labor Code, for the performance of the work for which this HAZARDOUS MATERIALS DISCLOSURE permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the s. I certify that in the performance of the work for which this permit is issuedI , California Health & Safety Code, Sections 25505, 25533, and 25534. I will shall not employ any person in any manner so as to become subject to the maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous Worker's Compensation laws of California. If, after making this certificate of material. Additionally, should I use eq 77�went or devices which emit hazardous exemption, I become subject to the Worker's Compensation provisions of the air contaminants as defined by the Ba rea Air Quality Management District I Labor Code, I must forthwith comply with such provisions or this permit shall will maintain compliance with the Cu ino Municipal Code, Chapter 9.12 and be deemed revoked. the Health & Safety Code, do 50 , 25533, and 25534. APPLICANT CERTIFICATIONa I certify that I have read this application and state that the above information is Owner or authorized agent: correct. I agree to comply with all city and county ordinances and state laws Date: 08/28/18 relating to building construction, and hereby authorize representatives of this city CONS C G CV to enter upon the above mentioned property for inspection purposes. (We) agree I hereby affirm that there is a const ction lending a ncy for the performance to save indemnify and keep harmless the City of Cupertino against liabilities, of work's for which this permit is is ed (Sec. 3097, judgments, costs, and expenses which may accrue against said City in Lender's Name consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Lender's Address Code, Section 9.18. ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Signature Date 08/28/18 Licensed LICENSED CONTRACTOR'S DECLARATION I BUILDING PERMIT INFO License Class B Lic. #770676 Contractor SPRINGER CONSTRUCTION Date 10/31/2019 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: i. I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 cribs Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by S3700 of the Labor Code, for the performance of the work for which this /�_r=emit 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 regulatio s per the Cupertino Municipal Code, Section 9.18. Signature Date 7-12-2016 OWNER-BUI ER DE ARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: r. 1, 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 far sele (See.7044, Business & Professions Code) z. 1, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (See.7044, Business & Professions Code). 1 hereby affirm antler penalty of perjury ons of the following How ileclan etiensi n I have and will maintain a Certificate of Consent to self -insure for Worker's Course nsation,as provided for by Section 3700 of the Labor Code, For the performance of the work for which this permit is issued. z. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for die performance of the work for which this permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any mantes 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 ceunty 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. BLDG X ELECT —PLUMB MECH X RESIDENTIAL COMMERCIAL DESCRIPTION: OND FLOOR - CONVERTAREA TO (N) BATHROOM (50 SF) AND 'ALL l) NEW WINDOW, BATHROOM REMODEL MASTER (150 FIRST FLOOR - REMOVE BRICK FIREPLACE, INSTALL (N) )ING DOOR; PANEL UPGRADE (200 AMP). Pt Moor Area: I Valuation: $25000.00 APN Number: Occupancy Type: 316 31 032 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Kim Dunbar RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. Its roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. 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 at -devices which emit hazardous air rontannina tits as defined by the Bay Area Air Quality Management District 1 will maintain connpllance with *�ti.nx unicipal Code, Chapter 9.12 and the Health & Safety 505, 25533, and 25534. Owner or authorized agent: Date: 7-12-2018 CO STRU I hereby affirm that there is a coVtruction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCH ITEGT' 9 llEC LAR.4TION I understand my plans shall be used as public records. Date 7-12-2018 Licensed Professional