B-2018-1102 CITY OF CUPERTINO BUILDING PERMIT
BUILDINCADDRESS: CONTRACTOR: PERMIT NO:B-2018-1102
20568 STEVENS CREEK BLVD CUPERTINO,CA 95014-2130(359 08 028) KYI CHOW SEAR
SOUTH EL MONTE,CA
91733
OWNER'S NAME:BYER PROPERTIES LP DATE ISSUED:07/25/2018
OWNER'S PHONE: PHONE NO:(626)444-6027
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C-45 Lie.#652665
Contractor KYI CHOW SHAR Date 08/31/2018 X BLDG—ELECT—PLUMB
MECH RESIDENTIAL X 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 full force and effect. JOB DESCRIPTION:
EVERTRUST BANK-(1)ILLUMINATED WALL SIGN-(45 SF)
I hereby affirm under penalty of perjury one of the following two declarations:
L 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 Code,for the
performance of the work for which this permit is issued.
z. 1 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 Arem 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: Occupancy Type:
and stale laws relating to building construction,and hereby authorize 359 08 028
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 9.1 B. 180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 07/25/2018 Issued by:Jasmine Archbold
Date:07/25/2018
OWNER-BUILDER DECLA ATION
f hereby affirm that I am exempt train the Contractor's License Law for one of the RE-ROOFS:
]allowing two reasons: All roofs shall be inspected to 10 any roofing notarial being installed.If a rool'is
r. I,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)
z, 1,as owner of the property,am exclusively contracting with licensed Signature ofApplicanc
contractors to construct the project(Sec.7044,Business&Professions Code). Date:07/25/2018
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
r. I 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,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 read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 ofthe Labor Code,for the performance of the work for
which this California Health&Safety Code,Sections 25505,25533,and 25534.1 will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
s. I certify that in due performance of the work for which this permit is issued,I Health&Safety Coda,Section 25532(.)should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the matnial.Additionally,should 1 use equipment or devices which emit hazardous
air conhrmimmts as detmed by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of wig maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
exemption,/became subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,lad 25534.
Labor Code,I most forthwith comply with such provisions m this permit shall
be deemerl revoked. Owner or authorized agent:
APPLICANT CERTIFICATION Date:07/25/2018
I certify that I have read this application and slate that the above information is CONSTRUCTION LENDIN E Y
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there Is a construction lendin 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 DECLARATION
Code,Section BAB. I understand my plans shall be used as public records.
Licensed
Signature Date 07125/2018 Professional