BLD-2019-1426BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 7640 ERIN WAY Cupertino
APN: 359 21 016
PERMIT NO: BLD-2019-1426
CONTRACTOR:
RANDO AAA HVAC INC, 1712 STONE AVE #1 SAN JOSE
CONTRACTOR PHONE:
DATE ISSUED 11 /21 /2019 11:18:24 AM
ISSUED BY: JARCHBOLD
VALUATION: $4465.00
JOB DESCRIPTION
REPLACE FURNACE - SAME LOCATION
LICENSED CONTRACTOR DECLARATION
of the
consent
work
of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
CONTRACTOR:
RANDO
LICENSED
C20
LICENSED
768871
EXP
09/30/2021
I hereby
force
I hereby
AAA HVAC INC
CLASS:
WARM -AIR HEATING%2C VENTILATING AND AIR-CONDITIONING
NO:
DATE:
affirm that I am licensed under the provisions
and effect.
affirm under penatiy of perjury one
I have and will maintain a certificate of
for which this permit is issued.
I have and will maintain Worker's Compensation
I certify that in the performance of the
laws of California. If, after making
with such provisions or this permit shall
following
to self
Insurance,
for which this
this certificate
be deemed revoked.
three declarations:
-insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the
work
as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's
of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith
V
issued.
Compensation
comply
HAZARDOUS MATERIALS DISCLOSURE
under
9.12 and the Health
Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance
I have read the hazardous materials requirements
the Cupertino Municipal Code, Chapter
V
with
equipment
Municipal
& Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use
as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino
Sections 25505, 25533, and 25534.
for this project.
Firm Certification No:
or devices which emit hazardous air contaminants
Code, Chapter 9.12 and the Health & Safety Code,
An EPA Lead -Safe Certified Renovator will be responsible
Firm Name:
No EPA Lead -Safe Certified Firm is required for this project.
Certified
CONSTRUCTION LENDING AGENCY
there is a construction 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
No
V
Lender's
Name:
APPLICATION CERTIFICATION
state
that the
of this city
judgements,
all non -point
above information is correct. I agree to comply with all city and county ordinances and state laws relating to building
to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep
costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,
source regulations per the Cupertino Municipal Code, Section 9.18.
I certify that I have read this application and
construction, and hereby authorize representatives
harmless the City of Cupertino against liabilities,
the applicant understands and will comply with
:
Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 365 days after its issuance, or if the work authorized on the site by such permit is suspended or abandoned for a period
of 365 days after the time the work is commenced.