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BLD-2022-1746_SignedPermit.pdf ITY OF BUILDING PERMIT CITY HALL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 PHONE 408-777-3228 CUPERTINO WWW.CUPERTINO.ORG BUILDING ADDRESS: 22353 RIVERSIDE DR APN: 356 04 001 PERMIT NO: BLD-2022-1746 OWNER'S NAME: ZHANG PENG AND HE NANNAN OWNER'S PHONE:4083355215 CONTRACTOR: HAPPY CONSTRUCTION GROUP INC CONTRACTOR PHONE: DATE ISSUED: Jan24,2023 ISSUED BY: Haley McKee VALUATION: 200000 JOB DESCRIPTION: REMODEL 2-STORY SINGLE FAMILY DEWELING; DEMO (E) FIREPLACE; REMODEL KITCHEN - (440 SF); CONVERT (E) STORAGE TO 4TH BATHROOM, AND REMODEL BATHROOM # 1, 2, 3 - (366 SF); (REMODEL OTHER - (179 SF); RELOCATE FURNACE TO ATTIC; (4) NEW SKYLIGHTS; (1) NEW SUN TUNNEL; RELOCATE ELECTRICAL PANEL; NEW TANKLESS WATER HEATER; NEW LIGHTS FIXTURES AND OUTLETS THROUGHOUT THE HOUSE LICENSED CONTRACTOR'S DECLARATION: NO: 905734 EXP DATE: 04/30/2023 7000) of Division 3 of the Business & Professions CONTRACTOR: I hereby affirm Code and that HAPPY CONSTRUCTION GROUP INC LICENSED CLASS: BBUGENERALILDING LICENSED that I am licensed under the provisions of Chapter 9 (commencing with Section my license is in full force and effect. under penalty of perjury one of the following three declarations: as provided for by Section 3700 of the I hereby affirm `/ I have and will maintain a certificate of consent to self -insure for Worker's Compensation, Labor Code, for the performance of the work for which this permit is issued. Section 3700 of the Labor Code, for the not employ any person in any manner so as to this certificate of exemption, I become subject to with such provisions or this permit shall be ❑ I have and will maintain Worker's Compensation Insurance, as provided for by 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 become subject to the Worker's Compensation laws of California. If, after making the Worker's Compensation provisions of the Labor Code, I must forthwith comply deemed revoked. HAZARDOUS MATERIALS DISCLOSURE & Safety Code, Sections 25505, 25533, and 25534. I the hazardous materials requirements under Chapter 6.95 of the California Health M I have read will maintain handle hazardous Air Quality Sections 25505, compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or air contaminants as defined by the Bay Area Chapter 9.12 and the Health & Safety Code, material. Additionally, should I use equipment or devices which emit hazardous Management District I will maintain compliance with the Cupertino Municipal Code, 25533, and 25534. EPA LEAD -SAFE DISCLOSURE No: -Safe Certified Renovator will be responsible for this project. Firm Name: Firm Certification ❑ An EPA Lead Certified ✓ No EPA Lead -Safe Certified Firm is required for this project. CONSTRUCTION LENDING AGENCY of the work which this permit is issued I hereby affirm under penalty of perjury that there is a construction lending agency for the performance (Section 7, Civil Code). Yes El No Lender's Name: Lender's Address: APPLICATION CERTIFICATION with all city and county ordinances and state the above mentioned property for inspection judgements, costs, and expenses which may understands and will comply with all non -point I certify that I have laws relating to purposes. (We) accrue against source regulations Signature.+%5°- read this application and state that the above information is correct. I agree to comply building construction, and hereby authorize representatives of this city to enter upon agree to save indemnify and keep harmless the City of Cupertino against liabilities, said City in consequence of the granting of this permit. Additionally, the applicant per the Cupertino Municipal Code, Section 9.18. Date Jan 24, 2023 EVERY PERMIT ISSUED SHALL BECOME INVALID UNLESS THE WORK ON THE SITE AUTHORIZED BY SUCH PERMIT IS COMMENCED WITHIN 365 DAYS AFTER ITS ISSUANCE, OR IF THE WORK AUTHORIZED ON THE SITE BY SUCH PERMIT IS SUSPENDED OR ABANDONED FOR A PERIOD OF 365 DAYS AFTER THE TIME THE WORK IS COMMENCED.