B-2019-0051BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS:
OWNER'S NAME: Not provided
OWNER'S PHONE: Not Provided
CONTRACTOR:
T R DEVELOPMENT & CONSTRUCTION INC, 15559 UNION AVE #229 LOS GATOS
CONTRACTOR PHONE:
4083292831
DATE ISSUED 10/30/2019 11:55:31 AM
ISSUED BY: KDUNBAR
VALUATION: $400000
JOB DESCRIPTION
AREA - (953 SF); REMODEL OTHER - (1281 SF); (N) DECK - (580 SF); UPGRADE PANEL - (200 AMP); (N) 75-GAL WATER HEATER; RELOCATE AND REPLACE
AC UNIT SAME LOCATION; INSTALL EV CHARGING STATION IN GARAGE - (40 AMP) REV#1 - FRONT ENTRANCE OVERHANG;ADD SIDE -LIGHT AT ENTRANCE
OF BEDROOM WINDOWS (2)-ISSUED 10/30/2019
ADD LIVING/DINING
FURNACE; REPLACE
DOOR;CHANGE HEIGHT
LICENSED CONTRACTOR DECLARATION
9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
CONTRACTOR:
T R DEVELOPMENT
LICENSED
B GENERAL
LICENSED
861855
EXP
11/30/2019
I hereby
force
I hereby
&
CLASS:
BUILDING
NO:
DATE:
affirm that
and effect.
affirm under
I have and will
for which this
I have and will
I certify that in
laws
with such
CONSTRUCTION INC
CONTRACTOR
I am licensed under the provisions of Chapter
penatly of perjury one of the following three
maintain a certificate of consent to self -insure
permit is issued.
maintain Worker's Compensation Insurance,
the performance of the work for which this permit
of California. If, after making this certificate of
provisions or this permit shall be deemed revoked.
declarations:
for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the
V
work
as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
is issued, I shall not employ any person in any manner so as to become subject to the Worker's
exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith
issued.
Compensation
comply
HAZARDOUS MATERIALS DISCLOSURE
6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance
I have read the hazardous materials requirements under Chapter
the Cupertino Municipal Code, Chapter 9.12 and the Health
V
with
equipment
Municipal
& Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use
defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino
25505, 25533, and 25534.
this project.
Firm Certification No:
or devices which emit hazardous air contaminants as
Code, Chapter 9.12 and the Health & Safety Code, Sections
An EPA Lead -Safe Certified Renovator will be responsible for
Firm Name:
No EPA Lead -Safe Certified Firm is required for this project.
Certified
v
CONSTRUCTION LENDING AGENCY
lending agency for the performance of the work which this permit is issued (Section 3097, Civil Code).
Lender's Address:
I hereby
Yes
affirm
under penalty of perjury that there is a construction
No
V
Lender's
Name:
APPLICATION CERTIFICATION
information is correct. I agree to comply with all city and county ordinances and state laws relating to building