B-2019-0800BUILDING 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:
CUPERTINO CONSTRUCTION, P O BOX 2554 SAN JOSE
CONTRACTOR PHONE:
4083137601
DATE ISSUED 12/18/2019 1:47:11 PM
ISSUED BY: KDUNBAR
VALUATION: $90000
JOB DESCRIPTION
BATHROOM (120 SF); INSTALL (1) NEW PORCH; RELOCATE THE STAIRWAY REV#1-BATHTUB WITH SHOWER -ISSUED 12-18-2019
ADD (177 SF) ENTRY; REMODEL(2)
LICENSED CONTRACTOR DECLARATION
(commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
CONTRACTOR:
CUPERTINO
LICENSED
B GENERAL
LICENSED
1005169
EXP
03/31/2021
I hereby
force
I hereby
CONSTRUCTION
CLASS:
BUILDING CONTRACTOR
NO:
DATE:
affirm that I am licensed
and effect.
affirm under penatiy of
I have and will maintain a
for which this permit is issued.
I have and will maintain Worker's
I certify that in the performance
laws of California.
with such provisions or
under the provisions of Chapter 9
perjury one of the following three declarations:
certificate of consent to self -insure for
Compensation Insurance, as
of the work for which this permit
If, after making this certificate of
this permit shall be deemed revoked.
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
issued.
V
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
by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino
25505, 25533, and 25534.
project.
Firm Certification No:
or devices which emit hazardous air contaminants as defined
Code, Chapter 9.12 and the Health & Safety Code, Sections
An EPA Lead -Safe Certified Renovator will be responsible for this
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
and state that the above information
representatives of this city to enter
against liabilities, judgements, costs,
:
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.