B-2019-1088 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR. PERMIT NO:B-2018-1088
10501 S FOOTHILL BLVD CUPERTINO,CA 95014-3913(342 46 003) SUN CONSTRUCTION
FREMONT,CA 94555
OWNER'S NAME: DATE ISSUED:08/06/2018
OWNER'S PHONE: P}IONE NO:(
LICENSED CONI'RACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lid.#984848
Contractor SUN CONSTRUCTION Date 06/30/2019 X BLDG X ELECT_PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH X RESIDENTIAL_COMMERCIAL
with Section 7000)alDivision 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
KITCHEN REMODEL(100 SF);LIGHT FIX(13);REMOVE WALL
I hereby affirm under penalty of perjury one of the following two declarations: BETWEEN KITCHEN&FAMILY ROOM
r. 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.
1 have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance o£the work for which this
permit is issued, Sq.Ft Floor Area: Valuation:$28000.00
APPLICANT CEI2TIFiCATION
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: Occupancy Type:
and state laws relating to building construction,and hereby authorize 342 46 003
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 WORI{IS NOT STARTED
may accrue against said consequence of the granting this permit WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicantt understands
rstands and will comply with all ll non-point
source regulations the Cup tlno Municipal Code,Section 9.18, 180 DAYS FROM LAST CALLED INSPECTION.
Signature �/� Date 08/06/2018 Issued by:Jasmine Archbold
Date:08/06/2018
O WNER-BUILDER DECLARATION
I hereby al'Po•m 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.Its roof is
r. 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 or offered for inspection.
sale(Sec.7044,Business&Professions Cade)
2. I,as owner of the property,am exclusively contracting with licensed Signature ol'Applicant,
contractors to construct the project(Sce.7044,Business&Professions Code), Date:08/06/2018
1 hereby affirm under penalty of perjury one of the 1'o11owfhg 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 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 Cade,Sections 25505,25533,ead 25534.I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
s. I certify that in the performance of the work for which this permit ie issued,I Health&Safety Code,Section 25532(a)should 1 store on handle hazardous
shall not employ any person in any manner so as to become subject to the material,Additionally,should 1 use equipment or devices which emit hazardous
airantamin nts as defined by the Bay Area Air an
Quality Management District I
Worker's Compensation laws of California.If,ager making this certI ionic of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
exemption,1 become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534.
Labor Code,1 mn st forthwith comply with such provisions or this permit shall
be deemed revoked' Owner or authorized agent;
APPLICANT CERTIFICATION Oate:98!0612018
I certify that I have read this application and state that the above information is T
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 DECLARATION
Code,Section 9.18. 1 understand my plans shall be used as public records.
Signature Data 08106/2018 Licensed
Professional