BLD-2021-0962BUILDING PERMIT
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 10118 BANDLEY DR STE H CUPERTINO
APN: 326 34 066
PERMIT NO: BLD-2021-0962
OWNER'S NAME:
CONTRACTOR: HF CONSTRUCTION COMPANY, 18920 LORRE AVE #B CUPERTINO
CONTRACTOR PHONE:
DATE ISSUED 9/15/2021 12:44:51 PM
ISSUED BY: Sean Hatch
VALUATION: $150000
JOB DESCRIPTION
SF) - DUAN CHUN ZHEN BEEF NOODLE
T.I. - TENANT IMPROVEMENT TO AN EXISTING RESTAURANT (2,695
LICENSED CONTRACTOR DECLARATION
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
10/31/2023
I hereby
force
I hereby
CLASS:
BUILDING
NO: 966862
DATE:
affirm
and effect.
affirm
I have and
for which
I have and
I certify that
with
HF CONSTRUCTION COMPANY
that I am licensed under the provisions of Chapter
under penatly of perjury one of the following three declarations:
will maintain a certificate of consent to self -insure for Worker's
this permit is issued.
will maintain Worker's Compensation Insurance, as provided
in the performance of the work for which this permit is issued,
laws of California. If, after making this certificate of exemption,
such provisions or this permit shall 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
Chapter 6.95
& Safety
as defined
Sections 25505,
of the California Health & Safety Code, Sections 25505. 25533. and 25534. I will maintain compliance
I have read the hazardous materials requirements under
the Cupertino Municipal Code, Chapter 9.12 and the Health
le
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
25533, and 25534.
or devices which emit hazardous air contaminants
Code, Chapter 9.12 and the Health & Safety Code,
EPA LEAD -SAFE DISCLOSURE
for this project.
Firm Certification No:
An EPA Lead -Safe Certified Renovator will be responsible
Firm Name:
No EPA Lead -Safe Certified Firm is required for this project.
Certified
V
CONSTRUCTION LENDING AGENCY
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 is a construction
No
V
Lender's
Name:
APPLICATION CERTIFICATION
information
to enter upon
costs, and expenses
source regulations
is correct. I agree to comply with all city and county ordinances and state laws relating to building
the above mentioned property for inspection purposes. (We) agree to save indemnify and keep
which may accrue against said City in consequence of the granting of this permit. Additionally,
per the Cupertino Municipal Code, Section 9.18.
I certify that
construction,
harmless
the applicant
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.