BLD-2020-1567BUILDING PERMIT
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS: 1451 POPPY WAY Cupertino APN: 366 15 022 PERMIT NO: BLD-2020-1567
OWNER'S NAME: OWNER'S PHONE: Not Provided
CONTRACTOR: MUST RETRIEVE DATA.CONTRACTOR PHONE:
DATE ISSUED 9/27/2020 10:06:23 PM ISSUED BY:VALUATION: $7245
JOB DESCRIPTION
Removal of old wood lap siding, if there is no existing shear wall we are to add shear wall plywood @6/12. Install tyvek house wrap and window flashing. Installation of new James
Hardie fiber cement siding and trim. Approximately 468 square feet of siding and 102 linear feet of trim.
LICENSED CONTRACTOR INFORMATION
CONTRACTOR: MUST RETRIEVE DATA.
LICENSED CLASS: MUST RETRIEVE DATA
LICENSED NO: MUST RETRIEVE DATA.
EXP DATE: MUST RETRIEVE DATA.
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.