Loading...
B-2017-0192CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0192 10655 MARY AVE CUPERTINO, CA 95014-1355 (326 06 050) MASTEC NETWORK SOLUTIONS INC CORAL GABLES, FL 33134 OWNER'S NAME: CUPERTINO LOC-N-STOR LLC DATE ISSUED: 07/10/2017 OWNER'S PHONE: PHONE NO: (866) 545-1782 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class @ Lic. #984138 Contractor MASTEC NETWORK SOLUTIONS INC Date 06/30/2019 X BLDG —ELECT —PLUMB MECH RESIDENTIAL X 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: INSTALL (3) RRU'S TO (E) AT&T ANTENNAS I hereby affirm under penalty of perjury one of the following two declarations: r. 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. J 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 Sq. Ft Floor Area: Valuation: $20000.00 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 326 06 050 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. Signature Date 7.10.17 Issued by: SEAN HATCH OWNER -BUILDER DECLARATION Date: 07/10/2017 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) z. 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: 7.10.17 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER r. 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 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(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 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: APPLICANT CERTIFICATION Date: 7.10.17 I certify that I have read this application and state that the above information is CON TRUCTION Lr4hl1'N"G 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 7,10,17 Professional 13 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 GUPERTINtJ (408) 777-3228 • FAX (408) 777-3333 • buildingPcugertincLorg I—I NEW CONSTRUCTION ❑ ADDITION ALTERATiON / Tl ❑ REVISION/ DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 10655 Mary Avenue, Cupertino, CA 95014 APN' 326-06-050 OWNERNAMECupertinno Loc-N-Stor, LLC. (ONE B -MAIL STREET ADDRESS P.O. BOX 1166 'ATE,ZIPPoint Reyes Station, CA 9495 FAX CONTACT NAMEJohn Zaimes - On behalf of AT&T PHONE 925-278-5907 E-MAIL John,zalmes@smartlinkllc.com STREETADDRESS2001 N. Main Street, Ste 240 CITY, STATE, ZIP Walnut Greek, CA 94596 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR IA CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER Nl yc, LICENSE TYPE BUS. LI C X 1/1 19b COMPANY NAME AAh %AG �Jn &Vr /� E-MAIL / ` _• R /I�D ®%NRST�e. Cp FAX STREETADURESS/'3`LG�q_3 if1//,' Pb/t7-12-oh-0 C1TY,ST54,C. N`�(eNrvi 64 PHONE�/6 A*6 61927 - �J 1927-ARCHITECT/ENGINEERNAME ARCH ITECT/ENOINEER NAME Bret McComb LICE NSENUMBER/'rC'^6-9891 BUS. LIC N COMPANY NAME Precision Design & Drafting, Inc, EMAIL bret@pdnd.com FAJ` STREET ADDRESS 11768 Atwood Road, Ste 20 CITY, STATE, ZIP Auburn, CA 95603 YHONB 530-823-6546 DESCRIPTION OF WORK Install (3) RRU's behind existing antennas on the tower. EXISTING USE PROPOSED USE CONSTR. TYPE I H STORIES USE 'TYPE OCC. SQ.FT'. VALUATION ($) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NETAREA BATHROOM KITCHEN REMODELAREA REMODEL AREA OTHER REMODEL AREA PORCH AREA DECK AREA TOTAL. DECKMORCH AREA OARAGE ARCA: DETACH ❑ ATTACH A DWELLING UNITS: IS A SECOND UNIT' ❑YES BEING ADDED? []NO SECONDSTORY EYES ADDITION? E] NO PRE -APPLICATION []YES IF YES, PROVIDE COPY OF PLANNrNGAPPLN [:]NO PLANNWGAPPROVAL LETTER ISTHI'I, Br.DG AN []YES EICHLER HOME? NO =,gfi IX „� TO EVALUATION: _ --.` By my signature below, I certify to each of the following: I am the property owner or authorized agent Lo ct on thk property owner's behalf. I have read this application and the information I have provided is correct. [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 building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: I SUPPLEMEN L 1N RMAT[ON REQUIRED _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s), Demolition permit is required prior to issuance of building permit for new building. _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project.— _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. [_RV��� fiNrrtlt [i $t)ri bINYrANR> VTCB ----J =fEPt2ES5 =-_ -hs'l•A'ND,iB1}- LCIIIy,RL}CNREI&j' _ © SdYtR=S1J'►s?713TR7i -- = ..= = E) LICQIRISNmiLN•PAGRE�TH __.._.:_' BldgApp_2011.doe revised 06/21/11 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: 0655- ;` - PERMIT #9 -2-el f12. OWNER'S NAME: (f(j%�ERT/A�p IX -V -,S K , L -LC PHONE # GENERAL CONTRACTOR: C �%9 BUSINESS LICENSE # ADDRESS: CITY/ZIPCODE:S.4CitA,1'6a7.O ?,90-3 *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: Owner / Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date