B-2019-0126 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2019-0126
19731 LA MAR DR CUPERTINO, CA 95014-3308 (369 10 022) ALL PRO REPIPES INC
SAN JOSE, CA 95112
OWNER'S NAME: DATE ISSUED: 01/18/2019
OWNER'S PHONE: PHONE NO: (408) 332-8571
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C-36 Lic. #1022644
Contractor ALL PRO REPIPES INC Date 01/31/2021 X BLDG — ELECT X 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 of the Business & Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
REPIPE (E) SINGLE FAMILY DWELLING WITH COPPER.
I hereby affirm under penalty of perjury one of the following two declarations:
1. 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.
.
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. Sq. Ft Floor Area: Valuation: $7300.00
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: Occupancy Type:
and state laws relating to building construction, and hereby authorize 369 10 022
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 Cup rtino against liabilities, judgments, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED
ccr
may aue J.Usf.,sai�'City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additional l, , ' appli . n ,ra,dt5'rs nds and will comply with all non-point
source
9.18. 180 DAYS. FROM LAST CALLED INSPECTION.
Signature ,. °'" Date 1 . 18. 19 Issued by: SEAN HATCH
Date: 01/18/2.019
W ER-BUI R DECLARATIO
I hereby affirm 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. 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, 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)
2. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant:
contractors to construct,the project (Sec.7044, Business & Professions Code). Date: 1.18.19
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1. 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 Code, Sections 25/505, 25533, and 25534. I will
maintain compliance with the Cupertino Mun'ki al Code Chapter 9.12 and the
.permit is issued. p � p � p
3. 1 certify that in the performance of the work for which this permit is issued, l Health & Safety Code, Sect's n 25532(a) sl uld I store or handle hazardous
shall not employ any person in any manner so as to become subject to the material. Additionally, should � se equip ent or evices which emit hazardous
air contaminants as defined by th e r ualityr1> 4anagement District 1
Worker's Compensation laws of California, If, after making this certificate of will maintain compliance witl
correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a o6struction 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.
Licensed
Signature Date 1.18. 19
Professional