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BLD-2021-1937BUILDING PERMIT CITY HALL 10300 Torre Avenue • Cupertino, CA 95014-3255 PHONE 408-777-3228 WWW.CUPERTINO.ORG BUILDING ADDRESS: 18945 BARNHART AVE Cupertino APN: 375 09 025 PERMIT NO: BLD-2021-1937 OWNER'S NAME: CONTRACTOR: KEVIN FARRER ENTERPRISES INC DBA SONRISE ROOFING, 37911 VON EUW COMMON FREMONT CONTRACTOR PHONE: DATE ISSUED 9/28/2021 4:25:32 PM ISSUED BY: JASMINE ARCHBOLD VALUATION: $2000 JOB DESCRIPTION (20 SQ) RE -ROOF; TEAR -OFF; INSTALL COMP SHINGLES - LICENSED CONTRACTOR DECLARATION ROOFING of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full CONTRACTOR: LICENSED C39 LICENSED EXP 11/30/2021 I hereby force I hereby KEVIN FARRER ENTERPRISES INC DBA SONRISE CLASS: ROOFING NO: 742713 DATE: affirm that I am licensed under the provisions and effect. affirm under penatiy of perjury one of I have and will maintain a certificate of consent for which this permit is issued. I have and will maintain Worker's Compensation I certify that in the performance of the work laws of California. If, after making with such provisions or this permit shall the following three to self -insure Insurance, for which this this certificate 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 under 9.12 and the Health Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance I have read the hazardous materials requirements 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 Sections 25505, 25533, and 25534. or devices which emit hazardous air contaminants Code, Chapter 9.12 and the Health & Safety Code, EPA LEAD -SAFE DISCLOSURE be responsible for this project. Firm Certification No: for this project. An EPA Lead -Safe Certified Renovator will Firm Name: No EPA Lead -Safe Certified Firm is required Certified V CONSTRUCTION LENDING AGENCY 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 there No V Lender's Name: APPLICATION CERTIFICATION that the above of this city judgements, all non -point information is correct. I agree to comply with all city and county ordinances and state laws relating to building to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, source regulations per the Cupertino Municipal Code, Section 9.18. I certify that I have read this application and state construction, and hereby authorize representatives harmless the City of Cupertino against liabilities, the applicant understands and will comply with 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.