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BLD-2020-1397BUILDING PERMIT CUPERTINO CITY HALL 10300 Torre Avenue • Cupertino, CA 95014-3255 PHONE 408-777-3228 WWW.CUPERTINO.ORG BUILDING ADDRESS: 10372 STERLING BLVD Cupertino APN: 375 24 009 PERMIT NO: BLD-2020-1397 CONTRACTOR: ALWAYS RESCUE PLUMBING INC, 1543 DINA CT SAN JOSE CONTRACTOR PHONE: DATE ISSUED 9/4/2020 2:34:14 PM ISSUED BY: JASMINE ARCHBOLD VALUATION: $8150.00 JOB DESCRIPTION REPLACE MAIN WATER LINE - COPPER 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: LICENSED LICENSED EXP I hereby force I hereby ALWAYS RESCUE PLUMBING INC CLASS: C36 PLUMBING NO: 1047627 DATE: 12/31/2020 affirm that I am licensed under the provisions and effect. affirm under penatiy of perjury one of the following 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 this with such provisions or this permit shall be deemed three declarations: to self -insure for Insurance, as provided which this permit certificate of exemption, revoked. Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for by Section 3700 of the Labor Code, for the performance of the work for which this permit is is issued, I shall not employ any person in any manner so as to become subject to the Worker's I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith V issued. Compensation comply HAZARDOUS MATERIALS DISCLOSURE under Chapter the Health & as defined Code, Sections 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 and V with equipment Municipal Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino 25505, 25533, and 25534. or devices which emit hazardous air contaminants Code, Chapter 9.12 and the Health & Safety EPA LEAD -SAFE DISCLOSURE for this project. Firm Certification No: project. An EPA Lead -Safe Certified Renovator will be responsible Firm Name: No EPA Lead -Safe Certified Firm is required for this Certified v CONSTRUCTION LENDING AGENCY 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 is No V Lender's Name: APPLICATION CERTIFICATION the above information this city to enter costs, and -point source .