B-2018-1287 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-1287
20568 STEVENS CREEK BLVD CUPERTINO,CA 95014-2130(359 08 028) RED HAWK FIRE&
SECURITY CA LLC
ORANGE,CA 92867
OWNER'S NAME:Byer Properties Up DATE ISSUED:08/21/2019
OWNER'S PHONE: PHONE NO;(
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class Ce16,C10 Lic.#17 3099
Contractor RED HAWK FIRE&SECURITY CA LLC Date 11/30/2018 X BLDG X ELECT—PLUMB
1 hereby affirm that I am licensed under the provisions of Chapter 9(commencing —MECH—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:
EVERTRUST BANK-T.I.-INSTALL(1)ATM
I hereby affirm under penalty of perjury one of the following two declarations:
t. 1 have and will maintain it 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.
�. have and will maintain Worker's Compensation insurance,as provided for by
Section 3700 of Che Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Flaar Area: Valuation:$30500.00
APPITCANT CERTTFTCATTON
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: Oce formey'lype
and state 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 WORI{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 8/21/2018 Issued by:Jasmine Archbold
Date:08/21/2018
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS:
following two rommnso All roofs.shall be inspected prior to any roofing material being installed.If a roof is
n. 1,as owner of the property,or my employees with wages as their sole installed without first obtaining Em inspection,I agree to remove all new materials for
compensation,will do the work,and the sit nature is not intended or offered for inspection.
sale(Sce.7044,Business&Professions Code)
z I,as owner of the property,am exclusively contracting with licensed Signature ofApplicanC
contractors to construct the project(Sea 7044,Business&Professions Cade). Dale; 24 1 2j 018
1 hereby affirm under penalty of perjury one ol'the following three declarations: A1.L 1200F 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 provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE
x, I have and will maintain Worker's Compensation Insurance,as provided for by I hnve read the haze dans materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code,for the perfmnmunce of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534.I will
mainudn compliance with the Cupertino Municipal Code,Chapter 9.12 and the
permit is issued.
s. 1 certify that in the perficat-mc of the work for which this permit is issued,I Health&Safety Coda Section 25532(a)should 1 stare or handle hazardous
shall not employ any person in any manner so as to become subject m the material.Additionally,should f use equipment or devices which emit hazardous
air contaminants as dented 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 became subject to the Worker's Compensation provisions of the the Health&Safety Cade,Stations 25505,25533,and 25534.
Labor Code,l must forthwith comply with such to or this permit shall
be deemed revoked.- Owner or authorized agent: ;?
APPLICANT CERTIFICA'1'fON Date:812T/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 MunicipalARCHITECT'S DECLARATION
Code,Section 9.18. 1 understand my plans shall be used as public records.
Licensed
Signature Date 8121!2018 Professional