BLD-2019-0587BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 10200 BYERLY CT CUPERTINO
APN: 342 12 088
PERMIT NO: BLD-2019-0587
CONTRACTOR: DESIGNERS GROUP INC, 328 AVENIDA PINOS CUPERTINO
CONTRACTOR PHONE:
DATE ISSUED 8/25/2020 1 1:12:26 PM
ISSUED BY: KDUNBAR
VALUATION: $180000
JOB DESCRIPTION
SPACE (121 SF); (N) FRONT PORCH (59 SF); KITCHEN REMODEL (239 SF); BATHROOM REMODEL (210 SF); REMODEL
ADDITION (243 SF); CONVERT GARAGE SPACE TO HABITABLE
OTHER (540 SF); PANEL UPGRADE (200 AMP); (N) WATER HEATER
LICENSED CONTRACTOR DECLARATION
Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
CONTRACTOR:
LICENSED
LICENSED
EXP
I hereby
force
I hereby
DESIGNERS GROUP INC
CLASS: B GENERAL BUILDING CONTRACTOR
NO: 875563
DATE: 04/30/2022
affirm that I am licensed under the provisions of
and effect.
affirm under penatiy of perjury one of the following
I have and will maintain a certificate of consent to self
for which this permit is issued.
I have and will maintain Worker's Compensation Insurance,
I certify that in the performance of the work for which
laws of California. If, after making this certificate
with such provisions or this permit shall be deemed
three
-insure
this
revoked.
declarations:
for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the
le
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.
V
Compensation
comply
HAZARDOUS MATERIALS DISCLOSURE
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 under
the Cupertino Municipal Code, Chapter 9.12 and the
le
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.
or devices which emit hazardous air contaminants
Code, Chapter 9.12 and the Health & Safety Code,
EPA LEAD -SAFE DISCLOSURE
for this project.
Firm Certification No:
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
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
above
city
.