B-2018-0975 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-0975
7703 RAINBOW DR CUPERTINO,CA 95014-5268(362 24 Ol4) CHANDLERS
PLUMBING
SAN JOSE,CA 95110-
2783
OWNER'S NAME: DATE ISSUED:06/07/2018
OWNER'S PHONE: PHONE NO:(408)449-3443
LICENSED CONTRACTOR'S BUILDING PERMIT INFO:
License Class CC=36 Lid.#971412
Contractor CHANDLERS PLUMBING Date 0913012018 X BLDG_ELECT X PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commenting —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:
REPLACE 50 GAL WATER HEARTER-SAME LOCATION
I hereby offlrm under penalty of perjury one of the following two declarations:
r. 1 have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 ofthe Labor Cade,for the
performance ofthe work for which this permit is issued.
have and will maintain Worker's Compensation Insurance,as in for by
Section 3700 ofthe Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Arca: Valuation:$1200.00
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 362 24 014
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-polnt
source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION,
Signature / / Date 06/07/2018 Issued by:Jasmine Archbold
Date:06/07/2018
OWNER-BUILDER DECLARATION
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
r. 1,as owner ofthe 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 inspcetlea
act,(Scc.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:06/07/2018
1 hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTERr. 1 have and will maimain 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
z. I have and will maintain Worker's Compensation Insurance,as In for by I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code,for the performance ofthe work for which this Cnllfornla Health&Safety Code,Sections 25505,25533,and 25534.twill
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9,12 sad the
s. I certify that in the performance ofthe 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 l use equipment or devices which emit hazardous
air contaminants as defined by the Buy 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,l become subject to the Worker's Compensation previsions ofthe the Health&Safety Code,Sections 25505,25533,and 25534,
Labor Code,I must forthwith comply with such provisions or this permit shall �--
APPLICANT CERTIFICATION Date;06107/2018
1 certify that I have read this application and state that the above Information is CONSTRUCTION LENDING 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,Clv 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.
Signature Date 06/07/2018 Licensed
Professional