BLD-2021-0177BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 10408 STERLING BLVD Cupertino
APN: 375 24 005
PERMIT NO: BLD-2021-0177
OWNER'S NAME:
JOB DESCRIPTION
DEMO 1-STORY SINGLE FAMILY DWELLING - (1048 SF) AND CARPORT - (264 SF)
LICENSED CONTRACTOR DECLARATION
CONTRACTOR: GILBERTO FERNANDEZ JR
LICENSED CLASS:
B GENERAL BUILDING CONTRACTOR
LICENSED NO: 954667
EXP DATE:
11/30/2022
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
force and effect.
I hereby affirm under penatiy of perjury one of the following three declarations:
I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the
work
for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
V
I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's
Compensation
comply
laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith
with such provisions or this permit shall be deemed revoked.
HAZARDOUS
MATERIALS DISCLOSURE
V
I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance
with
the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use
equipment
Municipal
or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino
Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534.
EPA
LEAD -SAFE DISCLOSURE
An EPA Lead -Safe Certified Renovator will be responsible for this project.
Certified
Firm Name:
V
Firm Certification No:
No EPA Lead -Safe Certified Firm is required for this project.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work which this permit is issued (Section 3097, Civil Code).
Yes
V
No
Lender's Name:
Lender's Address:
APPLICATION CERTIFICATION
I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep
harmless the City of Cupertino against liabilities, judgements, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,
the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18.
Signature:
...
.
CITY OF CUPERTINO - BUILDING DIVISION
10300 TORRE AVENUE CUPERTINO, CA 95014-3255
PHONE 408-777-3228 WWW.CUPERTINO.ORG/ACCELA
JOB CARD
THIS CARD MUST BE POSTED AT A LOCATION VISIBLE FROM THE STREET FRONTAGE ON SITE OF THE STRUCTURE
BEING PERMITTED AND IS NOT TO BE REMOVED UNTIL BUILDING FINAL.
A HARD-COPY OF THE APPROVED PLANS AND DOCUMENTS SHALL BE KEPT AT THE SITE OF WORK.
Permit No: BLD-2021-0177 Issued Date: 03/22/2021
Building Address: 10408 STERLING BLVD Cupertino Contractor: GILBERTO FERNANDEZ JR
Job Description:
DEMO 1-STORY SINGLE FAMILY DWELLING - (1048 SF) AND CARPORT - (264 SF)
EVERY PERMIT ISSUED SHALL BECOME INVALID UNLESS THE WORK ON THE SITE AUTHORIZED BY SUCH PERMIT IS COMMENCED WITHIN 12 MONTHS AFTER ITS ISSUANCE, OR IF THE
WORK AUTHORIZED ON THE SITE BY SUCH PERMIT IS SUSPENDED OR ABANDONED FOR A PERIOD OF 12 MONTHS AFTER THE TIME THE WORK IS COMMENCED.
*PLEASE REFER TO QR CODE FOR ANY REVISIONS OR UPDATED INFORMATION
INSPECTION RECORD
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 10408 STERLING BLVD Cupertino APN: 375 24 005 PERMIT NO: BLD-2021-0177
OWNER'S NAME: RANATUNGA JANAKA OWNER'S PHONE: 650-743-5497
CONTRACTOR: GILBERTO FERNANDEZ JR, 1821 SOUTH BASCOM AVENUE # 258 CAMPBELL CONTRACTOR PHONE: 4085008511
DATE ISSUED 9/7/2023 4:00:16 PM ISSUED BY:VALUATION: $30000
JOB DESCRIPTION
DEMO 1-STORY SINGLE FAMILY DWELLING - (1048 SF) AND CARPORT - (264 SF)
INSPECTION TYPE DATE STATUS INSPECTOR
PW-TREE PROTECTION 2021-03-10 Passed Kevin Rieden
DEMOLITION STRUCTURE 2021-04-02 Passed Bob Sabich
FINAL BUILDING 2023-09-07 Passed James Lee
EVERY PERMIT ISSUED SHALL BECOME INVALID UNLESS THE WORK ON THE SITE AUTHORIZED BY SUCH PERMIT IS COMMENCED WITHIN 12 MONTHS AFTER ITS ISSUANCE, OR IF THE WORK
AUTHORIZED ON THE SITE BY SUCH PERMIT IS SUSPENDED OR ABANDONED FOR A PERIOD OF 12 MONTHS AFTER THE TIME THE WORK IS COMMENCED.