05100211300
eu�
�2to
sro�
awl
�aC
u—u
_z>
EFC
02
z
CITY OF CUPERTINO
INT'ORMATION
BUILDING DIVISION PERMITCONTRACTOR
BUILDING ADDRESS:
DPR CONSTRUCTION INC
PERMITNO. 05100211
10131 BU55 RD
.R'S NAME:
PERMrr ISSUE DATE
APPLE COMPUTER
1450 VE
PHONE:
SANITARY NO. CONTROL NO.
(650)474-1450
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDGELECT PLUMB MECH
0 I 0 0
LICENSED CONTRACTOR'S DECLARATION
Job Description
p
1 hereby affirm that 1 am licensed under provisions of Chapmr 9 (commencing
ndmyliccna is
7gffduion]of We BminessandProtrusions Code, and
nithr3aae
full radeaee. �&it
2�>uawm
TEMPORARY PERMIT FOR TI COMMERCIAL
class
lranar
ORIGINAL PERMIT #05090214
ARCHRET.
1 on wound my plans shall W used as public records
Lmcmed Porfessional
OWNER -BUILDER DECLARATION
I booby oRrm Nal m I aexempt form We Commuars License Law far the
following ..on. (Seed.. 1031.5, Business and Pmfeerinns Code: Any city or county
which oquims a permit to cn umcl, alma Improve, dcmoiksb, or repair any structure
purer or it issumee. sett naquires the applicant for such permit m Ole a aigned comment
Sq. FC Floor Area
Valuation $0
Was he I, licensed puauanuo We provisional of the Contractor's LWomm Law (Chapter 9
(commencing with Section 70th) of Division ] of We Business and Professions Code) or
that he u acmpI tMmfmm and We btu for We alleged exemption. Any violation of
APN Number
Occupancy Type
Section 7071.5 by any applicml for a permit subject the applkant to a civil penalty of
not mart Wan five hundred dollars (OW).
35720004.00
L as owner of We property, or my conoyces with wages u their aide compewtion,
Required Inspections
LI
will do We work and We swcmo is fail in¢nded w oRcred far sales (Sec. TAW. Business
and Prefessiom Code: The ConsrazWrs Liana law dose nol apply to an owner of
p
property who builds or improves thereon. and who doesauch work himself or through his
aero employee, provided Was such improvemerds sm not intended arornoA (rel sale If.
however, We building w impmvemenl is old within oro year of completion. We awner-
builder will have We burden of proving dist he did nos Wild or improve for purpose of
sale.).
❑ 1. as owner of We property, am exclusively contracting with licensed cuntraCWrs to
construct We pmKm (Sec. 70ad. Boatmen; and Professions Code:) The Comranors Li-
ecMe Law dais not apply m an owner of pmperlywhc builds or improves thereon. and,
who contract for such project with a mouranw(a) licensed radicals to the Convenors
Liana law.
/
❑ l am exempt under Sea , B& P C for this¢nsan
\\
V
u Dau
WORKERS COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury ono of the following declade mt:
Q thaw and will maintain a Cerufioam of Cament ueself-imam, for Workers Compcn-
amon, m provided for by Scction 3700 of We Labor Code. for We Performance of We
work for which thio Fermis is issued.
❑ 1 have and will maintain Workers Campensxdon hour.. as mquued by genion
37W of We Labor Code, for We performance of the work fur which this permit is issued.
My Warkera Compensation Ms. ani. and Paliry number am:
Cartier, Polity No.: WC 12-/ 0 O &2
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION Z_I, .1j—yCEP% 'SB( A(f—
1124Th UNIOJJ
(Thkssection need not be completed if d¢ p .vol is for one hundod dollars (SIM)
or leu)
1 cerufv diel in We Performance of We work fur which this permit u Wood. I shall not
employ any person ire my manner so sa to became object in We WmIren' Co nforomm,
Laws or Caliromia. Dae
Applicant
NOTICE TO APPLICANT: If, are, mating Wu Ccnificam of Escmption. you Would
become subject in We Wohcrs Conformation pmvWom of We Labor Code. you mut
- forthwith comply with such provisions or Wu permit shall be domed revoked.
CONSfRUCnON LENDING AGENCY
thereby a?ren that martit. agency, for We perrarmancc of
- it(Sec. 30knding
work for Which Wu Permit u tissued ($a. ]09'1. Civ. C.)
