B-2018-1510 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-1510
23000 CRISTO REY LOOP VILLA 82(342 54 016)}23000 CRISTO REY LOOP VILLA QUIRING GENERAL
83(342 54 016)123000 CRISTO REY LOOP VILLA 79(342 54 016)123000 CRISTO REY LLC
LOOP VILLA 78(342 54 016)123200 VIA ESPLENDOR VILLA 63 CUPERTINO,CA FRESNO,CA 93727
95014-6546(342 54 016)123250 VIA ESPLENDOR VILLA 64 CUPERTINO,CA 95414-
6545(342 54 016)123250 VIA ESPLENDOR VILLA 65 CUPERTINO,CA 95014-6545
(342 54 016)23250 VIA ESPLENDOR VILLA 66 CUPERTINO,CA 95014-6545(342 54
016)123650 VIA ESPLENDOR CA 95014(342 54 016)123850 VIA ESPLENDOR VILLA
61 CA 95014(342 54 016)123850 VIA ESPLENDOR VILLA 62 CA 95014(342 54 016)
23000 CRISTO REY LOOP VILLA 77(342 54 016)123000 CRISTO REY LOOP VILLA
76(342 54 016)23000 CRISTO REY LOOP VILLA 80(342 54 016)23000 CRISTO REY
LOOP VILLA 81(342 54 016)123150 CRISTO REY LOOP VILLA 73(342 54 016)123000
CRISTO REY LOOP VILLA 74(342 54 016)123000 CRISTO REY LOOP VILLA 75(342
54 016)123150 CRISTO REY LOOP VILLA 72(342 54 016)23150 CRISTO REY LOOP
VILLA 71(342 54 016)23150 CRISTO REY LOOP VILLA 70(342 54 016)123150
CRISTO REY LOOP VILLA 69(342 54 016)123150 CRISTO REY LOOP VILLA 68(342
54 016)123050 VIA ESPLENDOR VILLA 67 CUPERTINO,CA(342 54 016)123500
CRISTO REY DR CUPERTINO,CA 95014-6527(342 54 999)
OWNER'S NAME: DATE ISSUED:05/23/2019
OWNER'S PHONE: PHONE NO:(559)432-2800
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#973147
Contractor QUIRING GENERAL LLC Date 05/31/2020 x BLDG _ELECT _PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH X RESIDENTIAL COMMERCIAL
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
THE FORUM VILLAS,23 NEW UNITS(40,615 SF);GARAGES(13,836
I hereby affirm under penalty of perjury one of the following two declarations: SF);PORCHES(23);SITE RETAINING WALLS.
1. I have and will maintain a certificate of consent to self-insure for Worker's (REFER TO B-2018-1819 FOR SITE RETAINING WALLS)
Compensation,as provided for by Section 3700 of the Labor Code,for the REV#I-OCCUPANCY CHANGE TO R3.1;ADDITION OF 2ND EXIT
performance of the work for which this permit is issued. _ STAIRS AND PATHWAYS;CHANGE IN PATIO ROOF HEIGHT AND
APPLICANT CERTIFICATION 40615
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 APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 342 54 999 R-3(Hillside,Custom)
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,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant understands and will comply with all non-point
source
Date:05/23/2019
OWNER-BUILDE DECLARATION
r
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS:
following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
1. I,'as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for
compensation,will do the work,and the structure is not intended or offered for inspection.
sale(Sec.7044,Business&Professions Code)
2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:05/23/2019
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1. 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. HAZARDOUS MATERIALS DISCLOSURE
2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
3. I certify that in the performance of the work for which this permit is issued'I Health&Safety Code,Section 25532(a)should I store or handle hazardous
material. Additionally,should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety