BLD-2020-0683BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 10349 PALO VISTA RD Cupertino
APN: 357 03 024
PERMIT NO: BLD-2020-0683
OWNER'S NAME:
OWNER'S PHONE: Not Provided
CONTRACTOR: ROYAL POOLS OF SANTA CLARA, 2258 CAMDEN AVE SAN JOSE
CONTRACTOR PHONE:
DATE ISSUED 8/14/2020 10:10:04 AM
ISSUED BY: haleym
VALUATION: $172000
JOB DESCRIPTION
SWIMMING POOL (602 SF) AND DETACHED SPA (64 SF); BOTH WITH AUTO SAFETY COVERS; AND A POOL WATER SOLAR SYSTEM (HELIOCOL) INSTALLED ON
TO SERVE FUTURE FIREPLACE AND BBQ.
INSTALL (N) IN -GROUND
ROOF; INSTALL GAS LINE
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
LICENSED
EXP
I hereby
force
I hereby
ROYAL POOLS
CLASS: C53 SWIMMING
NO: 278052
DATE: 12/31/2020
affirm that I am
and effect.
affirm under
I have and will maintain
for which this permit
I have and will maintain
I certify that in the
laws of
with such provisions
OF SANTA CLARA
POOL
licensed under the provisions of Chapter
penatiy of perjury one of the following three
a certificate of consent to self -insure
is issued.
Worker's Compensation Insurance,
performance of the work for which this permit
California. 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
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
Chapter
Health
as
Sections
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
the Cupertino Municipal Code, Chapter 9.12 and the
le
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 Code,
EPA LEAD -SAFE DISCLOSURE
for
this project.
Firm Certification No:
An EPA Lead -Safe
Firm Name:
No EPA Lead -Safe
Certified Renovator will be responsible
Certified
V
Certified Firm is required for this project.
CONSTRUCTION LENDING AGENCY
lending agency for the performance of the work which this permit is
Lender's Address:
issued (Section 3097, Civil Code).
I hereby
Yes
affirm
under
No
penalty of perjury that there is a construction
V
Lender's
Name:
APPLICATION CERTIFICATION
above
to
costs,
source
information is correct. I agree to comply with all city and county ordinances
enter upon the above mentioned property for inspection purposes. (We)
and expenses which may accrue against said City in consequence
regulations per the Cupertino Municipal Code, Section 9.18.
and state laws relating to building
agree to save indemnify and keep
of the granting of this permit. Additionally,
I certify that I
construction,
harmless the
the applicant
Signature:
have read
and hereby
City of Cupertino
understands
this application and state that the
authorize representatives of this city
against liabilities, judgements,
and will comply with all non -point
Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 365 days after its issuance, or if the work authorized on the site by such permit is suspended or abandoned for a period
of 365 days after the time the work is commenced.