B-2018-1186 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-1186
23100 VIA ESPLENDOR UNIT 44 CUPERTINO,CA 95014-6544(342 55 029) BAY AREA
ENTERPRISE
SAN JOSE,CA 95148
OWNER'S NAME: DATE ISSUED:07/16/2018
OWNER'S PHONE: PHONE NO:(
LICENCED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B LIc.#817817
Contractor BAY AREA ENTERPRISE Date 0313112019 X BLDG$ELECT$PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing X MECH X RESIDENTIAL_COMMERCIAL
with Section 7000)of Division 3 of the Business&Professions Cade and that my
license Is in full force and effect. JOB DESCRIPTION:
UNIT 44-REPLACE(7)LIGHTS TO LED LIGHTS;REPLACE(25)
I herebyaffirmunder penalty of perjury one of the following two declarations: OUTLETS;REPLACE(13)SWITCHES;REPLACE(2)BATHROOM
have and wgI maintain a certificate of consent to self-insure for Worker's FAN;REPLACE SHOWER WALL WITH SOLID CULTURED MARBLE
have and will maintain Worker's Compensation Insurance,as provided for by REV#1-INSTALL 65'3/4"GAS LINE FROM METER TO EXISTING
Section 3700 of the Labor Code,for the performance of the work for which this FIREPLACE-ISSUED 8/23/18
permit is issued.
APPLICANT CERTIFICATION Sq.Ft Floor Area: Valuation:$19000.00
1 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 342 55 029
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 lab les,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against sal y In consequence of the granting of this permit.
Additionally,the a p t understands and will comply with all non-point WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source regul Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Slg -u e Date 08123/1 B
2 Issued by:Kim Dunbar
Date:07/16/2018
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
A. 1,as owner of the 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 inspection.
sale(Sec.7044,Business&Professions Code)
2. 1,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sce.7044,Business&Professions Code). Date:08/23/18
I hereby affirm under penally of perjury one of the following three declarations:
1. 1 have and will maintain a Certificate of Consent to self-insure for Worker's ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
Compensation,m 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
3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous
shall not employ soy person in any manner so as to become subject to the material.Additionally,should I use equipment or devices which emit hazardous
Worker's Compensation laws of California.If,after making this certificate of air contaminants as defined by the Bay Area All
Qu Managemmd District I
exemption,I become subject to the Worker's Compensation provisions of the will maintain compliance with
25534.
be deemed revoked. - _-
Owner or authorized agent:
APPLICANT CERTIFICATION Date:08/23118
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 lawsI hereby affirm that there is a construction lending agency for the performance
relating to bullding 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 08/23/1 Licensed
Professional