HomeMy WebLinkAboutB-2018-0626 PermitI CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2018-0626
10460 BUBB RD CUPERTINO, CA 95014-4150 (357 20 037)
BARRON BUILDERS
INC
SANTA CLARA, CA
95054
OWNER'S NAME: BG CUPERTINO LLC
DATE ISSUED: 04/16/2018
OWNER'S PHONE: 408-230-9458
PHONE NO: (650) 964-4493
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
cease Class B Lic. #916366
ontractor BARRON BUILDERS INC Date 07/31/2019
X BLDG _ ELECT _ PLUMB
MEG! RESIDENTIAL A COMMERCIAL
hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
—
ith Section 7000) of Division 3 of the Business & Professions Code and that my
tense is in full force and effect.
JOB DESCRIPTION:
APPLE - TI- ADDING A NEW PARTITION WITH DOOR (5 SF)
hereby affirm under penalty of perjury one of the following two declarations:
t. 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.
g t 2. 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.
Sq. Ft Floor Area:
Valuation: $35000.00
certify that I have read this application and state that the above
nformatlon Is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize
epresentatives of this city to enter upon the above mentioned property for
nspectlon purposes. (We) agree to save Indemnify and keep harmless the
)ity of Cupertino against liabilities, judgments, costs, and expenses which
nay accrue against said City in consequence of the granting of this permit,
kdditionally, the applicant understands and will comply with all non -point
source regulations per the Cupertino MunicipalSQode, Section 9.18.
hereby affirm that I am exempt from the Contractor's License Law for one of the
,llowing two reasons:
n. 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)
2. 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Scc.7044, Business & Professions Code).
hereby affirm under penalty of perjury one of the following three declarations:
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.
2. 1 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.
3. 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
irreet. I agree to comply with all city and county ordinances and state laws
slating 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,
dgments, costs, and expenses which may accrue against said City in
ansequence of the granting of this permit. Additionally, the applicant understands
id will comply with all non -point source regulations per the Cupertino Municipal
ode, Section 9.18.
Date 04-16-2018
APN Number: Occupancy Type:
357 20 037 A (Tenant Improvements)
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Kim Dunbar
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection,
Signature of Applicant:
Date: 04-16-2018
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & SafetyCode, Sections 25505, 25533, sad 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 ur devices winch 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 Coda, Sections 25505, 25533, and 25534.
Owner or authorized agent:
Date: 04-16-2018
CONSTRUCTION LENDINGI 1's y
hereby affirm that there Is a construction lendiC��rgg agent or the performanceof work's for which this permit is issued (Sec. 3097'eiv-C.
Lender's Name
Lender's Address
ARCHI'TECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed