BLD-2020-0742BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 1052 BUBB RD Cupertino
APN: 362 04 014
PERMIT NO: BLD-2020-0742
CONTRACTOR:
CHANDLERS PLUMBING, 1729 N 1ST ST # 1 1204 SAN JOSE
CONTRACTOR PHONE:
4084493443
DATE ISSUED 6/25/2020 2:28:17 PM
ISSUED BY: KDUNBAR
VALUATION: $3000
JOB DESCRIPTION
SEWER LINE REPLACEMENT
LICENSED CONTRACTOR DECLARATION
CONCRETE RELATED SERVICES
9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
CONTRACTOR:
CHANDLERS
LICENSED
C36
LICENSED
977412
EXP
09/30/2020
I hereby
force
I hereby
PLUMBING
CLASS:
PLUMBING, D64 WATER REMEDIATION,
NO:
DATE:
affirm that I am licensed under
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. If,
with such provisions or this permit
C27 LANDSCAPING, D06
the provisions of Chapter
one of the following
of consent to self -insure
Compensation Insurance,
of the work for which this
after making this certificate
shall be deemed revoked.
three declarations:
for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the
V
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
issued.
Compensation
comply
HAZARDOUS MATERIALS DISCLOSURE
requirements under
Chapter 9.12 and the Health
Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance
I have read the hazardous materials
the Cupertino Municipal Code,
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.
or devices which emit hazardous air contaminants
Code, Chapter 9.12 and the Health & Safety Code,
EPA LEAD -SAFE DISCLOSURE
will be responsible for this project.
Firm Certification No:
is required for this project.
An EPA Lead -Safe Certified Renovator
Firm Name:
No EPA Lead -Safe Certified Firm
Certified
v
CONSTRUCTION LENDING AGENCY
that there is a construction 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
No
V
Lender's
Name:
APPLICATION CERTIFICATION
and state that the
of this city
liabilities, judgements,
with all non -point
days after its issuance, or if the work authorized on the site by such permit is suspended or abandoned for a period
of 365 days after the time the work is commenced.