BLD-2020-1146BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 20085 STEVENS CREEK BLVD Cupertino
APN: 316 23 025
PERMIT NO: BLD-2020-1 146
CONTRACTOR:
STATEWIDE ROOFING INC, 1615 S 7TH ST UNIT C SAN JOSE
CONTRACTOR PHONE:
408 286-7828
DATE ISSUED 7/29/2020 11:50:44 AM
ISSUED BY: haleym
VALUATION: $31309
JOB DESCRIPTION
ROOF DRAINS TOWARDS THE DRAINAGE AREA AT (5) RECESSED WELL AREAS AND PARAPET WALLS; INSTALL .25" SECUROCK
PROPERLY SIZED SCREWS AND PLATES; INSTALL (N) MECHANICALLY ATTACHED CARLISLE SYNTECTM 60 MIL TPO PER
APPLE SC07 - INSTALL TPO ROOFING WHERE THE SLOPED
FIRE BARRIER PER MANUFACTURER'S SPECS, USING
MANUFACTURER'S SPECS - (14 SQ)
LICENSED CONTRACTOR DECLARATION
of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
CONTRACTOR:
STATEWIDE
LICENSED
C39
LICENSED
803926
EXP
02/28/2022
I hereby
force
I hereby
ROOFING INC
CLASS:
ROOFING, C21 BUILDING MOVING%2C DEMOLITION
NO:
DATE:
affirm that I am licensed under the provisions
and effect.
affirm under penatiy of perjury one of the
I have and will maintain a certificate of consent
for which this permit is issued.
I have and will maintain Worker's Compensation
I certify that in the performance of the work for
laws of California. If, after making
with such provisions or this permit shall be
following three
to self -insure
Insurance,
which this
this certificate
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
under
and the Health
Code,
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
the Cupertino Municipal Code, Chapter 9.12
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
EPA LEAD -SAFE DISCLOSURE
responsible for this project.
Firm Certification No:
this project.
An EPA Lead -Safe Certified Renovator will be
Firm Name:
No EPA Lead -Safe Certified Firm is required for
Certified
V
CONSTRUCTION LENDING AGENCY
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 that there
No
V
Lender's
Name:
APPLICATION CERTIFICATION
that the above
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
of 365 days after the time the work is commenced.