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CITY OF CUPERTINO/�/�7�)��'BUILDING
DIVISION PERMIT
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BUILDING ADDRESS:
MEADE CONSTRUCTION GROUP
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10200 S DE ANZA BLV 2NDFLR
R'S NAME:
PTR MTT SUEDATE
SYMANTEC CORPORATION
645 RIVER OAKS PKWY
09/28/2006
NE:
SANITARY NO. CONTROL N0.
(408)321-6450
ARCHITER/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
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LICENSED CONTRACTOR'S DECLARATION
Job Description
p
1 bereby ".that 1 w Accused under, provision of Chapter 9 (commencing
with"Ancti7000)orDivim3oftheeaatna Proretsansandmylmenxe+s
I. full forte and effe
T.I. INTERIOR ONLY OFFICE SPACE -2ND FLOOR
Dames cenrtunor
ROOF TOP EQUIP MUST BE SCREENED FROM VIEW
ARCHITEUI-S DECLARATION
1 understand my plans shall W used u public records
Licensed Professional
OWNER -BUILDER DECLARATION
I hereby affirm Not I am exempt from the Commutes License Law for the
following mason. (section 703 1.5. Business and Professions Cole: Any City ar manly
which requires a permit to common. Wer. improve, asmolbh, ar repair any tectum
prior to its Issuance. strut requires dm applica n for such Permit in rile a signed statement
that he is Accused pummum W do previsions of the Connector's hors, Law (Chapter 9
Sq. Ft. Floor Area
Val 181 0 (] (]
(commencing with Section 7000) of Division 3 of the Business and Profmiem Code) o
Nat he b exempt therefrom and Ne bub ror the alleged exemption. My viol,dan of
Ap�j [Quypbe�
Occupancy Type
Section 7031.5 by any applicant for a permit subjects the applicant in a civil penalty of3
Nan
not mart Ove hundred dollars (MINAL
s 9 01 U S 5 0 0 _
I] 1. as owner of the properly, or my employees with wages as their sets compensation.
ns
Required Inspections
will do the work and Neswnam is an, intended ar offered for laic (Sm. 7044, Bualrcst
and Proh,siCommonestCommonestCode: TCommonestmine LiLaw dors rom t apply an owner of
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property who builds or i m proves banner, and who does such work himasf orthrough his
own employers. Provided themmuch improvements are cot Immedad woRered(mule. IL
huvever, Ne Wilding or Improvement Is mid within one year of compledon. be owner•
builder will have the human of proving tint he did not Wild er Improve for pulpae of
sa��
t p aaxe.
build.
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O 1, as owner of the property. am exclusively contracting wtd licensed contnman e
comma die project (Sec. 7064. Business and Professions Cade:) The Cmtncnnrs Lb
acme raw does nm apA Y to an mvmr orpmpeny who Wilds of Improve theman. and,
who contracts for such projects wish a canlnnor(s)licensed puna lin he Constrictors
License Law.
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❑lam esempt order See ,Ba PC fo Nis reawn
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r Data
BUILDING hghghq lis pppJJJ
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WORKERS COMPENSATION DECLARATION
I hereby alum under penally of perjury one aide following declarations:
IkkaYYYViV
I hsve and well maintain ACerdOata of Cement ro self -insure far WmkmrSCamPen-
aatlon, u provided for by Section 3700 of the Labor Cade. for be performance of the
sea for which Nis permit b issued.
1 have end will maintain Workers Compensation Insurance, u required by Section
3 of 0. UW, Codes. for do perNamme. of Cite work for which hats permit la Issued.
My W a���/yyco�p ns ian huts na canner.
rtier and Poliry number Vi�tt,,
Card [fC Polity No.:�L
CE FICATPRON FROM WOIIKMS,
COMPENSATION INSURANCE
(7hb section need nut becamplemd ifthe permit b fora.. hundred dollar (glen)
or less.)
1 certify that in the performance of the work for which this permit blame, I dell not
employ anyperen in any mercrsu as to became subject m do Worker'Compem m
Laws of Calromis. Data
Applicant
NOTICE TO APPLICANT. IL after making this Certificate of Exemption, you shitZ
become subject d the Workers Compensation provisions of the Labor Code, you mum
f.Mwish comply wit such pravisinm an this permit Shall W lamed rerokc,L
CONSTRUCTION LENDING AGENCY
I W eho Nat Nee as construction lending agency for dm Performance of
the work for whim this permit is sued (se3097, civ. C.)
..
Lenders Name
Lenders Address
11 certify Nu L have mad this application and sok Nn the ave information b
c.rtacl. I ager to comply with all city and county ordinances and state laws mbting to
Wilding construction, and hereby authmire mpresematises of Nis city to cncr upon the
above-memiuncd pmpersy far inspection purposes.
(We) ag a to save, indemnify and keep harmless Nc City of Cuperino against
I illYa.)ud a .coats nd apanca Ich may In any way... against said City
'tA CPL u� NASgraof AND IL 'COMPLY WITH ALL N N.POINT
Issued by: Date 'H
SU
Re -roofs
Type of Roof
Slgnatu . ppllan n tor uc
Dots TERIAIS DISCLOSURE
vQt;ArcspAll t. rectum u; ing ace panumrcmbandle haardous antitrust
di by she Cu a ani I Cade. Charm, 9.12..ad the Ha ild and Safety
. Section 155314)7
All roofs shall be inspected prior to any roofing material being installed.
❑Yes No
If a roof is installed without first obtaining an inspection, I agree to remove
will be appficael m Tamm Wilding aaup,nt a ega;pmal m devices semen
It hazardous air contaminants u defined by to Bay Area Air Quality Management
all new materials for inspection.
is.cl7 J
❑Yes $Nu
I have hzrardtcs amr;alam uiremm�uundc, Chepmr6.95ofbe Califon
n' Nh Saf C 25505,15 d25534.1undcrund thmifNr Wilding
docs ly m thathis Y' nsthiliiy to nodfy the occupant of the
tequWme whlchm et of acntrKamaroccupancy.
Signature of Applicant Date
All roof coverings to be Class "B" or better
owner a dire, c. Data