BLD-2020-0546CITY OF
BUILDING PERMIT
CITY HALL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
PHONE 408-777-3228
CUPERTINO WWW.CUPERTINO.ORG
BUILDING ADDRESS:
PERMIT NO: BLD- 2020-0546
OWNER'S NAME: KARLCUT AKBAL S AND KULDEEP K TRUSTEE
OWNER'S PHONE: 4088885959
CONTRACTOR: LUNDQUIST PLUMBING
CONTRACTOR PHONE: 4083944887
DATE ISSUED: 5/13/2020
ISSUED BY: haleym
VALUATION: 1,550
JOB DESCRIPTION:
EXTEND EXTERNAL GAS LINE (66 LF) TO CONNECT OUTDOOR BBQ, BURNER, AND FIRE PIT
LICENSED CONTRACTOR'S DECLARATION:
LICENSED NO: 932162 EXP DATE 05/31/2021
9 (commencing with Section 7000) of Division 3 of the Business & Professions
LUNDQUIST PLUMBING LICENSED CLASS: c36
I hereby affirm that I am licensed under the provisions of Chapter
Code and that my license is in full force and effect.
declarations:
to self -insure for Worker's Compensation,
for which this permit is issued.
Insurance, as provided for by Section
is issued.
for which this permit is issued, I shall not employ
laws of California. If, after making this certificate
Labor Code, I must forthwith comply with
as provided for by Section 3700 of the
I hereby affirm under penalty of perjury one of the following three
I have and will maintain a certificate of consent
Labor Code, for the performance of the work
3700 of the Labor Code, for the
any person in any manner so as to
of exemption, I become subject to
such provisions or this permit shall be
I have and will maintain Worker's Compensation
performance of the work for which this permit
?( I certify that in the performance of the work
become subject to the Worker's Compensation
the Worker's Compensation provisions of the
deemed revoked.
HAZARDOUS MATERIALS DISCLOSURE
6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I
)C I have read the hazardous materials requirements under Chapter
will maintain compliance with the Cupertino Municipal Code,
Chapter 9.12 and the Health &
Safety Code,
air contaminants
Chapter
No:
Section 25532(a) should I store or
as defined by the Bay Area
9.12 and the Health & Safety Code,
handle hazardous material. Additionally, should I use equipment or devices which emit hazardous
Air Quality Management District I will maintain compliance with the Cupertino Municipal Code,
Sections 25505, 25533, and 25534.
An EPA Lead -Safe Certified Renovator will be responsible for this project.
Certified Firm Name: Firm Certification
X No EPA Lead -Safe Certified Firm is required for this project.
CONSTRUCTION LENDING AGENCY
lending agency for the performance of the work which this permit is issued
I hereby affirm under penalty of perjury that there is a construction
(Section 3097, Civil Code).
Yes XNo
Lender's Name:
's Address: