B-2016-3169CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-3169
10325 RICHWOOD DR CUPERTINO, CA 95014-3374 (369 08 05 1)
MARCELO
CONSTRUCTION
SAN JOSE, CA 95111
OWNER'S NAME:
DATE ISSUED: 06/08/2017
OWNER'S PHONE:
PHONE NO: (408) 826-7757
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class B Lic. # 01 08
Contractor MARCELO CONSTRUCTION Date 05/31/2018
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:
REBUILD (E) ONE STORY SFD (1704 SQ FT) WITH (479 SQ FT) OF
I hereby affirm under penalty of perjury one of the following two declarations:
ADDITIONS.
r. 1 have and will maintain a certificate of consent to self -insure for Worker's
REV#1 - SHEAR WALL LENGTH ADJUSTED; WINDOWS (V,W,X,) TO
Compensati n, as provided for by Section 3700 of the Labor Code, for the
MEET EGRESS; ELIMINATE WINDOW (Y); BEDROOM (2) &
performance of the work for which, this permit is issued.
BATHROOM ADDED DOOR 2I; DOOR 4 CHANGE FROM SWING TO
I Piave and will maintain Worker's Compensation Insurance, as provided for by
SLIDER - ISSUED 08/10/2017
Section 3700 of the Labor Code, for the performance of the work for which this
Sq. Ft Floor Area: 2183
Valuation: $400000.00
permit is issued.,
i
APPLICANT CERTIFICATION
I certify than 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 08 051
R-3 (Custom)
representatives of thi§ 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 FORK IS NOT STARTED
may accrue;against said City in consequence of the granting of this permit.
Additionally,Jhe applicant understands a d will comply with all non -point
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source regulations per a Cupe !no nicipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
u 8!10/2017Issued
by: Abby A)L—
OWNER DECLARATION
Date: 06/08/2017
-BUILDER
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
t. I as owner of the property, or my employees with wages as their sole
installed without fust 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: 8/10/2017
I hereby affirm under.penalty of perjury one of the following three declarations:
"A"
i. I have and will maintain a Certificate of Consent to self -insure for Worker's
ALL ROOF COVERINGS TO BE CLASS OR BETTER
Compensiti n, 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
a.I certify tin the.performance of the work for which this permit is issued, I
Health & Safety Code, Section 25532(a) should I store or handle hazardous
ehat,
shallnot mploy any person in any manner so as to become subject to the
material. Additionally, should I use equipment or devices which emit hazardous
Worke'r's Compensation laws of California. If, after making this certificate of
air contaminants as defined by the Bay Area Air Quality Management District I
the CupertinoMunicipal de, Chapter 9.12
exemption, I become subject to the Worker's Compensation provisions of the
will maintain compliance with and
the Health & Safety CodySeet�i)2550 33, and 25534.
77
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Afner or authorized agent:
' ' APPLICANT CERTIFICATION
Date: 8/10/2017
1 certify that) have tread this application and state that the above information isONSTRUCT
N END GAGENCY
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 8/10/2017
Professional
CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-3169
10325 RICHWOOD DR CUPERTINO, CA 95014-3374 (369 08 05 1) MARCELO
CONSTRUCTION
SAN JOSE, CA 95111
OWNER'S NAME:
DATE ISSUED: 06/08/2017
OWNER'S PHONE: 408-691-8703 1 1 PHONE NO: (408) 826-7757
License Class a Lie. #1014082
Contractor MARCELO CONSTRUCTION Date 05/31/2018
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 a firm 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
C mpensation, 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 appli ant unders nds and will comply with all non -point
source regulations pAtheA Ono Municipal Code, Section 9.18.
Date 6/8/2017
I hereby affifm 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).
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.
i. 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.
Date 6/8/2017
BUILDING PERMIT INFO:
X BLDG —ELECT —PLUMB
_ MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
REBUILD (E) ONE STORY SFD (1704 SQ FT) WITH (479 SQ FT) OF
ADDITIONS.
Sq. Ft Floor Area: 2183 1 Valuation: $400000.00
"N Number: Occupancy Type:
36908 051 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 Aygnde
Date: 06/08/2017
RR -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 Al
Date: 6/8/2017
ALL ROOF COVERINGS 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 witZthneCupertino Munici al Code, Chapter 9.12 and
the Health & Safetyion 50 25533, and 25534.
