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BLD-2020-0533BUILDING PERMIT CUPERTINO CITY HALL 10300 Torre Avenue • Cupertino, CA 95014-3255 PHONE 408-777-3228 WWW.CUPERTINO.ORG BUILDING ADDRESS: 10353 MARY AVE CUPERTINO APN: 326 52 019 PERMIT NO: BLD-2020-0533 CONTRACTOR: MASTER PLUMBING AND SEWER INC, P O BOX 939 MOUNTAIN VIEW CONTRACTOR PHONE: 408-945-1000 DATE ISSUED 4/14/2020 7:23:42 AM ISSUED BY: KDUNBAR VALUATION: $9000 JOB DESCRIPTION ONLY (7 FIXTURES) PROVIDE FIRE CAULKING AT ALL FIRE WALL PENETRATIONS COVID-EP - INTERIOR COPPER REPIPE HOT WATER LICENSED CONTRACTOR DECLARATION provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full CONTRACTOR: MASTER LICENSED C36 LICENSED 812321 EXP 1 1 /30/2020 I hereby force I hereby PLUMBING AND SEWER INC CLASS: PLUMBING NO: DATE: affirm that I am licensed under the 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 of the following three consent to self -insure Insurance, work for which this this certificate be deemed revoked. declarations: 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 v 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 above of this city judgements, with all non -point - 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.