BLD-2021-1332BUILDING PERMIT
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 20200 LUCILLE AVE APT 40 CUPERTINO
APN: 316 02 094
PERMIT NO: BLD-2021-1332
OWNER'S NAME: VERANDAS APARTMENTS LLC
OWNER'S PHONE: Not Provided
CONTRACTOR: CORNERSTONE SELECT BUILDERS INC, 5542 BRISA STREET SUITE F LIVERMORE
CONTRACTOR PHONE:
DATE ISSUED 7/15/2021 1:07:34 PM
ISSUED BY: haleym
VALUATION: $45000
JOB DESCRIPTION
UNIT; REPLACE (3) WINDOWS AND (1) SLIDER; (N) 100 AMP SUB -PANEL; KITCHEN REMODEL (88 SF); BATHROOM REMODEL (165 SF); REMODEL
(15 TOTAL); (N) FURNACE AND A/C UNITS; SEE MASTER PLAN PERMIT B-2019-0090 FOR DRAWINGS
VERANDAS - UNIT 40- RE -PIPE ENTIRE
OTHER (122 SF); (N) LED LIGHTING
LICENSED CONTRACTOR DECLARATION
INC
the 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
01/31/2023
I hereby
force
I hereby
CORNERSTONE SELECT BUILDERS
CLASS:
BUILDING, C-9 DRYWALL
NO: 888881
DATE:
affirm that I am licensed under
and effect.
affirm under penatiy of perjury
I have and will maintain a certificate
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
with such provisions or this permit
one of the following three
of consent to self -insure
Insurance,
work for which this
making this certificate
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
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
requirements under Chapter
9.12 and the Health
6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance
I have read the hazardous materials
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
25505, 25533, and 25534.
or devices which emit hazardous air contaminants
Code, Chapter 9.12 and the Health & Safety Code, Sections
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
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
representatives
liabilities,
comply
and state that the above
of this city to
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
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 that
construction,
harmless
the applicant
Signature:
leis-94.1‘11—.—
I have read this application
and hereby authorize
the City of Cupertino against
understands and will
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.