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BLD-2020-1994 PermitBUILDING PERMIT CUPERTINO CITY HALL 10300 Torre Avenue • Cupertino, CA 95014-3255 PHONE 408-777-3228 WWW.CUPERTINO.ORG BUILDING ADDRESS: 10490 WUNDERLICH DR Cupertino APN: 375 17 055 OWNER'S NAME: CONTRACTOR: DISTINCT BUILDERS INC, 201 ADA AVE #31 MOUNTAIN VIEW DATE ISSUED 6/29/2021 2:09:21 PM N JOB DESCRIPTION ISSUED BY: JASMINE ARCHBOLD PERMIT NO: BLD-2020-1994 OWNER'S PHONE: CONTRACTOR PHONE: VALUATION: $750000 BUILD (N) 2- STORY, MODULAR SINGLE FAMILY DWELLING - (2429 SF) WITH ATTACHED GARAGE - (451 SF); (N) PORCH - (444 SF) N LICENSED CONTRACTOR DECLARATION CONTRACTOR: DISTINCT BUILDERS INC LICENSED CLASS: B GENERAL BUILDING CONTRACTOR LICENSED NO: 805220 EXP DATE: 09/30/2022 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 penatly 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 l I 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 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: 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). IV JYes■No Lender's Name: Umqua Bank Lender's Address: 1 southwest Columbia st. Portland Or 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. OFFICIAL NOTIFICATION OF NEW/ADDRESS CHANGE TO: All agencies FROM: City of Cupertino DATE: October 26th 2021 RE: Address Change for 10490 Wunderlich Drive # 375-17-055 Please note the following address change: This parcel has a new two story single family dwelling under construction and entrance to the property will be from Barnhart Avenue. The address has been changed to 18791 Barnhart Avenue. Please see the attached map. The new address will take effect 15 business days from the date of this letter. Please update your records accordingly. If you have any questions, please call me at (408)-777-3320. Sincerely, Sundari Pilaka Administrative Assistant Cupertino Community Development Department 408-777-3320 or sundarip@cupertino.org CITY OF CUPERTINO ADDRESS CHANGE FOR 10490 WUNDERLICH DRIVE NEW ADDRESS: 18791 BARNHART AVENUE APN: 375-17-055 OCTOBER 26, 2021 NEW ADDRESS: 18791 BARNHART AVENUE APN: 375-17-055