B-2018-0443 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-0443
10624 S DE ANZA BLVD CUPERTINO,CA 95014-4450(369 38 039) DESU
CONSTRUCTION INC
FREMONT,CA 94536
OWNER'S NAME:BYER PROPERTIES LP DATE ISSUED:03/26/2018
OWNER'S PHONE:530-204-8867 PHONE NO:(650)867-9606
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#102660fi
Contractor DESU CONSTRUCTION INC Date 05/31/2019 X BLDG ELECT_PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing —MECH_RESIDENTIAL X COMMERCIAL
with Section 7000)of Division 3 of the Business&Pref'enihms Code and that my
license is in fall force and effect. JOB DESCRIPTION:
CALCOLOR ACADEMY TL-(3872 SF)REMOVE AND REBUILD
I hereby affirm under penalty of perjury one of the following nvo declarations: WALLS;BATHROOM ADA UPGRADES,LIGHTING,PLUMBING AND
t. I have and will maintain a certificate ofconsent to self-insure for Worker's HVAC
Compensation,as provided not by Section 3700 of the Labor Code,for the REV#l CHANGE WALL CONFIGURATION TO ADD ROOMS
performance of the work for which this permit is issued. -ISSUED 03/29/2018
I I have and will maintain Worker's Compensation hrsmarm,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued, Sq.Ft Fluor Are.: Valu.timu;$40000.00
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 36938 039 A(Tenant Improvements),I3(Tenant Improvements)
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.
Date 03/29/2018 Issued by:Jasmine Archbold
Date:03/26/2018
OWNER-BUILDER DECLARA'T'ION
I hereby affirm that I am exempt from the Contractor's License Law for one of theRE-ROOFS•
following two returns: All roofs steal I be inspected prior to any roofing material being installed If a roof is
r. I,as owner of the property,or my employees with wages as their sole installed without Fast obtaining an inspection,1 agree to remove all new materials for
compensation,will do the work,.and the stracture is not intended or offered for inspection.
sale(Scc.7044,Business&Professions Code)
z. 1,as owner of the property,am exclusively contracting with licensed Signature ofApplirmit:
contractors to construct the project(Sec.7044,Business&Professions Code), Date:03/29/2018
1 hereby affirm under penalty of perjm•y one of the following three declarations: ALLROOF COVERINGS TO BE CLASS"A"OR BETTER
r, 1 have and will maintain a Certificate of Consent to sel&insure for Worker's
Compensation,as provided For by Section 3700 of the Labor Cade,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 rend the hazardous nmteri.ls 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,Sectlons 25505,25533,and 25534.I will
mit is issued, maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
per
a. I certify that in the performance o£tme work for which this permit is issued,I Health&Safety Code,Section 25532(a)should 1 store or handle hazardous
material.Additionally,should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the r contaminants as deputed by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. [f,aftm making this certlf�cate of will maintain compliance with the Cupertino Municipsd 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:03129/2018
I certify that I have read this application and state that the above information Is CONSTRUCTION I ENDING 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 DECI ARATION
Code,Section 9.18. 1 understand my plans shall be used as public records.
Signature Date Q3/2912018 Llcensed
Professlonal