Loading...
BLD-2020-2189BUILDING PERMIT CUPERTINO CITY HALL 10300 Torre Avenue • Cupertino, CA 95014-3255 PHONE 408-777-3228 WWW.CUPERTINO.ORG BUILDING ADDRESS: 1064 WESTLYNN WAY Cupertino APN: 359 32 062 PERMIT NO: BLD-2020-2189 OWNER'S NAME: OWNER'S PHONE: Not Provided CONTRACTOR: COSMOS ROOFING INC, 1901 OLD MIDDLEFIELD WAY STE 4 MOUNTAIN VIEW CONTRACTOR PHONE: 6507935012 DATE ISSUED 12/30/2020 3:35:14 PM ISSUED BY: VALUATION: $26465 JOB DESCRIPTION Re roof House, Garage and Shed LICENSED CONTRACTOR INFORMATION CONTRACTOR: COSMOS ROOFING INC LICENSED CLASS: C39 ROOFING LICENSED NO: 785441 EXP DATE: 04/30/2021 I hereby force I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full and effect. affirm under penatiy of perjury one of the following three declarations: I have and will maintain a certificate of consent to self -insure for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as I certify that in the performance of the work for which this permit laws of California. If, after making this certificate of with such provisions or this permit shall be deemed revoked. and agree that I am electronically signing and filing this that I have the option of filing a paper copy of this application for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the 1 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 exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith application and that checking the box below has the same legal effect as manual signature. I also with a manual signature but have chosen instead to file this application electronically. work 2 issued. 3 Compensation comply I understand understand