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Home My WebLink About15070058 PermitI CITY OF CUPERTINO BUILDING PERMIT PERMIT NO: 15070058 10335 N TANTAU AVE CUPERTINO, CA 95014 (316 06 064) REDWOOD DRES PKWY STE REDWOOD CITY, 94065 I'Nfl'S NAME: Mr Bernie Baker (CAMPUS HOLDINGS INC) I I DATE ISSUED: 01/23/2017 IO'NER'S PHONE: (408) 309-1730 I PHONE NO: None PERMIT INFO: Class CONTRACTOR - GENERAL Lic. #990050 lorTRUEBECK-WEBCORJV Date06/30/2016 y affirm that I am licensed under the provisions of Chapter 9 (commencing ctlon 7000) of Division 3 of the Business & Professions Code and that my is in full force and effect hereby affirm under penalty of perjury one of the following two declarations: r. 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. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION 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 and state laws relating to building construction, and hereby authorize 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 may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature / \!..p-'._) / Date 01 /2 312 01 7 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: r. 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) z. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). hereby affirm under penalty of perjury one of the following three declarations: r. 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. 2. L have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. a. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION certify that I have read this application and state that the above Information is orrect. I agree to comply with all city and county ordinances and state laws dating to building construction, and hereby authorize representatives of this city enter upon the above mentioned property for inspection purposes. (We) agree save indemnify and keep harmless the City of Cupertino against liabilities, idgments, costs, and expenses which may accrue against said City in ansequence of the granting of this permit. Additionally, the applicant understands n� will comply with all non -point source regulations per the Cupertino Municipal ode, Section 9.18. BLDG _ ELECT _ PLUMB MECH — RESIDENTIAL_ COMMERCIAL DESCRIPTION: PHASE IT: TANTAU 9 CAFETERIA AND EXPRESSO BAR ANT IMPROVEMENT ON FIRST FLR (14783 SQ FT). aCTTON HISTORY AVAILABLE UPON REQUEST* CHARGED PER DEVELOPMENT AGREEMENT* Floor Area: I Valuation: $7000000.00 ( Number: 06 064 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Kim Dunbar RP ROOFS: All roofs shall be inspected prior to any rooting material being installed. Ifa roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous 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, ectlons 25505, 255 3, and 25534. Owner or authorized agent: Date: 01/23/2017 I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address I understand my plans shall be used as public records.