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BLD-2021-1288BUILDING PERMIT CITY HALL 10300 Torre Avenue • Cupertino, CA 95014-3255 PHONE 408-777-3228 WWW.CUPERTINO.ORG BUILDING ADDRESS: 10164 EMPIRE AVE Cupertino APN: 326 23 038 PERMIT NO: BLD-2021-1288 OWNER'S NAME: OWNER'S PHONE: Not Provided CONTRACTOR: RNT ELECTRIC SOLUTIONS, 920 REDBIRD DRIVE SAN JOSE CONTRACTOR PHONE: 6692929707 DATE ISSUED 8/17/2021 11:42:34 AM ISSUED BY:VALUATION: $3000.00 JOB DESCRIPTION Electrical panel upgrade 200 amp same location REV #1 - INSTALL EV CHARGER (240 VOLT, 50 AMP); (N) SUB-PANEL (240 VOLT, 60 AMP) LICENSED CONTRACTOR INFORMATION CONTRACTOR: RNT ELECTRIC SOLUTIONS LICENSED CLASS: C10 ELECTRICAL LICENSED NO: 1063947 EXP DATE: 11/30/2022 I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penatly of perjury one of the following three declarations: 1 I have and will maintain a certificate of consent to self-insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 2 I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 3 I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, l must forthwith comply with such provisions or this permit shall be deemed revoked. I understand and agree that I am electronically signing and filing this application and that checking the box below has the same legal effect as manual signature. I also understand that I have the option of filing a paper copy of this application with a manual signature but have chosen instead to file this application electronically. BUILDING PERMIT CITY HALL 10300 Torre Avenue • Cupertino, CA 95014-3255 PHONE 408-777-3228 WWW.CUPERTINO.ORG BUILDING ADDRESS: 10164 EMPIRE AVE Cupertino APN: 326 23 038 PERMIT NO: BLD-2021-1288 OWNER'S NAME: OWNER'S PHONE: Not Provided CONTRACTOR: RNT ELECTRIC SOLUTIONS, 920 REDBIRD DRIVE SAN JOSE CONTRACTOR PHONE: 6692929707 DATE ISSUED 7/5/2021 12:06:18 PM ISSUED BY:VALUATION: $3000.00 JOB DESCRIPTION Electrical panel upgrade 200 amp same location LICENSED CONTRACTOR INFORMATION CONTRACTOR: RNT ELECTRIC SOLUTIONS LICENSED CLASS: C10 ELECTRICAL LICENSED NO: 1063947 EXP DATE: 11/30/2022 I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penatly of perjury one of the following three declarations: 1 I have and will maintain a certificate of consent to self-insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 2 I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 3 I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, l must forthwith comply with such provisions or this permit shall be deemed revoked. I understand and agree that I am electronically signing and filing this application and that checking the box below has the same legal effect as manual signature. I also understand that I have the option of filing a paper copy of this application with a manual signature but have chosen instead to file this application electronically.