BLD-2021-0303CITY OF CUPERTINO BUILDING PERMIT
https://apps.cupertino.org/Accela/BLD-Sign-Pennitaspx?AccelaUs...
BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW CUPE RTINO.ORG
BUILDING ADDRESS: 10672 DEEP CLIFFE DR Cupertino APN: 35604012 PERMIT NO: BLD-2021-0303
OWNER'S NAME:
CONTRACTOR: LANDCON LANDSCAPE CONSTRUCTION INC 1689 GARVEY PLACE SAN JOSE CONTRACTOR PHONE:
DATE ISSUED 3/4/2021 3:18:56 PM ISSUED BY: ICDUNBAR VALUATION: S8500
JOB DESCRIPTION
REPLASTER (E) SWIMMING POOL AND BRING DRAIN UP TO CODE AND INSTALL SAFE 1 Y FEATURES PER ADDENDLX V OF THE 2019 CA RESIDENTIAL CODE (SEE NOTES ON PLAN).
LICENSED CONTRACTOR DECLARATION
CONTRACTOR: LANDCON LANDSCAPE
CONSTRUCTION INC
LICENSED CLASS:
C27 LANDSCAPING, A GENERAL ENGINEERING
CONTRACTOR
LICENSED NO: 468632
FEY DATE:
01/31.2023
1 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 fall force and effect.
1
I hereby affirm under penally of perjury one of the foliawing three declare-11one SEa Kg!, -1 14114 14,4
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I have and will maintain a certificate of consent to self-Misure fax Wakes Compensation, as provided for by Section 3-00 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 perks] of the work for which this petal( is
I certify that in the performance of the work for which this permit is issued, 1 shall not &witty any person in any manner so as to become subject to the Worker's Compensation laws of Califorria. If, after
maing this certificate of etemption, I become subject to the Worker's Compensation provisions of the Labor Code, 1 rriust forthwith comply with such provisions or this permit shall be deemed revoked.
HAZARDOUS MATERIALS DISCLOSURE
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• I have read the hazardous material. s requirements underChapter 695 of the California Health & Safety Code. Sections 25505. 255:11 and 25534. I will maintain compliance with the C_ upertine Shank -nod Code
Chapter 9.12 and the Health & Safety Code, Section 25532(a) should 1 store or handle hazardous material. Additionally, should I use equipment or devices which emit himirdous 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 responsitie for this project_
Certified Finn Name:
• V
No EPA Lead -Safe Certified Finn is required for this project
CONSTRUCTION LENDINGAGENCY
hereby affirm under pettily of pertury that there is a construction lending agency for the perftainance of the work which this pewit is issued (Section 3097, Civil Code).
5/
Firm Certification No:
Yes 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 awl 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. (iVe) agree to save indemnify• and keep harmless the City of Cupertino against liatilities, judgements, rods and
expenses which may accrue against said City in consequence of the granting of this nnit. Additionally, the applicant imderstinals and will comply with all non -point source regulations per the cepertino Nlunicipul
Code Section 9 18.
Signature:
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