BLD-2020-1766BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 20488 STEVENS CREEK BLVD UNIT 2306
CUPERTINO
APN: 369 53 003
PERMIT NO: BLD-2020-1766
:
DATE ISSUED 10/29/2020 11:04:01 AM
ISSUED BY: haleym
VALUATION: $10000
JOB DESCRIPTION
WINDOW LIKE FOR LIKE - 2ND FLOOR UPSTAIRS HALLWAY; 1ST FLOOR LIVING ROOM REPLACE DRYWALL - (30 SF)
CONDO # 2306 - REPLACE
LICENSED CONTRACTOR DECLARATION
to
Insurance,
which
certificate
AND DECORATING
of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
CONTRACTOR:
LICENSED
B GENERAL
LICENSED
EXP
05/31/2022
I hereby
force
I hereby
TESLA ENERGY OPERATIONS INC
CLASS:
BUILDING CONTRACTOR, C10 ELECTRICAL, C33 PAINTING
NO: 617681
DATE:
affirm that I am licensed under the provisions
and effect.
affirm under penatiy of perjury one of the following
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
three
self -insure
this permit
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
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 Chapter
the Health
as
Code, Sections
6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance
I
the
have read the hazardous materials requirements
Cupertino Municipal Code, Chapter 9.12 and
V
with
equipment
Municipal
& Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use
defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino
25505, 25533, and 25534.
or devices which emit hazardous air contaminants
Code, Chapter 9.12 and the Health & Safety
EPA LEAD -SAFE DISCLOSURE
for this project.
Firm Certification No:
project.
An EPA Lead -Safe Certified Renovator will be responsible
Firm Name:
No EPA Lead -Safe Certified Firm is required for this
Certified
V
CONSTRUCTION LENDING AGENCY
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 there is a
No
V
Lender's
Name:
APPLICATION CERTIFICATION
this
the above
city to
costs,
-point source
information is correct. I agree to comply with all city and county ordinances and state laws relating to building
enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep
and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,
regulations per the Cupertino Municipal Code, Section 9.18.
I certify
construction,
harmless
the applicant
Signature:
that I have read this
and hereby
the City of Cupertino
understands
application and state that
authorize representatives of
against liabilities, judgements,
and will comply with all non
.