B-2018-1510BUILDING 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:
QUIRING GENERAL LLC, 5118 E CLINTON WAY SUITE 201 FRESNO
CONTRACTOR PHONE:
DATE ISSUED 11 /21 /2019 11:19:54 AM
ISSUED BY: PDEVRIES
VALUATION: $23000000
JOB DESCRIPTION
THE FORUM VILLAS, 23 NEW UNITS (40,615 SF); GARAGES (13,836 SF); PORCHES (23); SITE RETAINING WALLS. (REFER TO B-2018-1819 FOR SITE RETAINING WALLS) REV #1 -
OCCUPANCY CHANGE TO R3.1; ADDITION OF 2ND EXIT STAIRS AND PATHWAYS; CHANGE IN PATIO ROOF HEIGHT AND ASSEMBLY ON SEVERAL VILLAS - ISSUED 08/01/2019 DEF#2 -
VILLAS TRUSSES 63,64,65,66,69/70,71,72/73,74/75,76/77,78/79,80/81,82/83 REV #2 - REVISE LOCATIONS AND REMOVE ATTIC ACCESS PANELS WITHIN VILLAS- ISSUED 9/10/19 DEF # 1 -
TRUSSES FOR V61, V62, V67, V68 - ISSUED 08/28/2019 (B-2019-0416, B-2019-0421, B-2019-0415, B-2019-0418) REV #3 - CHANGE CONSTRUCTION TYPE FROM TYPE VA TO TYPE VB
LICENSED CONTRACTOR DECLARATION
CONTRACTOR:
QUIRING GENERAL LLC
LICENSED CLASS:
B GENERAL BUILDING CONTRACTOR
LICENSED NO:
973147
EXP DATE:
05/31/2020
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
No
Lender's Name:
Lender's Address:
APPLICATION CERTIFICATION
: