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Home My WebLink AboutB-2018-1164 Permit & REV 1 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-1164 .22115 DEAN CT CUPERTINO,CA 95014-2723(357 09 037) MIKE COUNSIL PLUMBING INC SAN JOSE,CA 95131 OWNER'S NAME:JOHN BUENZ DATE ISSUED:07/10/2018 OWNER'S PHONE: PHONE NO:(408)272-4900 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C36 Lic.#679261 Contractor MIKE COUNSIL PLUMBING INC Date 04/30/2019 X BLDG ELECT X PLUMB 1 hereby affirm that I am licensed tinder the provisions of Chapter 9(commencing —MECH X RESIDENTIAL—COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in fall force aad effect. JOB DESCRIPTION: WHOLE HOUSE WATER RE-PIPE(6 FIXTURES) I hereby affirm under penalty U perjury one of the following two declarations: 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:$35000.00 APPLICANT CERTIFICATION I certify that I have read this application and slate 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 35709 037 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 Ilabilitles,judgments,costs,and expenses which PERMIT EXPIRES IF WORI{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 upertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. SignatureI Date 7-10-2018 Issued by:Kim Dunbar Date:07/10/2018 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: followingt—reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is r. 1,as owner of the property,.,my employees with wages as their sole installed without first obtaining an inspection,1 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) z 1,as owner of the property;am exclusively contracting with licensed Signature of Applica o: contractors to construct the project(Sec.7044,Business&Professions Code). Date:7-10-2019 I hereby affirm finder penalty of perjury one of the following three declaratio n s : ALL ROOK COVERINGS TO BE CLASS"A"OR BETTER t. 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 z. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirennents 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 25534,1 will permit is issued, maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the s. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(x)should I store or handle Imzardous shall not employ any in an manner so as to become subject to the material.Additionally,should I use equipment m•devices which emit hazardous p y y person y man J ah•contanrinamts 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 Cade,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Cade Sections 25505,25533,and 25534. Labor Code,1 must forthwith comply with such provisions or this permit shall be deemed revoked, Owner or authorized agent: APPLICANT CERTIFICATION Date:7-10-2018 I certify that I have read this application and state that the above information is c T 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 DECLARn'1'lON Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date 7-10-2018 Licensed Professional CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1164 22552 POPPY DR CUPERTINO, CA 95014-0802(34212012) NELSON DANIEL RAMOS HALF MOON BAY, CA 94019 OWNER'S NAME: PHONE NO; (650) 834-1260 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class )} Lie. #Z96613 Contractor NELSON DANIEL RAMOS Date 06/30/2019 X BLDG _ 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: Construct a two story residence (3735 sq ft); attached garage (400 sq ft). I hereby affirm under penalty of perjury one of the following two declarations: rev #2 - INCREASE CEILING HEIGHT IN ENTRANCE - ISSUED 7-13- 1, ve and will maintain a certificate of consent to self -insure for Worker's 2018 .ompensation, as provided for by Section 3700 of the Labor Code, for the REV #1 - WINDOW DESIGN CHANGE (10) - ISSUED 11/14/2017 performance of the work for which this permit is issued. 1 -have mid 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 Sq. Ft Floor Area: 4135 Valuation: $350000.00 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 APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 342 12 012 Deferred Submittal (R -3),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 regulations per the Cupertino Municipal Code, Section 9.18, 180 DAYS FROM LAST CALLED INSPECTION. Slgnature 7c# 1 2 •C ) Date 7-13-2018 OWNER -BUILDER DECLARATION I hereby affirm that I an, exempt from the Contractor's License Law for one of the following two reasons: 1. 1, as ownerof 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) 2. 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 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 Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 2. 1 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. Kim Dunbar RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed If a roof is installed without first obtaining an inspection, l agree to remove all new materials for inspection. lure of Applicant: 7-13-2018 HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements tinder Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 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 Code, Sections 25505, 25533, and 25534. Owner or authorized agent: _ Date: 7-13-2018 CONSTRUCTION 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 Date 7-13-2018 Professic