BLD-2020-1434BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 10315 CALVERT DR Cupertino
APN: 375 17 020
PERMIT NO: BLD-2020-1434
CONTRACTOR: MIKE COUNSIL PLUMBING INC, 1915 O'TOOLE WAY SAN JOSE
CONTRACTOR PHONE:
DATE ISSUED 9/1 1 /2020 7:45:22 AM
ISSUED BY: JASMINE ARCHBOLD
VALUATION: $2097
JOB DESCRIPTION
WALL
REPLACE HALLWAY SINK DRAIN WITHIN
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:
LICENSED
LICENSED
EXP
I hereby
force
I hereby
MIKE COUNSIL PLUMBING INC
CLASS: Could not retrieve LP info.
NO: 679261
DATE: Could not retrieve LP info.
affirm that I am licensed under the provisions
and effect.
affirm under penatiy of perjury one of the
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 for
laws of California. If, after making this
with such provisions or this permit shall be deemed
following
to self
Insurance,
which this
certificate
three declarations:
-insure 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
revoked.
V
issued.
Compensation
comply
HAZARDOUS MATERIALS DISCLOSURE
requirements
Chapter 9.12
under
and the
Code,
Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance
I have
the
read the hazardous materials
Cupertino Municipal Code,
V
with
equipment
Municipal
Health & 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
EPA LEAD -SAFE DISCLOSURE
will be responsible for this project.
Firm Certification No:
is required for this project.
An EPA Lead -Safe Certified Renovator
Firm Name:
No EPA Lead -Safe Certified Firm
Certified
v
CONSTRUCTION LENDING AGENCY
that 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
No
V
Lender's
Name:
APPLICATION CERTIFICATION
and state
liabilities, judgements,
with all
i
.