Loading...
B-2017-0825CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0825 10903 CANYON VISTA DR CUPERTINO, CA 95014-3908 (356 28 007) PUTNAM GROUP INC MOUNTAIN VIEW, CA 94041 OWNER'S NAME: GOETZ DIANA P OWNER'S PHONE: 650-208-3059 LICENSED CONTRACTOR'S DECLARATION License Class @ Lic. #580506 Contractor PUTNAM GROUP INC Date 03/31/2018 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 Compensation, as provided for by Section 3700 of the 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 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. Signature OWNER-13UELDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 DATE ISSUED: 07/14/2017 PHONE NO: (650) 965-7858 BUILDING PERMIT INFO: BLDG —ELECT —PLUMB MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: REMOVE INTERIOR WALLS (300 S.F.) Sq. Ft Floor Area: I Valuation: $35000.00 APN Number: Occupancy Type: 356 28 007 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Kim Dunbar Date: 07/14/2017 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. 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: 07-14-2017 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 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 1 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 07-14-2017 TO BE CLASS "A" OR BETTER 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 Code, Sections 25505, 25533, and 25534. Owner or authorized agenS�Tr'"—"�— Date: 07-14-2017 CONST R TION •ENDING 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buildingacupertino.or4 ❑ NEW CONSTRUCTION ❑ ADDITION © ALTERATION 1 TI ❑ REVISION I DEFERRED ORIGINTAL PERMIT # PROJECT ADDRESSkt)qo,bAPN # 356-28-007 OWNER NAME P1i0NI�r &MAIL —�O �c� Diana Goetz 111 J v dianapgoetz@gmail.com STREET ADDRESS CITY, STATE, ZIP FAX 10903 Canyon Vista Drive Cupertino, CA 95014 CONTACT NAME PHONE E-MAIL Darryl Putnam 650-922-0262 darrylputnam@comcast.net STREET ADDRESS CITY, STATE, ZIP FAX 1 526 Mountain View Ave. Mountian View, CA 94041 650-964-5079 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ® CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER Cl TENANT CONTRACTORNAME LICENSENUMBER LICENSETYPE BUS. LIC# Daryl Putnam 580506 B-1 COMPANY NAME E-MAIL FAX Putnam Group, Inc darrylioutnern@comcast,net 650-964-5079 STREET ADDRESS CITY, STATE, ZIP PHONE 526 Mountian View Ave. Mountain View, CA 94041 650-922-0262 ARCHITECT/ENGINEER NAMB LICENSE NUMBER BUS. LIC # Catherine Larnond Designer, Weihong Yang Enginee S5347 Engineer COMPANY NAME E-MAILhoehn.catherine@gmall.com Designer FAX With+In Designer, Provest Engineer weihong@provestse.com En lner 510-763-0476 Engineer STREET ADDRESS 122 Walnut St., Designer CITY, STATE, ZIP Menlo Park, CA 94025 Designer PHO408-507-7317 Designer 160 Pine St„ Suite 200, Engineer San Francisco, CA Engineer 408-329-8787 Engineer DESCRIPTION OF WORK Remove interior walls to open up the space. EXISTING USE PROPOSED USE CONSTR, TYPE # STORIES Residential Residential Wood Frame 'I USE TYPE OCC. SQ.FT. VALUATIONS) EXISTG NEW FLOOR DEMO TOTAL AREA 1973 AREA O AREA 0 NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA I 1 REMODEL AREA n/a n1a 300 PORCH AREA DECKAREA TOTAL DECK/PORCH ARE GARAGEAREA; DETACH n/a I nla n1a I1 ATTACH I # DWELLING UNITS: 1S A SECOND UNIT ❑ YES SECOND STORY [] YES t BEING ADDED? QNO ADDITION? RING PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES REqELVE TOTAL VALUATION: PLANNING APDL N Rl NO PLANNING APPROVAL LEITER EICHLER HOME? ® NO 35,000 By my signature below, t certify to each of the following: I ain the property owner or authorized agent to actlon the property owner's behalf I have read this application and the information I have provided is correct. I 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 const rize re resentatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Age Date: 14 r' SUPPLE AL INFO TION REQUIRED Q PLAN CHECK.TYPE .' ---...;- - ROUTING SLIP. -`: ❑ I Its cquNT1 ❑ _ New SPD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition pennit is required prior to issuance of building pvER R BUfLDBVG PLAA REV1hW pennit for new building. El., EXPRESS: ❑ PLANNii PLAN REViEw Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑:; STANDARD : , ;, ❑ PUBLICWORKS Tenn if any Hazardous Materials are being used as part of this project. ❑ ._LARc� „; ❑ Fiiii DEP> _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ Ma rqR ❑ SANITARY SE�YER DISI RIOT submittal of Building Permit application. ❑-ENVIRON!•'rENTAL HEAE H B1dgApp j011.doc revised 06121111