Owner or authorized agent
Date: 6/8/2017
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
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO;B-2016-3169
10325 RICHWOOD DR CUPERTINO,CA 95014-3374(369 09 05 1) MARCELO
CONSTRUCTION
SAN JOSE,CA 95111
OWNER'S NAME: DATE ISSUED:06/08/2017
OWNER'S PHONE: PHONE No;(408)826.7757
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class @ Lic.#1014082
Contractor MARCELO CONSTRUCTION Date 05/31/2018 X BLDG—ELECT—PLUMB
I hereby affirm that[am licensed under the provisions of Chapter 9(commencing MECH X RESIDENTIAL_COMMERCIAL
with Section 7000)of Division 3 ofthe Business&Professions Code and that my
license is In full force and effect. JOB DESCRIPTION:
REBUILD(E)ONE STORY SFD(1704 SQ FT)WITH(479 SQ FT)OF
I hereby affirm under penalty of perjury one ofthe following two declarations: ADDITIONS.
t. I have and will maintain a certificate of eansent to self-insure for Worker's REV#I-SHEAR WALL LENGTH ADJUSTED;WINDOWS(V,W,X,)TO
Compensation,as provided for by Section 3700 ofthe Labor Code,for the MEET EGRESS;ELIMINATE WINDOW(Y);BEDROOM(2)&
performance of the work for which this permit is issued. BATHROOM ADDED DOOR 21;DOOR 4 CHANGE FROM SWING TO
I have and will maintain Worker's Compensation Insurance,as provided for by SLIDER-ISSUED 08/10/2017
Section 3700 of the Labor Code,for the performance of the work for which this REV#2-STRUCTURAL CLARIFICATIONS FOR ROOF AT REAR
permit is tainted, COVERED PATIO-ISSUED 04/02/2018
APPLICANT CERTIFICATION DEF#1-TRUSS CALCULATIONS-ISSUED 04/02/2018
I certify that I have read this application and state that the above Sq.Ft Floor Area:2183 Valuattom 5400000.00
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 369 08 051 R-3(Custom)
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 a plicant undo stands and will comply with all non-point
source regulation or
the ertino Municipal Code,Section 9.18. PERMIT EXPIRES IIP WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
signature Dale 04/02/2018 180 DAYS FROM LAST CALLED INSPECTION.
RAT Issued by:Abby Ayende
I hereby affirm that lain exempt Brom the Contractor's License Law for one of the Date:06/08/2017
following two reasons:
t. 1,as owner ofthe property,or my employees with wages as their sole RE-ROOFS:
compensation,will do the work,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 first obtaining an inspection,1 agree to remove all new materials for
x. 1,as owner ofthe property,am exclusively contracting with licensed tnspectieu.
contractors to construct the project(Sce.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations: Signature o£Applicann
t. 1 have and will maintain a Certificate of Consent to self-insure for Worker's Data:04/02/2018
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued, ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
2. I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 ofthe Labor Code,for the performance ofthe work for which this HAZARDOUS MATERIALS DISCLOSURE
permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the
a. I certify that in the performance of the work for which this permit is issued,I C.Iffornia Ileaith&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
Worker's Compensation laws of California,If,after making this certificate of health&Safety Cade,Section 25532(.)should I stare m•handle hazardous
exemption,I become subject to the Worker's Compensation provisions of the material.Additionally,should I rise equipment or devices which emit hazardous
Labor Code,I must forthwith comply with such provisions or this permit shall air eontamimmts ns detmed by the Bay Area Air Quality Management District 1
be deemed revoked. will maintain compliance with the Caper I thim Murd'al Code,Chapter 9.12 and
the Health&Safety Cade,Se tens 0,25533,.rid 25534.
APPLICANT CEIi'fIFICNrION
I certify that I have read this application and state that the above Information Is Owner or an agent:
correct.I agree to comply with all city and county ordinances and state laws Date;04/02/2018
relating to building construction,and hereby authorize representatives of this city CONSTRU PCbN LCNDINC A('CNCY
to enter upon the above mentioned property for Inspection purposes. (We)agree hereby affirm that there is a construction lending agency for the performance
to save indemnify and keep harmless the City of Cupertino against liabilities, of work's for which this permit is Issued(Sec.3097,Civ C.)
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.
ARCHITCCT'S DECf,ARATION
Signature Date 04/02/2018 1 understand my plans shall be used as public records.
Licensed