BLD-2019-0568BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 10715 S BLANEY AVE CUPERTINO
APN: 369 34 045
PERMIT NO: BLD-2019-0568
CONTRACTOR:
JZL CONSTRUCTION, 33523 14TH ST UNION CITY
CONTRACTOR PHONE:
DATE ISSUED 12/4/2019 1:57:39 PM
ISSUED BY: HALEYM
VALUATION: $69050
JOB DESCRIPTION
REMODEL (2) (120 SF); NEW AC SYSTEM; REPLACE FURNACE (SAME LOCATION); NEW SUB -PANEL (200 AMP); NEW VAULTED CEILING;
ROOM TO MUD ROOM (18 SF); REPLACE (1) WINDOW (LIKE FOR LIKE); SECOND FLOOR (2) NEW WINDOWS; REPLACE SEWER LINE; REPLACE
KITCHEN REMODEL (240 SF); BATHROOM
REMOVE FIREPLACE; CONVERT STORAGE
WATER LINE
LICENSED CONTRACTOR DECLARATION
9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
CONTRACTOR:
JZL CONSTRUCTION
LICENSED
B GENERAL
LICENSED
1045736
EXP
10/31/2020
I hereby
force
I hereby
CLASS:
BUILDING CONTRACTOR
NO:
DATE:
affirm that I am licensed
and effect.
affirm under penatly of perjury
I have and will maintain a certificate
for which this permit is issued.
I have and will maintain Worker's
I certify that in the performance
laws of California.
with such provisions or this
under the provisions of Chapter
one of the following three
of consent to self -insure
Compensation Insurance,
of the work for which this
If, after making this certificate
permit shall be deemed revoked.
declarations:
for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the
work
as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's
of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith
V
issued.
Compensation
comply
HAZARDOUS MATERIALS DISCLOSURE
Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance
I have read the hazardous materials requirements under
the Cupertino Municipal Code, Chapter 9.12 and the Health
V
with
equipment
Municipal
& Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use
as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino
Sections 25505, 25533, and 25534.
for this project.
Firm Certification No:
or devices which emit hazardous air contaminants
Code, Chapter 9.12 and the Health & Safety Code,
An EPA Lead -Safe Certified Renovator will be responsible
Firm Name:
No EPA Lead -Safe Certified Firm is required for this project.
Certified
v
CONSTRUCTION LENDING AGENCY
lending agency for the performance of the work which this permit is issued (Section 3097, Civil Code).
Lender's Address:
I hereby
Yes
affirm
under penalty of perjury that there is a construction
No
V
Lender's
Name:
APPLICATION CERTIFICATION
and state that the above
representatives of this city
:
Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 365 days after its issuance, or if the work authorized on the site by such permit is suspended or abandoned for a period