B-2019-0752BUILDING PERMIT
CUPERTINO
CITY HALL
10300 Torre Avenue • Cupertino, CA 95014-3255
PHONE 408-777-3228
WWW.CUPERTINO.ORG
BUILDING ADDRESS:
OWNER'S NAME: Not provided
OWNER'S PHONE: Not Provided
CONTRACTOR:
RE -MODEL DESIGN & BUILD CO, 2033 GATEWAY PL #500 SAN JOSE
CONTRACTOR PHONE:
5103447706
DATE ISSUED 10/17/2019 11:59:51 AM
ISSUED BY: KDUNBAR
VALUATION: $250000
JOB DESCRIPTION
(350 SF); REMODEL (3) BATHROOMS (311 SF); REMODEL OTHER FAMILY RM/PANTRY (275 SF); REPLACE (2) SLIDING DOORS AND (1) WINDOW IN STUDY/GUEST;
FANS IN BEDROOMS; INSTALL (35) LIGHTS THROUGHOUT RESIDENCE; INSTALL (4) EXTERIOR LIGHTS; ADD WET BAR WITH SINK IN LOFT AREA; REMOVE ILLEGAL
SIDE YARD (575 SF).
KITCHEN REMODEL
INSTALL (3) CEILING
ROOF STRUCTURE AT
LICENSED CONTRACTOR DECLARATION
9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full
CONTRACTOR:
RE -MODEL
LICENSED
B GENERAL
LICENSED
1042279
EXP
07/31/2020
I hereby
force
I hereby
DESIGN & BUILD
CLASS:
BUILDING
NO:
DATE:
affirm that
and effect.
affirm under
I have and will
for which this
I have and will
I certify that in
laws
with such provisions
CO
CONTRACTOR
I am licensed under the provisions of Chapter
penatly of perjury one of the following three
maintain a certificate of consent to self -insure
permit is issued.
maintain Worker's Compensation Insurance,
the performance of the work for which this permit
of California. If, after making this certificate of
or this permit shall be 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
is issued, I shall not employ any person in any manner so as to become subject to the Worker's
exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith
V
issued.
Compensation
comply
HAZARDOUS MATERIALS DISCLOSURE
6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance
I have read the hazardous materials requirements under Chapter
the Cupertino Municipal Code, Chapter 9.12 and the Health
V
with
equipment
Municipal
& Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use
defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino
25505, 25533, and 25534.
this project.
Firm Certification No:
or devices which emit hazardous air contaminants as
Code, Chapter 9.12 and the Health & Safety Code, Sections
An EPA Lead -Safe Certified Renovator will be responsible for
Firm Name:
No EPA Lead -Safe Certified Firm is required for this project.
Certified
v
CONSTRUCTION LENDING AGENCY
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 a construction
No
V
Lender's
Name:
APPLICATION CERTIFICATION
information is correct. I agree to comply with all city and county ordinances and state laws relating to building