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B-2019-0968BUILDING 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: BARRON BUILDERS INC, 2346 CALLE DEL MUNDO SANTA CLARA CONTRACTOR PHONE: DATE ISSUED 11 /4/2019 3:04:37 PM ISSUED BY: JARCHBOLD 1 VALUATION: $250000 JOB DESCRIPTION AMAZON SJC1 SUITE 800 (8TH FLOOR)- T.I. (4,352 SF); REFRESH BREAK ROOMS, PARTIAL NEW OPEN OFFICE FURNITURE, NEW DOOR IN EXISTING WALL, NEW GENDER NEUTRAL RESTROOM AND NEW FINISHES/FURNITURE IN 5 ROOMS AND RECEPTION. NEW WORK INCLUDED PARTITIONS, DOORS, ACOUSTIC CEILING, ELECTRICAL, MECHANICAL, PLUMBING, MILLWORK AND FINISHES. LICENSED CONTRACTOR DECLARATION CONTRACTOR: BARRON BUILDERS INC LICENSED CLASS: B GENERAL BUILDING CONTRACTOR LICENSED NO: 916366 EXP DATE: 07/31/2021 I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penatiy of perjury one of the following three declarations: 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. V I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation comply laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith with such provisions or this permit shall be deemed revoked. HAZARDOUS MATERIALS DISCLOSURE V I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment Municipal or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. An EPA Lead -Safe Certified Renovator will be responsible for this project. Certified Firm Name: v Firm Certification No: No EPA Lead -Safe Certified Firm is required for this project. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work which this permit is issued (Section 3097, Civil Code). Yes V No Lender's Name: Lender's Address: APPLICATION CERTIFICATION I certify , Section 9.18. Signature: