B-2019-0786BUILDING 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:
OK HEE KIM, 825 S SAN TOMAS AQUINO RD #26 CAMPBELL
CONTRACTOR PHONE:
DATE ISSUED 8/7/2019 1:17:30 PM
ISSUED BY: HALEYM
VALUATION: $250000
JOB DESCRIPTION
(1,464 SF); REMODEL BATHROOMS (191 SF); REMODEL KITCHEN (132 SF); (N) FRONT PORCH (73 SF); REMOVE
FULLY SPRINKLER BLDG; UPGRADE ELECTRICAL PANEL (200 AMPS); (N) TANKLESS WATER HEATER; (N) FURNACE;
FRONT ADDITIONS (56 SF); REAR ADDITION (912 SF); REMODEL OTHER
ENTIRE ROOF FRAMING WITH NEW ROOF TRUSSES FOR LIVING SPACE;
(N) A/C UNIT. UPGRADE WATER LINE AND METER AS REQUIRED.
LICENSED CONTRACTOR DECLARATION
9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
CONTRACTOR:
OK HEE
LICENSED
B GENERAL
LICENSED
638489
EXP
01/31/2020
I hereby
force
I hereby
KIM
CLASS:
BUILDING
NO:
DATE:
affirm
and effect.
affirm
I have and
for which
I have and
I certify that
with
CONTRACTOR
that I am licensed under the provisions of Chapter
under penatly of perjury one of the following three
will maintain a certificate of consent to self -insure
this permit is issued.
will maintain Worker's Compensation Insurance, as
in the performance of the work for which this permit
laws of California. If, after making this certificate of
such 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
work
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
V
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