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B-2018-1244 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO:B-2018-1244 20690 STEVENS CREEK BLVD CUPERTINO,CA 95014-2120(359 08 028) SUPERIOR ELECTRICAL ADVERTISING INC LONG BEACH,CA 90813 OWNER'S NAME:BYER PROPERTIES LP DATE ISSUED:07/31/2018 OWNER'S PHONE: PHONE NO:( LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-45 Lie.#771598 Contractor SUPERIOR ELECTRICAL ADVERTISING INC Date 02/28/2019 X BLDG_ELECT—PLUMB I hereby affirm that 1 am licensed ander the provisions of Chapter 9(commencing MEC14_RESIDENTIAL X COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is In full force and effect. JOB DESCRIPTION: INSTALL(2)ILLUMINATED WALL SIGNS I hereby affirm under penalty of perjury one of the following two declarations I. 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 far which this permit is issued 2 ,-I have and will maintain Worker's Compensation insurance,as provided far by Section 3700 afire Labor Code,fet the performance of the work for which this permit is issued Sq.Ft Flour Arca: Valuation:$6000.00 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: Occupimey'lype: and state laws relating to building construction,and hereby authorize 35908 028 A(Tenant hol—venteuts) 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 regul�theunicipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. 07131/2018 Issued by:Jasmine Archbold Date:07/31/2018 OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for one of the RE-ROOFS: following hvo reasons: All..is shall be inspected prior to any roofing material being installed.If a roof is 1. I,as owner of the 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. .to(See.7044,Business&Professions Code) z 1,as owner of the property,am exclusively contracting with licensed Signature of Applicanh contractors to construct the project(Sec.7044,Business&Professions Code). Date:07/31/2018 I hereby affirm tender penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER u I have and will maintain a Certificate of Consent to self-insure for Worker's Compensation,as provider)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 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 ise oxl. maintain compliance with fine Cupertino Municipal Code,Chapter 9.12 and the s. I certify that in the performatim of the work for which this permit is issued,I Health&Safety Code,Section 25532(x)should I store or handle Imzardous shall not employ my on in an manner so as to become subject to the material.Additionally,should I use equipment at-devices which emit hazardous P y yion l y l air rea tamhmnts as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California.If,after making this eertifiente oP will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked, Owner or authorized agent: APPLICANT CERTIFICATION Date:07/31/2018 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 ARCA I'1'LC'1"S DECLARATION Code,Section 9.18. I understand my plans shall ba used as public records. Signature Date 07/3112018 Licensed