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BLD-2021-0640BUILDING PERMIT CUPERTINO CITY HALL 10300 Torre Avenue • Cupertino, CA 95014-3255 PHONE 408-777-3228 WWW.CUPERTINO.ORG BUILDING ADDRESS: 10129 S BLANEY AVE APT I CUPERTINO APN: PERMIT NO: BLD-2021-0640 OWNER'S NAME: LAKE BILTMORE APARTMENTS OWNER'S PHONE: Not Provided JOB DESCRIPTION UNIT D "CLARION" - Remodel Bath (212 S.F.); Remodel Kitchen (101 S.F.); Remodel Other (35 S.F.); New Lights (7 Total); New Floor plans are on Master Permit Number B-2017-1522. THE BILTMORE APARTMENT - Remodel Apartment: Outlets (7 Total) ; New Condenser/Fan Coil System. LICENSED CONTRACTOR DECLARATION provisions 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 10/31/2022 I hereby force I hereby REEGS INC CLASS: BUILDING CONTRACTOR NO: 885297 DATE: affirm that I am licensed under the and effect. affirm under penatly of perjury one I have and will maintain a certificate of for which this permit is issued. I have and will maintain Worker's Compensation I certify that in the performance of the laws of California. If, after making with such provisions or this permit shall of the following three consent to self -insure Insurance, work for which this this certificate be deemed 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 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 V issued. Compensation comply HAZARDOUS MATERIALS DISCLOSURE under 9.12 and the Health Chapter 6.95 of the California Health & Safety Code, Sections 25505. 25533. and 25534. I will maintain compliance I have read the hazardous materials requirements the Cupertino Municipal Code, Chapter V 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 will be responsible for this project. Firm Certification No: for this project. An EPA Lead -Safe Certified Renovator Firm Name: REEGS INC No EPA Lead -Safe Certified Firm is required V Certified CONSTRUCTION LENDING AGENCY 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 that No V Lender's Name: APPLICATION CERTIFICATION state that the above of this city judgements, costs, with all non -point source information is correct. I agree to comply with all city and county ordinances and state laws relating to building to 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 Signature: that I the applicant have read this application and and hereby authorize representatives City of Cupertino against liabilities, understands and will comply .