B-2018-0625 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-0625
11233 LA JOLLA CT CUPERTINO,CA 95014-4738(356 21 045) ALL PRO REPIPES INC
SAN JOSE,CA 95112
OWNER'S NAME: DATE ISSUED:04/16/2018
OWNER'S PHONE: PHONE NO:(408)332-8571
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C36 Lic.#1022644
Contractor ALL PRO REPIPES INC Date 01!31/2019 X BLDG—ELECT X PLUMB
I hereby affirm that I am licensed tinder 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 affect JOB DESCRIPTION: -
REPIPE SFD(PEX)-FULL
I 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.
ji`C z. 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. Sq.Ft Floor Arca: Valuation:$8166.00
I APPLICANT CERTIFICATION
certify that 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 slate laws relating to building construction,and hereby authorize 35621 045
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 u ers a ds and will comply with non-point
source regulations per ape oynclipal code,Section 9.16. 180 DAYS FROM LAST CALLED INSPECTION.
Signature ✓ Date 04/16/2018 Issued by:Jasmine Archbold
..- -- Date:NtM/2018
D TIO
I hereby affirm that I am exempt from the Contractor's License Law far one of the RE-ROOFS
folimving two reasons: All roots shall be inspected prior to any roofing materiel being installed.If.rootis
1. I,ns owner of the property,or my employees with wages as their sole installed without first obtaining an iuspe hmtu,I agree to remove all new materials for
ompensation,will do the work,and the advcture is not intended or offered for inspection.
sale(Sec.7044,Business&Professions Code)
z. 1,as owner of Ore property,am exclusively contracting with licensed Siguamre of Applicant
contractors to construct the project(Sec.7044,Business&Professions Code). Date:04/16/2018
I hereby affirm under penally of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
r. 1 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
z. 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. ..Iota].compliance with the Cupertino Municipal Code,Chapho 9.12 mad the
s. I certify that in the performance of the work for which this pewit is issued,I Health&Safety Code,Section 25532(x)should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the material.Additionally,should I use equipment or devices which emit hazardous
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 Code,Sections 25505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall `
be deemed revoked, Owner or authorized agent: �, ,
APPLICANT CERTIFICATION Date:0411612018 '
I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there Is a construction lending agency for the performance
relating to bullding construction,and hereby authorize representatives of this city of work's for which this permit is Issued(Sec.3097,Civ C.)
to enter upon the above mentioned property for Inspection purposes. (We)agree Lender's Name
to save Indemnify and keep harmless the City of Cupertino against liabilities,
judgments,costs,and expenses which may accrue against said City in Lender's Address
consequence of the granting of this permit.Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION
Code,Section 9.18. 1 understand my plans shall be used as public records.
Signature Data 04h 61201 8 Licensed
Professional