BLD-2020-2092BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 20200 LUCILLE AVE APT 78 CUPERTINO
APN: 316 02 094
PERMIT NO: BLD-2020-2092
OWNER'S NAME: VERANDAS APARTMENTS LLC
OWNER'S PHONE: 408-257-9941
JOB DESCRIPTION
ENTIRE UNIT; REPLACE (3) WINDOWS AND (1) SLIDER; (N) 100 AMP SUB -PANEL; RE -PIPE ENTIRE UNIT; REPLACE (3) WINDOWS AND (1) SLIDER; (N) 100 AMP
(88 SF); BATHROOM REMODEL (165 SF); REMODEL OTHER (122 SF); (N) LED LIGHTING (15 TOTAL); (N) FURNACE AND A/C UNITS; SEE MASTER PLAN
VERANDAS - UNIT 78- RE -PIPE
SUB -PANEL; KITCHEN REMODEL
PERMIT B-2019-0090 FOR DRAWINGS
LICENSED CONTRACTOR DECLARATION
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
01/31/2023
I hereby
force
I hereby
CORNERSTONE SELECT
CLASS:
BUILDING CONTRACTOR,
NO: 888881
DATE:
affirm that I am licensed
and effect.
affirm under penatiy
I have and will maintain
for which this permit is issued.
I have and will maintain
I certify that in the performance
laws of California.
with such provisions
BUILDERS INC
C-9 DRYWALL
under the provisions of Chapter
of perjury one of the following three
a certificate of consent to self -insure
Worker's Compensation Insurance,
of the work for which this
If, after making this certificate
or this permit shall be deemed revoked.
declarations:
for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the
V
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.
Compensation
comply
HAZARDOUS MATERIALS DISCLOSURE
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 Chapter
the Cupertino Municipal Code, Chapter 9.12 and the Health
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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
Renovator will be responsible for this project.
Firm Certification No:
Firm is required for this project.
An EPA Lead -Safe Certified
Firm Name:
No EPA Lead -Safe Certified
Certified
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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
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 that
construction,
harmless
the applicant
Signature:
I have read this
and hereby authorize
the City of Cupertino
understands and
application and state that the above
representatives of this city to
against liabilities, judgements, costs,
will comply with all non -point source
4:54..A..../GO
.