BLD-2021-1130BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 10873 SWEET OAK ST Cupertino
APN: 326 51 036
PERMIT NO: BLD-2021-1 130
OWNER'S NAME:
OWNER'S PHONE: Not Provided
CONTRACTOR: I Q V CONSTRUCTION & ROOFING, 877 CHESTNUT STREET SAN JOSE
CONTRACTOR PHONE:
DATE ISSUED 6/15/2021 12:07:15 PM
ISSUED BY: haleym
VALUATION: $26667
JOB DESCRIPTION
BUILDING H - 10873 &10875
- Re -Roof. Remove existing BUR Roof, Install Carlisle 50 mil PVC over tapered system (18.5 sq)
LICENSED CONTRACTOR DECLARATION
CONTRACTOR: I Q V CONSTRUCTION & ROOFING
LICENSED CLASS:
B GENERAL BUILDING CONTRACTOR, C39 ROOFING
LICENSED NO: 963219
EXP DATE:
07/31/2021
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.
V
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.
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
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
comply with such provisions or this permit shall be deemed revoked.
HAZARDOUS MATERIALS DISCLOSURE
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
V
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
or devices which emit hazardous air contaminants
as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino
Municipal 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:
Firm Certification No:
V
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:
/
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.