BLD-2020-0634BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 10818 CARVER DR Cupertino
APN: 375 32 003
PERMIT NO: BLD-2020-0634
CONTRACTOR:
TOP BUILDER, 10750 MINETTE DR. CUPERTINO
CONTRACTOR PHONE:
408-598-0850
DATE ISSUED 5/11/2020 10:51:09 AM
ISSUED BY: haleym
VALUATION: $600
JOB DESCRIPTION
TEMPORARY POWER POLE (100 AMP)
LICENSED CONTRACTOR DECLARATION
of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
CONTRACTOR:
TOP
LICENSED
B GENERAL
LICENSED
1003446
EXP
05/31/2021
I hereby
force
I hereby
BUILDER
CLASS:
BUILDING CONTRACTOR
NO:
DATE:
affirm that I am licensed under the provisions
and effect.
affirm under penatiy of perjury one of
I have and will maintain a certificate of consent
for which this permit is issued.
I have and will maintain Worker's Compensation
I certify that in the performance of the work
laws of California. If, after making
with such provisions or this permit shall
the following three
to self -insure
Insurance,
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
issued.
V
Compensation
comply
HAZARDOUS MATERIALS DISCLOSURE
under
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 9.12
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
is a construction lending agency for the performance of the work which this permit is issued (Section 3097, Civil Code).
Lender's Address: 10818 carver dr, Cupertino ca 95014
I hereby
Yes
affirm
under penalty of perjury that there
No
Liawhai-Pyng peter
V
Lender's
Name:
APPLICATION CERTIFICATION
that the above
of this city
judgements,
all non -point
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 state
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.