BLD-2021-0095BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 19711 AUBURN CT Cupertino
APN: 316 32 003
PERMIT NO: BLD-2021-0095
OWNER'S NAME:
OWNER'S PHONE:
CONTRACTOR: BWB BUILDERS INC, 534 HORNING ST. SAN JOSE
CONTRACTOR PHONE:
DATE ISSUED 1/20/2021 2:36:38 PM
ISSUED BY: JASMINE ARCHBOLD
VALUATION: $50000
JOB DESCRIPTION
REMODEL KITCHEN (160 SF)
LICENSED CONTRACTOR DECLARATION
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
07/31/2021
I hereby
force
I hereby
BWB BUILDERS INC
CLASS:
BUILDING CONTRACTOR
NO: 1005702
DATE:
affirm that I am licensed under the provisions
and effect.
affirm under penatiy of perjury one of
I have and will maintain a certificate of consent
for which this permit is issued.
I have and will maintain Worker's Compensation
I certify that in the performance of the work
laws of California. If, after making
with such provisions or this permit shall
the following three declarations:
to self -insure for Worker's
Insurance, as provided
for which this permit is issued,
this certificate of exemption,
be deemed revoked.
Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the
work
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
I shall not employ any person in any manner so as to become subject to the Worker's
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
Chapter 6.95
Health & Safety
as defined
Sections
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
Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use
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
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
V
CONSTRUCTION LENDING AGENCY
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 there
No
V
Lender's
Name:
APPLICATION CERTIFICATION
and state
representatives
liabilities,
will comply with
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.