B-2018-1299 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-1299
20731 PAROO DR CUPERTINO,CA 95014-1903(326 33 033) ALLSTAR PLUMBING
CORPORATION
SAN JOSE,CA 95112
OWNEI2'SNAME: DATE ISSUED:08/01/2018
OWNER'S PHONE: PHONE NO:(
LICENSED CONTRACTOR'S DECLARATION - BUILDING PERMIT INFO:
License Class C36 LIc.#732611
Contractor ALLSTAR PLUMBING CORPORATION Date 0212812019 X BLDG ELECT X PLUMB
I hereby affirm tint I am licensed trader the provisions of Chapter 9(commencing —MECH 2i RESIDENTIAL—COMMERCIAL
with Section 7000)of Division 3 of the Business&Professions Code and flint my
license is in full force and effect. JOB DESCRIPTION:
REPLACE GAS LINE-(4)FIXTURES
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.
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 Are.: Valuation:$6000.00
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 APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 32633 033
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 IIT WORK IS NOT STARTED
may accrue against said City In asequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant nude lands and will comply with all non-point
source regulations
from the Contractor's License Low fur one of theRE-ROOFS•
following two reasons: All roofs shall be inspected prior to any roofiug material being installed.To roof is
r. 1,ns owner of the property,or my employees with wages as their sole installer!Without first obtaining an inspection,l agree to remove all new materials for
compensation,will do the work,and the structure is not intended or offered for inspection.
sale(Scc,7044,Business&Professions Code)
z. 1,as owner of the property,am exclusively contracting with licensed Signature of Applicant.
contractors to construct the project(See.7044,Business&Professions Cede). Date:8t f;
I hereby affirm under penalty 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 ofthe work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE
z. I have and will premium 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 25534.1 will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
3, 1 certify that In the performance of the work for which this permit is issued,I Tlealth&Safety Code,Section 25532(n)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 o•devices which emit hazmedous
m contaminants.s defined by the Bny Are.Air Quality Ma amort District I
Worker's Compensation laws of California.if,atter making this certificate of will maintain compliance with the Cupertingig,'" C e hapten 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Section3 nd 25534.
Labor Code,l must forthwith comply with such provisions or tris permit shall
be deemed revoked. Owner or authorized agent:
APPLICANT CERTIFICATIONDate:8--201 a
I certify that I have read this application and state that the above Information is NSTR TIO
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there a cans ction lending agency for the performance
relating to building constructlon,and hereby authorize representatives of this city of work's for which this pe Emil' ssued(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 DECLARAT10N
Code,Section 9.18. 1 understand my plans shall be used as public records.
SignatureLicensed
Date B-1-2018
Professional