B-2018-0889 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-0889
23050 VIA ESPLENDOR UNIT 39 CUPERTINO,CA(342 55 025) BAY AREA
ENTERPRISE
SAN JOSE,CA 95148
OWNER'S NAME: DATE ISSUED:05/23/2018
OWNER'S PHONE: PHONE NO:(408)238-5043
LICENSEDTRA T R' DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#817817
Contractor BAY AREA ENTERPRISE Date 03/3112019 X BLDG X ELECT X PLUMB
X 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 fall force and effect. JOB DESCRIPTION:
UNIT 39-REPLACE(1)BATHROOM FAN;UPGRADE SHOWER
I hereby affirm under penalty of perjury one of the following two declarations: WALLS AND(N)SHOWER VALVES;UPGRADE TO LED RECESSED
f. l have and will maintain a certificate of consent to self-insure for Worker's LIGHTS(8);ADD(l)4"RECESSED LIGHTS;ADD(1)SWITCH
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued.
G1 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. Sq.Ft Floor Arca: Valuation:$5000.00
APPLICANT CERTIFICATION
I certify that I have read this application and slate that the above
information Is correct.I agree to comply with all city and county ordinances APN Number: Occapaacy'lype:
and state laws relating to building construction,and hereby authorize 342 55 025
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 agai t liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORT{IS NOT STARTED
may accrue1' aid City in consequence of the granting all
this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Addi10 Ilyt plicant understands and will comply with all non-point
sou re I i ns per the supe Igo Municipal Code,section 9.16. 180 DAYS FROM LAST CALLED INSPECTION.
gnatore�' Date 05/2312018 Issued by:Jasmine Archbold
Date:05/23/2018
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS:
following hvo reasons: All roofs shall be inspected prior to any roofing material being installed.If—oris
1. I,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 at offered for inspection.
.1,(Sec.7044,Business&Professions Code)
z. 1,as owner of the property,am exclusively contracting with licensed Signolure ofApplieant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date;05/23/2018
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1. 1 have and will maintain a Certificate of Consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Cade,Por 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 read the hazardous asierb0a requirements under Chapter 6.95 of the
Section 3700 of the Labor Cade,for the performance of the work for which this California health&Safety Code,Sections 25505,25533,and 25534.1 will
Permit is issued, m aintain compliance with the Cupertino Municipal Cade,Chapter 9,12 and the
z. 1 certify that in dee performance of Bre work for which this permit is issued,I Health&Solely Cade,Section 25532(x)should I store or handle hazardous
shall not employ any person in any manner so as ro become subject to the material, ttiHyrally,should I 9-equipmenfor devices which emit hazardous
air con mimants`us definy'-ttiy�ae Bo Area Air Quality Management District 1
Worker's Compensation laws ofCalifornia If,after making this certificate of wlll s, to eo)i rpli yY`e"ith th npertu o Municipal Cade,Chapter 9,12 and
exemption,I became saibjecf to the Worker's Compensation provisions of the /�a'rtJ�°'re'B nlflf&Safsty Code, ectiy�s-'505,25533,and 25534.
Labm Code,I must forthwith comply with such provisions or this permit shall / ,.-----
be deemed revoked. Owner or authorized
APPLICANT CERTIFICATION Date:95!2312016
I certify that I have read this application and slate 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,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-paint source regulations per the Cupertino MunicipalARCHITECT'S DECLARATION
Code,Section 9,18, understand my plans shall be used as public records.
Licensed
Signature Date 05/23/2018
Professional