B-2017-0420 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-0420
ABLE PAINTING&
CONSTRUCTION CO
FREMONT,CA 94555
OWNER'S NAME:YUN JUNG SUK AND FLING SUE HUNG DATE ISSUED:03/14/2017
OWNER'S PHONE: PHONE NO:(510)414-7533
LICENSED TRA T DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#594438
Contractor ABLE PAINTING&CONSTRUCTION CO Dale 05/31/2018 X BLDG_ELECT_PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing —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:
REMODEL KITCHEN(63 SF);(N)BATHROOM(43 SF)/LAUNDRY
I hereby affirm under penalty of perjury one of the following two declarations: ROOM(18 SF);NEW SUB PANEL(50 AMP)
r. I have and will maintain a certificate of consent to self-insure for Worker's REV 91-LOCATION CHANGE OF BATHROOM ADDITION,
Compensation,as provided for by Section 3700 of the Labor Code,for the LAUNDRY ROOM,AND SIDE ENTRY DOOR;ADD ONE WINDOW 1N
performance ofthe work for which this permit is issued. BATHROOM ADDITION-ISSUED 7/13/2018
2. 1 have and will maintain Worker's Compensation loans ice,as provided for by
4�,Scetion 3700 of the Labor Code,for the performance of the work for which this
Permit is issued. Sq.Ft Flo.,-Area: Valuation:$50000.00
APPLICANT CRRTiFICA1'ION
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: Occupancy Type:
and stale laws relating to building construction,and hereby authorize 375 12 042
representatives of this city to enter upon the above mentioned properly for
inspection purposes.(We)agree to save Indemnify and keep harmless the
City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IIP WORT{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.
Signature /�-=, - % Date 07/13/2018 Issued by:Kim Dunbar
c,' �' Date:03/14/2017
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of theRE-ROOFS:
following two reasons: All of,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,1 agree to remove all new materials for
compensation,will do the work,and the structure is not intended or offered for inspection,
sale(Sce.7044,Business&Professions Code)
z. 1,as owner ofthe property,am exclusively contracting with licensed Signature ofApplicc.t:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:07/13/2018
I hereby affirm under penalty of perjury one ofthe following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
r. 1 have and will maintain a Certificate of Consent to self-insure£or 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
e. I have and will maintain Worker's Compensation Insurance,as provided for by I leiverend the hazm-dmis 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
r it is issued. maintain complionce with the Cupertino Municipal Code,Chapter 9.12 and the
rye m Health&Safety Code,Section 25532(a)should 1 store or handle hazardous
s. I certify that in the performance of the work for which this e is issued,/ material.Additionally,should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to becomesubjsubject to the •contaminants as defined by the Bay 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,I beconne subject to the Worker's Compensation provisions £the the Health&Safety Code,Sections 25505,25533,and 25534.
Labor Code,l must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agent:
APPLICANT CERTIFICATION Date:07/13/2018
I 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,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 DECLARA'T'ION
Code,Section 9.18. 1 understand my plans shall be used as public records.
Licensed
Signature Date 07113/201 8 Professional