Le
Landers Name
Lender. Addm..
I certify mat I have road this application and sum that de above information is
` cenKL I agree W empty with all city and county aNlNncou and supe laws relating W
Wilding consultation. and hereby mitmiae repr.cnutlws of this city to onto upon de
.hove -mentioned pmpcny far inspection purposes-
urposes(We.)
(Witagree to save, indemnify and keep hamdev We City of Cupertino against
j Iiabilifies,Judgment, cost and expenses which may in any way aceom against mid City
n conaqumm of the grshumg of Wu permit.
` APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
Issued by: Date�-
SOURCE REG TIONS.
Re -roofs
l 2
Signmife of ApplicmVConummr - Dam
if Z ROD 1 ALS DISCLOSURE
Type of Roof
wlldeapplianlwfwum ding oceupanusom orhandk hvallous material
defined by the Cupertino Muniw al Code. Chaff mr 9. 12. and We Health and Safety
me.saction255a2(a)T"
All roofs shall be inspected prior to any roofing material being installed.
s ❑Yes ON.
If a roof is installed without first obtaining an inspection, I agree to remove
Will We applicant Of home building occupant use equipment or devices which
emit b t,shm. air ccmuminmt. defined by We Bay Area Air Q alhy Management
all new materials for inspection.
Distia7
❑Ya ON.
I have mad the hvardoumamriau requimmcnt under Chipmr6.95 of de Califor.
ria Halal k Safely Cadre.Seem=255(15,2557] od Z51s. 1umknslvW Watihmc Wilding
does Trot eunemly have a moans War it u my mipunsibility to notify We occupant of the
roquim which noun to 'orwissuan¢oraCefornmotoctrmay.
Signature of Date
All roof coverings to be Class "B" or better
. .
410 rcr ✓
o'r aomam=a seg am
Testing Engineers, Inc.
Quality Assurance Services
Materials Consulting
Since 1954
Regular Concrete Compression Test Report
Project No.: 47915 Client: APP33 Sample No.: 253169 / Page 1 of 1
Project Name: Report Date : 01/27/16
10131 Bubb Road - Apple #9 [' Sample Date :12/30/15
Cupertino, CA„ Time Sampled: 0920AM
Permit #s 05100211; 05090214 Date Received : 12/31/15
Inspector: S. Brooks, TEI
Supplier: Milpitas Materials
Mix: 5PP60138
Ticket No.: 174640
Trench from lines 2 to 3.8 between A
and B.5.
Sp(Vcimens Cast (AST/M C-31) : 5
Air Temperature(AASTM C-1064) : 41 deg F -
bhxtt4rRLe. rature (ASTM C-1064) : 57 deg F
Slump (ASTM C-143) : 5 inches
Specimens _ ASTM C-617 ASTM C-1231
Date Tested
01/06/16
01/27/16
01/27/16
01/27/16
HOLD
ID Number
2A
2B
2C
2D
2E
Mark Sample
Dimension, Inches
Diameter
4
4
4
4
Length
8
8
8
8
Area, sq. inches
12.57
12.57
12.57
12.57
Ultimate Load, lbs
38000
58000
61000
61000
Ultimate Str., psi
3020
4610
4850
4850
Average, Str., psi
4770
Age Tested, Days
7
28
28
28
HOLD
Fracture Type
1
1
1
1
Specified Strength, psi
3000
3000
3000
SPECIMENS NOT SCHEDULED FOR TESTING WILL BE DISCARDED AFTER 28 DAYS OLD
The Material _ WAS WAS NOT The Material Tested rK MET DID NOT MEET THE
SAMPLED AND TESTED IN ACCORDANCE WITH THE REQUIREMENTS OF THE BLDG. DEPT. OR DSA APPROVED DOCUMENTS.
REQUIREMENTS OF THE BLDG. DEPT. OR DSA APPROVED DOCUMENTS.
Remarks: Samples Tested in General Conformance with ASTM C-39
1 cc. City of Cupertino
1 cc. DPR Construction, Inc. Reviewed By:
1 cc. Apple Computer, Inc.
Robert Green
Concrete Lab Supervisor
The results presented in this report relate only to the item(s) tested.
This report can be reproduced only in its entirety unless written permission from TEI is obtained.
Corporate Office - 2811 Teagarden Street, San Leandro, California 94577 - (510) 835-3142 - Fax (510) 834-3777